10.23.16 DeMystifying Alzheimer’s with Mary Yamin-Garone
Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “Hallucinations, Delusions and Paranoia Related to Alzheimer’s.”
Watching someone you love experience hallucinations and delusions can be difficult. As a caregiver, you want to help them understand that these behaviors aren’t real but that instinct may be wrong.
According to Lisa P. Gather, associate professor in the Department of Psychiatry and Behavioral Sciences at Duke University and director of the Duke Aging Center Family Support Program, “You can’t argue or rationally explain why something happened. That doesn’t help. It just frustrates the person. The person somehow knows that you are talking down to them, not taking them seriously, treating them in an undignified manner.”
Major psychiatric symptoms of Alzheimer’s include hallucinations and delusions, which usually occur in the middle stage. About 40% of AD sufferers experience delusions, while hallucinations occur in about 25% percent of cases.
Hallucinations, delusions and paranoia are symptoms of disease. Caregivers can’t prevent them. They can, however, help the individual deal with the reactions, such as aggression, agitation and violent outbursts. As Alzheimer’s progresses, the responses may become more dangerous as your loved one attempts to act on the delusions or hallucinations.
- A sensory experience—visual, auditory and/or tactile—that often happens when the individual wakes up.
- A misperception of something they see, hear or feel that can’t be corrected by being told it’s not real.
- A fixed false belief not supported by reality and often caused by a faulty memory.
- Often blaming caregivers for theft and infidelity.
- Centered around suspiciousness.
- A way your loved one projects hostility and frustration onto caregivers.
Dr. Marion Somers, author of Elder Care Made Easier: Doctor Marion’s 10 Steps to Help You Care for an Aging Loved One, suggests, ”Go to their reality. Otherwise, you’re going to aggravate them and you don’t want to increase the level of agitation. You want to calm the situation. Reassure them by saying, ‘I see you’re scared. I would be scared if I saw those things, too.’ Tell them you’ll stay with them and they are safe with you.”
A comforting touch, like gently patting their back, may help your loved one turn their attention to you and reduce the hallucination. You also can suggest they move to a different room or take a walk to get away from what they’re seeing.
Other causes of hallucinations can be:
- Sight or hearing problems
- Physical problems, such as dehydration and kidney or bladder infections
- Alcohol or drug abuse
Severe hallucinations may call for anti-psychotic medication but Lasher says medication can present a risk for someone with Alzheimer’s. She recommends first changing the way you communicate by reassuring your loved one and changing the activity and their environment.
The Alzheimer’s Association offers these tips to change the environment:
- See if any lighting or lack of lighting casts shadows, distortions or reflections on walls, floors or furniture.
- Listen for any sounds, such as TV or air conditioning noise that could be misinterpreted.
- Remove or cover up mirrors if it could cause your loved one to think they’re seeing a stranger.
Typically, delusions among Alzheimer’s sufferers are mild and the result of memory problems. According to Lasher, “Individuals fill a hole in a faulty memory with a delusion that makes sense to them because they don’t remember where they last saw an object. Recognize that your loved one is living in a world that doesn’t make sense and is scared. Don’t take any accusations personally or respond by saying, ‘Why would I take that?’”
Instead, reassure them without asking questions. If they’re looking for an item, tell them you’ll help them find it. You also may want to have a spare set of items that are frequently lost. Then try to distract them by saying something like, “But before we look, why don’t we take a break and have some ice cream?”
Paranoia is the least likely of the three behaviors but just as troubling when it’s out of character for your loved one. According to the Alzheimer’s Association, “When paranoia occurs, caregivers can assess the problem by considering these questions:
- What happened right before the person became suspicious?
- Has something like this happened before?
- Was it in the same room or the same time of day?
lf your loved one is experiencing paranoia, it’s important to discuss their medications—prescribed, over-the-counter and vitamins—with their doctor. They may be overmedicating themselves, which can bring on paranoia.
Recognizing the causes of these behaviors and understanding the mindset when someone you love is experiencing hallucinations, delusions and paranoia can help you stay calm as a caregiver.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me next time for more Demystifying Alzheimer’s.