Even if your loved one isn’t agitated or aggressive, they may have hallucinations, delusions or paranoia as a result of their Alzheimer’s disease or dementia. A hallucination is a false perception of an object or event. You may notice your loved one experience one or more of the following:

• Tactile hallucinations: These are hallucinations involving the sense of touch. Your loved one may report that someone is touching them or that they feel something moving around inside their body.
• Auditory hallucinations: Auditory hallucinations are associated with a person’s sense of hearing. This type of hallucination causes someone with Alzheimer’s disease or dementia to hear things that aren’t really there.
• Visual hallucinations: This type of hallucination involves seeing something that isn’t there. Your loved one may see flashing lights or tell you that they can see someone standing in the doorway even though there’s no one else in the house.
• Gustatory hallucinations: Gustatory hallucinations relate to the sense of taste. It’s common for people with Alzheimer’s disease or dementia to report a metallic taste in their mouths.
• Olfactory hallucinations: Alzheimer’s disease and dementia can also cause people to smell things that aren’t there. The phantom smell may be something pleasant, such as the scent of fresh flowers, or something unpleasant, such as the smell of rotting garbage.

‍

Responding to Hallucinations

If your loved one is distraught due to a hallucination, speak in a calm tone of voice. Assure them that you love them and will protect them from harm. In some cases, distracting your loved one can make the hallucination feel less real, making them calmer. You can distract your loved one by changing the subject, suggesting that the two of you move to another room or turning on music that both of you enjoy.

It’s important not to argue with someone having a delusion. Instead of telling them, “there’s no one there” or “it doesn’t smell like flowers in here,” say something like “I know you’re smelling flowers, but I can’t smell them.” This acknowledges that their experience is different from yours without you having to lie and say you’re experiencing the same thing.

You may also want to try modifying the environment. Some appliances, such as air conditioners and humidifiers, make noises that can trigger auditory hallucinations. Turning these off or moving them to another area can help. If your loved one frequently reports seeing another person in their house, try covering up each mirror with a sheet or blanket.

‍

Delusions in People With Alzheimer’s Disease and Dementia

Delusions are similar to hallucinations, with one key difference. While a hallucination is related to the senses, a delusion is a sincere belief in something that isn’t real. For example, your loved one may truly believe that someone is poisoning their food even if that’s not the case. Memory loss and confusion contribute to these beliefs, making delusions one of the symptoms associated with Alzheimer’s disease and dementia.

If your loved one experiences delusions, stay calm and don’t try to convince them that they’re wrong. This can cause agitation and other dementia symptoms to worsen. Instead, acknowledge the belief and let your loved one know that you care about them. Moving to another room or redirecting the conversation to another topic can help your loved one stop focusing on the delusion.

The Alzheimer’s Association operates ALZ Connected, an online support community where you can connect with other caregivers. If your loved one experiences hallucinations or delusions, you can use the message board to ask questions and get answers from people who’ve been in your shoes.

‍

Paranoia in People With Alzheimer’s Disease and Dementia

Paranoia involves intense feelings and thoughts that are usually related to conspiracies, threats or persecution. In people with Alzheimer’s disease and dementia, paranoia is usually related to memory loss. People may feel as if other people are out to get them, especially if they can’t remember where they put things or recognize you or another loved one. For example, if your loved one forgets what you just told them, they may think that you are trying to trick them in some way.

If your loved one exhibits paranoia, try not to overreact. Even if your feelings are hurt, it’s important to stay calm, acknowledge their feelings and let them know you’re committed to protecting them. Explain to other family members that your loved one is paranoid due to Alzheimer’s disease or dementia, not because of anything a family member said or did. If the paranoia gets worse, contact your loved one’s primary care physician or neurologist for guidance.

Unfortunately, people with Alzheimer’s disease and dementia are often the targets of scams and financial abuse. If you think your loved one is being paranoid, stop and think about whether it’s possible someone really is taking advantage of them. You may want to pull copies of their credit reports to make sure no one has signed up for credit accounts in their name. Checking bank account and credit card balances can also help you determine if someone is stealing from your loved one.

‍