What is a Hallucination?
A hallucination is a sensory experience that has no real external trigger. Someone who hallucinates sees, hears, feels, smells, or touches something that is not actually there. Visual and auditory hallucinations are the most common. For example, someone might see strangers in the room, notice animals in the house, or hear voices that do not actually exist.
A hallucination is not simply imagination or daydreaming. To the person experiencing it, the event feels completely real, as if it is actually happening.
The Unique Nature of Hallucinations in Dementia
One of the most important features of dementia-related hallucinations is that your loved one with dementia usually experiences what they see or hear with absolute certainty as reality. For them, there is no difference between the hallucination and the real world.
This is a major difference compared to hallucinations that occur in other conditions. There are people who experience hallucinations but can at least partially recognize that what they are sensing might not be real. They might say, “I know this is probably just my imagination,” or “I hear the voice, but I suspect no one else can.”
However, your loved one with dementia does not have this awareness. They truly see the stranger in the room, they truly hear the voices, or they truly perceive what others cannot. The experience is just as real to them as any other everyday event.
This distinction is incredibly important. If we assume that your loved one is “just imagining things,” or if we try to use logical arguments to convince them that what they see does not exist, we often only increase their fear, confusion, and distrust.
How to Respond to Hallucinations
Do Not Argue
When your loved one with dementia is hallucinating, it is not helpful to flatly state: “There is no one there,” “You’re just imagining it,” or “Don’t talk nonsense.” Because they experience the event as real, these types of reactions make them feel as though they are not believed, or that they have been left alone with their fear.
Why is It Not Worth Arguing?
For someone with dementia, a hallucination is not an imagination or a mistake—it is reality. If they see a stranger lying in their bed, then they truly see that person. They do not think, “maybe I’m just imagining things”; instead, they are convinced that what they see is really there.
Therefore, in many cases, what calms your loved one down is not trying to convince them that no one is there, but rather accepting the situation as they experience it and offering a solution. For example, if they say someone is lying in their bed, you could tell them: “Come, wait in the kitchen for a moment, and I’ll go check if someone is really there.” Then, you can return to them and let them know that you handled the situation, and the person is no longer there because you sent them away. You can even share in their annoyance about how unpleasant it is for someone to enter their room without permission.
This kind of reaction can be highly effective because it responds to your loved one’s feelings and fears rather than arguing about the content of the hallucination. They believe their own eyes. If they see someone in their bed, then to them, that person is truly there. If we respond by saying “there is no one there,” they can easily feel that we do not believe them, are not taking them seriously, or are trying to deceive them.
In these situations, the result is often not calmness, but arguing, tension, and a loss of trust. Your loved one will not override their own senses just for the sake of our words. Since the experience is real to them, they are more likely to think that we are mistaken or that we are not telling the truth. This can damage your relationship without stopping the hallucination.
In dementia care, it is therefore generally more important to maintain your loved one’s sense of safety and peace than to prove that what they see or hear does not exist. If we respond to their fear and help them feel that the situation is resolved, they will often calm down much faster than if we enter into an argument about what they experience as reality.
Respond to the Emotions First
Often, what your loved one is feeling is much more important than exactly what they see or hear. For example, you can say: “I can see that this frightened you,” or “You are safe, I am here with you.”
Phrases like these provide comfort without either validating or denying the hallucination.
Check the Environment
Sometimes poor lighting, shadows, mirrors, or certain sounds can contribute to mistaken perceptions. It is worth checking whether:
- the lighting is adequate,
- there is any disturbing background noise,
- furniture or curtains are casting shadows,
- a mirror or a television is causing the issue.
Distract Their Attention
If your loved one is anxious or restless, changing to another activity can help:
- having a conversation together,
- listening to music,
- going for a walk,
- looking through photographs,
- having a cup of tea.
In many cases, redirecting their attention is much more effective than trying to convince them.
Take Recurring Hallucinations Seriously
If the hallucinations are frequent, suddenly become more intense, or cause great fear and anxiety, it is advisable to consult a doctor. These symptoms could be driven by the progression of dementia, medication side effects, an infection, sleep disorders, or other underlying medical issues.
One of the keys to managing dementia-related hallucinations is understanding that these experiences are completely real to your loved one. While many other people who hallucinate can at least partially recognize that their perception does not match reality, someone with dementia often believes in what they see or hear with absolute certainty. This is why arguing and trying to convince them usually does not help. A calm, empathetic approach, creating a sense of security, and accepting your loved one’s emotions are much more important.
Important Disclaimer
The information and advice presented on this website and in this article are for informational purposes only. They do not constitute a medical diagnosis or individual therapeutic recommendations. The operator/author of the website assumes no liability for any direct or indirect damages, health issues, or misunderstandings resulting from the use of this information. Everyone applies the described methods at their own risk. Please consult your physician before making any lifestyle changes or applying any complementary therapies.
About the Author
Suzanne Sandwiese – Dementia Caregiver, Mental Health Assistant
I have more than 12 years of practical experience in caring for elderly people and patients living with dementia. My goal is to translate knowledge about dementia into understandable, practical advice that can be applied in daily life, thereby helping families live together with the disease. As the author of several professional books and the founder of a popular Facebook page, my mission is to provide clear and, above all, usable guidance to all those who care for loved ones living with dementia.