Hallucinations

Person experiencing a hallucination and delusion thinking that someone is trying to harm her.

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Hallucinations

 

Hallucinations occur with mental and physical illnesses, often due to medications, low oxygen, or trauma. Therefore, don’t assume someone has a mental health condition if they start seeing something you don’t see or hearing voices you can’t hear. Waking up within an extended dream state or with hallucinations is one symptom that warns me that my husband has often developed an infection before any other signs appear.

Tricks of the Brain

 

So, what are hallucinations? Hallucinations are brain tricks telling you something is true that isn’t. The lie is so natural that the person cannot distinguish between truth and fiction. The person experiencing the hallucination smells, hears, sees, tastes, and feels what is before them. For example, if they see a tree not there, it is as natural to them as it is not real to you. They smell it, feel its bark, hear the leaves rustle, and see it swaying in the breeze. Therefore, you cannot easily persuade them that it is not.

Helping Someone Having Hallucinations

 

Feeling safe

Dealing with hallucinations is frightening. Most people feel very insecure during the episodes since it’s challenging to know what is real and what isn’t. Therefore, determine what triggers the hallucinations to prevent them if you can. In the meantime, do whatever you can to create a sense of security. Below are some ideas to help you find triggers or create a greater sense of security.

  • Try to surround them with things that comfort them – go to their favorite room, sit in their chair, watch a favorite TV program, read a book, listen to music, etc.
  • Turn on the lights, open or close curtains (whichever you prefer) to remove shadows, or keep “people out there” from seeing inside.
  • If a hallucination is due to an object’s shadow creating fear, attempt to identify what it is and let them discover how it’s different from what they imagined, i.e., the hat rack is not a monster.
  • Play their favorite, most relaxing music in a room with a comfortable temperature setting with the light set at a brightness that appeals to their visual ability.
  • Spend time talking with them or set up a video call with another family member or friend.
  • Attempt to focus their attention on an alternate activity. For example, working diverts the mind long enough to create a new story.
  • Consider getting a pet for them as a companion.
  • More significant periods of stress may bring on hallucinations or delusional episodes. If so, focus on improving life balance with improved sleep, eating, and activity.
  • Cut out (or reduce exposure to) toxic people, places, and habits.
  • Use caller ID to avoid talking to persons who only share opposing viewpoints.
  • Determine if a medical reason could be causing the break from reality.
  • Consider whether dehydration could be the cause.
  • Confirm your family member is taking all their prescribed medications as directed and not too many others.
Know Warning Signs

 After a few episodes, you may notice a pattern of events leading to hallucinations. The pattern can serve as your warning of things to come. If you can recognize what causes them, sometimes you can prevent them from occurring. Other times, you can just be prepared for them when they happen. Some common warning signs include, but are not limited to, the following:

  • Changes in sleep routines
  • Wanting to be alone, isolating themselves
  • Irritability, frustration, anxiety
  • Refusing medication
  • Decrease in personal hygiene
Focused Breathing Exercise

 

Some people find it helpful to focus on breathing when managing a hallucination. You might be able to help your family member use this technique, too. It’s like meditation in that the person concentrates on thinking about how they are breathing as they are doing it. 

Steps for Focused Breathing
  1. Help your family member get comfort.
  2. Tell them to think about how their lungs and chest walls move in and out when they breathe as they pay close attention to the movement.
  3. Then tell them to concentrate on taking in a full deep breath. Feel the air pulled into the mouth, travel down the throat, and enter the lungs. Feel their lungs fill up as their chest wall expands outward. 
  4. Hold the air inside for four seconds.
  5. Slowly releasing the air through their lips, gradually relax their chest wall. Think about how the air feels as it leaves their lungs and travels out of their lungs, through their throat, out of their mouth, through their lips, and out of their body.
  6. Repeat this over and over until the hallucination is gone. 
Offer Reassurance

 People often know hallucinations occur even if they cannot tell what is real in their world. It’s terrifying. They need your reassurance and support to know someone protects them from themselves. However, they are also confused about who and what to believe, so be cautious whenever you interact with them and try not to take it personally if they are resistant.

Below is an example of how you might approach someone with a hallucination.

  • Before approaching them, speak calmly and with a caring voice. Show support with your words before you attempt to touch them (remember you may be a stranger to her).
  • Identify yourself-“Hi, Mom, it’s Donna.”
  • Let her know you are there to help her. “Are you okay? I heard you call out and came to see if I could help.”
  • You can gently pat her shoulder or touch her hand if she recognizes you or welcomes your presence.
  • Acknowledge that she seems upset and describe how you think she feels. Ask her to validate that you are correct in interpreting her feelings. For example, “It sounds like you are afraid. Did something scare you?”
Respond Honestly

If your family member asks you if what they are seeing is real, be honest but sensitive to the fact that they believe it’s real. For example. If they ask if you see the man sitting on the sofa and no one is there, say, “Do you mean the green sofa? I’m sorry, but I don’t see anyone there. However, I believe you when you say you see something when you look over there.”   

There are two approaches to the above situation depending on the hallucination cause. If the underlying cause is a short-term condition or a mental health disorder where the individual is expected to re-orientate to the “real world” soon, you want to be honest that you don’t see what they see. Helping them to know they are not seeing the world as it should be helping them to heal.

 However, if the situation is related to someone with dementia or Alzheimer’s and disorientation is their “normal,” trying to get them to agree that Aunt Agnes isn’t there will only be disruptive. For those with long-term dementia, try distraction and clarifying information to keep them safe and functioning with accurate information as closely as possible. Don’t attempt to argue with them over whether a hallucination is real. Instead, try to find a way to clarify it if possible but don’t lose the war to win a battle over the reality of a hallucination if you can divert their attention and move on to another discussion.

Make Changes in the Environment

Sometimes the trigger for the hallucination is something correctable in the environment, such as noise or a flashing light. Ask your family member to tell you about what they are experiencing. Based on their details, look for anything that might mimic that description in the environment. If you find it, try to remove or alter it and see if it makes a difference. You might find that you can “cure” the hallucination yourself.

  • Check for (1) sounds from radios left on stations that are not coming in clearly or that someone forgot to turn off, (2) equipment hums or noises that are confusing, (3) building or street noises that regularly occur that might also come across as a whisper or voice.
  • Change burned-out light bulbs to remove shadows and brighten up the room. Check the light fixtures’ position related to mirrors or windows to determine if reflections or distortions occur at certain times from the sun or moon bouncing off their surface.
  • Remove clutter from rooms that could appear as shapes representing scary forms such as intruders.
  • Cover or remove mirrors that may appear to be someone watching when the person passes by them.
  • If using agency attendants, ask if the same individuals can be assigned to provide consistency and familiarity.
  • Place familiar personal belongings around the room from several years ago. Long-term memory is more robust than short-term memory, and they may be able to recall memories better.
https://www.wikihow.com/Handle-Hallucinations.
https://alz.org/help-support/caregiving/stages-behaviors/hallucinations

What’s the Difference Between Delusions and Hallucinations? U.S. News & World Report

VIDEOS

UCLA Health Caregiver Training: Hallucinations Produced By:  UCLAHealth

 

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