Visual Hallucinations in Dementia Patients
Visual hallucinations can sometimes occur in patients with dementia. They are most common with Lewy Body Dementia, but can be seen in other types of dementia as well.
Because the elderly brain appears to be more susceptible to additional neurological insults, dementia patients experience hallucinations in up to 25% of cases. It can be extremely frightening for the person suffering from it as well as for care givers.
Although all people with Alzheimer's, Parkinson's and other dementias are at risk for this side effect, those with Lewy Body Dementia often present with visual hallucinations as their primary symptoms.
Interestingly, some people are able to recognize that they are having these visual disturbances, and some are not. Either way, it can cause added stress and in some cases, absolute terror.
Can you imagine seeing someone in the room that you know isn't there, but you can actually see them?
Hallucinations Caused by Dementia
The occipital lobe of the brain is responsible for visual interpretation. Visual hallucinations do not stem from a problem with the eyes, optic nerve or retina, but instead it is believed they stem from occipital lobe dysfunction.
Although the exact mechanism remains unknown, it would make logical sense that as the brain becomes damaged from dementia, the effects on the occipital lobe could lead to problems with visual interpretations, including hallucinations.
There may also be a genetic link to hallucinations experienced by dementia patients. The research remains ongoing.
Other Causes in Dementia Patients
Due to the disease process itself, people with dementia often have other, related medical conditions. Sometimes, the visual issues can be a result of other disease processes, such as infections or elevated blood sugar.
Any condition that causes delirium in the dementia patient can make them more prone to isolation. It could be as simple as a hospitalization. Changes in light, sound and social isolation can lead to delirium, which in turn can lead to hallucinations.
Certain medications can also lead to hallucinations, including anti-anxiety meds and certain pain medications such as Morphine.
Another condition that causes this syndrome is alcohol withdrawal. This should always be a consideration. Even if mom only has a glass of wine per night, if she is suddenly not able to consume it, she could go into active alcohol withdrawal with all the symptoms associated with it, including visual hallucinations.
What to Do if Your Loved One Has Hallucinations
First of all, don't panic. If they notice any increase in stress in you, it will only make the situation worse.
Second, call their doctor immediately. Let whoever answers the phone know that this is an emergency. Not a life threatening emergency, but an emergency just the same. You will need an appointment as soon as possible. Don't be surprised if they direct you to an emergency room. If they can't get you in to the office right away, they will probably want a full medical workup done while the hallucinations are active.
Let the doctor's office or emergency room personnel know any and all changes that occurred around the onset of the visual disturbances. This could be as simple as a diet change or as serious as your loved one moving. Environmental stresses can cause these types of problems as well.
Next, try to keep them as calm as possible. For some people, it can be as simple as reassuring them that whatever they are seeing isn't real. Try that approach, but if you are met with anger, agitation or increased anxiety ... STOP.
Another way to manage it is to help them with the hallucination. If they are seeing bugs crawling on the wall, spray some room freshener on it and tell them they are dead now. It also works great for putting out "fires" they may see. Trust me, it really does work, if not to eliminate the hallucinations, then at least to decrease their anxiety related to it.
Managing visual hallucinations at home can be difficult depending on how the person is responding to it. As I said before, try to stay calm and do what it takes to keep them calm.
This condition can indicate progression of the underlying dementia, but it could just as easily be caused by contributing factors that are either treatable, such as a
Urinary Tract Infection
, or at least manageable.
Once reversible causes are ruled out, there are some medications that can be used that may help. Each patient, and each disease process, is so individual that there is not a perfect solution to this problem. It could be a lot of trial and error, but chances are you can find a way to manage this at home.
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