Causes of Hallucinations in the Elderly: Helping Dementia Sufferers

Hallucinations are terrifying to experience and heartbreaking to witness in a loved one. You have no control over what they see or hear and if they suffer from dementia, it’s not easy to put them at ease.

If you care for an elderly person, this guide can help you to better understand hallucinations, including how and why they occur and what you can do to remedy them.

What are Hallucinations?

A hallucination is a sensory experience that seems real but is created entirely by the mind. It’s often incorrectly believed that hallucinations are entirely visual experiences, such as seeing a person or object that isn’t there, but they can affect all of the senses and include:

Visual Hallucinations

A visual hallucination can range from seeing a person, pet, or object that isn’t there to seeing lights and other disturbances. These things appear very real and are often solid and detailed, making them hard to distinguish from reality.

Auditory Hallucinations

One of the most common types, an auditory hallucination is when you hear noises that aren’t present. The noises can range from music and background sounds to conversations.

Gustatory Hallucinations

Gustatory hallucinations involve the taste buds. Many strange tastes are the result of dental problems, including the build-up of bacteria under poorly fitting crowns and implants. Gustatory hallucinations are also present in patients with epilepsy, where they may present with a metallic taste.

Tactile Hallucinations

A particularly uncomfortable type of hallucination that may feel like bugs are crawling on the skin. 

Olfactory Hallucinations

An olfactory hallucination is when you smell a fragrance that isn’t present. It can be good or bad. It ranges from pleasant smells remembered from childhood to bad and disturbing smells that make you nauseous.

What are the Causes of Hallucinations?

Dementia is the main cause of hallucinations in seniors. All types are common but visual ones are by far the most prevalent. Mental health conditions, like schizophrenia, also cause hallucinations. 

It’s rare for schizophrenia to occur over the age of 65 and is typically onset while one is middle aged, but it is becoming more of a problem as the aging population grows.

Other causes of hallucinations in the elderly include:

Sleep Deprivation

You mind can play many tricks on you when it is deprived of sleep. Hallucinations are common after the body has been deprived of sleep for several days and mild symptoms may present after just a day or two. 

Hallucinations can also occur before waking and just after waking.

Medications and Substance Abuse

Drugs like LSD trigger hallucinogens following consumption and may trigger flashbacks later in life. However, it’s not only these mind-altering drugs that have this effect.

Hallucinations also present as a side effect of psychoactive substances and are associated with alcohol, benzodiazepines, and opioids/opiates.


High fevers in very young and very old patients are more likely to cause hallucinations and delirium. A fever presents as a symptom of both viral and bacterial infection and can be treated with medication and fluids. It’s a serious symptom in frail individuals and the patient should be monitored closely to determine if medical intervention is required.

How to Respond to Hallucinations in Dementia Sufferers

If you care for a dementia patient who suffers from hallucinations, it can be a scary experience for everyone involved. Take a look at the following tips to help you out:

  • Decide if Help is Needed: Hallucinations generally have very negative connotations, but they can be pleasant. If they’re seeing or hearing something harmless, soothing, and benign, consider not getting involved and letting the moment pass.
  • Don’t Try to Use Logic: Telling someone that what they are seeing isn’t real generally doesn’t work. This is true for anyone suffering from hallucinations but is especially true for individuals with dementia. They may panic and get agitated, which can worsen the experience.
  • Listen to Them: Understand what they are experiencing. Ask them about it and speak calmly. It may help them to have someone to talk to. It will give you more information to provide to a healthcare professional.
  • Record Everything: Make a note of the day and time that these hallucinations occur and write down everything that happened in the lead-up to them.
  • Reassure: Rather than dismissing what they are experiencing, reassure them. Tell them that you understand how scary or interesting the experience must be for them, as opposed to writing it off as “silly” or “fake.”
  • Discover and Remove Triggers: Over time, you’ll learn that some objects, foods, noises, and fragrances act as triggers for hallucinations. Once you identify these, remove them, and look for alternatives. For instance, darkness is often a trigger, and keeping the house well-lit will prevent it from triggering a hallucination.
  • Distract: If they are agitated because of a visual or auditory hallucination, distract them and make them focus on you.

Am I Hallucinating?

From time to time, we all hear, see, taste, and feel things that are not there. However, there is usually a simple explanation, followed by the realization that what we’re experiencing is not real.

For example, you may see a blotch of color in the corner of your eye that you mistake for a cat or dog. You’re used to that pet following you around, so you don’t question their presence, but when you look, it’s just an errant strand of hair or eye floater. 

Maybe you hear what you think is a doorbell, only to realize that no one is at the door and no one else heard the sound. This could be explained away by everything from extreme tiredness to tinnitus and medication-related disturbances.

Additionally, you have the sensation that something is crawling on your arm, when it’s only your body hair, or the feeling that someone is standing in front of you, when no one is there.

The human mind is a complex machine and sometimes it malfunctions. Such events are common and are much more prevalent in the presence of extreme fatigue and strong medications. 

Unless the events are common and prolonged, it’s not necessarily something you need to worry about. However, if you’re concerned about the increased frequency or severity of these experiences, speak with your doctor, and if you ever see someone or hear someone that isn’t there, consult them immediately.