Hallucinations, delusions and suspicious beliefs can be frightening for someone with Alzheimer’s and stressful for the caregiver. The person may see or hear something that is not there, believe an event is happening when it is not, or become convinced that someone is stealing, hiding objects or trying to harm them.
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The caregiver’s first job is usually not to prove the person wrong. It is to assess safety, reduce fear and decide whether medical help is needed.
Looking for an organized caregiving system? The Alzheimer’s Caregiver Compass™ covers communication, routines, safety, planning and caregiver support.
What to say
Respond to the emotion before the facts. You might say, “That sounds frightening. I’m here with you.” Keep your voice calm, reduce noise and move to a quieter area if that seems to help. Redirecting to a familiar activity can sometimes lower distress.
What not to do
Long arguments rarely help when the person’s brain cannot process the situation in the same way you can. Avoid mocking, shaming or aggressively correcting. Also avoid agreeing with a dangerous false belief in a way that could reinforce risky action.
Check the environment
Mirrors, television, shadows, reflections, unfamiliar visitors and poor lighting can sometimes contribute to confusion. Look at the room from the person’s perspective and remove unnecessary triggers when practical.
Tell the clinician
The National Institute on Aging advises telling the person’s doctor about hallucinations or delusions. Bring notes about when they happen, how long they last, what medications are being taken, recent illnesses, sleep changes and whether the experiences are upsetting or dangerous.
When it may be urgent
Seek urgent medical help for sudden severe confusion, a sudden major behavior change, signs of illness or injury, or any situation in which the person may harm themselves or someone else. In an immediate emergency in the United States, call 911.
This page is educational and does not replace individualized medical advice.
Sources and further reading: National Institute on Aging: Hallucinations, Delusions, and Paranoia; Alzheimer’s Association: Stages & Behaviors.
Keep difficult moments easier to organize
The Alzheimer’s Caregiver Compass™ gives family caregivers a practical structure for communication, safety, routines and planning.