Numerous studies show that hallucinations in the elderly happen more frequently than in any other age group. Fear and stigma often block seniors from sharing these experiences. Scientists still find it hard to explain some details about hallucinations, especially their ties to mental health conditions.
Older adults don’t experience hallucinations alone—younger adults and teens face them too. These examples highlight the need for better awareness among the public and professionals as we age.
Today, hallucinations in the elderly often suggest mental health struggles, yet they sometimes affect healthy individuals too in the general population.
Explaining hallucinations feels tough—they involve sensing things that don’t exist. Hallucinations in the elderly often start quickly, tied to brain functions and how we adjust to changes.
Even though hallucinations upset and stress many, some people try triggering them for fun. Others use this method to explore what hallucinations mean and how they feel.
Recent data shows that about one in four hallucinations starts around age 40. This suggests we need to pay more attention, especially when they happen in people without mental disorders or diseases.
Why Understanding Hallucinations Matters
Knowing the causes and effects of hallucinations matters, especially for older adults. This understanding assists in planning and delivering the right care services.
Some important definitions
1. Charles Bonnet Syndrome: this usually has to do with visual hallucinations. Such experiences are not real and can also happen in people who are alright mentally speaking. What they see may include familiar or unfamiliar images. The images can be of patterns, inanimate objects, animals, and people.
Types of visual hallucination
Hallucinations in the elderly come in two types: complex or simple. Simple ones show basic shapes like unclear patterns, colors, or lights. Complex ones, known as formed hallucinations, create clear scenes of objects, animals, or people.
2. Hallucinations: can be defined as a perception of events or objects but without external stimulus.
3. Musical hallucinations: this is where one experiences music or different musical aspects that can have or not have any lyrics or voice when there is evidently nothing being played.
4. Minor hallucinatory phenomena: this is where there is sensed the presence, visual illusions, and passage hallucinations.
5. Passage hallucinations: this happens when someone notices something moving in their side vision.
6. Out of body experiences: this involves sensing as if you are floating somewhere outside the body. In this case, you can also feel as if you are observing your own body from a position away from it.
7. Sensed presence: this is a kind of vivid sensation that there is the presence of a known or an unknown person quite close but just behind them. It is also called guardian angel or continued presence when referring to when you sense that there is a presence of someone who is already bereaved.
8. Visual illusions: these brief mistakes trick you into seeing an object or living thing that isn’t real.
9. Tinnitus: this is hearing sounds when no real noise exists, no external source of sound is present. The sounds are usually simple like buzzing, hissing, or ringing even though there are some complex percepts such as music.
Distress and stigma
Studies on hallucinations in the elderly reveal seniors avoid sharing their experiences, fearing others might call them mad or demented. This builds self-stigma. Seniors also worry about public reactions if they speak up, which fits under public stigma.
Why Seniors Hide Hallucinations
Seniors rarely report post-bereavement hallucinations. Elderly people do not like sharing such experiences with people, including professionals, friends, and family. Most people who do not disclose their experiences do not want to be ridiculed.
The way people respond to hallucinations is different and every individual has their own way of dealing with it. For older people who have lost loved ones, experts notice that hallucinations often comfort them.
However, when hallucinations come as a result of Charles Bonnet syndrome, the perceiver can be distressed and the hallucinations can actually be more persistent. Also, people with Tinnitus are also greatly distressed under such circumstances.
There are also studies that show that there is an association that exists between suicidal behavior and hallucinations especially in younger and older people.
How Hallucinations Affect Seniors
If someone close to you or you have ever experienced hallucinations, then you most likely understand just how troubling that experience can be. Having a sensory experience that something which doesn’t really exist is there can be traumatizing, to say the least.
A hallucination can make you hear or see things that aren’t there. There are many reasons as to why a person can hallucinate, but there are some causes that actually tend to affect the elderly. When some symptoms are recognized, it is always important to get help so as to ease or eliminate the hallucinations altogether.
Different factors trigger hallucinations in the elderly, making diagnosis tough. Doctors first look for mental health issues like depression, schizophrenia, or bipolar disorder, which often cause these episodes.
These include depression, schizophrenia, and bipolar disorder. After doctors dismiss psychiatric disorders, they should explore other causes of hallucinations in the elderly.
What Triggers Hallucinations in the Elderly?
⇒ Alzheimer’s or dementia: hallucinations act as early signs of these diseases. Doctors should check further if an elderly person starts hallucinating.
⇒ Charles Bonnet Syndrome: this is a condition that leads to visual hallucinations, especially in elderly persons that have severe or partial blindness.
⇒ Side effects from medication: drugs can have some side effects and there are some that are closely related to hallucinations. Drugs that treat erectile dysfunction and hypertension can actually cause hallucinations. Also, medicines used to treat disorders such as Parkinson’s can have such an effect. There are some antibiotics too, that could lead to one have hallucinations.
⇒ Bereavement: there is research which indicates that quite a significant percentage of elderly person’s experiences hallucinations once they lose their spouse.
⇒ Delirium: the hallucinations that come as a result of delirium are usually experienced together with UTIs or after surgery.
⇒ Illness: kidney failure, liver failure, and even brain cancer can cause serious hallucinations as well.
⇒ Dehydration: dehydration is an issue that affects the elderly. When our bodies lack enough water, it can confuse the brain, leading to hallucinations and tiredness.
⇒ Hearing and vision loss: As we get older, nerves weaken and they don’t work as they did when we were younger. However, when an elderly person has some hearing and vision loss to a certain extent, there is a risk that the brains can get hyperactive and cause hallucinations. This is true for conditions such as otosclerosis and glaucoma.
⇒ Sleep deprivation: when you don’t get adequate sleep, you may get cranky and this can lead to hallucinations regardless of age.
Other issues that can cause hallucinations to include alcohol, drug abuse, and epilepsy.
How to Spot Hallucinations in the Elderly?
Notice that hallucinations don’t always mean seeing things that aren’t there. Aging weakens our senses, making them less sharp over time. This causes brain areas controlling senses to overreact when they lack enough input. Hallucinations can affect one sense or all five due to an overactive nervous system. Reactions differ, so you might not always know when it’s happening. Seniors might not notice it either.
For you to notice that an elderly person is actually hallucinating, it will have to be severe to a certain extent. One indicator of hallucination is the behavior of an elderly person changes. You can get a bit more anxious and irritable than usual. They can also seem to be more forgetful and confused more than usual.
This is aside from signs like smelling, hearing, or seeing things that are not there to start with. When an elderly person is hallucinating, they can sense that there is something totally wrong and because of this, they may start isolating themselves because of the shame and embarrassment that is usually associated with such things.
Symptoms associated with hallucinations
If you do not observe carefully, you may end missing the symptoms associated with hallucinations. The other thing is that elderly persons don’t like talking about such episodes and so they may not even disclose them to anyone. Some of the symptoms that you could stay alert for include:
- Talking about people or things that aren’t there, to begin with
- Withdrawal
- Insomnia
- Difficulty expressing thoughts and speaking
- Delusions
- Memory lapses and confusion
- Poor judgment
- Great sense of judgment
- Irritability and anxiety
- A drastic change in mood and behavior
Helping the elderly
If a loved one faces hallucinations in the elderly, visit a doctor quickly. After diagnosis, treatments can ease or stop these moments. Here are some useful tips:
Stick with it: know that hallucinations feel very real to the person experiencing them. Showing empathy helps a lot. Take time to check the hallucinations and see if they’re upset, so you can find the best solution.
Practical Tips for Caregivers
Distractions: Try calming them down with care. The best thing to do is to shift focus to other things that the elderly person may possibly enjoy. You can try a game or some music.
Routine: when you are dealing with a senior who experiences hallucinations, it is important to stick to a routine which is consistent. Make sure that you let them remain in surrounding that they are familiar with so as to avoid further hallucinations.
Comfortable environment: you should keep the elderly person in an environment that is unfamiliar and confusing as this can make the hallucinations even worse. The things that can help prevent hallucinations and confusion includes signs in cabinets and doors, large clocks, and great lighting.
Hallucinations can be alarming for the perceiver and those around him/her. If a loved one experiences hallucinations, you should not let them go through it alone.
Trained caregivers can spot the symptoms of hallucinations and this can help them respond in a quick and way so as to offer the much-needed help. When treated, hallucinations can go away, but it takes time.
If you are taking care of an elderly person with such an issue and you are not in a position to offer full support, it is important to get help from people who specialize in this area. This will ensure the safety and the peace of mind of your loved one.
Treatment Options for Hallucinations
Hallucinations are not like dreams. In a dream, you can do just about anything. Your life is different and it is possible to have some abilities. However, you can also have a nightmare where you are trapped and the experience is not good. Once we awake from a dream, all things are normal immediately.
With hallucinations, the visions do not end even with eyes open. Our reality can change a lot if we suffer from hallucinations when we are awake. It can be frightening and unsettling regardless of how old we are and it is even worse when an elderly person is concerned because there can be an underlying condition that is present.
You should not conclude that a disease or condition is causing the hallucination. Instead, do proper research so that you can find the true issue because only then can proper action be taken.
When caregivers find the reason behind hallucinations, they should begin treatment immediately and this usually depends on what is actually causing the hallucination to start with. Doctors treat conditions in very different ways.
For example, dementia is handled very differently from say Charles Bonnet syndrome. There are some medications that are common with people who have hallucinations, such as sleep aids, sedatives, and even muscle relaxers.
These are meant to calm nerves so that agitation can be reduced together with the chances of getting a hallucination episode.
How to Support Seniors During Hallucinations
You should never tell an elderly person that the hallucination is not real. Try as much as you can to help and start by asking what they are hearing and seeing exactly. This is the only way you can find the best way to help them. Try as much as you can to get their attention to some other things as this can end the hallucination.
Hallucinations are not always distressing and can actually be pleasant some extent. A caregiver should seek help for the elderly person as soon as they notice any of the symptoms. Comfort them as they have a hallucination as this can bring about some level of peace even in a distressed setting.
Understanding differences between conditions
Paranoia, delusions, and hallucinations can show signs of disease and are not always a part of the ageing process. Though they are similar, they are different to many levels.
Hallucinations are usually a sensory experience that is false and it can be tactile, auditory or visual. The auditory hallucinations causes include mental illness, brain tumours, epilepsy, and hearing loss.
You cannot fix these experiences by simply telling someone that they didn’t exist. The best example is when a dementia patient hears music while nothing is playing. They may also see bugs on a surface when in reality nothing is there.
Hallucinations vs. Delusions
As for delusions, one has a fixed false belief that is not really supported by reality. They happen as a result of a faulty memory. A good example is when caregivers are accused of infidelity or even theft. Understanding the hallucinations vs. Delusions can help you deal with each should they arise.
Paranoia, on the other hand, has to do with suspiciousness. The elderly persons can actually show great hostility as well as frustrations towards the caregivers. This is because of the paranoid behaviours that they have.
How to cope
You may opt to join the elderly person in their hallucination. Join them in their reality as this can help them to a great extent. When you can tell exactly what they are experiencing, it becomes easier to defuse the current situation.
Don’t explain what they feel, see, or hear, as this will just upset them. Do not agitate them unnecessarily. Try to validate their feelings and try to show them that you understand their reason for being upset. It is important to actually assure them that they are safe regardless of what they are experiencing.
Comfort them by touching them and try as much as you can to make them focus their attention on you as this can reduce the hallucination greatly. Take them to another room or even try to take a walk with them so that you can remove them from the circumstance that could have caused the experience in the first place.
Some hallucinations can actually be comforting such as hearing music or even seeing children. If you feel that an elderly person is being comforted by a hallucination, there is no need to stop it. Respond to the things that tend to be disruptive and scary. Just ensure that the elderly person gets enough help under the circumstances.
How to change the environment?
There are several tips that can help in changing an elderly person’s environment so as to stop the hallucinations.
The first thing is the lighting. Try to see if there is any kind of issue with lighting. Check if shadows appear when you turn the lighting on or off. Check for reflections and distortions on the walls, on the floors and even on the furniture since they could all contribute greatly to one having some visual hallucinations.
Keep an ear open for any kinds of sounds such as conditioning and TV noise which the elderly person could be misinterpreting. You can remove mirrors or cover them if you feel like they could make the elderly person feel as if there is someone in the room with them.
Sleep and hallucinations
It is not uncommon for elderly persons to experience some sort of hallucination just as they are about to fall asleep. This is the hypnagogic hallucination. It is also common to experience some sort of hallucination as you wake up (hypnopompic).
You may feel like you have seen a moving object or even a formed image like a person and this may cause you to think that you have actually seen a ghost.
Hypnopompic and hypnagogic hallucinations often occur in healthy people without narcolepsy or other kinds of disorders. Experts view them as more like dreams and they are not something that you should be too worried about. It is not clear how long you can go without sleep before hallucinating.
Conclusion
Hallucinations in the elderly bring unusual sights, sounds, or rarely smells—without real triggers. They often happen when seniors are fully awake and aware of their surroundings.
What you notice is that these perceptions didn’t really have any real triggers. This means that you hear or see things that don’t exist. You can hear voices when no one is speaking, see lights as well as patterns and forms that are not real, and you may even feel some crawling sensation on your skin.
