One of the most unsettling experiences for families is when a loved one begins seeing or hearing things that aren’t there.
You may hear:
“There are children playing in the living room.”
“Someone is standing in the corner.”
“There’s a dog in my bedroom.”
Or perhaps your loved one becomes frightened by people they believe are entering the house.
Your first instinct may be to say:
“There’s no one there.”
“You’re imagining it.”
“That isn’t real.”
While these responses are understandable, they often increase fear and distress.
The key is remembering this:
The hallucination may not be real to you—but it is very real to them.
Why Do Hallucinations Happen?
Hallucinations occur when the brain creates sensory experiences that aren’t actually present. A person may see, hear, smell, feel, or even taste something that isn’t there.
Visual hallucinations are the most common in dementia.
While hallucinations can occur in several types of dementia, they are especially common in Lewy Body Dementia and can also occur in the later stages of many other dementias, including Alzheimer’s disease.
They are not a sign that someone is “going crazy.”
They are a symptom of changes happening within the brain.
Hallucinations Are Common in Lewy Body Dementia
For many people living with Lewy Body Dementia, visual hallucinations appear early in the disease and can become a regular part of daily life.
They are often vivid and detailed.
Someone may see:
- Children playing.
- Animals in the house.
- Strangers sitting on the couch.
- A spouse who passed away years ago.
- People standing in the yard or outside a window.
Interestingly, some individuals recognize that what they are seeing may not be real.
Others fully believe the hallucination is happening.
Both experiences deserve compassion.
First, Ask Yourself…
Not every hallucination needs to be “fixed.”
Before responding, ask:
- Does the hallucination seem pleasant?
- Is it causing fear or distress?
- Is it putting the person at risk?
- Are they asking me to respond?
If someone happily tells you there are beautiful birds flying through the room, there may be no reason to correct them.
If the hallucination is comforting, sometimes the kindest response is simply to enjoy the moment with them.
How to Respond When Hallucinations Are Frightening
If the hallucination is causing fear, your goal is not to convince the person they are wrong.
Your goal is to help them feel safe.
DO:
Acknowledge their feelings.
Instead of saying:
“There’s nothing there.”
Try:
“That sounds scary.”
“I can see why that would make you feel uncomfortable.”
“I’m here with you.”
Validation reduces distress because it focuses on the person’s emotional experience rather than arguing about reality.
Offer Reassurance
Sometimes all someone needs to hear is:
“You’re safe.”
“I’m staying right here with you.”
“I’ll help you.”
Your calm presence often provides more comfort than your words.
Investigate Together
If appropriate, gently look around with them.
You might say:
“Let’s check together.”
After looking, you can reassure them:
“Everything looks safe.”
Notice you never have to say they were wrong.
Reduce Environmental Triggers
Sometimes the environment contributes to hallucinations.
Look for:
- Shadows
- Mirrors
- Dim lighting
- Busy wallpaper or patterned flooring
- Reflections in windows
- Background television
- Fatigue
- Dehydration
Improving lighting, closing curtains at night, reducing clutter, or turning off the television can sometimes reduce visual confusion.
When NOT to Argue
Imagine seeing a stranger standing in your bedroom.
Now imagine someone insisting:
“No you don’t.”
Would you suddenly stop seeing the person?
Probably not.
You would likely feel alone, misunderstood, or frustrated.
The same is true for someone living with dementia.
Arguing rarely changes what they see.
It usually changes how safe they feel.
Could Something Else Be Causing It?
While hallucinations are common in Lewy Body Dementia and later-stage dementia, a sudden change should always be taken seriously.
Contact your healthcare provider if hallucinations appear suddenly or worsen rapidly, especially if accompanied by:
- Fever
- Increased confusion
- New sleepiness
- Pain
- Falls
- Medication changes
- Signs of infection, such as a urinary tract infection (UTI)
Medical conditions can increase confusion and should always be ruled out.
You Don’t Have to Solve Every Hallucination
Sometimes families feel pressure to make the hallucinations stop.
Instead, focus on helping the person feel:
- Safe
- Heard
- Reassured
- Comfortable
- Connected
Those goals are often far more important than determining what is real.
A Different Way to Think About It
Instead of asking:
“How do I convince them nothing is there?”
Try asking:
“What do they need from me right now?”
Usually, the answer isn’t proof.
It’s comfort.
It’s reassurance.
It’s your presence.
Remember…
People living with dementia experience the world through a brain that is changing.
Our job is not to pull them into our reality.
Our job is to enter theirs with compassion, reduce fear, and help them feel safe.
That is where trust grows.
That is where connection happens.
Need Support Navigating Hallucinations?
Hallucinations can be frightening for both the person living with dementia and the people who love them—but you don’t have to navigate them alone.
At Dementia Family Support, we help families understand why hallucinations happen, learn practical communication strategies, and develop personalized approaches that reduce distress while preserving dignity. Whether your loved one is living with Lewy Body Dementia, Alzheimer’s disease, or another form of dementia, we’re here to help you respond with confidence, compassion, and understanding.
