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Hallucinations in Dementia and Alzheimer’s Clients


Old friends coming to call, past loved ones reaching out, strange animals at their feet, and monsters at the window and under the bed. No, they are not inhaling smoke or sniffing an illegal substance. These are Alzheimer’s and Dementia patients experiencing what can transiently turn into a dangerous side effect of their disease – hallucinations.

Clinical trials show a link between fall and winter holidays and an increase in auditory (sound), olfactory (smells), visual (seeing things), gustatory (taste), and tactile (feel / touch) hallucinations. The last three months of the year are full of specific imagery, accompanying smells, and memorable sounds. Family gatherings generate long-term memories of cozy fireplaces, vanilla candles, cookies baking, or a freshly cut pine tree. These smells, like nostalgia, bring back memories; the more potent the smell, the more visible or impressionable the memory. As dementia progresses into the later stages, these fantasies, apparitions, and hallucinations increase. The counselors and therapists of Improving Lives Counseling Services treat mental and psychotic disorders.

Understanding the anatomy of the brain may explain the relationship between smells, memories, and emotions. “The olfactory bulb is connected to two brain areas that are strongly implicated in emotion and memory. Once a smell enters the nose, it travels through the cranial nerve then through the olfactory bulb which helps the brain process smells.” “Olfactory has a strong input into the amygdala which processes emotions.” For most, smells are associated with an experience, a remembrance, or an idea. Smells are often used to recall information, study content, and in memory contests. Dementia and Alzheimer’s patients experience an increase in hallucinations brought on by both real and phantom smells. During the holidays, they might experience good and bad smells they can’t escape or get away from. For some, just seeing a freshly cut tree, can trigger a hallucination.

Hallucinations can be caused by schizophrenia, kidney infections, dehydration, drug abuse, difficulty hearing, or medications. If a person with Alzheimer’s or Dementia begins hallucinating, a medical evaluation is important. “If a person with Alzheimer’s begins hallucinating, it’s important to have a medical evaluation to rule out other possible causes and determine if medication is needed,” As caregivers or family members, there are things you can do. Look for objects or lights that cast shadows and for infiltrating sounds, indoors or outdoors. Christmas lights from nearby homes, smells of smoke from a neighbor’s fireplace, the sound of games on electronic devises, or something as simple as a holiday ring-tone might be the cause.

The holidays are great for bringing families together, connecting with friends, and traveling to places that bring back warm memories. For seniors or the elderly experiencing hyperactive delirium or confusion, hearing sounds, sensing beings, or seeing faces might be hallucinations but might not. Knowing and understanding the difference, at this most important time, comes with proper early screening and diagnosis. Having the tools and guidance needed to inform family members prior to gatherings is the first step in ensuring uneventful events. The more information you give extended family, the more protected your loved one will be.

Identifying a hallucination can be challenging. Just because you don’t see, hear, or feel what they are relaying doesn’t make it impossible. There are stark differences in hallucinations and other forms of delirium. Let Improving Lives Counseling Services’ team of professionals provide the help, guidance, and support you need and the screening, diagnosis, and treatment your loved one requires. We treat children, adolescents, teens, adults, and seniors in individual, couples, family, group, and video sessions. Live the life you were meant to live. Call us.