What are Delusions and Hallucinations?

Hallucinations and delusions are different symptoms of Alzheimer's disease and related dementias.

Delusions are false beliefs. Despite any evidence that you present to the person with dementia, they will not change their belief about something. For example, a person with dementia may have a delusion in which they believe there is someone living in their house when they actually live alone.

Delusions can also be experienced in the form of paranoid beliefs, or accusing others for things which have not occurred.  For example, the person with dementia may lose an item and blame others for stealing it when in fact, they have misplaced the item. Some people with dementia may have the delusion that others are "out to get them", for example, they may believe that their food is being poisoned.


Hallucinations are sensory experiences that seem real to the person experiencing them but cannot be verified by anyone else. Hallucinations are a false perception involving the senses and can result in either positive or negative experiences.

Hallucinations experienced by people with dementia are usually either visual (seeing something that isn't really there) or auditory (hearing noises or voices that do not actually exist). For example, a visual hallucination could be seeing bugs crawling over the bed which aren't actually there.

Possible Causes

  • Sometimes, different combinations of medications are the cause of hallucinations or delusions (you may want to speak to a doctor)
  • Unfamiliar people and environments
  • Changes in routines
  • Inadequate lighting
  • Over stimulation of environment (too much noise, too many people, too many distractions)
  • Sundowning, which is a form of disorientation and confusion that some people with dementia experience in the late afternoon. Learn more about Sundowning...

Coping with Delusions and Hallucinations

  • Try to determine if it is a problem with hearing or seeing may be a cause for hallucinations (seek medical evaluation of senses).
  • Make sure that there is adequate lighting available for the person with dementia.
  • Make sure that the person with dementia is eating a well-balanced diet (malnutrition or dehydration can result in undernourishment of the brain).
  • Try and make the environment comfortable for the person with dementia (unfamiliar people or environments may be disruptive).
  • Keep routines and schedules consistent.
  • Try not to change the environment.
  • Check for signs of physical injuries such as bruises or scrapes (a fall that was not witnessed by anyone could cause hallucinations).
  • Determine whether or not a hallucination or a delusion is bothering the person with dementia (for example, a hallucination may only be hearing music that is not there). If it is not causing any distress, it may be okay to let it go.
  • Try to find a way to alleviate their distress (for example, if the person with dementia says that her necklace has been stolen, help the person with dementia look for the necklace or distract them with another activity).
  • Respond to the feelings, and not to the issue. Rather than contradict the person with dementia, acknowledge their concern.
  • Do not get angry with the person and avoid arguing with them. You will not win an argument with a person who is having a hallucination or delusion, remember, that their hallucinations and delusions are very real to them.
  • Investigate suspicions that may be based on fact. It’s possible that they really could be a victim.
  • Use familiar distractions such as listening to music, exercise, playing cards, or looking at photos.
  • Offer them reassurances.