My husband has had Alzheimer's for several years. He now has hallucinations everyday. Not sure how to handle this.

Here is what I wrote about hallucinations and how to deal with them in my recent book "Dementia Care Companion"


Hallucination
She talked nonstop, sometimes through the night. She talked at length with dead relatives, and when they’d offer her some food, she’d politely accept and eat it. The meds her doctor had prescribed couldn’t get her to sleep. Eventually, after twenty-four hours, having completely worn herself out, she’d settle down and sleep for a whole day.


Hallucination is a condition where the patient sees someone or hears their voice in the absence of actual external stimuli. The patient may see a friend’s face in the folds of a curtain or think there’s a stranger somewhere in their home. They may see a parent who passed away years ago, hold a conversation with a friend who is not there, or even try to serve them something to eat or drink. Although none of this is real, the experience is nevertheless quite real to the patient, and any attempt to convince them otherwise would be futile.
Hallucinations occur in most types of dementia, and visual hallucinations are the most common type. The duration and severity of hallucinations vary across different types of dementia. In Lewy Body Dementia, this condition is usually more severe and lasts longer.

Helping the Patient Cope
Do not argue with the patient. Trying to convince them that they are mistaken is futile. It may even lead to aggression.
Remember that the patient is not trying to deceive you. What they experience is quite real to them. Do not scold or accuse them of lying. Instead, express your love, care, and support.
Stay with the patient and reassure them. Say things like: “Don’t worry, I will stay with you and protect you.”
Try to understand what they are hearing, seeing, and thinking. Find out in what situation, time, and place they find themselves. Adjust your reaction accordingly.
Try easy and relaxing activities to distract the patient and redirect their attention.

Eliminate Environmental Triggers
Reduce sensory stimuli. Excessive noise, including TV, music, or a running air conditioner, can trigger hallucinations.
Too much, or too little, stimulation may trigger hallucinations. If the presence of others is creating problems, take the patient to a quieter and more familiar environment, such as their bedroom. If being alone makes them see or hear things, take them to where others are present.
Due to the effects of sundowning, confusion and hallucination are more likely at dusk. As the sunset approaches, turn on the lights and draw the curtains to eliminate shadows.
Eliminate strong reflections. Bright light reflecting on shiny surfaces can create problems.
Looking in the mirror, the patient may not recognize the person looking back at them. Cover mirrors or remove them from the patient’s room.

Address Medical Factors
end to failing eyesight or hearing loss, if present. Does the patient need new eyeglasses? Do they suffer from cataracts? Do they need new hearing aids?
Examine the patient’s physical condition. Are they constipated? Do they have a skin rash, fever, pain, or urinary tract infection? Consult with your doctor when necessary.

Is It Really Hallucination?
Dad keeps hearing people calling him from a distance. He answers in a loud voice, but there’s nobody there. This usually happens before he goes to sleep at night or shortly after he wakes up in the morning.


Sometimes it is difficult to tell the difference between hallucination and other conditions such as illusion, delusion, or delirium. The problem is compounded by the fact that the patient is often unable to articulate what they are experiencing. As a result, it may take some detective work to determine which condition is present. Proper detection is critical, however, since each symptom is a clue to underlying conditions and a possible way

Antipsychotics, including Seroquel, are designed to counter delusions and hallucinations. They will also increase drowsiness and fall risk, so perhaps a question for his doc.

His symptoms are typical of someone with Lewy Body Dementia. My mother had this. There are YouTube videos that describe the disease to a “T.” I found them helpful.

I had my mom seen by Neuropsychiaty, but there are very few in the country. The right medication made all the difference and she is able to be at home. Her symptoms are controlled.

We tried to go through primary care first since it was the fastest, but the doctor had limited medication knowledge until waiting for a telehealth psychiatry appointment. General psychiatry helped some with medicine, but ultimately neuropsychiatry was the best.

My husband had the same issue, mostly in the evening and through the night (sundowning). We switched the timing of one of his medications (Donepezil) from bedtime to morning. Seems to be helping quite a bit.

Sorry, your husband needs to be in Memory Care. He may get violent. This disease is so heartbreaking! Please look into placing your husband somewhere safe. There are medications to potentially calm him as well.

Shadowing is very common. you are a "safe person" one that he can rely on.
As to the hallucinations his doctor should be made aware of them.
His doctor should also be made aware if your husband begins to get violent at any time.
And if he does you need to make sure that you are safe. Call 911 if you have to, tell the dispatcher that you are afraid for your safety.

It may be getting to the point where it might not be safe for your husband to remain at home.. If he is wandering around the house at night you can not be getting a good night sleep.

Sounds like he's shadowing you and now having hallucinations, which of course can be helped with medication. Have you talked to his doctor to see what can be done to help with the hallucinations? If not, you should start there.
When he asks you questions about what he's seeing, it's usually best to just go along with it, as that will make both your lives much easier. There is no use trying to tell him otherwise as these hallucinations are very real to him.
And there are some on here that believe that you need to break your loved one of shadowing you, but I disagree. By wanting to be in the same room with you, your husband just needs to know that you are near as he feels much safer when he's near you, as his world with his broken brain can be quite frightening at times, and if you're near he knows he's safe. And I personally see nothing wrong with that.
Plus the shadowing phase doesn't last all that long anyway.
I wish you the very best as you take this very difficult journey with your husband.

should have him seen by a Geriatric psychiatrist