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Little-Known Scientific Facts About Hallucinations in the Elderly

Hallucinations in the elderly occur due to several conditions ranging from dementia and delirium to side-effects of medication that are administered to treat infections.
Rutuja Jathar
Last Updated: Mar 26, 2018
A hallucination is a profound distortion in a person's perception of reality, typically accompanied by a powerful sense of an alternate reality. A hallucination may be a sensory experience in which a person can see, hear, smell, taste, or feel something that is not there.
A hallucination is an abnormal sensory perception, a parasomnia event that can target any visual, auditory, olfactory, or tactile sensory organ responses. Hallucinations are commonly mis-conceptualized with delusions, illusions, and dreams. A thing to remember here is that hallucinations and delusions are a lot different from each other. A hallucination is a distorted sensory experience that appears to be real to that person. There is no external stimuli present that boosts this feeling. A delusion is a totally different concept; it is a false belief that makes the person deny what almost every other person accepts. An illusion is an image that is believed to be real in our mind but that is not actually real. Hallucinations can be controlled by medication in many cases.
Types of Hallucinations
Hallucinations in the elderly are the same as those that occur in younger people. They aren't always associated with mental illnesses. As such, this condition occurs in the elderly mostly due to internal changes that take place in a person's body. A lot of on-line posts of people whose loved ones are experiencing hallucinations throw light on two major contributors to this condition. The pattern that emerges either indicates an infection, or incorrect med doses that may prove to be too strong for the person to handle, resulting in side-effects in the form of hallucinations.
People sense various voices and sounds even though no one's around. A person may start to say something and then suddenly stop, as though waiting for someone else to finish what he/she is saying, or suddenly shout when there is no one there. The sounds that can be heard can vary from primitive sounds like a beep, a bang, screams, claps, and whistling to music and speech. Auditory hallucinations often take the form of a voice of a deceased person, a good friend, a lost partner that may originate from almost anywhere, a tree, the ground, the wall, etc. They are referred to as paracusis and paracusia, both psychological conditions involve a false sense of hearing. These hallucinations often trigger psychotic conditions like schizophrenia. More than 75% patients suffering from schizophrenia suffer from this disorder.
Visual hallucinations start with misinterpretations, for example, a person might think that he is seeing fabric patterns or faces in the shadows. This is the most common type of hallucination in the elderly, especially those who are suffering from dementia. They might see people, animals and many other things like complicated scenes or bizarre scenarios. These visual hallucinations last for a second or two but can be persistent which might create more annoyance. People suffering from Lewy body dementia suffer from visual hallucinations that come along with slow body movements and physical stiffness.
Olfactory hallucinations, also called phantosmia, are a prominent type of hallucination found in elderly. This renders them sensitive towards certain odors that are not present. These hallucinations vary from person to person, but are mostly of fetid smells such as the smell of rotten food or rotten flesh, however, they may also include pleasant experiences such as smells of fresh flowers and perfumes. Phantosmia could also be a predominant symptom of epilepsy, temporal lobe seizures, migraines and several psychotic illnesses.
Such hallucinations present themselves while a person is asleep. This brings about a feeling that the person is falling off the bed, or a sudden jerk that is felt with a dream like state. Hallucinations while sleeping can occur during day time sleep as well as at night. In short, we can say that hypnagogic hallucinations are felt in the form of dreams that seem to disturb a person's sleep, which can cause visual, auditory, or touchable sensations, only that they occur within sleep and waking. Hypnagogic hallucinations are often a symptom of narcolepsy and can appear right after a cataleptic attack.
There are several common causes of hallucinations. Seeing things, people, color patterns, faces, halos around lights, feeling as if a bug (like a spider) is crawling under the skin or on the face, briefly seeing a deceased person and hearing his/her voice, and other such experiences are the symptoms of this disorder that can be caused by many factors.
Effects of several drugs, LSD, cocaine, alcohol, marijuana and drug withdrawal can cause tactile as well as visual hallucinations. These are also called hallucinogens. Extreme stress, fatigue, aging, loss of a beloved or friend, emotional exhaustion, post traumatic stress disorder, depression, sleep deprivation or insomnia, lesion and head injuries, high fever, severe illnesses like liver failure, brain cancer, kidney failure, etc. are the common hallucination causes in the elderly.
Sometimes a person may also feel an aura of touch or smell that could indicate several changes taking place in the organic compounds of the brain. These could warn of an impending epileptic attack or migraine as well. Sensory deprivation or lack of any external stimuli could also contribute to hallucinations, especially behind deaf people suffering from auditory hallucinations and the blind from visual hallucinations. Along with these common causes, the following are some specific reasons of hallucinations.
Charles Bonnet Syndrome
This is the most common cause of hallucinations in the elderly. Charles Bonnet syndrome is a condition that is observed in people who are suffering from vision loss. These people see lines across their visual field, and birds and animals moving in front of their eyes that are not there. They also suffer from varying degrees of dementia and delirium. Such people are mentally healthy but can still have these visual hallucinations due to the lack of an external stimulus.
Sundown Syndrome
Sundown syndrome is also known as sundowning syndrome in medical terms. This medical condition occurs especially during the late afternoon, evening, and night. Sundowning syndrome occurs in people who are already suffering from dementia, Alzheimer's, or psychosis. Visual and auditory hallucinations are the prime symptoms of the sundown syndrome.
Treating People with Hallucinations
Apart from hypnagogic hallucinations, all the other types of hallucinations must get proper medical intervention for the prognosis as well as treatment. Psychiatrists and psychologists play a vital role here in treating the condition. On prognosis, chronic hallucinations, such as those in schizophrenia are treated and controlled with several prescribed anti-psychotic medication and psychosocial therapies. Visual hallucinations like seeing a deceased person may soon disappear, as they may be a part of the grieving process.
Hallucinations in the elderly can render a person scared, unsure, and sad, and even though it becomes difficult to live with such a person, it's best not to leave such people on their own. If you check on-line, you will come across several blogs and websites where people have discussed their grievances over living with parents that see hallucinations, it would do good to go through them and look up a few suggestions that may be helpful along with you drawing strength from people's posts which will help you and the patient deal with the situation better. It is one's prime responsibility to give all the possible TLC to his/her loved one who is suffering from hallucinations. Take care!