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Friday, March 7, 2014
Confronting Someone with Alzheimer's Disease
My 80-year old sister-in-law has been experiencing visual hallucinations for over a year. At first it was rare, but now the "people" are in her house every day. She has seen a number of different doctors and has had many tests. She has an appointment to see a neurologist next month. In the meantime, we need to know how to talk to her about this. She lives alone and will not agree to moving into an assisted living situation. She calls and wants our help in getting rid of these trespassers in her home. Of course, she is the only one who can see them. I think she probably has Alzheimer`s. She is usually mentally alert and bright, but she has had some spells of confusion recently. Can you suggest how we should speak with her and what could be helpful until she sees the next doctor?
The best way to handle hallucinations is to provide reassurance and to not challenge the person or try to convince them that they are not real, as they are very real to her. It is often difficult to not respond with the very rational response of trying to convince the person that her beliefs are not real. But this will not work. She may also be having delusions, where she believes people are in her house, even if she is not actually having visual hallucinations, but rather delusions, or false beliefs. The key is to make your sister-in-law feel safe. This may be done by assuring her that the people are not bad and will not harm her. Or try to see if you can talk her into ignoring them. It often takes a trial and error approach to see what works. But the key is to provide reassurance and support, and to not challenge her very real reality.
There are a number of medications that are effective in treating these types of symptoms in older adults. It sounds like you have been very supportive of your sister-in-law and are doing all you can to arrange medical intervention. If her hallucinations become very severe and your sister very upset, one approach may be to contact her primary care physician/family doctor to see if he/she would be comfortable prescribing a medication for a short time, until you can get in to see the neurologist.
Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University