Fact sheet
Recognizing and managing hallucinations and delusions in Alzheimer’s disease

 

A guide for caregivers

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In Alzheimer’s disease, small proteins called amyloid and tau change, build up and clump together in the brain, affecting how cells function and eventually damaging them. While changes in memory and cognition are the most recognized symptoms of Alzheimer’s disease, behavioral changes appear in up to 70% of patients.

 


Seeing or hearing things that aren’t there (hallucinations) or believing something that is untrue (delusions) are common symptoms of Alzheimer’s disease. These may be referred to as psychosis and can feel unsettling for you and your loved one. It means that the brain is processing reality differently, which can happen at any stage of Alzheimer’s disease, often becoming more common as the disease progresses.

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What can psychosis look like?
 

  • Insisting there’s a stranger in the room/living with them when no one is there or not recognizing a spouse or family member
  • Believing someone is stealing from them, wants to harm them or that family has abandoned them
  • Talking to voices or people others cannot see

What may help?
 

  • Don’t argue or try to correct
  • Acknowledge feelings: “I can understand that is frustrating. Let me help you.”
  • Redirect to calming activities like music, photos or a comfort object (blanket, doll, pet)
  • Reduce noise and use soft but adequate lighting
  • Ensure glasses and hearing aids are on
  • Remove mirrors and clutter
  • Maintain a predictable routine
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These behaviors or symptoms can become worse late in the day or evening‭, ‬called‭ ‬sundowning‭.‬

Understanding the impact and seeking support

 

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If you are caring for someone with Alzheimer’s disease‭, ‬seeing them‭ ‬experience hallucinations or delusions may‭ ‬feel unsettling‭, ‬frightening and overwhelming‭. ‬These‭ ‬episodes can add to the burden of managing an already‭ ‬devastating disease‭, ‬but it’s important to remember that the‭ ‬episodes are the result of real‭, ‬physical changes in the brain‭.  ‬

As a caregiver‭, ‬it can be difficult to recognize when these‭ ‬symptoms are happening and to know how to respond in‭ ‬the moment‭. ‬Your calm presence can help ground them‭.‬

Remember‭, ‬you are not alone in facing these challenges—your healthcare team and your community are important resources that can help you navigate the complexities of caregiving‭, ‬answer your questions about the symptoms of Alzheimer’s disease and provide support for both you and your loved one‭. ‬

Download this‭ ‬helpful discussion guide‭ ‬to bring‭ ‬with you to your loved one’s next appointment‭.‬

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Creating a circle of support can make care more sustainable and less isolating

Ask relatives,
neighbors, friends or
faith communities
to help with small tasks

Connect with
local or online
caregiver support
groups

Explore respite
services to give
yourself planned
breaks

Reach out to local
Alzheimer’s disease
organizations for guidance
and community programs

Bristol Myers Squibb is conducting clinical trials in Alzheimer’s disease with the goal of improving available care and treatment options. Learn more and see if your loved one is eligible for a trial at NavigatingALZ.com.


Download Recognizing and managing hallucinations and delusions in Alzheimer’s disease fact sheet