Inside the World of Dementia Hallucinations
Have you ever heard your loved one say, “There’s someone in the room,” or describe something you know isn’t really there?
For many caregivers, dementia hallucinations are one of the most emotional—and confusing—parts of caregiving. Especially when a loved one begins seeing people who aren’t actually there, it can feel both unsettling and heartbreaking.
But not all hallucinations are scary. Some are oddly comforting. Others may be a red flag for something more serious. In this post, we’ll explore what causes dementia hallucinations, what they mean, and how to respond with calm, compassion, and confidence.
What Are Hallucinations, Really?
Hallucinations are real experiences for the person having them—even if no one else can see, hear, feel, smell, or taste what they’re sensing. It’s not “just in their head.” Their brain is actively creating something that feels very real to them.
Types of Hallucinations in Dementia
Visual hallucinations: Seeing people, animals, insects—often very detailed. Common in Lewy body dementia.
Auditory hallucinations: Hearing voices, music, or noises no one else hears.
Olfactory hallucinations: Smelling things like perfume or smoke that aren’t present.
Tactile hallucinations: Feeling things crawling on the skin, like bugs.
Gustatory hallucinations: Tasting something (often metallic) that isn’t there.
Some people who are blind—even those blind from birth—report vivid visual hallucinations. This is called Charles Bonnet syndrome, and it happens when the brain fills in missing visual information. Even without functioning eyes, the brain still “sees.”
Can People Near Death See the Dead?
It may sound eerie, but stories of people seeing deceased loved ones before death are common—and not just among those with dementia. This phenomenon is called a “peak-in-darien” experience and has been documented across cultures and religions.
Even more curious? Some people report seeing a dead relative they didn’t even know had passed away.
Scientists still don’t fully understand this, but it’s a real and powerful part of the end-of-life experience for many.
Who Experiences These Encounters?
These visions are not limited to people with dementia. They’ve been reported by:
Hospice patients
People in coma-like states
Those with full mental clarity in their final days
According to research published in the American Journal of Hospice & Palliative Medicine, nearly 80% of terminally ill patients in one study reported visions or dreams of deceased loved ones in the weeks leading up to death.
Is It the Brain? Or Something More?
Science hasn’t fully explained these end-of-life experiences. Some researchers believe they’re due to:
The brain coping with fear or stress
Changes in oxygen or brain chemistry
The mind detaching from physical reality
Why Hallucinations Happen in Dementia
When the brain is affected by dementia, it can misprocess sensory information, leading to hallucinations. In some types, like Lewy body dementia, visual hallucinations are so common they’re considered a core symptom.
In other cases, hallucinations may be caused or worsened by:
Medications
Sleep deprivation
Poor lighting
Sensory loss (like hearing or vision loss)
Hallucinations are not always harmful—but understanding their cause can help you respond better.
How to Respond to Hallucinations With Compassion
The #1 thing to remember is this: Your loved one truly believes what they’re seeing or feeling is real.
Telling them “It’s not there” or trying to correct them often doesn’t help. In fact, it can make things worse by causing confusion, fear, or conflict.
Your Caregiver Response Toolkit
Stay calm and reassuring – Let them know they’re safe and you’re there for them. Your calmness will help them feel more grounded.
Assess their emotion – If the hallucination is comforting—like a child playing in the room—don’t interrupt or try to change it. Let them enjoy the moment.
Don’t argue or correct – Even if you know it’s not real, challenging it may just increase distress.
Redirect gently – If the hallucination is disturbing or causing fear, try shifting their attention to a different activity or room.
Improve the environment – Make sure the lighting is good, and reduce background noise or visual clutter.
When to Call the Doctor Immediately
If hallucinations begin suddenly, especially in someone who hasn’t had them before, it could be a sign of something else going on—like an infection, medication reaction, or delirium.
In these cases, call your loved one’s doctor immediately. Sudden changes in behavior or perception should always be medically evaluated.
Hallucinations: Terrifying, Comforting, or Something in Between?
Believe it or not, not all hallucinations are bad. Some people with dementia find them comforting—seeing a smiling child, or thinking a late spouse is sitting nearby. In those moments, there’s no need to intervene.
But if the hallucination causes fear, agitation, or danger, it’s time to step in with calm reassurance, environmental changes, and medical support if needed.
Final Thoughts
Hallucinations are one of the most mysterious—and misunderstood—parts of dementia care. They can be deeply emotional, sometimes beautiful, sometimes scary. But most of all, they remind us just how complex and powerful the brain really is.
Whether your loved one is seeing things, hearing things, or simply reacting in ways that don’t make sense to you—you are not alone. Other caregivers are navigating this too.
You Don’t Have to Do This Alone.
Caring for someone with dementia is hard—but you don’t have to figure it all out alone.
The Dementia Dose is a free, weekly email newsletter that delivers clear advice, new breakthroughs, and proven behavior tips straight to your inbox every Thursday.
It’s made for caregivers. Just like you.
Want to watch the in-depth video that inspired this post?
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Frequently Asked Questions
Yes, some people with dementia experience hallucinations where they see or interact with deceased loved ones. These hallucinations can be vivid and emotionally significant. While not all are harmful, caregivers should observe the context and emotional response of their loved one.
Hallucinations in dementia are caused by changes in the brain that affect how sensory information is processed. They can also be triggered by medications, infections, sensory loss (like vision or hearing loss), or specific types of dementia such as Lewy body dementia.
No, not all dementia hallucinations are distressing. Some may be neutral or even comforting, like seeing a child playing or a familiar face. If the hallucination causes fear or aggressive behavior, caregivers should speak to a healthcare provider.
Caregivers should stay calm and offer reassurance. Avoid arguing or correcting the person, and instead focus on making them feel safe. If the hallucination is not upsetting, there may be no need to intervene. Seek medical help if hallucinations appear suddenly or cause distress.
