First, let me repeat that hallucinations only need management if they are distressing to your loved one. If they are distressing to you, this means that you need to find a way to accept your loved one's behaviors. Otherwise, he/she will pick up on your negative emotions and mirror them, with a likely increase in hallucinations or worse, in their intensity.
However, if a hallucination is stressful, there are some ways to help your loved one de-stress. This week, we are focusing on what Tanis calls "solution-focused management," which involves identifying patterns and triggers.
Once you know about the trigger, it is often easy to solve the problem. Even more important, it is often possible to prevent the behavior by removing or avoiding the trigger. For example, Iris, tells about her husband Eric, a Vietnam veteran, who becomes violent when he "sees" war battles and delusionally believes that he's involved.
How is this is a problem?
- It's a problem for Iris because she's afraid she'll be hit.
- It's a problem for Eric because he thinks he's being attacked by the enemy.
- It is most often the result of a dream that wakes Eric up acting out what he had been dreaming.
- In bed.
- They often happen after a physically exciting scene on TV. It doesn't have to be about war. The last time, it was a football game.
- After Eric wakes up fighting, Iris leaves the bed.
- Usually only Iris. But it was triggered once, when an old buddy showed up and they got to reminiscing.
- Physical: Medications, dehydration, infection, not enough exercise, pain, constipation, sleepiness, alcohol, mood.
- Environment: Clutter, lighting, cues (TV), move misperceived objects
- Task demands: Task too hard, causing stress, or too easy, causing boredom.
- Fluctuations: Not actually triggers, but if you are aware of your loved one's pattern of fluctuations, you can usually choose activity times for when he/she is more aware which will decrease stress and increase awareness.
For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia
Responsive Dementia Care: Fewer Behaviors Fewer Drugs
Lewy Body Dementia: A Manual for Staff
Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.