Understanding Hallucinations, Delusions and Paranoia With Dementia

Nov 6, 2023 | Caregivers

Hallucinations, Delusions and Paranoia With Dementia

Hallucinations, delusions and paranoia are all symptoms that individuals with dementia commonly experience. It can be distressing to witness these types of behaviors in a loved one, but you can help by understanding each of these symptoms, their differences, and how to manage them.



“Hallucination” is a term for sensory experiences that are caused by changes in the brain. Hallucinations can cause someone to see, hear, smell, taste or hear something that isn’t actually there. In individuals with dementia, hallucinations are usually in the form of a misinterpreted sight or sound.


Delusions are persistent beliefs held by someone, despite any evidence to the contrary they may see. Many people living with dementia experience delusions in the form of paranoia.


Paranoia, an extreme distrust of others, is very common with dementia. It can be hurtful when your loved one doesn’t trust you, but you must remember that they can’t help it.

How To Help Someone With Dementia Experiencing Hallucinations, Delusions or Paranoia

Talk, Acknowledge and Reassure

To the person experiencing a hallucination or delusion, what they’re seeing is very real. For example, someone with dementia might think a tree outside their bedroom window is someone looking in at them – an understandably frightening experience! Acknowledge and try to understand your loved one’s fear or worry. Reassure them that everything is ok.

Offer an Explanation

Don’t upset your loved one further by trying to convince them that what they’re experiencing isn’t real. Instead, offer a calm explanation for what might have happened. If you’re being accused of something, stay calm and do not try to defend yourself. Instead, keep your answers simple and supportive and, if necessary, change the subject.

Avoid Further Distress

Don’t assume your loved one is merely delusional. Make sure that they are safe by always giving them the benefit of the doubt.

Related article: Celebrating Our Parents With Dementia

Is It Time To Ask For Help?

It’s understandable that you want to take care of your loved one, but we all need a little help sometimes. The behavior changes that often come with dementia can be overwhelming for even the best caretakers.

If you could use a little help, schedule your visit online or by calling 512-399-5080.