Delusions vs. Hallucinations

Delusions vs. Hallucinations

Delusions vs. Hallucinations

If you have an aging loved one with Alzheimer’s, they may at one point experience delusions and/or hallucinations.

In this blog, we want to talk about the difference between these two phenomena. Knowing the difference between them will help you respond more efficiently and appropriately when these instances occur.


A delusion is defined as a belief that is held when there is evidence that the belief is not true. For example, consider a hypochondriac who believes he or she has a terminal illness. This person has visited the doctor numerous times and each time the doctor tells them that there is nothing wrong, but our worried friend does not believe the repeated tests and evaluations performed already. This person is considered deluded by thinking they have a sickness they probably do not have, based off of reliable evidence.

In Alzheimer’s patients, especially during the mid- to late-stages, delusions become common. This is because as memory loss becomes worse, Alzheimer’s patients may begin to forget about people around them or events that are happening. Some may falsely believe that certain family members are stealing from them or that a deceased individual is still alive. A person who is deluded cannot (or will not) incorporate the facts contradicting their belief into their mind. For a person with Alzheimer’s or another dementia, this is completely out of their control because of the nature of degenerative brain disorders.


Hallucinations are perceived experiences of things that are not real. For instance, if you have ever seen the movie The Big Lebowski, there is a scene where Jeff Bridges’ character, The Dude, has a surreal hallucination in which he is bowling (apparently) in outer space. Although The Dude was hallucinating because of drugs given to him, the scene illustrates just how vivid these experiences can be.

On a more serious note, people who have dementia can experience hallucinations in a variety of ways, and they usually occur in the later stages of the disease. They may (commonly) experience auditory hallucinations, hearing a person who isn’t really there. People may also see faces or unfamiliar things around them. Regardless of the kind of hallucination, these experiences can cause concern.

It is important to rule out other causes of hallucinations, such as other mental health problems or medications, before concluding that they are caused by Alzheimer’s (or another dementia).


You will likely have to respond differently to hallucinations than to delusions.

For delusions:

  • Do not get confrontational, as it may make the situation worse
  • Try to gracefully change the subject
  • Offer “yes” or “no” answers in order to avoid confusing your loved one
  • Use “therapeutic lying”, a harmless lie usually meant to avert a negative situation

For hallucinations:

  • Respond calmly
  • You may have to help get your loved one’s attention directed back at you by gently patting their arm, etc.
  • Change the environment by moving them to another room in the house
  • Try to find the “trigger” of the hallucination, a sound, an unfamiliar item, or a shadow can often lead to hallucinations
  • Brighten the room since shadows can often act as “triggers”

If you have any questions, do not hesitate to call ElderCare at Home at 888-285-0093 or visit our website!

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