Marilyn was watching television with her husband when her eye caught some movement in the corner of the room. Suddenly several elf sized people ran behind the couch. She screamed, “Harold, a bunch of little people are hiding behind the couch!” Harold was used to Marilyn’s hallucinations; she had several a day, usually little people. He understood this was a symptom of her dementia but he still had trouble getting used to it and felt annoyed.
Exasperated he replied, “Oh, for God’s sake Marilyn, I’ve told you a thousand times they don’t exist. There are no little people.” Marilyn can see their sinister little eyes peeking at her from under the couch. One of the little people stands right in front of her husband and stick out his tongue. She hollers, “Look at that one! It’s right in front of you!”. “Honey, they don’t’ exist.” he replies with a sigh.
Again, he sees nothing and repeats they don’t exist and her panic mounts as more little people begin climbing out of the television screen and joining the others who have come out of hiding. They are all over the room now and smiling at her wickedly.
She covers her eyes with her hands and begins to cry.
When a person with dementia hallucinates its never advisable to tell them what they see doesn’t exist. They not only see a hallucination as very solid and very real but often other senses are involved. As in Marilyn’s case, maybe the little people smell bad or begin to chatter. Maybe one jumps on her and pinches her and she feels the pain. This is an actual experience for the one hallucinating and when you don’t validate their feelings and support them, they can become angry or frightened. They need you to travel this journey with them and learning to agree they see something is an essential part of enabling them to stay calm and out of fear.
“Yes, Marilyn, they come to visit us from time to time. No need to be concerned.”
“I know you can see them, but I’m having trouble. Where did they go? Do you want me to shoo them out or will they just go on their own.”
“Ok, you little guys, out you go. Neither Marilyn nor I invited you here. I’m opening the door… now get out.”
“They must be magical and don’t want me to see them. Glad you can. Where are they? Are they doing anything they shouldn’t?”
Remember when you were a child and could imagine all sorts of things and interact with them. With your friends everyone pretended to be on a jungle safari where animals appeared. Revisit your childhood and let your imagination create a playtime out of your loved one’s hallucinating.
That is unless the hallucination is a frightening one. Then become the hero and assure the person you will keep them safe.