Hallucinations in the Elderly

Hallucination is a profound distortion in a person's perception of the reality, typically accompanied by a powerful sense of reality. A hallucination may be a sensory experience in which a person can see, hear, smell, taste, or feel something that is not there.

Hallucination is an abnormal sensory perception, a parasomnia event that can target any sensory organ like auditory, visual, olfactory, tactile or other senses. Hallucinations are commonly mis-conceptualized with delusions, illusions and dreams. A thing to remember here is that hallucinations and delusions are a lot more different form each other. Hallucination is a distorted sensory experience that appears to be real to that person. There is no external stimuli present that boosts this feeling. Delusion is a totally different concept; it is a false belief that makes the person to deny what almost every other person accepts. An illusion is an image that is believed to be real in our mind but that is not actually real. Hallucinations can be controlled by medications in many cases.

Hallucinations in the Elderly
Hallucinations in the elderly are the same as that of the other people. In elderly, hallucinations can not always be associated with the mental illnesses. Hallucinations in the elderly can be an effect of several external factors as well as the internal changes that take place in their bodies. Following are the type of hallucinations in the elderly.

Auditory Hallucinations
People sense various voices and sounds when nobody is around. Many a times, these people talk something and suddenly stop, as though they are waiting for someone to finish what they are saying or suddenly shout when there is no one there. These sounds can vary from primitive sounds like beep, bang, screams, claps, whistle to music and speech. Auditory hallucinations in the elderly are often the voice of a deceased person, a good friend, a lost partner that may originate from almost anywhere, a tree, the ground, the wall etc. Auditory hallucinations can also be referred to as paracusis and paracusia, both the psychological conditions involve a false sense of hearing. These hallucinations often trigger in psychotic conditions like schizophrenia. More than 75% patients of schizophrenia suffer from various types of hallucinations.

Visual Hallucinations
Visual hallucinations start with misinterpretations, for example, the person might think that he is seeing fabric patterns and faces in the shadows. This is the most common type of hallucination in the elderly people, especially who are suffering with dementia. They might see people, animals and many other things like complicated scenes and other bizarre scenarios. These visual hallucinations in the elderly last for a second or two but can be persistent that might create more annoyance. People suffering with the Lewy body dementia suffer from visual hallucinations that come along with slow body movements and physical stiffness.

Olfactory Hallucinations
Olfactory hallucinations, also called as phantosmia, are also a prominent type of hallucination in the elderly people. They get sensitive towards certain odors that are not present. These hallucinations vary from person to person, but are mostly of fetid smells. For instance, smell of rotten food, rotten flesh and also pleasant smells of fresh flowers and perfumes. Phantosmia can be a predominant symptom of epilepsy, temporal lobe seizures, migraine and also several psychotic illnesses.

Hypnagogic Hallucinations
Hypnagogic hallucination can be called as hallucinations while sleeping. Hallucinations while sleeping or during the onset of the sleep can be referred to the situations when a person feels that he is falling off the bed, feels a sudden jerk with a dream like state of the sleep. Hallucinations while sleeping can occur during the day time sleep as well as at night. In short, we can say that Hypnagogic hallucinations are dreams that intrude on wakefulness, which can cause visual, auditory, or touchable sensations., only that they occur within sleep and waking. Hypnagogic hallucinations are often a symptom of narcolepsy and can appear right after a cataleptic attack.

Causes of Hallucinations in the Elderly
Seeing things, people, color patterns, faces, halos around lights, feeling as if a bug (like spider) is crawling under the skin or on the face, briefly seeing a deceased person and hearing his/her voice, and other such experiences are the symptoms of hallucinations in the elderly that can be caused by many factors. There are several common causes of hallucinations in the elderly that can also be observed in the people other than the elderly.

Effect of several drugs, LSD, cocaine, alcohol, marijuana and drug withdrawal can cause tactile as well as visual hallucinations in the elderly.These are also called hallucinogens. Extreme stress, fatigue, aging, loss of a beloved or friend, emotional exhaustion, post traumatic stress disorder, depression, sleep deprivation or insomnia, lesion and head injuries, high fever, severe illnesses like liver failure, brain cancer, kidney failure, etc. are the common hallucination causes in the elderly.

Many a times, people feel an aura of touch and smell that can be a sign of several changes that take place in the organic compounds of the brain. These can be the warnings of an epileptic attack or migraine as well. Sensory deprivation or lack of any external stimuli can be a major cause, especially behind the deaf people suffering with auditory hallucinations and blind people suffering from visual hallucinations. Along with these common causes, following are some major causes of hallucinations in the elderly.

Charles Bonnet Syndrome
This is the most common cause of hallucinations in the elderly. Charles Bonnet syndrome is a condition that is observed in the people who are suffering with vision loss. These people see lines across their visual field, see birds and animals moving in front of their eyes that are not there. They also suffer from varying degrees of dementia and delirium. These people are mentally healthy but still they can have these visual hallucinations due to the lack of the external stimulus.

Sundown Syndrome
Sundown syndrome is also called as sundowning syndrome in the medical language. This medical condition occurs especially during the late afternoon, evening and night. Sundowning syndrome occurs with the people who are already suffering from dementia, alzheimer's disease, psychosis etc. Visual hallucinations and auditory hallucinations are the prime symptoms of the sundown syndrome.

Treatment of Hallucinations in the Elderly
Apart from the hypnagogic hallucinations, all the other sorts of hallucinations in the elderly must get proper medical intervention for the prognosis as well as the treatment. Psychiatrists and psychologists play a vital role here in treating hallucination in the elderly. On prognosis, chronic hallucinations, such as those in schizophrenia are treated and controlled with several prescribed antipsychotic medications and psychosocial therapies. Several visual hallucinations like seeing a deceased person can go away as they can be a part of the grieving process. Hallucinations due to sleep deprivation and stress can fade away on removal of the cause. Read more on hallucination - tips to tackle.

Hallucinations in the elderly people make them to get easily agitated, afraid, scared and paranoid, so it is best not to leave them on their own. Hallucinations leave the senior citizens detached from the reality and they require immediate medical attention as well. Hence, it is one's prime job to give all the possible TLC to any of his/her loved one who is suffering from the hallucinations. Take care!