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Posted March 19, 2009

Ask An Expert

Handling Hallucinations Linked to Parkinson's Disease

Q.  My 85-year-old aunt is having hallucinations due to advanced Parkinson’s disease. I have been going along with them (for example, shooing the children out of the room or moving the bricks off of her legs). Is this the best way to handle this, or should I try to explain that this is not real? I am not her primary caregiver; I just have her some of the time and want to do what is best for her. Thanks.

Stephanie G., Charleston, South Carolina.

A.  In Parkinson’s disease, hallucinations often occur before or at the same time as patients begin to develop loss of memory and cognition.  Because of this, some people with Parkinson’s disease can understand that their hallucinations are not real. 

In general, I recommend trying to gently re-orient a person to reality by letting them know they are having a hallucination, that it is not real, and that they are safe. However, many times people with hallucinations also have moderate to severe cognitive loss and can not understand this. To them, these hallucinations are so real that when you try to re-orient them to reality they became very agitated.  If this is the case for your aunt, I would suggest you continue to play along.  

What is best for your aunt is to promote her quality of life and for her to remain calm and engaged in activities -- not worrying about her hallucinations. I would suggest you ask her primary caregiver how he/she handles the hallucinations. It would be helpful for everyone to have a consistent approach.

This answer is provided by Dr. Vivian Argento, a trained geriatrician and member of the geriatric medical team at Bridgeport Hospital in Bridgeport, Connecticut.  Dr. Argento is an expert in memory and medical problems affecting the elderly and serves as a clinical instructor at the Yale School of Medicine at Yale University in New Haven, Connecticut. She’s also a consultant both in and out of hospitals and cares for patients in various locations, including nursing homes, assisted living facilities, and in their homes via a house calls program. Dr. Argento can be reached at pvarge@bpthosp.org

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