Hallucinations in the Elderly (Causes, Symptoms and Treatment)

Hallucinations are any type of feeling or perception of something occurring when it actually is not present. When most people think of hallucinations they think of either tactile or visual hallucinations, but there are actually five types that each correlate with one of your senses. Our first part of this series covered the five types of hallucinations and discussed briefly what the main cause of each type was. In this article, we are going to discuss the common causes, symptoms, and treatment of hallucinations.

Common Causes

Hallucinations can have many causes, which makes them hard to diagnose. If you or your loved one begins to experience any symptoms of hallucinations, then your doctor may first rule out a psychiatric disorder. Disorders such as bipolar disorder, schizophrenia, psychotic depression and various personality disorders are all very common causes of all types of hallucinations. Once psychiatric disorders have been ruled out, then doctors can begin looking into other medical reasons for hallucinations. Some of the most common medical causes of hallucinations include: brain tumors or brain damage, dementia, epilepsy, sleep deprivation, vision loss, hearing loss, or substance abuse. Many medications can also cause hallucinations as a side effect, and therefore your doctor may switch your medications if you begin to suffer from hallucinations to determine if your medication is the cause. In the elderly population, the most common cause of hallucinations is dementia. Hallucinations can be an early sign of dementia, and therefore its vital that if you or your loved one is suffering from hallucinations that you visit a doctor as soon as you can. If dementia is caught early, then its progression can be slowed. Hallucinations can also be an early warning sign of Alzheimer’s disease in the elderly.

Another fairly common cause of visual hallucinations in the elderly is Charles Bonnet Syndrome. This syndrome only affects those who have impaired vision. Patients with Charles Bonnet Syndrome will suffer from visual hallucinations in relation to their impaired vision. The good news though is that patients with this syndrome often do not have very frequent hallucinations, and they usually completely disappear within two years.

If you or your elderly loved one suffer from either dementia or Alzheimer’s disease and are experiencing hallucinations, then they may be because of Sundowners Syndrome. This syndrome causes patients with dementia or Alzheimer’s disease to portray very uncharacteristic behaviors in the evening and at night (while the sun is going down). Doctors believe these types of hallucinations cause the patient to act uncharacteristically because they are reacting to their hallucination. They believe they are caused by patients feeling overly tired at night, and therefore to treat them, the patient should take frequent naps throughout the day to prevent feeling overly exhausted.


The symptoms of a hallucination can often be difficult to catch. Unless the hallucinations are very severe, then the patient may not know they are having them. The most common symptom of any type of hallucination is a change in behavior. If you have noticed one of your loved ones has had a drastic change in their behavior, then they may be suffering from some type of hallucination. Watch out for these other common symptoms that could signify hallucinatory activity:

  • Anxiety and irritability
  • Confusion and memory lapses
  • Delusions
  • Speaking about things that are not actually there
  • Difficultly speaking, or conveying their thoughts
  • Mood instability
  • Reduced sense of judgment
  • Insomnia
  • Heightened sense of awareness
  • Withdrawal

Elderly people who suffer from any type of hallucination may experience a variety of these symptoms. Often, patients who deal with hallucinations frequently will inadvertently pull away from their family members and become slightly depressed or anxious. They may grow confused about what is happening to them, and may be too ashamed to admit their symptoms to someone else. Therefore, if you notice any of these symptoms, or notice any type of obvious symptoms of any type of hallucinations then talk to a doctor immediately. Obvious symptoms would include your elderly relative telling you they hear voices, see objects or people that are not there, smell odors that are not there, etc.


In order to properly treat hallucinations, the root cause of the hallucination must be uncovered. If doctors cannot uncover the root cause, then they may simply prescribe anti-anxiety or anti-depression medications to help calm you down in order to help prevent any more hallucinations. However, if the root cause can be uncovered, the treatment of your hallucinations will depend on the cause. For example, patients with Charles Bonnet Syndrome can often be treated by simply changing their environment. If they often suffer from hallucinations in dark rooms, then by simply keeping a light on at all times they can prevent their hallucinations from occurring.

Other common treatment options for patients with different types of hallucinations include sedatives, sleep aids, and muscle relaxers. These types of medications help patients to relax, and therefore will reduce their frequency of hallucinations. If the root cause of their hallucinations can be uncovered though, then their treatment will be centered on treating the root cause in order to remove the hallucinations from their life completely.

Hallucinations are often very disorienting and confusing. If you or one of your elderly relatives suffers from hallucinations, then it is vital to get them to a doctor. Hallucinations can be the first sign of very serious diseases including Alzheimer’s disease and Dementia. They can also be a sign of serious psychiatric disorders such as schizophrenia and bipolar disorder. In the elderly, hallucinations are most often caused by dementia, Alzheimer’s disease, medications, or anxiety and depression. All of these causes can be treated so that you or your relative will not have to suffer from hallucinations any longer. By simply mentioning your symptoms to your general practitioner, you may be able to stop your hallucinations and go on living your life normally.