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. 2018 May 30:4:2333721418777086.
doi: 10.1177/2333721418777086. eCollection 2018 Jan-Dec.

Visual Hallucinations and Paranoid Delusions

R C Hamdy  1 , A Kinser  1 , Tracey Kendall-Wilson  1   2 , A Depelteau  1 , R Copeland  1 , K Whalen  1 , J Culp  1
Affiliations

Visual Hallucinations and Paranoid Delusions

R C Hamdy et al. Gerontol Geriatr Med. .

Abstract

Visual well-formed hallucinations, fluctuations in the level of cognition, and alertness and extrapyramidal signs are core features of dementia with Lewy bodies. Some patients realize that what they are seeing or hearing are just hallucinations and learn to accept them. Others, however experience these hallucinations as quite real and cannot be dissuaded from the firm belief that they are. In fact, efforts to dissuade them often serve only to confirm the often associated paranoid delusions and this may lead to a catastrophic ending. Hence, it is best not to contradict the patient. Instead, attempts should be made to distract the patient and change the focus of her or his attention. In this case scenario, we present a 68-year-old man who has been diagnosed with dementia with Lewy bodies. He lives with his daughter. He has visual hallucinations and paranoid delusions that worsen at night: He thinks there are people outside the house plotting to kill him. We discuss what went wrong in the patient/caregiver interaction and how the catastrophic ending could have been avoided or averted.

Keywords: Alzheimer’s/dementia; caregiving and management; cognition; confusional states.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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