Many times as we are learning about an illness or disease, we or a loved one has, it seems we only have a limited knowledge of it. Many of the diseases and illnesses come with a component of Dementia or Hallucination. We have learned more about Dementia and its role in the medical issues we have, but what about Hallucinations. What are they and how do they fit into our already crowded vocabulary regarding medical issues.
The definition of Hallucination is: (supplied by the American Webster Dictionary)* false sense perception: the perception of somebody or something that is not really there, which is often a symptom of a psychiatric disorder or a response to some drugs *something imagined: something that somebody imagines seeing, hearing, or otherwise sensing when it is not present or actually occurring at the time
Reading this definition it is easy to see how some people can confuse dementia and hallucinations. The key to the difference is dementia is the forgetting of reality during the thought process; while hallucinations are the belief we are right about what we see, no matter how farfetched. With dementia we see or hear something and know that vision or noise but are unable to use the correct word or term to name it, while with a hallucination we cannot think of the correct word or term because we know what it is.
This may seem like a meniscal difference however it is as large as the buffalo in the room. Hallucinations are harmful in their process, creating a situation which often requires treatment for safety of self or others, while dementia is associated with a disease is not the harmful part; rather the action associated with it is harmful, wondering and unknown people. Remember with dementia, we are talking about the inability of the brain to connect on its usual paths.
Anyone can have hallucinations for a variety of reasons. Besides mental health disorders (which make up the majority of reasons, medication interactions (can and do cause a significant reason for them), high fevers, and of course anytime we introduce a new chemical (alcoholic beverages, for instance) to our system and today the combination of chemicals (alcohol and caffeine).
Perhaps the best way to explain the difference is an example. Mrs. R. has dementia and no longer knows her children, but believes her son is her husband, because of his resemblance in appearance of her younger husband. Mrs. R. was sent to the hospital for treatment of pneumonia and was given several drugs to help her body repair itself. Unfortunately, there was an interaction between drugs and Mrs. R. Believed she was in a high rise apartment in New York City and the date was 9/11/01. She was taking out I.V. lines and trying to run to the stairway to save herself and she could see the planes in the air outside.
The belief that her son was her husband was dementia. The New York City high rise with all the fear and planes was a hallucination. Many times there is not this clear cut difference between dementia and hallucination; it may take an expert to get all the factors lined up.
One of the important facts for us to know is that from time to time we will need the help of a professional. This must be someone we trust completely, because if we don’t; our friend will know and not cooperate as necessary. Many times the new generation of medications and our diagnostic tools provide a much clouded picture of what is causing the events taking place. More and more often today, we are finding older adults who are having trouble living in society being sent to a Gerio-psychiatric Hospital for an inpatient evaluation. This is scary for all concerned. This is most often a diagnostic tool the physician is using to perform a medication vacation. This means just as suggested bring the patient down from all medication and then slowly reintroducing them until the optimal quality of life has been attained.
As a relative, friend or caregiver you have every right (obligation) to be concerned and ask questions. You should be given the opportunity to observe and know what the physician is looking for and what the goal is. Although, you may not have had an opportunity to have insight into one of these hospitals before, do not be intimidated by the place, medical staff or your own long held beliefs. Most people leave after a short stay and will have a different demeanor. Please remember this is only a tool, much like a blood test, x-ray or ultrasound.
Your ability to know the difference in dementia and hallucinations will work well for you as you are walking through this journey. Just mastering these so you will be able to understand both physician and friend will make your ability to help far greater than it was before. There are components of these in many if not all of the diseases we see in the aging population.
Both of dementia and hallucination are difficult to understand. They can and often are a factor of depression, which is the most underdiagnosed illness in our country. Again this is an illness you cannot see as easily as Chicken Pox, but you will realize the behaviors of depression. Please do not be frightened by this illness rather seek treatment for our friend or family member. Depression can exacerbate both dementia and hallucinations.