Introduction
There is a need to address the unique healthcare challenges older people face. Visual hallucinations, in particular, have gained attention as a notable concern affecting geriatric individuals. These hallucinations (or illusions) can be unsettling and require a comprehensive assessment and management approach. Dementia, stroke, and the use of numerous medications are the main causes of visual hallucinations.
What Is Visual Hallucination in Geriatric People?
Visual hallucinations in geriatric individuals are when elderly people perceive vivid (producing bright, colorful images) and false visual stimuli that do not exist in reality. These hallucinations can range from simple shapes to complex scenes and are generated by the individual's brain without any external stimulus. It is also associated with underlying medical conditions, medications, sensory impairments, or psychiatric issues.
What Are the Causes of Visual Hallucinations of the Elderly?
Lewy body dementia has Lewy bodies with abnormal protein deposits in the brain. Visual hallucinations are a prominent feature of Lewy body dementia. Certain medications, especially those used to treat psychiatric conditions, can lead to visual hallucinations as a side effect. These may include antipsychotic drugs, antidepressants, and drugs used to treat Parkinson's disease. Age-related sensory deficits, such as vision and hearing impairments, can contribute to visual hallucinations.
When sensory input is limited, the brain may compensate by generating visual experiences not based on external stimuli. Conditions like bipolar disorder can occasionally involve visual hallucinations, particularly during episodes of extreme mood disturbance. Some individuals with migraines experience visual disturbances known as "migraine aura," including visual hallucinations, such as flashing lights or geometric patterns. Prolonged periods of sleep deprivation or extreme fatigue can trigger visual hallucinations as the brain's normal functioning is disrupted.
What Are the Symptoms Which Occur in Visual Hallucinations of the Elderly?
1. Seeing Objects or People: Individuals experiencing visual hallucinations often report seeing objects, people, or animals that others cannot perceive (notice or realize something). These hallucinations can take on various forms, from simple shapes to highly detailed and complex scenes.
2. Colors and Patterns: Visual hallucinations may involve the perception of colors, patterns, or textures, vibrant and unreal colors, patterns, or textures. These distortions can be vivid and unsettling, creating a sense of unreality.
3. Flashes of Light: These can be fleeting and intermittent. Some elderly individuals may experience brief and sudden or brief flashes of light during visual hallucinations. These flashes can be disruptive and surprising.
4. Moving Objects: Moving or changing objects in visual hallucinations can make inanimate objects appear as if they are moving, changing shape, or behaving in unnatural ways. This phenomenon can be disorienting and confusing.
5. Transparent or Overlapping Images: In certain cases, elderly individuals may see multiple, overlapping (extend or lie partly over) , or transparent images of people, objects, or scenes. This can lead to a confusing visual landscape.
6. Faces or Figures: Visual hallucinations may involve seeing faces, human figures, or even whole scenes that are not present. These hallucinations can be particularly distressing when they involve people or situations from the past.
7. Visual Disturbances in Low-Light Conditions: Visual hallucinations might become more pronounced in low-light conditions or darkness. Elderly individuals may find it challenging to navigate their environment at night due to these hallucinatory experiences.
8. Hallucinations With Specific Themes: Some visual hallucinations have distinct themes or content, such as religious, supernatural, or threatening imagery. The content of these hallucinations can vary widely between individuals. Visual hallucinations are more likely to occur during stress, fatigue, or emotional distress.
What Are the Complications That Occur in Visual Hallucination?
Visual hallucinations can be deeply distressing for the individuals experiencing them. The perception of seeing things others do not can cause anxiety, fear, and emotional confusion. Hallucination increases anxiety levels, and people may become worried about the next hallucinatory episode.
People who experience frequent visual hallucinations may withdraw from social interactions. They might fear judgment and struggle to explain their experiences to others, leading to isolation and loneliness. Visual hallucinations' emotional and psychological toll can significantly reduce people's lives. Everyday activities may become challenging to face. Family members and caregivers of individuals experiencing visual hallucinations may experience increased stress and emotional burden. They may find it challenging to provide support and care to someone with these symptoms. Depending on the content of hallucinations, safety risks can arise. For instance, if they hallucinate dangerous situations, they might react inappropriately, potentially leading to accidents and can also cause self-harm.
Parkinson's disease and schizophrenia are some reasons to have hallucinations in the elderly. Failure to recognize these hallucinations as a sign of a more significant issue can lead to delayed diagnosis and treatment.
What Is the Therapeutic Management of Visual Hallucination?
Healthcare professionals should carefully review the medication of the elderly, as certain medications can contribute to hallucinations. Changes in medication may be necessary to reduce hallucination-inducing side effects. Identifying the root causes of visual hallucinations is essential. If the hallucinations are related to neurodegenerative diseases like Parkinson's or Alzheimer's, appropriate treatment should be implemented.
Correcting sensory deficits, such as vision and hearing impairments, is crucial. Providing eyeglasses, hearing aids, or other devices can enhance sensory perception and reduce the risk of hallucinations. Cognitive behavioral therapy (teaching the strategies of realizing the hallucination and reality) is a valuable therapeutic approach for managing visual hallucinations. Creating a safe and supportive living environment is vital.
Ensure that lighting conditions are appropriate, as well-lit spaces can reduce the occurrence of hallucinations, especially in low-light situations. Minimize potential stressors and triggers in the environment. In severe cases where hallucinations cause significant distress to the risk to the people, healthcare professionals may consider prescribing antipsychotic medications. However, this is typically a last resort due to potential side effects and risks, especially in older adults.
Conclusion
Visual hallucinations in geriatric individuals are a complex issue that demands careful assessment and comprehensive management. Addressing underlying causes, providing sensory support, offering psychological interventions like CBT (cognitive behavioral therapy), and creating a supportive environment can enhance the well-being and quality of life of those experiencing visual hallucinations. Regularly monitoring older people by healthcare professionals is essential to effective management.
