Seeing things that are not there is common in delirium. To the person, what they see feels completely real.
Delirium affects how the brain makes sense of what comes in through the eyes and ears. Real things get built into a wrong picture. A dressing gown on a door becomes a person watching. A drip line becomes something holding them down.
Can delirium make someone think people are trying to harm them?
Yes. Delirium can cause frightening beliefs, sometimes described as delusions or paranoia. Someone may believe that food is poisoned or that staff or family mean them harm. Stay calm and acknowledge the fear: “That sounds frightening. I am here with you. Let us ask the nurse to help.” Tell the care team what has been said. Take any report of harm seriously and ask staff to check it.
What helps
Arguing does not help. You can’t reason someone out of something they see or hear but other people do not, because it feels real to them.
Respond to how they are feeling rather than trying to correct what they are saying. You can say something like: “I believe this feels real. You are safe. I am here.” Then offer something ordinary and true: who you are, where they are, that the doctors are looking after them. If they say something odd but are not distressed, you do not need to correct it at all.
Tell the staff
Tell the staff what the person is seeing, especially if it frightens them. Distress can be treated, and its causes can be looked for. See what to do if they refuse food, drink or medicines.
If the hallucinations have just started
If someone was thinking clearly yesterday and is seeing things today, that is new confusion. Get medical help now. Outside a care setting, call local emergency services. In a hospital, care home or nursing home, tell staff immediately. Say what has changed and ask whether it could be delirium.
As the delirium clears
Hallucinations usually fade as the delirium clears. Many people remember little about them. Some remember them clearly and need to talk about it. There is more about whether they will remember it.
When to get help
Delirium (acute confusion) is a medical emergency. Outside a care setting, call local emergency services now. In a hospital, care home or nursing home, tell staff immediately. Say what has changed and ask whether it could be delirium.