October 2025 blog Navigating Difficult Interactions- Hallucinations, Delusions, and Paranoia

Thursday, January 29, 2026

Navigating Difficult Interactions: Hallucinations, Delusions, and Paranoia 

How to Navigate Challenging Interactions: 

To navigate challenging interactions, hallucinations, delusions, and paranoia, it is important to validate what the person is experiencing. 

Do not deny their reality but meet them where they are now. Be sensitive to the specific journey the person is on. The correct approach is essential, especially for the Violet, Rose, and Bouquet Journey. (moderate to advanced cognitive decline) Use face to face simple verbal interactions combined with visual cues. 

 Keep in mind that someone on the Violet, Rose or Bouquet Journey is likely to mirror the emotional state of their care partner or immediate environment and space. (Be sensitive to the message you are sending) 

Do remember that you are the anchor for them in their current reality. It is up to you to offer a positive sensory experience to replace the current negative state of mind.  

Here are some tips to try introducing a positive experience: 

  • When in doubt: hydrate your person. Dehydration may cause abnormal thinking patterns – keep favorite drinks handy. 
  • Get a UTI test if it is a sudden onset- it may be caused by an infection. 
  • The sucking or rooting reflex is a powerful way to calm the nervous system immediately (try lollipops; mints; drinking a cold sweet drink through a straw; popsicles)  
  • Cold temperatures (drinks/ice-cream/popsicles) will assist in anchoring the person in the here and now/reality 
  • Deep therapeutic touch such as massaging hands/feet/extremities with lotion may be helpful for tactile hallucinations (to relief excessive itching or the feeling of bugs under the skin; also consider pressure garments to assist with circulation) 
  • Music of their choice will help calm the nervous system. 
  • Picture/videos: Try funny topics; children, animals, family, or friends to elicit positive emotions. 
  • A weighted blanket over the shoulders or on the lap may be helpful. 
  • Sharing a salty or sweet snack is a way to use taste as anchoring. 
  • Nature videos or sounds or just going outside to sit or walk, and observe the breeze, sights, and sounds while sipping a cold drink is a great way to elicit a positive experience. 
  • For Lewy Body Disease: 

Create a written recipe of strategies for your person to try when they experience hallucinations and/or delusions/paranoia – keep items ready in a basket or marked clearly in the fridge, or on the countertop, or bedside table especially for nighttime challenges. 

Keep several copies of the individualized recipe where your person can see it: by their chair; next to the bed; on the refrigerator; by their medication box. 

Sample recipe (for LBD): 

” When you experience upsetting thoughts; sounds or voices or even seeing strange things, it is your brain needing some therapy. Drink a cup of cold water and set the TV to the nature channel number 3 (select the channel according to your TV provider) – these thoughts and images or voices will soon stop. Please call or ask for help if you feel frightened. (provide a name and number)” 

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