What should we do when the patient is experiencing delusions or hallucinations?
When delusions or hallucinations occur, they often lead to negative emotions such as fear, anxiety, irritability and agitation, which may affect their daily lives, or cause them to act differently. Although these hallucinations and delusions can be very hard to understand and may appear unreasonable to most people, they are very real to the patient. Therefore we should first find a quiet and private place (i.e. turn off the television), and then consider the following while trying to communicate with the patient:
- Enquire about the patient with an open-minded attitude (i.e. “you look really nervous, what is worrying you?”)
- Speak clearly and slowly, try to use short sentences and be precise
- Be patient and allow the patient to have time to respond
- Do not argue with the patient over the validity of these delusions and hallucinations, because to them these experiences are very real. On the contrary, try to empathize with the patient by imagining their situation, and acknowledge the negative emotions caused by these delusions or hallucinations (i.e. “If I felt like I was being watched all the time, I would be scared too.”)
- Do not have to pretend that you experienced the delusions or hallucinations too. Do not agree with them
- Do not make demands or blame the patient, and it is unnecessary to debate about what to do
- Do not stare at the patient for an extended period of time
- Lead and encourage the patient to talk about facts or actual events
If necessary, we can consider recording the patient’s emotional or behavioural changes and informing the relevant professionals about them. If the situation is severe and urgent (threatening the patient’s safe or those around them), we need to seek help from the police, professionals or social workers.