Difficulties and associated coping methods regarding visual hallucinations caused by dementia with Lewy bodies

Individuals who have dementia with Lewy bodies present various symptoms that differ from those associated with Alzheimer's disease. Of the several characteristic symptoms of dementia with Lewy bodies, visual hallucinations often appear in the early stages of the disease, and some hallucinations cause people with dementia with Lewy bodies to experience unique difficulties in their daily lives. The aim of this paper is to clarify the visual hallucination-related difficulties experienced by people with dementia with Lewy bodies as well as their coping methods. Participants were 10 people with dementia with Lewy bodies who were living at home, with input also obtained from their family members. Data were collected through semi-structured interviews, and a qualitative content analysis was consequently performed. The qualitative analysis showed four primary difficulties in the period before a patient realizes that their visual hallucinations are a symptom of an underlying disease; these included "feeling something strange is happening" and "restrictions on activities." Realizing that what they were experiencing was not real was a significant turning point for the participants, with some discovering this by discussing their apparitions with their families. It was consequently determined that, after an individual realizes that their hallucinations are indicative of a more serious condition, two further difficulties arise, including the "inability to discuss the visual hallucinations with friends and family." With regard to coping methods, some participants reported rearranging their living environments to hide areas where hallucinations commonly appeared. This paper suggests that care is needed to help people with dementia with Lewy bodies recognize that their visual hallucinations are a manifestation of their illness. In particular, psychological support should be made available to address the anxiety caused by the appearance of visual hallucinations and to help patients adjust their environments to reduce or prevent the appearance of such hallucinations.