Seeing Things Others Don't: A Patient's Guide to Hallucinations in Parkinson's
A figure stands in the doorway. A cat is curled up on the couch, though you’ve never owned one. Out of the corner of your eye, something small darts across the floor, then vanishes the moment you turn your head.
For many people living with Parkinson’s disease, moments like these are real experiences. They aren’t a sign that you’re “losing it,” and they’re more common than most people realize. They’re also rarely talked about, which can leave patients and families feeling frightened and alone.
What hallucinations in Parkinson’s can look like
Hallucinations happen when you see, hear, or feel something that isn’t there. They aren’t dreams or nightmares and they can occur anytime you’re awake. According to the Parkinson’s Foundation, hallucinations in Parkinson’s are usually visual: animals, people, or a loved one who has died sitting in the room.
Some people see things only in their peripheral vision, such as a flash of light or a small animal that disappears when they look closer. Others have what are called presence hallucinations, the feeling that someone is in the room or standing right behind them. Hearing voices or sounds is less common, and smells, tastes or sensations on the skin with no source are rare.
A related experience is an illusion, or when the brain misreads something real. Clothes hanging in a closet might look like a group of people. Illusions and visual hallucinations both tend to show up in low light.
The Michael J. Fox Foundation notes that hallucinations can be gentle, like children playing in the backyard or a visit from a dear relative. They can also be frightening, like an intruder in the home. Some people recognize that what they’re seeing isn’t real, which is called “retaining insight.” Others find the experience completely real, or lose that insight as the disease progresses.
For families, watching a loved one go through this can be painful. In a thread on Reddit’s r/Parkinsons community, one user wrote about their father:
“My dad sees dead animals, especially dogs, everywhere. Sometimes as reanimated sort of zombies from his description. It’s especially upsetting to him because he is such an animal lover, but especially dogs. We even watch dog shows together a lot. Also he sees bugs everywhere. It’s just part of the disease.”
Another commenter in the same thread, described a more recent change in their father:
“My dad has recently been [seeing] things that are not there (while awake). He’ll ask my mom who that is that’s sitting in the porch but no one is there or he’s hearing voices thinking someone is in the house that is not there.”
Symptoms that are new, like these, are worth raising with a doctor right away. The cause can be something treatable, such as a medication change or an infection. And as the caregiver put it, hallucinations are part of the disease, not a reflection of the person experiencing them.
How common are they?
The numbers vary. The Parkinson’s Foundation reports that 20–40% of people with Parkinson’s experience hallucinations or delusions, and that you’re more likely to experience it as the disease progresses. The Michael J. Fox Foundation adds that when these symptoms do develop, it’s usually after many years or decades with Parkinson’s.
Why do they happen?
There are three main contributors: medication, dementia and delirium. Because they can overlap and look alike, finding the cause takes some detective work.
Medication. Some medications for Parkinson’s and over-the-counter sleep aids and allergy medications can cause emotional and behavioral changes.
Delirium. This is a sudden, reversible change in attention and awareness, and it can come from an infection like a urinary tract infection or pneumonia. People with Parkinson’s face a higher risk of delirium during hospital stays.
Other triggers. Unfamiliar environments, big changes in routine, surgery, a few nights of poor sleep, stress, and vision or hearing loss, which can cause normal sights and sounds to be misread. Depression, vivid dreaming, older age and advanced Parkinson’s are risk factors.
Why speaking up matters
These symptoms can be confusing and embarrassing, so many people keep them to themselves. But as one care partner told the Michael J. Fox Foundation, “keeping it hidden doesn’t help the patient at all.” Even if the hallucinations aren’t bothersome, it’s important to let your care team know.
For care partners
Arguing with someone about what they see usually doesn’t help. Try to stay calm, offer reassurance, and validate the experience. For example, offer to take the cat outside rather than insisting there’s no cat. Good lighting and stimulating evening activities can help, too.
If you’re seeing things others don’t
Tell your care team, however minor, rare or strange it seems. These symptoms are manageable, and you don’t have to sort them out alone. The Parkinson’s Foundation Helpline can connect you with a specialist, and you can find others who understand in The Mighty’s Parkinson’s disease community.