The word hallucination can turn a symptom into a character assassination before anybody finishes the sentence.
A person looks toward an empty corner, mentions someone who is not there or mistakes a coat for a figure. What people see is a mind disappearing. Reliability gets questioned. Decisions get taken over. Every sentence spoken before and after the moment is suddenly placed under suspicion, because apparently one unreliable image makes the entire person inadmissible.
What may actually be happening is a hallucination or illusion associated with Parkinson’s. A hallucination is a perception without an outside source. An illusion is a real object misread by the brain—the coat that becomes a person, the curtain that briefly acquires a face. Visual experiences are common, but sounds, sensations or a strong sense that someone is nearby can occur too.
These symptoms can be related to changes in Parkinson’s itself, medication, sleep disruption, vision problems or a combination of factors. They do not happen to everyone. They also do not arrive in one standard form. Some people fully believe what they perceive. Others retain insight and know the image is not real even while seeing it clearly.
That distinction matters. Knowing the room is lying does not necessarily make the room stop lying. Imagine having enough awareness to recognize the experience as false while also knowing that saying it aloud may cause everybody else to question whether you can still manage your own life.
After 35 years with Parkinson’s, I know how quickly one symptom can swallow the person standing behind it. The public likes clean categories: rational or irrational, independent or incapable, safe or dangerous. Neurology is less considerate. Insight can be partial. Symptoms can fluctuate. A person can need help with one perception and remain perfectly capable of making decisions about everything else.
A change in perception is a symptom. Turning the whole person into a symptom is our mistake.
The cost is silence. People may hide hallucinations because they fear embarrassment, medication changes, loss of independence or being treated as if they are no longer credible. Care partners may hide them too, hoping the situation will pass. Meanwhile, fear grows privately and the clinical team loses information it needs to evaluate what changed.
A new or sudden hallucination—especially with abrupt confusion, fever, illness or a major behavior change—needs prompt medical attention. Infection, dehydration, medication changes and other medical problems can trigger delirium. Gradual or recurring symptoms also belong in an honest conversation with a Parkinson’s clinician. Do not stop or change Parkinson’s medication without guidance.
What needs to change outside the clinic is just as important. Do not mock, interrogate or aggressively argue with the person. Do not pretend to see what they see either. Acknowledge that the experience feels real, reduce hazards and stimulation, and ask what would help them feel safe. Then report the details: what happened, when it happened, how long it lasted, whether insight was present and what else changed.
The goal is not to win an argument with the room. It is to protect the person, find the cause and preserve as much autonomy as the actual situation allows—not as much as fear is willing to permit.
TODAY’S DEFIANT TRUTH:
The room can lie without making the person a liar.
Investigate the perception. Do not erase the person reporting it.
Live Defiantly. — Richie Pikunis