When Your Parent Sees Someone Who Isn’t There: Understanding Hallucinations and Delusions in Parkinson’s

Your father mentions, almost in passing, that a man was standing in the corner of his bedroom last night. He wasn’t afraid. He didn’t call out. This morning he seems fine, maybe a little embarrassed he brought it up at all.

It’s tempting to let it go. It was probably a dream. Maybe he’s just tired. But if your parent is living with Parkinson’s, this is worth pausing on – not because something is wrong with how you’re caring for him. Parkinson’s hallucinations are a recognized, described part of the condition itself, with their own clinical profile, and their own reason to involve his medical team.

This piece is here to help you understand what’s happening, what to do in the moment, and what to bring to the people who can actually adjust his care.

Hallucinations and Delusions Are Not the Same Thing

These two words get used interchangeably, but they describe different experiences, and the difference matters when you’re describing what you saw to a doctor.

A hallucination is sensing something that isn’t there – seeing a person standing in the room, hearing a voice, seeing an animal move past the doorway. The sense itself is real; there’s simply nothing in the room causing it.

A delusion is a fixed, untrue belief that doesn’t respond to evidence. This might look like conviction that a spouse is being unfaithful, or that money is being stolen, even when nothing supports it.

Clinicians who study Parkinson’s have found that this combination – hallucinations, delusions, or both – forms a recognizable clinical picture distinct from other kinds of psychosis, with its own diagnostic profile developed by an NIH-sponsored expert work group. That matters for you mainly as reassurance: this isn’t confusion your family invented a name for. It’s named, described, and understood by specialists.

The Small Ones Count Too

When people picture a hallucination, they picture something dramatic – a full figure, a conversation with someone who isn’t there. But quieter versions are common too, and families often wave them off.

Watch for:

• A sense that someone is present in the room, without actually seeing anyone (sometimes called a “presence” hallucination)
• A shape or shadow passing at the edge of vision
• Mistaking an object for something else – a coat on a chair becomes a person, a pattern in the curtains becomes a face

A single-center clinic study of 216 people with Parkinson’s found that minor hallucinations like these were more common than fully-formed visual hallucinations within the three months studied. If your parent mentions one of these, even casually, even without distress, it’s worth writing down and reporting. It’s not a false alarm. It’s useful, early information.

Insight Varies – and That Should Guide Your Response

Not everyone experiences a hallucination the same way. on how commonly individuals living with Parkinson’s recognize in the moment that what they saw wasn’t real, versus how commonly they believe it fully. What we can say with confidence is practical, not clinical: when your parent seems to know it wasn’t real, a brief acknowledgment (“that must have been strange”) is usually enough. When he seems convinced, correcting him rarely helps and can add distress on top of an already unsettling moment. Either way, the goal in the moment is the same – calm, not correction.

In the Moment: What Actually Helps

If your parent is in the middle of a hallucination, a few things matter more than getting the facts straight.

Don’t argue, and don’t quiz him for details. Pressing him to describe exactly what he saw, or insisting he’s wrong, tends to prolong the moment rather than settle it.

Acknowledge the feeling, not the content. Something as simple as “That sounds unsettling – I’m right here” validates what he’s going through without requiring you to agree the man in the corner is real. The Parkinson’s Foundation advises families to validate rather than argue when a loved one describes a hallucination or delusion.

Change the room. In our own experience caring for individuals managing Parkinson’s, Care Mountain’s caregivers find it helps to turn on more light, reduce shadows and reflective surfaces, and turn off a background television during an episode. This is a practical comfort measure we recommend from practice, not a treatment – it is not a way to prevent, support, or slow the condition itself.

What to Track for the Specialist

If you take one habit away from this article, make it this: start a simple written log. When you eventually speak with his neurologist, this record will matter more than your memory of “it’s been happening a lot lately.”

For each episode, note:

• What was seen or heard – as specific as your parent can describe it
• Time of day it occurred
• What was different that day – poor sleep, a new environment, a change in routine, illness
• How long it lasted
• Whether he was distressed, or calm and aware it wasn’t real

You don’t need to interpret this data. You just need to capture it accurately and bring it in.

Why This Belongs in a Conversation With the Prescriber – Not With You

Here’s the part that matters most, and it’s the reason this article exists.

The Parkinson’s Foundation is direct about two things: hallucinations and delusions should be reported to the medical team even when they aren’t bothersome to your parent, and many antipsychotic medications – the category sometimes used for hallucinations in other conditions – can worsen Parkinson’s movement symptoms and should not be prescribed to someone managing Parkinson’s.

That second point is exactly why your role, and even a trained caregiver’s role, stops at accurate reporting. Neither of you adjusts anything. The prescriber weighs this information against his overall movement symptoms, his other medications, and his broader health picture – decisions that belong entirely with his neurologist.

If your father isn’t already seeing a movement disorder specialist, it’s worth knowing one exists close to home: UT Southwestern Medical Center states on its own site that it holds a Parkinson’s Foundation Center of Excellence designation, with Movement Disorders clinics in Dallas and Frisco. That’s simply a fact about a resource that exists – not a referral or partnership – but it may be a useful next call.

Why a Trained Caregiver Makes a Real Difference Here

In our experience, a caregiver who sees your father regularly brings something a rotating cast of helpers can’t: a familiar face and a steady routine, which we find matters in a moment that is already disorienting for him. A trained caregiver can also respond with practiced calm – acknowledging the feeling, adjusting the lighting, letting the moment pass without confrontation – without carrying the emotional weight you feel as his daughter.

Just as important, a caregiver present in the home can capture details you would otherwise only hear about secondhand: what time it happened, how long it lasted, what was different that day. An accurate written record kept by someone who was actually there is often the only way anything meaningful reaches the neurologist at all.

Care Mountain caregivers bring more than ten years of experience specifically in Alzheimer’s and Parkinson’s support. Care Mountain is a member of the Dallas Area Parkinson Society (DAPS) and a key member of the Independent Parkinson’s Network (IPN), a national coalition of local Parkinson’s non-profits that share vetted medical resources, with twenty-one years serving Dallas-Fort Worth families across eight metroplex offices.

This Is Common Ground for Specialists, Not Uncharted Territory

Hallucinations and delusions show up in a meaningful share of people living with Parkinson’s – not in every individual, and not on any predictable timeline, but often enough that neurologists who treat Parkinson’s see this regularly. This is a named, recognized clinical picture, set apart from other causes of psychosis by an NIH-sponsored expert work group – a feature of Parkinson’s itself, not a sign that you missed something or handled his care wrong.

It’s a known part of a well-studied condition, with a clear next step: write down what you see, and bring it to the people trained to respond to it.

Gagan Bhalla

Gagan Bhalla is the Executive Director of Care Mountain Home Health Care. For over 21 years, Care Mountain has offered dedicated expertise in senior in-home care to seniors in the Dallas Fort Worth area. Managing eight locations across the DFW metroplex, Gagan has committed his life to enhancing the well-being of seniors and their families needing home health care. Through insightful articles and blogs, he shares his wealth of knowledge, empowering families to make informed decisions about home care. Trust Gagan’s experience to guide you on the path to compassionate and professional senior care if you our loved one need in home care across the Dallas Fort Worth metroplex.

LinkedIn: https://www.linkedin.com/in/gagan-bhalla