Aug 19, 2014

A Nursing Home Mini-Series: Seeing Things That Aren't There, aka Hallucinations

Maggy was a fall risk, never knowing when she would pass out, and Beatrice, who fell in her kitchen, had an IV bag attached to her arm because she was dehydrated. They were relegated to their rooms for all activities, including therapy. And Cassey was, at last, home. So I had to find a new "eating" table, the most popular activity in the nursing home.

I chose to sit with Tillie because no one else wanted to. Tillie was always seeing things. She was 92 years old and she talked about the cats she saw so clearly on her feet, in the garden, through the plants. But there were no cats to be seen. She had a stroke 12 years ago, had macular degeneration, had a recent fall, and she was hallucinating. She was healthy otherwise, knowing that people rejected her but not knowing why.


During breakfast, she said, "Of course, the mother cat looked after her offspring. She was tawny in color and searching for food the kittens could eat." And she described the kittens, one being all white and one being striped. And she had a vision of dogs playing in the courtyard of our nursing home--one a blonde cocker spaniel, the other a tan and black beagle. 

So I decided to do some research on seeing things that weren't there. 

Oliver Sacks -- Hallucinations
The hallucination [that's what most neurologists call them] is convincingly apparent, produced by the same neural pathways as real-as-life perceptions. 

Oliver Sacks, a professor of neurology at the N.Y.U. School of Medicine and the author of a book called “Hallucinations," wrote this excerpt in The New York Times in 2012: "People with impaired sight, similarly, may start to have strange, visual hallucinations....Perhaps 20 percent of those losing their vision or hearing may have such hallucinations." Remember Tillie had macular degeneration?

Sacks added that Charles Bonnet Syndrome (CBS) is a condition where people with vision problems begin to experience visual hallucinations. This condition -- CBS -- usually belongs to the elderly. They may see active cats or flying birds, for example. Remember Tillie saw cats and dogs?

New medications or a faulty mix, or a quick change in environment, may cause hallucinations as well. I remember when my grandfather suddenly moved to a nursing home and he "saw," though nobody else did, a variety of animals soon after. Tillie went into the nursing home suddenly, too.

Given the imperfection of the human body, aka nobody is perfect, it is more than likely that something in the brain
is at fault. After all, the brain controls everything, as individuals, that make us who we are, like strokes, for instance. Any of those factors -- macular degeneration, Charles Bonnet Syndrome, sudden change in environment -- could have contributed to Tillie's hallucinations.

However, it didn't matter. Tillie, at 92, is who she is and lucky to be alive, and seeing things that aren't there is a part of her. I'd always sit with her because hearing odd shit is who I am.