Gregory Pontone, MD, is the chief of the University of Florida’s Aging, Behavioral and Cognitive Neurology Division and studies psychiatric disorders that occur in Parkinson’s. He shares practical ways that a caregiver can help their loved one manage psychosis symptoms.

It really, to me, starts with having open dialogue, being on the same page, being able to sort of openly and freely discuss the symptoms that are occurring, right? Without shame or stigma. OK, this is just another aspect of the disease, just another nonmotor symptom of Parkinson’s. That’s probably the single most important thing that facilitates a caregiver’s ability to help with these psychotic symptoms.

There’s a couple of sort of tested — what we call behavioral interventions — that can be done with family members and caregivers.

And so one is visual techniques, things like better focusing on an object. And that can be as simple as walking closer to the object that looks either distorted, in the case of illusions, or if it’s something like a hallucination, providing better lighting. We’ve actually found that in conditions where the lighting is better, hallucinations are a) less likely to happen in the first place, and b) more likely to be dispelled upon increasing the illumination.

OK, so increasing lighting. So let’s say that every evening the people start showing up in the living room. Well, if you increase the lighting in the living room, oftentimes that decreases how often they show up.

Looking away: Sometimes if the caregiver can say, “Hey, you see that thing, it’s bothering you. Look away, look back a couple of times.” Sometimes that visual technique can dispel it, OK?

Now, cognitive techniques. So noting that the hallucinations are not real and reassuring oneself, you know, and this can be an exercise that the caregiver can walk them through, like, why does it not make sense? “Well, his feet are 2 feet off the ground.” Yeah. So it’s not likely that it’s a real person if they’re floating, right?

Or, you know, “He looks like he’s talking a mile a minute, but I don’t hear any sound.” So, very often, hallucinations will appear to be talking. But then when you ask people, “Are they actually making noise or can you hear the speech?” And they’ll say “No.”

So just the process of interacting with another person about the false perception can really help. At a minimum, it’s gonna provide reassurance and verification from others. “Yeah, the people are in the garage.” “I don’t see them. I don’t see anything threatening” — even if they continue to have the hallucination.

The other thing that’s really important is that you’ll start to notice many times a pattern to when the hallucinations are most likely to occur.

People who are involved in a structured environment — meaning they have things to do and keep them occupied or actually interacting with other people and stimulated — studies across the board show that hallucinations are less likely to happen in structured environments where the patient is stimulated.