Hallucinations

[babaloo, BSN]

If a patient is having a hallucination, but believe that hallucination is real, does that mean that patient is also having a delusion? I ask this because in my psychiatric clinicals I've had patients who were having a hallucination but know that the hallucination isn't real, yet I've also had patients who were having hallucinations but believe them to be real. Do you provide reality orientation to both types of patients?

[MrChicagoRN, RN]

Delusions and hallucinations are separate phenomena.

Also, for some people, hallucinations never ever totally go away. If someone knows their hallucination is not "real" there is no reality reorientation to do. What you can do is support them in dealing with the hallucination, make sure they stay safe, maybe engage them in some distracting activities.

[tareija]

I would check with your clinical instructor. Delusions and hallucinations are two separate things, but sometimes they are related. For example, someone who hears what they think is God's voice talking to them, and has no insight. The experience of hearing the voice is an auditory hallucination. Believing that God is talking to them is a delusion. Reality reorientation depends on a few factors.

[babaloo, BSN]

so if a patient believes that their hallucination is real, would you provide reality orientation?

[tareija]

I went in to some detail about providing reality orientation or not on your other post. I think the title of your post was "reality orientation for hallucinations/delusions". There's a lot of variables. Are you doing a clinical rotation in psych as a nursing student currently? Again I would check with your instructor.

[Mandychelle79, ASN, RN]

Delusions and hallucinations are separate phenomena.

Also, for some people, hallucinations never ever totally go away. If someone knows their hallucination is not "real" there is no reality reorientation to do. What you can do is support them in dealing with the hallucination, make sure they stay safe, maybe engage them in some distracting activities.

When someone tells me they are hallucinating I ask two questions: Are they telling you to harm yourself or others ( if the answer is no), are they bothersome to you. If both answers are no, I basically tell them that I only worry when they answer yes to either of those questions'

[lub dub]

A hallucination is a sensory event ("seeing" things, "hearing" things, etc.). A delusion is, for lack of a better term, an intellectual event (believing that an irrational thought is true). So, technically speaking, believing that a hallucination is real is a delusion, since the belief that the delusion is real is a thought.

[CapeCodMermaid, RN]

I would disagree that believing God speaks to me is delusional. Thinking I am God is delusional.