Hallucinations can be distressing for the person with LBD to experience, and they also may be difficult for caregivers to know how to handle. So, what's an effective way to respond to these hallucinations?
While there's no one-size-fits-all response, one approach you may want to avoid using (or at least use with caution) for someone with Lewy body dementia is the therapeutic lie. The therapeutic lie, where the caregiver may bend the truth with good intentions, has been recommended by some people in an attempt to reassure someone with Alzheimer's disease.
However, people with Lewy body dementia who hallucinate are often functioning at a higher cognitive level since hallucinations tend to develop early in LBD than in Alzheimer's. Some caregivers have shared that their attempts to untruthfully reassure someone have backfired because the person with LBD could detect the untruth and then became even more upset. In other situations, however, caregivers have had success in "going along with" the hallucination, and expressed that they felt this was the only way they could help their loved one at that time. (Of interest, the Lewy Body Dementia Association has a forum where caregivers share some concerns and ideas.)
My Two Cents
When working with someone who has dementia (regardless of its type), I would advocate for first trying validation therapy, distraction through meaningful activities or other kinds of reassurances. To me, these other approaches- when possible (and I realize there may be times where they're not possible or effective)- make sense, both because they are often helpful, as well as due to my own preferences for how I would want to be treated.
For more ideas on how to respond, here's an article I recently wrote on this topic: Responding to Hallucinations in Lewy Body Dementia
More About Lewy Body Dementia