The appearance of hallucinations usually has pathological changes, and the elderly may have organic brain lesions. The hallucinations are often due to substantial lesions in the brain, such as brain hemorrhage, infection, cerebral infarction, benign tumors and malignant tumor occupancy, and need to be examined accordingly. Hallucinations can be manifested by voices speaking to the ears, which may come from the outside world, and the sound is often clearer and more realistic. There is another kind of hallucination that comes from the brain, and this sound is not very clear. In addition, phantom hearing needs to be distinguished from tinnitus in the elderly. Tinnitus is often a mechanical sound that tends to vary little, while phantom hearing tends to have more sounds. The presence of phantom hearing also requires the exclusion of psychological factors and, if necessary, a professional psychological evaluation.