Welcome to Alicia’s monthly advice column where she’ll provide tips on caring for a loved one with dementia. Alicia Seaver is the Director of Memory Care at Bridges® by EPOCH and is a certified memory impairment specialist. This month’s topic is paranoia.
If you’ve ever been called “delusional” or “paranoid,” you know these words carry an insulting connotation. The truth, however, is that a person living with dementia is prone to delusions, and their delusions can lead to paranoia. When applied to a person living with dementia, these terms are not meant to be insulting, and they do not mean that the person is crazy or unhinged. Rather, it means they are simply coping with another challenging symptom of memory loss.
Understanding delusions
Delusions are firmly held beliefs in things that are not real. People with mid- to late-stage Alzheimer’s may experience delusions. For example, your loved one may believe they’re being stolen from or that someone is following or watching them. Delusions can become paranoia if your loved one develops consistently suspicious behaviors as a result of their delusions, such as hiding money and possessions or expressing extreme worry over being followed or watched.
Helping your loved one cope
Since these delusions seem very real to your loved one, you should approach the situation with care and caution. Reassure your loved one with kind words and touch. Offer to hold their hand and take them on a walk. Embrace them in a hug and tell them there’s no need to worry with you there.
Try and understand how your loved one feels and express their feelings aloud. You may say, “I can see you’re worried” or “I know this is scary.” Even though you’re not experiencing the delusion, you can still validate their feelings to ease them and avoid an argument. If they ask if they’re being followed, you may respond: “I haven’t seen anyone following you, but I know you have.”
After soothing your loved one, distract them from the situation. Moving to a bright area can subside the delusion. You may also try distracting them with a beloved activity like listening to music or drawing.
Seeking professional help
If your loved one’s delusions become severe and paranoia sets in, it’s time to visit a doctor. The doctor can rule out physical causes such as kidney or bladder infections, dehydration or pain. They will also conduct a medical history to ensure that a family history of mental illness, such as schizophrenia, is not the cause. Bring a list of your loved one’s medications to the doctor appointment to rule out negative side effects as a cause.
If your loved one is unable to cope with non-medical intervention, their doctor may prescribe medication to manage symptoms. Monitor your loved one’s behavior in the coming weeks, and report back to the doctor if symptoms do not improve.
Managing your feelings
While it can be unsettling watching your loved one live with delusions and paranoia, know there are numerous steps you can take to help them. Do not take offense if delusions or resulting agitation is directed at you. Remember: Your loved one is trying to understand the world around them while living with cognitive impairment — not an easy thing to do — and you’re doing your best by helping them cope.
If there is a topic you would like Alicia to discuss, please send suggestions to [email protected].