Delusions And Paranoia in Dementia Care – How to Deal With It?

delusions and paranoia in dementia

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Being a caregiver for a family member can be overwhelming and stressful. You are completely preoccupied with providing care for a loved one. You sacrifice a significant amount of time to assist them by taking up their household responsibilities, driving them to their medical appointments, and assisting them with their care.

However, instead of gratitude, you may be confronted with accusations such as “You stole my purse! You are stealing from me without my consent.” Finally, after several minutes of searching, as is customary, they locate the purse under the bed, where they had hidden it but forgot to look for it.

In Alzheimer’s disease and other dementias, a common symptom is the development of false beliefs, fixed, erroneous ideas known as delusion. The very nature of the disease and the brain damage that dementia causes might frequently be the root cause of these symptoms. There is a chance that the one you care about hid their wallet “to keep it secure.”

However, they failed to remember that they put it beneath the bed, and as a result, it is currently missing. Because you are the only one who has been there, you become the one that gets blamed and is responsible for this.

Similarly, forgetting is a common factor in cases of mistaken identification, which is another type of fallacy. For example, a man can forget what his spouse, son, or daughter looks like to the point where he can no longer recognize them.

For the male, this could be a very uncomfortable experience. Or, since he is forgetful and confused, he can think he is only 40 years old instead of 80, leading him to mistake his grandson with his son.

More often than not, delusions are more complex. For example, a person with dementia might conclude that people are breaking in at night.

In any event, delusions can be a distressing and agonizing experience for the person living with dementia as well as for the people who care about them.

Those who have dementia have a more difficult time recalling recent events and are living in the present moment, but also could be experiencing delusions about this recent or present moment. This might bring up accusations, delusions, and paranoia in the individual. When someone you care about is caught up in a delusion, it takes a lot of patience and strength to help them through this.

Learn more about delusions and paranoia and how to deal with them if you’re caring for someone who has them.


Delusions also known as mistaken ideas that a person is firmly convinced are true, are a common thing I see in dementia. They are able to manifest themselves in the form of paranoia, which causes the individual to feel threatened even when there is little or no basis for feeling this way. Hence, people with dementia may grow wary of those in their close surroundings.

Someone going through a delusion could get the impression that they are being watched or someone is plotting against them. They could draw hasty conclusions without a lot of supporting facts.

For instance, if one of their neighbors has made a snide remark about them in the past, they might conclude that the other neighbor is orchestrating a campaign of hatred against them. In addition, the person with dementia may have lost the ability to keep their thoughts to themselves.

Suppose the individual you care for suffers from delusions. In that case, dealing with their condition can be very challenging, particularly if they are under the impression that you have wronged them in some way or are attempting to cause them damage.

Remember that their delusions seem just as real to them as your reality to you, and try to take that into account. It is unlikely that you will be able to persuade a person who is having delusions that they are incorrect or misguided in their beliefs.

If you observe this sudden shift, contact your health care provider right away so that they can make the best recommendations for your specific concerns. If the delusions are persistent and causing the patient stress, the primary care physician may consider prescribing medication.


An individual who experiences paranoia has an irrational fear that others have bad intentions against them and acts accordingly.

If it is not treated, paranoia in older people can cause serious problems that need to be addressed immediately. Symptoms such as anxiety, elevated stress, and agitation are more likely to occur in older people who actually believe they are being threatened or who believe they live in a social environment that is unpleasant to them.

It’s possible that a senior’s troubling thoughts could push them to lash out at caretakers physically or to withdraw from family members and friends.

Fear and distrust are the emotional elements of paranoia. Memory lapses are aggravating and unsettling, frequently triggering paranoid tendencies in people with dementia. In addition, hallucinations and delusions can have a paranoid quality to them. The belief that one’s caretaker has stolen from them, cheated on them, or attempted to harm them physically are all examples of paranoid delusions.

What Causes Delusions And Paranoia?

Memory loss and shifts in personality are both symptoms of dementia caused by the brain changes. When short term memory is impaired, it’s possible that they’ll try to fill them with a false memory or a hallucination that makes sense to them. Their impaired thinking and decreased ability to recall objects or recognize faces are factors that contributed to the formation of these erroneous ideas.

Because of this, if they can’t remember where they put their wallet and a new caregiver has just started coming to visit them, they can conclude that the new caregiver is the one who took it from them. It could be uncomfortable or upsetting, but from their point of view, it makes complete sense.

A person with dementia may be unable to appropriately piece together snippets of information and memories, which might cause them to jump to incorrect conclusions and think something untrue.

As a person’s dementia progresses over time, the likelihood that they will experience delusions increases.

Delusions are more prevalent in dementia with Lewy bodies, although they can also affect patients who have Alzheimer’s disease and vascular dementia, primarily in the later stages of the disease. People who have frontotemporal dementia are less likely to have these symptoms.

Even if paranoid behavior is an indication of another medical issue, make sure to bring this up to the healthcare provider. If you are concerned about the health of a loved one, you should make an effort to make an in-depth inquiry and consult a medical professional.

Tips on How to Deal With Delusions And Paranoia Among People With Dementia

Tips on How to Deal With Delusions And Paranoia Among People With Dementia

Keep in mind that for a person who is going through a delusion, the reality that they are experiencing is extremely true for them. Therefore, it is only reasonable for you to feel upset, and it is only natural for you to want to inform the individual that what they are saying is not true.

On the other hand, it is extremely difficult, if not impossible, to persuade a person who is dealing with a delusion of the reality of the situation. It is much more probable that you will upset them by trying to do so than that you will convince them to change their views. There are more effective techniques to help someone who is experiencing delusions, such as the ones listed above.

There is no question that those with  dementia experiencing paranoia can be challenging for their caretakers. It’s possible for those living with dementia seniors to inadvertently isolate their loved ones and leave their caretakers distressed as they strive to feel safe in their surroundings.

This can also make the situation more difficult for the person. The following is a list of advice for caretakers, which can be used to assist in providing care to older individuals who experience paranoia and delusions:

1. Acknowledge Their Distress

Recognize the anxiety that they must be experiencing and how they would be feeling. If their concerns are ignored or the caregiver attempts to divert them without first addressing them, the issue may become more serious, and the patient may lose trust in the person caring for them.

For instance, if the person believes that a caregiver has been taking from them, you should pay attention to what they have to say. Acknowledge the feelings that they must be experiencing and offer to assist them in their search for the missing objects. Then another activity to the person in a gentle manner; this will perhaps divert them from their delusion and cause them to forget about it.

2. Do Not Argue With Them

Those who struggle with paranoid delusions, particularly those with dementia, are likely to regard them as a real experience. Arguing with them will simply serve to reinforce their belief that you are not on their side. Instead of explaining or answering your loved one’s questions logically, try to comfort and acknowledge the feelings they are experiencing.

3. Respect Their Private Space

Make sure that their space is spotless, well-lit, decorated in an engaging way, and has robust safety measures. In addition, make sure that they have a place to store their valuables, including a safe or lockbox if they live in a community setting or with roommates, which is highly recommended. Before making any adjustments to someone’s personal space, make sure to get their consent first.

4. Reassure Them

Tell them you are willing to assist them in their search for an item if they believe it has been relocated or stolen. Share your thoughts with them if there is a straightforward response, but don’t try to convince them of anything with complex arguments or a drawn-out explanation.

Try not to let accusations that you haven’t visited them in a long time or that you’ve been unfaithful get to you. Accusations like this one frequently originate from the worry that the accused will be abandoned. So again, reassure them and make it quite obvious that you will continue to stand by their side.

5. Encourage Them to Express Their Feelings

It could shed light on the motivations that lie behind their misconception. For instance, if they don’t feel like they belong in their own home, it could be because the furniture has been rearranged recently or because ‘strangers’ (caregivers that may be new to working with them) have been hanging around in their space.

6. Notice The Changes in Their Behavior

It’s important not to ignore seemingly insignificant shifts in behavior. These are potential warning signs of a more serious issue. For example, if someone suddenly begins to feel anxious or stressed out, it may be a sign that they are not happy with their current surroundings.

Keep an eye out for patterns. For example, does the activity tend to occur at a particular time of the day? Maintain a record of the individual’s activities and search for strategies to steer clear of precarious situations that could bring on episodes of paranoia or delusion.

7. Stay Calm

When talking with a person who has dementia and paranoia, the last thing you want to do is yell at them or demonstrate any type of aggressive behavior. If you notice that you are becoming increasingly frustrated, you should probably take a few moments to collect yourself before responding to their worry.

If you still feel that you are unable to maintain your composure, you might want to investigate different meditation approaches. Meditation can help promote a sense of  calmness.

8. Distract Them

You might want to attempt diverting someone with dementia’s attention if they are unwilling to go through the issue with you through conversation. It doesn’t have to be something spectacular; pulling back the drapes or putting on some music will do the trick.

However, if it doesn’t work, you shouldn’t try the distraction tactic repeatedly because this will only make the individual feel more frustrated. Instead, you should try something else.

9. Examine The Environment

Occasionally, there may be visual clues in the room that could set off paranoid delusions in a person who is suffering from dementia. For instance, if the light is reflected off of a window, they would conclude that there is an unidentified flying object outside.

Or, they may see their own reflection in the mirror and mistake it for evidence that someone is observing them. You can make this scenario better by drawing the curtains or concealing the mirror with something.

10. Keep Spares of Items That ‘Goes Missing’

Establishing permanent locations for objects that are prone to be misplaced, such as keys or spectacles, and maintaining a supply of backups just in case. Check to see that things are put back in the same location. For instance, make sure that you always hang your keys on the key hanger.

This can make it easier for the person to find things, which in turn may minimize the likelihood that they are under the false impression that items that have gone lost or been misplaced have been stolen.

Final Note

It is normal for family carers to experience difficulty adapting to changes in the physical, cognitive, and emotional capabilities of the people they care for. Regrettably, approaches such as acceptance and redirection for dealing with the behaviors associated with dementia are not as widely known as they might be.

Even if dementia caregivers have gained an understanding of these approaches, the process of exchanging logical reasoning for acceptance and reassurance requires experience and a significant amount of patience.

Be aware of the fact that dealing with delusions or paranoia can be very challenging and tough at times. Therefore, do not attempt it on your own. Instead, join a support group or look for an internet forum where you and others who are experiencing the same thing may share and talk about your feelings.

Make an appointment with a doctor right away if you notice any significant changes in the health or behavior of a loved one you’re caring for. Likewise, if your loved one’s paranoia or delusion is interfering with their ability to perform activities of daily life or if they become a risk to themselves or others, it is imperative that you seek assistance from medical professionals as soon as possible.


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