It can be incredibly upsetting when a loved one with dementia suddenly accuses you of stealing their wallet or whispers in an agitated tone that someone is threatening to harm them. These accusations are alarming and can feel personal, especially when you're doing everything you can to care for them.
What family caregivers need to understand is that paranoia is a common symptom of dementia. It is not a reflection of how your loved one feels about you or anyone around them. It's the result of changes happening in the brain.
Research cited by the National Institutes of Health has found that delusions affect up to one-third of people with dementia. Paranoia is a type of delusion, a firmly held false belief, that can occur as dementia progresses. Symptoms such as delusions and suspiciousness are common behavioral changes associated with Alzheimer's disease and related dementias.
Why does paranoia occur with dementia?
As an individual’s dementia progresses, it affects the regions of their brain responsible for memory, reasoning, and perception. This makes it more difficult for them to accurately process their surroundings and the people around them and put them into perspective.
For example, if your loved one can't remember where they put their glasses or purse, their brain naturally tries to fill in the missing information. Instead of thinking, "I misplaced it," they may genuinely believe someone took it.
Other perception changes in the brain can also cause familiar people and places to seem unfamiliar or even threatening. For instance, a caregiver they've known for years may suddenly seem like a stranger, or an ordinary conversation across the room may be perceived as people talking about them.
It is important to realize that these fears, while unfounded, feel very real to your loved one.
What does dementia-related paranoia look like?
Every person is different, but some common examples include:
Even though these beliefs are not based on reality, it is unlikely that attempting to reason with them will change their mind.
How should family caregivers respond to a loved one’s increased paranoid behavior?
First, remember that when they are frightened, they're looking for reassurance, not proof that they're wrong. So, instead of attempting to correct them, try the following:
Some reactions to avoid:
Watching someone you love experience paranoia can be heartbreaking, especially when you're the target of their fears. But remembering that these behaviors stem from changes in the brain, not from anger or resentment, can help you respond with greater patience and compassion. Meeting them where they are is always the most effective and compassionate approach.
It is also important to ensure you are properly caring for your own emotional well-being. Consider joining a dementia support group. Our Anthem Memory Care communities regularly host these groups, led by licensed, qualified professionals. There, you can share your experiences and concerns with others who are facing many of the same issues, all in a supportive, compassionate environment.
Remember that some days will be harder than others, and that's okay. Because even when your loved one can't always recognize your efforts, your calm presence and reassurance can help them feel safer and more secure. And that will make you feel better, too.