How to Assist someone living with dementia with paranoia
Why do people living with dementia become paranoid?
According to the Alzheimer’s Society, “Delusions…can take the form of paranoia, which makes the person feel threatened, even if there is no or little reason to feel this way. Dementia can make a person suspicious of the people around them.” This can understandably be very upsetting for the person, their loved ones and their carers, as accusations and suspicions may cause additional stress and anxiety for everyone involved.
Delusions, including paranoia, tend to become more common as dementia progresses because the person may struggle to recall memories and moderate their thoughts. The person may feel they’re being watched or that someone is conspiring against them. They may accuse people of saying things about them or acting negatively towards them, often without much evidence.
What to expect
Paranoia associated with delusions can take many forms. In some cases this can stem from something said to them years before, such as an argument with a neighbour, but now that the person cannot moderate their thoughts because of dementia, they may feel that the issue is still ongoing.
Caring for someone who is experiencing delusions and especially paranoia can be difficult because they may be convinced that you are the person meaning them harm. No amount of reasoning with them will usually convince the person that they’re wrong, which is why it’s essential to approach the situation carefully and to try and remain calm.
How to support someone with paranoia and dementia
Paranoia can lead someone to believe that items are missing because they don’t remember where they put them or that they don’t own them anymore. For instance, they may have sold a gold ring that belonged to their mother some years earlier but don’t remember this, causing them to accuse people close to them of losing or stealing it. This is upsetting for everyone involved and the person is unlikely to believe that they were the one to part with the item.
Discussing their delusion may not be easy, but the Alzheimer’s Society recommends ways to avoid further distress. “For example, if they believe their friend is bringing over poisoned food and this is causing them to stop eating, look into local meal delivery options or microwave meals they can make themselves. Ask them what they would prefer to do instead.”
Always let the person know you are taking their concerns seriously. “Encourage them to talk through their thoughts,” recommends the Alzheimer’s Society, “It may reveal what is behind their delusion.” Perhaps they’re feeling that their home isn’t their home due to well-meaning changes that loved ones may have made, or because unfamiliar people, such as professional carers are in their home. It’s important that we acknowledge their feelings as genuine and don’t just dismiss their concerns. Listen to them and let them see that what they’re saying matters. For instance, if they’ve lost something and are saying it’s been stolen, help them to look for the item first and offer explanations for what might have happened.
How to prevent/reduce paranoia
You can try to prevent or reduce delusions by:
Avoiding unnecessary changes
Keeping their surroundings familiar can help reduce paranoia, so if possible, keep furnishings and decoration as unchanged as possible. If the person is living in an earlier time then introducing objects they grew up with may also help.
Having routine places
Having set places for items that keep getting lost may help, as will having several spares. A familiar key hook or glasses holder may help reduce the idea that things have become misplaced.
Providing stimulating distractions
Loneliness, isolation and boredom can all contribute towards delusions and paranoia. Having stimulating activities available and opportunities for socialisation may all help to keep delusions at bay.
Having regular health checkups
Speaking to the GP or healthcare practitioner regularly is important to rule out potential side effects of new and existing medications that could be causing delusions or paranoia.
Bringing a Helping Hands carer into their home
Bringing someone new into the person’s home can sometimes cause paranoia or delusions to worsen due to the unfamiliarity of having someone different in their environment or not believing their home is their own because of it. However, if you are looking for professional dementia care, you need to be reassured that the transition will be handled carefully by Helping Hands, as we have decades of experience supporting people at various stages of their dementia journey. We are the UK’s most trusted home care provider because we’re small enough to care while large enough to cope. We don’t operate franchises like most home care companies, instead we own, run and manage all of our 150 branches across England and Wales. We’ll work with you and your loved one to gradually introduce the new carer to them, whether they’re needed on a visiting or live-in care basis. Hopefully, they’ll eventually see them as someone they feel they can ‘confide’ in, increasing their confidence and reducing anxiety.
