Senior woman looking worried

Understanding Challenging Dementia Behaviors: Paranoia/Suspicion (Part 4 of 4)

Alzheimer’s disease and other dementias affect the brain in different ways. Memory loss is one of the most well-known hallmarks of the disease, but if you speak to caregivers and professionals, you’ll soon hear about “challenging behaviors.” In this four-part series, we’ll explore some of the more challenging behaviors you may have to address as a caregiver to someone with dementia.

Generally, trusting our family comes naturally to us. Which is why it’s so jarring if your loved one with dementia suddenly becomes suspicious of you, accusing you of stealing or other improper behavior. Although paranoia and suspicion are common symptoms of dementia, that doesn’t make it any less hurtful.

“It’s one thing to logically understand what’s happening to your loved one, but it’s another thing entirely to view it as a symptom of the disease and not a direct reflection on how your loved one feels about you,” says Andrea Campisi, Marketing and Admissions Director of The Reutlinger Community, a Continuing Care Retirement Community in Danville, CA. “The delusions are very real for the senior, which is another reason why this behavior can be so challenging and disruptive for caregivers.”

Delusions, which include feeling paranoid and acting suspicious, may occur in the mid- to late-stage of dementia such as Alzheimer’s disease. Part of the reason this occurs is due to increasing confusion and memory loss. Someone with dementia may misplace an item or hide it for safekeeping and not remember where he or she put it, causing them to accuse others of hiding or stealing the items. Another reason why someone is experiencing paranoia may simply be an expression of loss. For them, no other explanation makes sense than that someone “took it.”

Here are some examples of how paranoia can play out with a senior loved one:

  • They forget where they put something, such as their keys or eyeglasses, and believe that another person is taking them when they’re not looking.
  • Your loved one may think you’re a stranger due to the advancement of dementia. They may not believe that you’re their caregiver and be untrusting towards you.
  • They may be scared or suspicious of people they’ve been introduced to, because they believe that strangers can be harmful.
  • Giving directions to them can be difficult, because your loved one may feel like you’re trying to trick them.

If your loved one is showing signs of paranoia and suspicion, the first thing you need to do is understand why it’s happening. It’s possible that these delusions are not dementia-related at all but are due to medication interaction, infection or some other illness. Schedule an appointment with your loved one’s doctor to get a full check-up and see if the behavior is something that can be treated. Even if it’s a dementia-related issue, there are some prescription drugs that may be able to help reduce the symptoms.

Tips for dealing with paranoia and suspicion.

  • Have a plan in place. It’s possible that your loved one could become a danger to themselves or others. Have a plan to de-escalate violence or get help, and act on it if the situation calls for it.
  • Don’t try to use logic. Whatever paranoia your loved one is dealing with is very real to them. Trying to explain the reality of the situation will only serve to make you and them more agitated.
  • Stay calm. Remaining collected will help you manage the situation, and will hopefully keep your loved one from becoming even more agitated.
  • Offer reassurance. Letting your loved one know that they are safe, that they are cared for and that they are loved can help diffuse the situation.
  • Create a distraction. Redirecting your loved one’s attention is an excellent tool for just about any disruptive behavior. Ask for help with a chore, or set your loved one to a task. Taking their attention off the matter at hand can diffuse the situation quickly. You can start by looking for the lost item and parlay that into a different activity.
  • Offers simple answers. Anything that’s too complex can be overwhelming and make their anxiety skyrocket.
  • Make duplicates of items that are often lost. If your loved one is often looking for their wallet, keys, glasses or other regular items, make duplicates and keep them in a safe place. That way, you at least know where they are and can manage the situation quickly (and give you time to go and look for the actual misplaced item).
  • Find ways to make it easy for loved ones to inspect things. For example, if your mom is always suspecting that money is missing, give her small amounts of money to keep in a purse so she can easily inspect it.
  • Learn where “hiding spots” are. A senior loved one will often have hiding spots where they put things for safekeeping (and then forget they put them there). If you know where these spots are, you can look for “lost” items there first.
  • Let others know the situation. Talk to other family members and friends and explain that your loved one’s symptoms are due to the disease, not who they are as a person.
  • Respond to the feeling, not the behavior. Your loved one is reacting to something they’re feeling, so do your best to determine what that is and react to that.

Knowing how to respond to your loved one’s challenging behaviors is definitely a challenge of its own. It’s not unusual to feel angry, frustrated or hurt. By reminding yourself that everything your loved one is doing and expressing is because of the disease, you may be able to manage what you’re feeling and your reactions. Remember also that it’s okay to ask for help and give yourself a break when things get to be too much. Dementia is a challenging journey, but with patience and perseverance, you can make it as smooth as possible for yourself and your loved one.

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Offering Assisted Living, Enhanced Assisted Living, Memory Care, Skilled Nursing and Rehabilitation, The Reutlinger Community provides a continuum of care that allows seniors to live a life-enhancing and stimulating environment. Located in Danville, California, The Reutlinger Community’s newly renovated, 110,000 square foot community combines the comfort and familiarity of home with seasoned senior care and skilled nursing specialists to suit any seniors needs, allowing them to live the life they choose with freedom and security.

Because we specialize in a continuum of care, our residents never need to worry about leaving the community they call home or wonder what will happen when they need some more care. Residents and families alike can have peace of mind knowing that there are full-time licensed nurses available, along with activity coordinators, social workers, caregivers, a concierge and Rabbi who focus solely on helping each resident thrive. Even better, our services and amenities are equal to those of a state-of-the-art resort. This is the lifestyle and care that your loved one deserves.

At The Reutlinger Community, seniors have numerous opportunities to engage in award-winning programs that are designed to engage the mind, renew the spirit and provide opportunities to meet new people and learn something new. Whether residents are enjoying our art program and museum, listening to a lecture or educational program or attending spiritual programming and our wide range of activities, there’s something for each resident to love. Participate as much or as little as you like, the choice is all yours.

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