Paranoia and delusions are both mental health conditions characterized by false beliefs but differ in their severity and nature.
Paranoia focuses on suspicion and distrust of others and delusions are thoughts that are completely detached from reality. They are generally more severe and persistent than paranoia.
Delusions and paranoia are both common symptoms of dementia.
Delusions
Delusions (or firmly held false beliefs) are a common symptom seen in a person with Alzheimer’s disease or other dementia. A person experiencing a delusion may feel that they are being watched, or that someone is acting against them. They may jump to conclusions without much evidence. If the person you care for has delusions, this can be very difficult to cope with, especially if they are convinced that you have done something wrong or are trying to harm them. Try to remember that their delusions feel as real to them as your reality feels to you. You will generally not be able to convince a person experiencing delusions that they are wrong or mistaken.
Important to Note: Delusions are more common in Lewy Body Dementia but can affect people with all types of dementia, including Alzheimer’s disease and vascular dementia, particularly in the later stages.
Paranoia
A person with Alzheimer’s disease or other dementia may experience a kind of suspicious delusion referred to as paranoia. People with paranoia may believe, without good reason, that others are lying, unfair, or out to get them. Your loved one may become suspicious, fearful, or jealous of other people. They may believe a family member is stealing their possessions or that the police are following them. In a person with Alzheimer’s disease or other dementia, paranoia is often linked to memory loss.
Here is a common example: Your loved one with dementia loses things due to short-term memory loss. Since they can’t find the money, keys, jewelry, or whatever the item is, they conclude it was stolen. Their brain can only focus on what is happening in the moment; you as the caregiver are with them, but their jewelry is missing. Therefore, their logic concludes that you did something with the missing item. Although not grounded in reality, the situation is very real to the person with dementia. It is difficult for a person with dementia to distinguish what is real and what isn’t. The disease has damaged that part of the brain.
Another potential cause of delusions and paranoia is delirium. This is a state of mental confusion that develops suddenly because of an underlying medical problem. It can occur in people with or without dementia. This is why doctors like to rule out urinary tract infection, fever from infections, sleep deprivation, dehydration, medications, or chronic health conditions before prescribing antipsychotic medications. If these symptoms are new or particularly troublesome, please alert your NAN Navigator and contact your loved one’s medical providers for support.
The Emotional Impact of Delusions and Paranoia
Being falsely accused can be distressing. We can’t change how dementia affects a person; however, we can change how we respond to that person.
Keep in mind that your feelings of distress, frustration, guilt, or exhaustion are very normal when caring for a loved one with paranoia. Fortunately, there are ways of responding to and coping with paranoia that can help reassure your loved one and minimize this behavior.
Tips On How To Respond To Paranoid Behavior
It’s not you! Try not to take it personally when your loved one falsely accuses you.
Is there a kernel of truth? Consider that your loved one may have confused the past and present, so accusations may be based on things that have happened in the past.
Don’t argue! Don’t correct! What they think has happened feels real to them. Acknowledge their feelings and offer them reassurance.
Investigate accusations, at least once. If, for example, a person is accusing someone of stealing something, carefully look into it. Also, see if you can find other reasons. For example, accusing someone of stealing may be because they have lost something.
Switch the focus to another activity. Engage your loved one in an activity or ask for help with a chore.
Duplicate lost items. If your loved one is often searching for a specific item, have several available. For example, if they are always looking for their wallet, purchase two of the same kind.
Source: https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/alzheimers-caregiving-coping-hallucinations
Please talk with your own/loved one’s healthcare provider before using any of this information.
