Coping with suspicons and delusions in someone with dementia

It can be very distressing to see a loved one experiencing delusions, suspicions and paranoia. But you aren't alone, this is a fairly common symptom of dementia. Here’s how to deal with it

When you have dementia it becomes harder to remember things and stay in the current moment. This can lead to suspicions, delusions and paranoia. If the person you care for is in the grips of a delusion it can also take every ounce of energy and love to manage.

Did you know? About 40 per cent of people living with dementia experience delusions.

What is a delusion?

When someone is deluded, it means that they have a distinct set of beliefs, which are false, but which they believe to be true.

Often, the delusion will lead to extreme suspicion, with the person affected thinking that people around them – family, carers, friends – are trying to trick them.

Delusions can take many forms, but often revolve around a number of paranoid scenarios such as believing that someone is trying to steal their possessions, that someone is following them, or that there is a stranger in the house trying to get them.

What is paranoia?

Paranoia can occur as a result of delusion. It is centred round suspicions and can become a way for the person with dementia to project feelings of fear. Paranoia can also be caused by hallucinations.

What causes delusions and paranoia?

When someone has dementia, glitches within their brains cause memory problems and changes in personality. If there’s a hole in their memory, they may try to fill in that faulty memory with a delusion that makes sense to them. Their confusion and inability to remember objects or recognise faces contributes to the development of untrue beliefs.

So, if they’ve forgotten where they left their wallet, and a new carer has just started visiting them, they may simply assume that this new person has stolen the wallet. If you're caring for a loved one he might accuse you of being unfaithful or trying to poison them, all of which is extremely traumatic.

However, there are some simple steps which can help, no matter how difficult the situation may seem.

Don’t take it personally

If they suddenly start accusing you of something, try not to take offence. This is the illness talking, not them. So put yourself in their shoes and listen to what might be behind the accusations.

Don’t argue or try to convince

Try not to respond with ‘Why would I do that?’ or ‘Don’t be silly!’ If you attempt to convince the person you’re caring for that they’re in the wrong, they could end up feeling very agitated and angry that you’re not considering their point of view. They’ll also feel like you’re not listening to them.

Reassure without asking questions

Tell them that you’ll help them look for an item if they think it’s been moved or stolen. If there’s a simple answer, share your thoughts, but don’t overwhelm them with clever arguments or a lengthy explanations. If you’ve been accused of infidelity, don’t take it personally. Often fears such as this stem from being abandoned. Once again, provide reassurance and make it clear that you’re sticking with them.

Keep a spare set of ‘stolen’ items

If it always seems to be a specific item that is ‘going missing’, see if you can have some spare ones ready, such as wallets or spectacles.

Switch focus

If they’re still frustrated, suspicious or agitated, try distracting them. For example, say, ‘Before we start looking for your book, why don’t we have some lunch, then we’ll look for it after that?’

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Good to know

Remember, someone with dementia who is experiencing delusions is simply trying to make sense of their world while dealing with cognitive decline, confusion and fear. Try to ensure that other family members and friends understand this too and that they take their lead from you. Remember, you're the expert!