Coping with suspicions and delusions in someone with dementia

It can be very distressing to see a loved one experiencing delusions, suspicions and paranoia, but they are fairly common symptom of dementia. Here’s a few ideas to help you cope

People with dementia find it harder to remember things and stay anchored in the present moment. This can lead to suspicions, delusions and paranoia. If the person you care about is in the grips of a delusion, it can take every ounce of energy and love to manage.

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

What is a delusion?

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

The delusion will often lead to extreme suspicion. For example, your loved one might think that people around them (family, carers, friends and even you) are trying to trick them.

Delusions can take many forms, but commonly revolve around a number of paranoid scenarios. For example, people with dementia often believe someone is trying to steal from them or follow them. Sometimes they believe there’s 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 are gaps in their memory, they may try to fill them with a faulty memory or delusion that makes sense to them. Their confusion and inability to remember objects or recognise faces contributes to the development of these untrue beliefs.

So, if they’ve forgotten where they left their wallet, and a new carer has just started visiting them, they may decide that this new person has stolen the wallet. It may be embarrassing or upsetting, but it makes sense to them.


5 ways to cope with suspicions, delusions and paranoia.

1. 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.

2. 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 care about that they’re wrong, they’re more likely to become increasingly agitated and angry, than simply back down. They’ll also feel like you’re not listening to them.

3. 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 explanation. If you’ve been accused of never visiting them or being unfaithful, try not to take it to heart. Accusations like this often stem from a fear of being abandoned. Once again, provide reassurance and make it clear that you’re sticking with them.

4. Keep a spare set of ‘stolen’ items

If it always seems to be a specific item that is ‘going missing’, try to think ahead and be practical. Is it possible to have a spare set of keys or spectacles ready and waiting?

5. Switch focus

Try distraction techniques. 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?’


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!