Handling Paranoia and Delusions in Alzheimer's Patients

By Jane Farrell

From the National Institute on Aging

As Alzheimer’s disease progresses, the person with the disease may have hallucinations, delusions, or paranoia. During a hallucination, the person sees, hears, smells, tastes, or feels something that isn’t there. He or she also may have delusions—false beliefs that the person thinks are real.

Paranoia is a type of delusion in which a person may believe—without a good reason—that others are mean, lying, unfair, or “out to get me.” He or she may become suspicious, fearful, or jealous of people.

Hallucinations and Delusions

Here are some tips for coping with hallucinations and delusions:

• Tell the doctor or Alzheimer’s disease specialist about the hallucinations or delusions.

• Discuss with the doctor any illnesses the person with Alzheimer’s has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.

• Try not to argue with the person about what he or she sees or hears. Comfort the person if he or she is afraid.

• Distract the person. Sometimes moving to another room or going outside for a walk helps.

• Turn off the TV when violent or upsetting programs are on. Someone with Alzheimer’s may think these events are happening in the room.

• Make sure the person is safe and can’t reach anything that could be used to hurt anyone or him or herself.

Paranoia

In a person with Alzheimer’s disease, paranoia often is linked to memory loss. It can become worse as memory loss gets worse.

For example, the person may become paranoid if he or she forgets:

• Where he or she put something. The person may believe that someone is taking his or her things.

• That you are the person’s caregiver. Someone with Alzheimer’s might not trust you if he or she thinks you are a stranger.

• People to whom the person has been introduced. He or she may believe that strangers will be harmful.

• Directions you just gave. The person may think you are trying to trick him or her.

Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

Here are some tips for coping with paranoia:

• Try not to react if the person blames you for something.

• Don’t argue with the person.

• Let the person know that he or she is safe.

• Use gentle touching or hugging to show you care.

• Explain to others that the person is acting this way because he or she has Alzheimer’s disease.

• Search for things to distract the person, then talk about what you found. For example, talk about a photograph or keepsake.

Also, keep in mind that someone with Alzheimer’s disease may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with Alzheimer’s.

Reprinted with permission from the National Institute on Aging. For more information from the NIA about Alzheimer’s, visit http://www.nia.nih.gov/alzheimers.