5 Ways to Cope with Delusions and Paranoia in Memory Care

“At-home caregivers of those living with memory loss face multiple challenges, which typically increase as the disease progresses,” says Susan Irrgang, Executive Director of Saunders House located in Wynnewood, PA. “Among the most difficult are psychological symptoms such as delusions and paranoia that often appear during the middle and later stages of memory loss. 

“And while delusional and paranoid behaviors are considered mostly harmless, they can be deeply troubling and emotionally stressful to loving caregivers. Sadly, the delusions and paranoia exhibited are often accusatory and directed at the same family members who are providing their care. For example, a loved one might suddenly begin to accuse their caregiver of stealing their money,” says Susan.

“To help caregivers cope, it is important for them to understand the various forms of delusional behavior and paranoia and take appropriate steps to manage them – for their own well-being as well as that of their loved ones,” she adds.

Understanding Delusions and Paranoia in a Loved One with Memory Loss

According to memory care authorities, delusions and paranoia are a direct result of the ongoing changes occurring in the individual’s brain that create a changed state of reality for them. It is important for caregivers to understand that while the thoughts and perceptions of the person with memory loss might seem delusional or paranoid to us, they are very real to that person.

Memory care experts also advise that delusions and paranoia should not be confused with hallucinations. They say that while hallucinations are sensory-based and cause a person to see, hear, feel, taste or smell something that isn’t there, delusions are strongly held beliefs that aren’t true. For example, a hallucination would be seeing a sailboat in the middle of the living room. Paranoia would be believing the caregiver is hiding their favorite pair of shoes.

Examples of delusional behavior and paranoia that people with memory loss may experience include:

  • Theft – Believing someone has stolen belongings or is breaking into the house
  • Persecution and endangerment – Believing that someone is “out to get them,” following them or poisoning their food
  • Spouse infidelity – False certainty that their spouse is seeing another person
  • Infestation – Believing that their body or home is infested with insects or parasites
  • Misidentification – Believing that a familiar person has been replaced by an imposter; not recognizing themselves or objects in a mirror
  • Television – Believing that people or events that happened on a TV program are real or happening to them
  • Abandonment – Persistent fear that their caregiver will leave them
  • Delusions of love – Believing that an important, famous or otherwise unreachable person is in love with them
  • “The phantom boarder” – Believing that other people are living in the house; or that family members are speaking to someone who isn’t there

Although there is no known scientific explanation for the delusions and paranoia that occur with memory loss, memory care experts tend to believe that the person with memory loss is merely attempting to make sense of their own changed reality.

5 Memory Care Tips for Managing Delusional and Paranoid Behaviors

Delusions and paranoia can be very difficult for at-home caregivers to manage. However, when managed appropriately, caregivers can help their loved ones to stay calm and make their own job less stressful.

The Alzheimer’s Association® offers several expert tips you can apply when attempting to cope with your loved one’s delusions and paranoid behavior. 

  1. Don’t take it personally – Remember that your loved one’s delusional or paranoid behavior is a symptom of their memory loss, not a personal attack on you. Be reassuring and let them know you care.
  2. Don’t argue with them – Let them express their thoughts and listen carefully to what is troubling them. Try your best to meet them in their reality. Then reassure them and let them know that you care.
  3. Redirect their attention – You may be able to distract them from their paranoia by focusing on another activity or asking them to help you with a chore.
  4. Offer simple answers – Respond to their concerns and share your thoughts, but keep your answers simple. Lengthy explanations or complicated reasons may only overwhelm them more.
  5. Keep duplicates of certain items – If your loved one with memory loss frequently misplaces the same item and gets upset when it’s lost, purchase a few duplicates of the item. For example, purchase an extra wallet if your loved one is always losing his/hers.

Support for Caregivers Is Also Very Important

Supporting your own physical and emotional needs is extremely important, especially during the challenging mid and later stages of your loved one’s memory loss. Caregivers can find needed support for themselves by joining a local support group and sharing experiences with others who are in the same situation.

The Alzheimer’s Association® can help you to locate a support group in your community. In addition, they have an online support community and message board, ALZConnected®, that enables you to share what memory care coping strategies have worked for you while also getting ideas from other caregivers.

If your loved one’s delusions and paranoia are becoming more than you can handle, talk to your doctor about their psychological symptoms.

Memory Care at Saunders House: Caring for the Mind, Body and Spirit 

It might also be time to consider 24/7 professional memory care. At Saunders House, we understand that those with Alzheimer’s disease or other memory impairments have unique needs that demand special care and attention by specially trained and compassionate staff.

Our specialized Care Traditions program takes a holistic approach to memory care, incorporating programming for the mind, body and spirit. We also encourage our residents to engage with others and enjoy enriching activities. Everything we do in Care Traditions promotes positive interactions among residents, staff, volunteers, family and friends.

We’d Love to Hear Your Thoughts!

If you have comments or questions about our blog ondealing with delusions and paranoia for a loved one with memory loss, we’d love to hear from you. And we encourage you to share any of your caregiving experiences with us in our comments section. 

We also invite you to stay current on senior health and senior care topics by viewing the latest articles and tipson our website.

Discover Our Healthy Tradition of Care and Wellness

Located adjacent to Lankenau Medical Center, Saunders House – part of Main Line Senior Care Alliance – has a celebrated tradition of providing exceptional care and services to seniors and their families. It’s a tradition we’re proud to continue.

Today, Saunders House offers a range of services – including short-term rehabilitation, traditional nursing care, restorative care, memory care, respite care and specialized care for individuals with visual impairments – all in a setting that is warm, welcoming and nurturing.

For more information on Saunders House, our Care Traditions Memory Care program and other professional services, please call us today at (610) 658-5100 or contact us online. 

Disclaimer: The articles and tip sheets on this website are offered by Saunders House and Main Line Senior Care Alliance for general informational and educational purposes and do not constitute legal or medical advice. For legal or medical advice, please contact your attorney or physician.

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