What
Is Paranoia?
Paranoia is an unrealistic
fear or concern that harm is imminent or that others are out to get you. A
paranoid person does not generally accept other explanations and may blame you
if you try to use logic to reason away their fears.
Some people experience paranoia if they have a psychological disorder
like schizophrenia. Others develop it in relation to different medical
conditions, including Alzheimer’s, other dementias or delirium.
What
Are Delusions?
Delusions are fixed (not
easily changed) false beliefs. Dementia often results in paranoid delusions,
where there may be a fixed belief that someone is poisoning the food or
stealing money. Other delusions, infrequently experienced by those with
dementia, include delusions of grandeur, where there is the false belief that
one has extra power or a higher position in society or the world.
An Example of Paranoia
and Delusions in Alzheimer’s
Alzheimer’s can change the way
others are perceived. For example, you may have always had a good relationship
with your father and are trying to help him with his finances. Instead of being
grateful for your assistance, your father, who has Alzheimer's, might accuse
you of trying to take his money or "pull one over" on him.
Common Delusions in
Dementia:
·
Spouse/partner is being unfaithful.
·
Someone else is living in their home.
·
Their belongings/money are stolen.
·
Others are out to get them.
·
Food is poisoned.
·
Prevalence of Delusions in Alzheimer’s Disease
Approximately 30% to 40% of people with Alzheimer’s will develop
delusions at some point during the disease, many of them being paranoid
delusions. The incidence may be increased in those who have a history of abuse
or trauma.
Delusions appear to be more
common in Parkinson’s-related dementia, vascular dementia and Lewy Body disease
(LBD), with up to 70% of people with LBD experiencing delusions or
hallucinations.
Could Paranoia or
Delusions Be a Sign of Delirium?
If paranoia or delusions are a new behavior for your loved one or someone
you’re caring for, consider the possibility that she might be experiencing
delirium. Delirium is a sudden change in thinking and orientation, usually
quite reversible, brought on by a physical condition such as an infection,
surgery or other illness.
How Can You Decrease
the Likelihood of Paranoid Delusions in Alzheimer’s?
Be careful what television shows are playing in the background. To you,
it might just be background noise, but to a person who’s confused, violent or
fear-provoking shows may trigger fear and paranoia for that person. For the
person with Alzheimer’s, the line between reality and fantasy can easily become
blurred.
Ensure that your loved one is receiving the correct medication doses. Too
much or too little medication can affect a person’s mental and emotional
stability.
If you’re providing care for someone in a facility, try to keep the
routine as consistent as possible. A regular rhythm of the day and familiar,
consistent caregivers help reduce anxiety and stress for people.
Responding to Paranoid
and Delusional Behavior in Alzheimer’s:
·
Provide reassurances.
·
Remain calm.
·
Explain any procedures before performing them.
·
Avoid laughing or whispering near the person.
·
Don’t agree with the person that you did something that you didn’t do.
·
Use a behavior log (a way to track behaviors) to identify triggers and
times of day they occur.
·
Don’t argue.
·
Use distraction.
·
Enter into their world. Put yourself in their shoes.
·
Help them look for things they think are stolen or missing.
·
Have duplicates of things they lose and think are stolen.
You may also need to consider the possibility that their fears are
accurate - that someone is actually taking advantage of them. Older adults can
be vulnerable to different types of abuse, including financial and physical.
Most delusions in dementia really are delusions, but a healthy awareness (not
constant suspicion) of others is the better part of wisdom.
(Source: about.com, Alzheimer’s/Dementia)
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