Paranoia Delusion And Hallucinations
Distortions of reality, such as paranoia, delusions, and hallucinations, can be another result of the disease process in dementia. Not everyone with dementia develops these symptoms, but they can make dementia much more difficult to handle.
Lewy body dementia, in particular, increases the likelihood of delusions and hallucinations, although they can occur in all types of dementia.
Caregiving In The Late Stages Of Alzheimers Or Dementia
As Alzheimers or another dementia reaches the late stages, your loved one will likely require 24-hour care. They may be unable to walk or handle any personal care, have difficulty eating, be vulnerable to infections, and no longer able to express their needs. Problems with incontinence, mood, hallucinations, and delirium are also very common.
In your role as caregiver, youll likely be combining these new challenges with managing painful feelings of grief and loss and making difficult end-of-life decisions. You may even be experiencing relief that your loved ones long struggle is drawing to an end, or guilt that youve somehow failed as a caregiver. As at the other stages of your caregiving journey, its important to give yourself time to adjust, grieve your losses, and gain acceptance.
Since the caregiving demands are so extensive in the later stages, it may no longer be possible for you to provide the necessary care for your loved one alone. If the patient needs total support for routine activities such as bathing, dressing, or turning, you may not be strong enough to handle them on your own. Or you may feel that youre unable to ease their pain or make them as comfortable youd like. In such cases, you may want to consider moving them to a care facility such as a nursing home, where they can receive high levels of both custodial and medical care.
Connecting in the late stages of care
Dealing With Dementia Behaviors: Expert Tips For Understanding And Coping
Anger, confusion, and sadness are a few symptoms a person with dementia;may experience regularly. The;result of these feelings is a range of unpredictable behaviors including using poor judgment, aggression, mood swings, and repeated questioning or manipulation.
Even though you know your loved ones;dementia behaviors;are symptoms of a disease and not intentional, dealing with them is often emotionally and physically challenging. Learn more about typical;dementia behaviors in the elderly;and expert tips for managing them.
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Tips To Handle An Elderly Persons Paranoia
Its not uncommon for elderly people to exhibit signs of dementia in their later years. Dementia changes the way the brain works, often causing people to lose their memories and fail to process what they see around them. Dealing with the world when their mental capacity is reduced can cause some seniors to develop paranoia. They may believe the police are after them or that the elder care assistant isnt who they claim to be. Some seniors may even try to harm themselves or others in their paranoid state.
Its important that everyone who works with the elderly personfamily members, elder care assistants and otherslearn strategies and techniques to deal with volatile moods and reduce the feelings of paranoia whenever they can.
Here are 25 tips on how to deal with an elderly relatives dementia-related paranoia:
Join Them In Their World
When your loved one is accusing you shes trying to make sense of her reality as best she can. Stay calm and dont argue. Join her in the world that she understands. Reassure her that you understand that this item is missing and that you will help her find it. You can say that you didnt take it but that you understand why it seems that way. Then try distraction. If she cant be distracted in some way, let her watch you as you hunt for the missing article. Remember to check the garbage.
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Why Seniors With Dementia Make False Dementia Accusations
Their accusations may sound crazy, but the situation is very real to your older adult.
Their minds are trying to make sense of the world while their cognitive abilities are declining.
People with dementia often feel anxiety, frustration, and a sense of loss. Those feelings, plus memory loss and confusion, can easily lead to paranoia.
Thats why many seniors with dementia feel like people are stealing from them or mistreating them.
When they cant find something theyve misplaced, their brain leads them to believe that someone stole from them.
When you prevent them from;wandering and getting lost, they think theyre being kept prisoner.
These dementia accusations can be extremely hurtful to hear, but its important to remember that theyre not personal attacks against you.
Their brain cant make sense of whats happening and has created an alternate version of reality to compensate.
Try To Keep Track Of Where Objects Are Kept And Where They Tend To Be Hidden
Try to notice where the person with dementia leaves or hides their belongings. You may find that objects always seem to turn up in the same place. Then, whenever they complain that something has been stolen or is lost, you will have a good idea where it is. By locking drawers and cupboards you can reduce the number of possible hiding places for objects and speed up the search process when something is mislaid. Dont forget that the person with dementia might put things in unusual places, so check wastepaper bins and laundry baskets before emptying them.
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Do Not Shy Away From Asking For Help
No one may have all the answers especially when it comes to taking care of a person with dementia. Try doing research on how their behavior changes and what needs to be done to help them live their lives without too many complications. Hire help when it becomes too much as it also ensures that you do not become too frustrated or drained. When you have multiple family members who can help, ask everyone to pitch in and look after the patient so that you can get some personal space to breathe and re-energize when it is your time to look after the patient. When you feel like you can no longer look after your loved one at your own home, it may be time to consider assisted living. In such case, look into dementia care homes that can provide specially trained professionals.
How To Deal With Manipulation
Your loved one may have lost the ability to distinguish between truth and falsehoods, and they may no longer have a sense of morality around lying. These symptoms can be especially difficult for a caregiver to handle, as it may feel like a complete change in personality. In fact, a person with dementia may not realize theyre lying.
Manipulation is often the root behavior for trust, control, and security. Sometimes, it can even be a cry for help.
- Set limits when possible.
- Remain aware of your personal responses. Do you feel angry, hurt, or frustrated? Acting on these emotions can bring more distress to an already stressful situation.
- Hold dementia behaviors against your loved one.
- Bring up events to prove or disprove statements.
- Use accusatory language such as youre lying or youre being manipulative.
- Engage in heated arguments.
Dealing with dementia behaviors can quickly wear;out a caregiver or family member. If you care for a person with dementia and are feeling resentment, anxiety, or depression, dont hesitate to seek help. A;caregiver support group, counselor, friend, or family member can offer camaraderie and advice.
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Suggested Responses To 4 Common Dementia Accusations
1. You stole my money!Having dementia means giving up control over their own finances.
That loss of control, combined with paranoia or delusions, can cause them to think people are stealing their money.
- Oh no, is your money missing? I can see why youre upset. Dont worry, Im going to help you look for it. Lets start by checking this drawer
- Oh no, is there money missing? That can be very upsetting. Lets check your bank statements to make sure its all there.
- It sounds like we need to look into this. Lets go to the bank tomorrow when its open to get it straightened out. Since the bank is closed right now, lets do .
How to help them feel more in control:
- Give them a checkbook to help them track their money
- Let them keep a wallet with a small amount of real money or realistic-looking fake money
- Keep files of very old bank statements for them to review when they feel anxious
- Let them write checks to pay bills and secretly shred them later
2. You stole my purse / wallet / glasses / hearing aid / dentures !Someone with dementia may accuse you of stealing an item when they cant find it themselves.
Its easier to cope with the changes in their brain by saying that someone stole the item rather than admit they cant find it.
How to help them feel more in control:
3. Youre poisoning me! Im not going to eat.Paranoia or delusions can cause someone with dementia to believe that youre putting poison in their food or drinks.
What Are False Beliefs And Delusions
Beliefs:A persons beliefs are the basis for how they view the world. We start forming what we believe as children and continue to build upon it throughout our lives. Examples could include someones religious or political beliefs. But there are life lessons that people can pick up that can have a negative influence on their lives, for instance, beliefs such as: Dont trust people; theyll always let you down.
Our beliefs are personal to us, and as such, its possible that all of us might have thoughts and beliefs at some time that are false. Someone might believe that their neighbour doesnt like them when theres no evidence to support this. But people with normal cognitive function have some control over how their beliefs affect them and dont usually allow them to become a negative influence in their life.
When someone has dementia, they may lose the ability to moderate their thoughts or keep them in check, and this is when false beliefs can become a problem.
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Rummaging And Hiding Things
Caring for a patient who rummages around or hides things in the home can be a challenge, but not an insurmountable one.
|Rummaging/hiding things behavior management|
|Lock certain rooms or cabinets to protect their contents, and lock up all valuables.|
|Have mail delivered out of reach of your loved oneperhaps to a post office box.|
|If items do disappear, learn the persons preferred hiding places.|
|Restrict access to trashcans, and check all wastebaskets before disposing of their contents in case objects have been hidden there.|
|Protecting your loved one from harm|
|Prevent access to unsafe substances, such as cleaning products, alcohol, firearms, power tools, sharp knives, and medications.|
|Block unused electrical outlets with childproofing devices. Hide stove knobs so the person cant turn on the burners.|
|Lower the temperature on water heaters.|
|Designate a special drawer of items that the person can safely play with when keen to rummage.|
How Do I Deal With Delusions
It can be one of the most upsetting things about being a family caregiver. Youre consumed with the care of your mom. You spend hours helping her, taking over household chores, driving her to medical appointments, struggling with her personal care. Yet instead of thanks, you may be met with accusations: Youve taken my purse! Youre stealing my money. Then, as usual, after a few minutes search, the purse turns up under the pillow, where Mom hid and forgot it.
Delusionsfixed, false ideasare quite common with Alzheimers disease and the other dementias. Often, they can simply be caused by the very nature of the disease and the damage to the brain caused by dementia. It may be possible that mother hid her purse to keep it safe. However, she forgets that she put in under the pillow so now its missing. You are the only person who has visited; therefore, you must be the guilty party.
Likewise, mistaken identity, another common delusion, can be caused by forgetfulness. As painful as it may be, your father may not remember what his wife, daughter, or son look like, so he no longer recognizes them. Or, forgetful and confused, he may think he is 40 years old, not 80, and so may mistake his grandson for his son.
Sometimes delusions are more mysterious. A person with dementia may decide that the neighbors have moved the fence in six feet during the night or that someone is constantly breaking into the house.
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Do Not Try To Stop A Person Who Wants To Leave A Room
Staying in one place for long periods may result in behavior problems in the dementia patient. It is essential to have a safe environment where they can enjoy the outdoors without any problem. When someone tries to leave a room, do not force them to stop. Doing this may result in an extreme reaction such as severe distress or injuries.
Instead, it is best to accompany the patient so that they are safe. You can even suggest going for a drive around the block so that they can experience a new environment for a short period. If they do not want company, just let them go but stay close by to make sure that the patient is safe at all times.
Repeating The Same Question Or Activity
Repeating the same question or activity may be a result of memory loss where the person cannot remember what they’ve said or done.
It can be frustrating for the carer, but it’s important to remember that the person is not being deliberately difficult.
- be tactful and patient
- help the person find the answer themselves, for example, if they keep asking the time, buy an easy-to-read clock and keep it in a visible place
- look for any underlying theme, such as the person believing they’re lost, and offer reassurance
- offer general reassurance, for example, that they do not need to worry about that appointment as all the arrangements are in hand
- encourage someone to talk about something they like talking about, for example, a period of time or an event they enjoyed
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Dementia Delusions And False Accusations Of Elder Abuse
I was fortunate that none of the elders I cared for ever leveled serious accusations against me, even in their severely demented states. Some caregivers arent so lucky, and some fabrications can have very grave consequences. False allegations of elder abuse and neglect arent just emotionally devastating; they can have dire legal and financial ramifications for family caregivers as well.
If reported, Adult Protective Services or the police may investigate allegations of elder abuse. Even if it has been confirmed that a loved one has dementia, making up stories about being mistreated or financially exploited can still trigger a full APS investigation. This is often humiliating for family caregivers and may seem like a waste of time and resources, but elder abuse is a reality for many seniors. The National Center on Elder Abuse estimates that as many as 2 million seniors are abused in the United States. Proper authorities must look into all reports to protect vulnerable adults.
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Voice Tone And Body Language Are Important
Never underestimate the power of voice tone and body language when interacting with someone who lives with dementia. Stay calm. Keep your voice compassionate but not condescending. Use a soft touch or a hug if your loved one is receptive to this. Affirm her feelings. She needs to feel that you are on her side. If she feels this, she may let go of the idea that you stole from her, or at least allow you to look for the missing object without getting even more upset.
Dont Take Accusations Personally
It may be difficult not to take an accusation personally or be offended. But it is important to remember that the person with dementia does not mean to offend you and that their behaviour is merely a result of the disease. Such false accusations are perhaps understandable – they know that something was in a particular place, but have forgotten having moved it or given it away. Someone must have moved or stolen it. The person may be more suspicious of people than they were before the disease and may therefore be more inclined to believe that it was stolen .
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