Understanding Dementia Paranoia and How to Respond with Compassion

Many people with dementia will develop paranoia at some point through their diagnosis, which can be a precursor for delusions and hallucinations. They might become paranoid that someone is trying to steal from them or that a loved one is going to harm them.

It can be very upsetting when a loved one experiences dementia related paranoia, and it is not always easy to know how to respond. This can feel especially hard if you find yourself being falsely accused of something.

Today, we’ll explore what dementia paranoia is, the correct way to respond to a loved one going through it and how a live-in carer can help.

What is dementia related paranoia?

Paranoia in dementia is when someone begins to feel suspicious or believe things that are not true. They may think people are hiding items, talking about them behind their back or even trying to cause them harm. These feelings are very real and distressing for the person, even if there is no evidence to support them.

Dementia affects the brain and can change how a person understands the world around them. Memory loss, confusion and difficulty recognising people or places often play a part in these paranoid thoughts. Understanding that paranoia is a symptom of dementia, rather than a deliberate action, is the first step in responding with patience and compassion.

What’s the link between paranoia and dementia?

Paranoia is a common symptom of dementia and often develops as changes in the brain affect memory, reasoning and perception. When someone cannot remember where they put something, they may believe it has been stolen. If they struggle to recognise familiar faces, they may feel suspicious of the people around them.

These thoughts and fears are not deliberate but a result of how dementia changes the way a person understands their world. Recognising this link can help families respond with empathy and patience, focusing on reassurance rather than confrontation.

If your loved one is experiencing dementia paranoia, they might:

• Be suspicious towards family, friends and carers
• Buy into conspiracies
• Misinterpret environmental cues and sensory information
• Experience neurological and structural changes in the brain

Early signs of paranoia in dementia

Knowing the signs of paranoia in dementia helps your loved one get the correct care sooner rather than later. This can prevent them from getting into a dangerous situation and give you the right support to properly handle their feelings.

If you’re worried about your loved one developing dementia paranoia, look out for these early signs:

• Heightened suspicion and mistrust of their closest relatives
• Misinterpretations of your intentions
• Distorted perception, which can result in hallucinations
• Increased sensitivity to threatening stimuli, including loud noises or unfamiliar faces
• Hypervigilance and anxiety, potentially disrupting sleep patterns and daily function

Supporting a loved one experiencing dementia paranoia

You might not know how to support your paranoid loved one, especially if you’re being accused of stealing or trying to harm them. It’s tempting to retaliate or take a step back from the situation to protect your own feelings, but this often isn’t the best reaction.

The most important thing to remember is: for a person experiencing paranoia and delusion, their reality is very real for them. It’s natural to be upset, but trying to convince them of the truth is usually futile and causes more harm than good.

Here are some practical tips on how to talk through your loved one’s paranoia:

Encourage them to talk through their feelings

Opening the conversation up and listening to their feelings might give you insight into why they’re experiencing their paranoia. Encourage them to talk to you, and don’t interrupt them or put words in their mouths if they’re struggling to articulate themselves straight away.

For example, if they think you’re trying to poison them through food, ask them if they’d like to cook dinner together or eat with them to show them that their meals are safe.

Acknowledge their reality

Remember, your loved one believes their paranoia is real and justified. Dismissing them or distracting them without acknowledging their feelings can make them more suspicious of you, leading to the situation escalating and breaking trust completely.

For example, instead of jumping to defence when they accuse you of stealing from them, listen to their reasoning. See if something you did led them to believe you stole something, and acknowledge how that must make them feel. Once their feelings have been validated, gently suggest looking for the item together or doing something else to distract them. Some paranoia may be forgotten with time.

Offer a gentle explanation for their confusion

Once you’ve listened to the reason for their paranoia, carefully offer up another explanation for what may have happened. Instead of opposing their view completely by saying what they believe is wrong, consider another possibility to offer alongside their delusion.

For example, if they’re paranoid that their home isn’t their real home, instead of insisting that it is and shutting their anxiety down, consider whether anything’s changed. Different furniture, such as a reclining chair or electronic bed, or a new carer, may lead them to believe they’re in someone else’s house.

Explain this with clear and encouraging language: “You’re home – we just made a few updates to help you feel more comfortable. This new chair makes it easier for you to sit and stand safely, so we swapped it for your old one.”

Reassure them that you’re taking their belief seriously

Giving the impression that you’re not taking their paranoia seriously can lead your loved one to shut down and not want to confide in you, making it much more difficult to get to the root cause of the issue. The key here is to actively listen, agree with them and give them ways to resolve their worries.

For example, say you need to take your loved one to an appointment, but when you get to their home, they won’t let you in because they think you’re trying to harm them. Instead of agitating the situation and making you both more stressed, see if they’d be more comfortable with another loved one taking them instead. You can resolve the paranoia at a later date when everyone’s calmed down.

Find ways to avoid further paranoia

Sometimes, dementia paranoia resolves itself, and your loved one will forget what they were worried about within a matter of time. However, this isn’t always the case. Paranoia can be ongoing and cause big problems in your family dynamic – especially if you’re their primary carer. Finding ways to avoid further paranoia helps avoid this to give you both one less thing to worry about.

For example, if they think you’re stealing from them because they keep hiding their belongings and forgetting where they are, consider getting them a safe and having them write the code down in a sealed envelope.

Is there a way to prevent or reduce dementia paranoia?

There’s no guarantee that you’ll be able to prevent your loved one’s paranoia altogether, but there are some things to try to reduce their false beliefs:

• Create and label set places for things that get lost easily, such as keys, phones and remote controls
• Keep them up to date with their eyesight and hearing tests to avoid paranoia being heightened by sensory impairment
• Avoid making unnecessary changes around their home, keeping it their safe space that helps make sense of the world around them
• Ask their doctor for a medication review, as certain medicines can increase the risk of paranoia and delusions
• Encourage them to take part in stimulating activities and social interactions to reduce isolation and loneliness-induced paranoia

 

How Country Cousins can help

At Country Cousins, we understand how challenging it can be to care for a loved one with dementia, especially when symptoms like paranoia or confusion become overwhelming. Our live-in carers provide compassionate, one-to-one support that allows your loved one to remain safe and comfortable in their own home.

We carefully match each family with a carer who has experience in dementia care and the patience and understanding needed to provide reassurance. From helping with daily routines to offering companionship and emotional support, our carers are there to bring comfort and stability.

As part of our dementia care, Country Cousins offers:

• A deep understanding of dementia and its side effects
• Meal planning and preparation of delicious, nutritious meals
• Support with continence assistance with showering, bathing, shaving and oral hygiene
• Transport to and from appointments
• Compassionate care and companionship
• Support that focuses on upholding dignity and independence

Talk to our team today

As the UK’s longest-serving introductory live-in care agency, we have been providing compassionate live-in care to those who need it since 1959 – all from the comfort of their own homes.

Give us a call today on 01293 224 706. Our experienced team is on hand to help from Monday to Friday, 8 am to 6 pm. Alternatively, contact us through our online enquiry form.