Challenging Behaviors - Paranoia and False Ideas

Paranoia is defined as suspiciousness of others that is not based on fact. Progressive brain impairment in persons with Alzheimer's disease affects their ability to interpret information accurately. Suspiciousness is a common response to the persons dwindling control of their world. They may develop false ideas that they insist upon being true. For example, a person may insist that her husband is not her husband but someone who is an imposter.

> Insecurity, which is associated with progressive brain impairment, often leads a person to interpret events from a fearful and thretening perspective. Sometimes a person misinterprets what he or she sees or hears. The following two examples show how caregivers responded to paranoia and misinterpretation.

> Mrs. Jones* is living with Alzheimer's disease. She has misplaced her purse but believes it was stolen. Carla*, her daughter, was the last person Mrs. Jones saw that morning. She accuses Carla of stealing her purse. Carla responds to her mother's paranoia by saying, "Mom, I am sure that we will find your purse. Let's look for it in the dining room."

> Mr. Smith* calls for help in the middle of the night. He tells Bill*, his son, "Call the police! I heard someone trying to break into the house!" Bill responds to his father's misinterpretation by saying "Dad, the sound you heard is the rain tapping on your window. Why don't I sit with you awhile."

Note that in both scenerios, the caregivers did not attempt to correct or reason with their family member. They simply responded to the fear or misinterpretation and offered to support them.

(* Names are changed to protect identity)

Paranoia may also occur because of:

>Lack of sensory stimulation.

A confused person may begin to feel unsafe if he or she is alone. You can help them by spending time with them talking or taking a walk.

>Certain medications

Discuss the family members medication with their physician if paranoia and suspicion become frequent occurances.

>Other medical conditions like infection may also cause a change in behavior. Be sure to report any changes you note in their behavior to their physician.

Although paranoia and suspiciousness may be upsetting, always respond calmly to the persons behavior and concerns. If something is lost, offer to help find it. Avoid contradicting or arguing with them. Communicate a sense that things are all right and you will protect and help them.

The Alzheimer's Association of WNY has a variety of helpful videos and books in their lending library. For more information, please contact them at (716) 626-0600.

For more information on the care and services offered through ElderWood Senior Care, please contact (716) 633-3900.