How Do I Deal With Paranoia in My Loved One with Dementia?

Jul 22, 2022 | Caregivers

“You are always stealing money from me! Where are my glasses? You’ve stolen them too!”

Your loved one with dementia may have given up control of their finances to you, but due to the impairment of mental functions with dementia, they may not remember doing so.

They may have taken their glasses off and set them down somewhere different, and changes in their field of vision can prevent them from seeing beyond where they are looking. They also may develop an overall level of distrust, whether it is within reason or not, So, when they feel that an item is missing, it might lead them to assume it has been stolen.

They may experience delusions – strong beliefs that have no real basis in reality, which can form into paranoia which worsens as dementia progresses. This can lead your loved one to feel threatened and suspicious of you and any people around them.

Understanding Hallucinations, Delusions, and Paranoia

As the caregiver, hallucinations, delusions, and paranoia can add an extra layer of stress to your already difficult list of responsibilities.

Understanding the difference between these three common symptoms of dementia can help you cope:


Hallucinations are sensory experiences caused by changes in the brain that involve someone seeing, hearing, smelling, tasting, or feeling things that do not exist. Hallucinations with dementia are commonly triggered by sights and sounds that are not within the person’s perception.


Delusions are persistent beliefs held by a person despite any evidence to the contrary. Delusions in dementia often take on the form of paranoia, which can make the person feel threatened even if there is no valid reason to support it.


Paranoia is an extreme and unrealistic distrust of others, which leads a person to become suspicious, fearful, or jealous of people. In dementia, paranoia is often linked to memory loss.

How to Help a Person with Hallucinations and Delusions

Bring any new dementia symptoms, such as hallucinations and delusions, to the attention of your loved one’s physician to rule out any underlying causes, such as infections or pain.

It is often difficult, if not impossible, to completely diminish paranoia with dementia, but here are some practical steps that may tamper it down, and can help you cope with delusional behaviors:

Talk, Acknowledge, and Reassure

When we fear something in life, we all have the human need for someone to be there for us in support.

Talk with your loved one with dementia when they experience delusional behaviors in a reassuring manner. Do not argue with them.

You can be honest that you don’t see or hear what they are experiencing, but that you understand, and that you are there to support and take care of them. This reassures your loved one that you are acknowledging their concerns, and that you are not ignoring them…and this is calming!

Offer Explanation

Offer a gentle explanation for what might have happened. “Hmm…I would be upset if I thought my money was being stolen. Perhaps someone else is helping you with your banking. Let’s take a look.” Then, help your loved one find their pocketbook, and keep a small amount of change in it, or perhaps an old check register book to refer to.

If your loved one with dementia thinks that they are being poisoned, for example, consider saying, “I understand. I thought that (food) tasted funny too. Let’s just make sure it isn’t cooked that way again. We’re both okay…we’re both safe. Problem solved!”

Avoid Further Distress

Make sure that your loved one is safe. Never assume that they are delusional. Always give them the benefit of the doubt.

Rid the environment of practical things that may add fear to your loved one’s life, such as television shows that rouse anxious thoughts. A recent move of furniture or a change in professional caregiving staff can also spark fear in a person with dementia.

Organize your loved one’s environment but involve them in the process. Encourage routine to diminish frustration and anxiety.

Distress can ramp up to verbal and physically aggressive behaviors. Remember that aggression may be unprovoked, but when it comes from a person with dementia, it can be caused by many factors, for example, confusion, discomfort, environmental factors, and misunderstandings through poor communication.

Related article: Behavior Changes with Dementia: Aggression

How to Manage Accusations

As caregivers who want one thing above anything else – to ensure the well-being of our loved ones – it can be distressing to be on the receiving end of accusations.

Remembering these key points can help you manage:

  • Do not take accusations personally (it may happen despite your best efforts)
  • Do not try to defend yourself (keep your answers simple and supportive)
  • Use a calm voice and body language
  • Provide distractions (i.e., pleasant and fun activities)
  • Maintain a calm environment (you and your loved one with dementia deserve this!)

Keep in mind that sometimes accusations from people with dementia are not related to paranoia. Some individuals take advantage of elderly and disabled people. Ensure this is not the case with your loved one. Also, you may be falsely co-accused (from a family member or a close friend) of mistreatment or mishandling finances. In any of these scenarios, consider reaching out to an Elder Law Attorney.

Seek Help from Others

As much as we would like to handle everything ourselves, we all need a little help. The behavior changes that come with dementia can be overwhelming for even the best caretaker!

If you are a caregiver and would like to talk about the best options for the future, give us a call at 512-399-5089. We can help you through every step of the way