Alzheimer's Foundation of America

Select text size: a | a | a

Education and Care

Behavioral Challenges:  
Coping With… Paranoia/Suspiciousness

Individuals with dementia may become paranoid as a result of false beliefs, or delusions, which are a symptom of the disease. Examples of paranoia are accusations that someone is poisoning their food or stealing their money, or statements such as, "My spouse is an imposter."

Possible Tips:
  • Discuss paranoia/suspiciousness with the individual’s doctor, including behavioral interventions and, if necessary, medications. In severe cases, when behavioral interventions do not suffice and risk of injury exists, a physician may suggest the use of psychotropic medication to manage paranoia.
  • Explain to other family members and caregivers that suspicious accusations are a part of the illness.
  • Acknowledge and validate the feeling behind the accusation. If the accusation involves hurting someone who has passed away, you might suggest, "You really miss your mother; tell me about her."
  • Speak in a gentle, calm tone of voice.
  • Try non-verbal reassurances like a gentle touch or hug.
  • Declare your intention to keep the person safe (i.e., “I understand that you are afraid that someone is following you.  I will be right here by your side to make sure that you are safe.”)
  • Redirect the person’s focus away from the distressing situation towards a more pleasant one (i.e., looking at family photos, playing soft music).
  • Adapt the environment to be more peaceful by removing excess stimuli (i.e., turning off a loud TV).
  • If the individual suspects money is "missing," allow them to keep small amounts of money in a pocket or pocketbook for easy inspection.
  • Assist the person in looking for a missing object. Try to learn where their favorite hiding places are for storing objects that are frequently "lost."
  • Avoid arguing.

Click here to read about causes of behavioral symptoms.

Click here to read about additional strategies to manage behavioral symptoms.

For more information, connect with the Alzheimer’s Foundation of America’s licensed social workers. Click here or call 866.232.8484. Real People. Real Care.