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Paranoia in the Elderly

Kimberly Fowler
By Kimberly FowlerDecember 5, 2016

Are you caring for a family member or an elder who is experiencing extreme anxiety, paranoia or unfounded worry? According to Dr. Leslie Kernisan, MD, MPH, “it’s very common for older adults to develop persisting fears, worries, and complaints that often strike their family members as irrational, paranoid, absurd, or ridiculous.”

Caregivers may find it difficult to ease the elderly person’s fears or worries, and many feel at a loss as to how to help. “Most concerns families have about an aging parent track back to underlying medical problems that should be identified and addressed,” Dr. Kernisan says. So, the first step is to visit your family doctor. Learn more about how to handle paranoia in the elderly.

Possible Reasons for Paranoia

There are a number of medical conditions that can cause irrational anxiety, paranoid behavior or persistent fear.

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These include (but are not limited to):

Talk to a doctor if you are worried about your loved one’s behavior. Depending on the state you live in, if your aging parent is on Medicare and showing symptoms of dementia (like paranoia), testing may be free at a geriatric assessment center.

Visit Alz.org for more information.

Symptoms of Paranoia

Although in many cases paranoid behavior is a symptom of a medical condition, in some cases the senior’s concern is well founded. Don’t immediately dismiss the worries that someone is stealing cash (when the money has just been misplaced), or that the neighbor is taking the newspaper (when it’s a holiday and there is no delivery). Such concerns warrant a thorough investigation before being dismissed.

Take into consideration the frequency and severity of the paranoid behavior. In addition to the examples given above, other common fears, worries and complaints that may seem irrational or paranoid to caregivers include the elderly person:

  1. Feeling extreme agitation, caution or stress that isn’t easily explained.
  2. Feeling they are unfairly persecuted.
  3. Hearing strange noises (could the noise be innocent, like a tree branch scratching a window, for instance).
  4. Seeing people or animals who are not there (possibly a vision problem or a a side effect of medication).
  5. Thinking people are talking behind their back (check their hearing aid with an audiologist).

It’s important to note that the senior’s environment can exacerbate feelings of stress or anxiety.

According to MedScape, “Living in an unfriendly social environment leads to heightened agitation, anxiety, caution and stress among older persons.”

This is especially important to remember if your loved one lives in an assisted or long term care community. New feelings of stress or anxiety may be a signal that the senior is not comfortable in their environment.

Tips for Caregivers

There’s no doubt that the disruptions that these behaviors cause can be difficult for caregivers to manage. MedScape points out that paranoia can “frequently alienate family and friends and leave caregivers frightened, distressed and exhausted by the increased demands of caring for a paranoid older person.”

Here are some tips to help caregivers navigate a senior’s paranoia:

  • Be patient and understanding
  • Don’t overlook small changes in behavior, because over time these can indicate a larger problem
  • It’s more important to reassure and validate your loved one’s feelings than try to provide rational explanations
  • Journal day-to-day behaviors so you can objectively look for signs of improvement or regression
  • Keep careful watch of the senior’s behavior and possible causes of this behavior
  • Keeping a record of the elderly person’s behavior is a useful tool for medical professionals
  • “No matter what their age or mental condition, people respond to feeling heard and loved,” Dr. Kernisan says
  • “Reason why, rather than reasoning with,” Dr. Kernisan suggests
  • Remember that most cases of paranoia are treatable
  • Seek medical advice
  • Try to figure out what is triggering their feelings

Most importantly, remember you’re not alone. Reach out for help. Ask your family for support and connect with other caregivers for advice. They know better than anyone what you’re going through and may have tricks and tips that will help your unique situation.

Are you or a loved one facing the challenging symptoms of paranoia in the elderly? Share your experiences and stories with us in the comments below.

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Kimberly Fowler
Kimberly Fowler
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