Paranoia in the elderly is a widespread concern. It’s estimated that nearly 70% of seniors with Alzheimer’s will experience paranoid beliefs, and one in four will experience some form of psychosis, according to the National Institutes of Health. Caregivers working with paranoid seniors may find it difficult to ease those seniors’ fears, and many caregivers feel at a loss about how to assist them. Some caregivers may even find that they are the target of a senior’s paranoid thoughts when they are simply trying to help. Read on for several useful tips and treatments that may help ease your loved one’s paranoia.
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Paranoia can be described as an individual’s unfounded belief that others intend to do them harm. For instance, a senior experiencing paranoia may believe that a caregiver is stealing from them or that one of their friends wishes to hurt them.
Paranoia can be extremely harmful to seniors if left untreated. Seniors who believe they are being threatened or feel that they live in an unfriendly social environment are more likely to experience anxiety, heightened stress, and agitation. A paranoid senior’s distressing thoughts may even drive them to lash out physically at caregivers or alienate family members.
Paranoia is a symptom of a broader condition known as psychosis, which occurs when a person’s mental processing becomes disconnected from reality. While there can be many different triggers, psychosis in seniors generally tends to be caused by one of the following symptoms or factors:
Although paranoid behavior is typically a symptom of another medical condition, you should never immediately write off a senior’s concerns as being unfounded. Take the time to do your own thorough investigation, and talk to a doctor if you are worried about your loved one’s well-being.
While the experience of paranoia may vary between individuals, the most common symptoms of elderly paranoia fall under three general categories:
Several warning signs can help you identify if your loved one is experiencing paranoia. Symptoms of paranoia may include these behaviors:
Many people often incorrectly use the terms paranoia, delusions, and hallucinations interchangeably when referring to psychosis. The main difference between paranoia and hallucinations is that hallucinations involve a sensory experience, while paranoia affects a person’s thoughts and beliefs. External events do not necessarily cause hallucinations. On the other hand, paranoia is related to a person’s perception of their environment. Meanwhile, a delusion is simply a belief that is not true. In many cases, a person may experience paranoia, delusions, and hallucinations simultaneously. This is especially true in seniors with Alzheimer’s or other forms of dementia.
There’s no doubt that paranoia in seniors can be difficult for caregivers to manage. Seniors may unintentionally alienate their loved ones and leave their caregivers distressed while they struggle to feel safe in their environment. Here are some tips for caregivers to help care for seniors with paranoia:
It is important to remember that most cases of paranoia in old age are treatable. “Most families’ concerns about an aging parent track back to underlying medical problems that should be identified and addressed,” according to Dr. Leslie Kernisan, MD, who holds a master’s degree in public health. This means that the first step in managing symptoms of paranoia is to visit your family doctor.
Depending on the frequency and severity of a senior’s paranoid behavior, a doctor may explore several different treatment options. For example, a licensed therapist can help your loved one better understand their underlying emotions, and palliative care techniques can alleviate some of the discomforts of Alzheimer’s or other forms of dementia. Another technique, known as redirection, involves introducing a third party into a situation to distract the individual and help alleviate the tension.
If a senior’s paranoia does not improve, your loved one’s doctor may suggest medication as a further treatment option. A doctor may prescribe antidepressants to help treat symptoms of depression that often accompany dementia. In severe cases, they may prescribe antipsychotics. However, antipsychotics are used sparingly due to their potential for adverse side effects.
Contact a doctor if you notice any significant changes in the health or behavior of your loved one. It is crucial to reach out to medical professionals if your loved one’s paranoia is affecting their ability to complete activities of daily living or if they become a danger to themselves or others.
If your loved one is experiencing symptoms of paranoia, it may be time to consider other senior living arrangements. A Place for Mom’s Senior Living Advisors can help you explore local assisted living, independent living, and memory care options to find the services that best suit your family’s needs.
Reinhardt, M. & Cohen, C. (2015, February). Late-life psychosis: diagnosis and treatment. Current psychiatry reports.
Brendel, R. & Stern, T. (2005). Psychotic symptoms in the elderly. Primary care companion to the journal of clinical psychiatry.
Caregiver Assistance News. (2020, July). Alzheimer’s – hallucinations & paranoia. Caregiver Assistance News.
Chaudhary, M. & Rabheru, K. (2008). Paranoid symptoms among older adults. Geriatrics and aging.
Salters-Pedneault, K. (2020, November 16th). What is paranoid ideation? Verywell Mind.
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