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Paranoia in Dementia

Dementia is a term used for diseases and conditionscaused by a decline in memory, language and thinking skills affecting a person’s ability to carry out day-to-day activities. The most common cause of Dementia is Alzheimer’s. Dementia patients can often be found suffering from undesirable emotions such as fear, anger and jealousy. This sort of behavior spotted in Dementia patients is known in the field of medical science as Paranoia.

Antipsychotic Drugs are used for treating Dementia patients suffering from Paranoia. The most widely prescribed antipsychotics for dementia include aripiprazole, olanzapine, quetiapine and risperidone. Risperidone for that matter,is now the only licensed drug subscribed for treating paranoia in dementia, with the patient being closely monitored for ill-effects.

What stage of dementia is paranoia?

There are 7 known stages of Dementia:

Stage 1: is where every Dementia patient begins and is known as No Impairment. There are no visible symptoms of cognitive impairment in this stage and mental function is normal.

Stage 2: is Very Mild Cognitive Decline, in which patients begin to show some signs of Alzheimer’s disease and side effects at this stage include forgetting everyday phrases and forgetting the location of important objects.

Stage 3: is known as Mild Cognitive Decline in which patients begin to show symptoms of Dementia and people around the patient notice many things such as the patient’s impaired work performance, memory loss, forgetfulness, verbal repetition, poor organization, concentration, difficulty in driving and struggle to complete complex tasks.

Stage 4: is known as Moderate Cognitive Decline, in which symptoms such as social withdrawal, moodiness, non-responsiveness, trouble with routine tasks and denial are visible in the patient.

Stage 5: is known as Moderately Severe Cognitive Decline, in which the patient’s loved ones must help out with routine tasks such as dressing and bathing as the patient is found suffering from confusion, forgetfulness, memory loss of personal details and current events and reduced mental acuity and problem solving capacity.

Stage 6: is known as Severe Cognitive Decline in which the patient requires his loved one’s help to carry out activities of daily living such as using the bathroom and eating. The patient can also be found experiencing a lot of difficulty in sleeping, delusions, anxiety and difficulty recognizing loved ones.

Stage 7: is Very Severe Cognitive Decline and is also known as late-stage dementia. The patient can be found living with severe moor and communication impairment.

“Paranoia can be classified as either Stage 3 or Stage 4 or somewhere between the two in Dementia patients.“

What triggers paranoia?

There are many things that eventually trigger paranoia in dementia patients. Dementia patients often going without sleep are often found to be suffering from paranoia. They find it hard to think as clearly as others and are more likely to clash with others and have misunderstandings. The patient may begin to feel that people are working against him and even starts to see and hear things that are not there. Stress is another factor that triggers paranoia.

Stress can emanate from not only something negative but also from an event such as a wedding and dementia patients must take out time to relax, spend time friends, find a reason to laugh, get lots of exercises and meditate in order to keep a clear mind.

Alcohol and substance use can also lead to paranoia. Marijuana, Hallucinogens such as LSD and Psychotic Mushrooms, and Stimulants such as Cocaine and Methamphetamine can lead to paranoia. Finally, psychiatric disorders such as paranoid personality disorder also trigger paranoia. The patient finds it hard to trust others and is always haunted by negative which makes him think that somebody is making fun of him or scheming against him.

 How do you deal with paranoia in dementia?

The best way to deal with paranoia in dementia is through some behavioral techniques meant to calm dementia patients experiencing paranoia. The first such technique is to rule out non-dementia causes of paranoia. Paranoia can also result from:

• Urinary tract infections
• Liver diseases
• Systemic infections and
• Anxiety disorders

Dementia patients must be told that the cause of paranoia is none of these and only dementia-related reasons. Hiding the reality from them is unwise.

Using validation techniques to acknowledge what the patient is going through is wise. Working to meet the need they are expressing must be done. Such patients should never be proven wrong and must be dealt with honestly. Nothing extra should be added to their reality and remaining calm while dealing with paranoid patients of dementia is of paramount importance.

Arguing is not really that helpful in such cases and offering reassurance is another good option. This can be done through a physical touch combined with reflecting their reality. Shifting attention by turning on the lights or opening blinds or talking on a favorite topic can also be helpful.

Does paranoia go with dementia? 

It is not certain whether paranoia goes with dementia or not. Even if a person is cured of dementia and carries out day-to-day activities and no longer struggles with memory-related problems or with the ability to communicate, there is no certainty that he or she will stop feeling jealous or angry or fearing something or someone. Such feelings may well exist even in the post-treatment phase and those administering treatment must be extra careful while doing so. Dementia patients may continue experiencing such feelings despite having been cured of dementia.