Delusions in dementia

Delusions are fixed, false ideas. They occur commonly in the course of a dementia, sometimes accompanied by sensory hallucinations. This happens as the person’s brain attempts to make sense of the world with diminishing mental resources.

Your behaviour may become incorporated into a delusion. You may be perceived as a thief who keeps taking their possessions and putting them where they cannot find them. Or as a jailer who is restricting them from leaving the house.

Types of delusions can include:

  • paranoid (suspicious, doubtful or others)
  • persecution (you are making my life difficult, harming me)
  • control (a force is making me do things)
  • reference (the numbers on a licence plate mean the end of the world is coming)
  • grandiose (I have a special mission in life).

If the person with dementia who you care for has a delusion do not try to argue against it to prove how it is false. This will only reinforce the belief and create distress for them.

Empathise with their feeling-state rather than debate the truth of their belief. Being understood and calmed will be more help to them. For instance, if they feel agitated by the belief you may say, “I am sorry this has upset to so much” or “I am sorry you are so agitated”. You position yourself as a trusted companion at a time when they may be suspicious and wary.

Medication may be a solution to help minimise the distress or the person but it should always be used with specialist medical advice and reviewed regularly.