Caregiving for Elderly Parents With Paranoia

Oct 1st, 2010 | By Sharon Shaw Elrod MSW EdD | Category: Senior Moments Blog

Caregiving for the elderly parents of our SCJ editors seems to be replete with topics for discussion these days.  The next one on the list is paranoia, which may be related to Alzheimers or other forms of dementia.  Our elderly parents are in their 90s, with one in her mid-80s.  If we believed in the position of the moon or what just got dumped into the public water system, we would have a way of explaining why they all got paranoid at the same time.  But, in reality, there are other very plausible explanations.

Paranoia is one of the symptoms of dementia, and particularly Alzheimers.  With any form of dementia, the brain functioning is compromised/altered and the elderly individual often becomes paranoid about any variety of issues–finances, caregivers, terrorism, etc.  Medications may exacerbate the problem, and the elderly person’s primary care physician needs to evaluate that possibility.  However, for most elderly seniors, paranoia is just part of the territory of dementia, Alzheimers or not. 

So what are the issues involved and what is the best approach for a caregiver in dealing with paranoid demented parents?

A friend’s elderly parent recently became paranoid over night.  He was very concerned about the sudden change of behavior and  contacted his parent’s physician, who immediately identified a new medication that was probably the culprit.  The physician stopped the medication and the paranoia disappeared. 

  • be sure your elderly parent is evaluated for any possible medication-related causes;
  • some elderly people become schizophrenic as they age, and that is treatable with medication;
  • in addition, regarding medication related issues, inquire with your parent’s physician about any possible medications to alleviate the paranoia;

Another elderly parent has become increasingly paranoid over the past decade.  The issues have varied but seem to all be related to finances.  His dementia is severe and he has been unable to manage his financial life for some time; two of his adult children manage it on his behalf.  He now frequently accuses them of taking all his money. 

  • the adult children continue to be as transparent as possible about their management of his finances, reviewing every detail with him on a monthly basis; they answer all his questions (usually the same ones every month) and provide all the information they have available;
  • with a paranoid issue that comes up over and over again, write on a piece of paper a statement of reality that your parent(s) can have available to read; this, of course, pre-supposes they will choose to read reality in the midst of paranoia (which may never happen) but you will have provided a tool that you can use when you are with them to address the paranoid issue;  these two people have a ‘reality statement’ written that identifies where his money is and what has happened to the money he has spent; they plan to do this for as long as he lives.

A third elderly parent has become convinced her adult children do not love her because they aren’t living according to her prescription.  The ‘you don’t love me’ in a mild form can be simple manipulation.  The paranoid state is more severe and can have a serious impact on the relationship. 

  • the adult children continue to offer reality statements in the face of her paranoia; the reality usually falls on deaf ears, but nevertheless they continue to respond in a calm and reasoned manner.  They are beginning to recognize the seeds of this paranoia have been with her all her life, and are now beginning to grow out of control with the course of her dementia.  They will likely not be able to change her paranoia, but they are committed to continue to love her.

Paranoia in elderly parents is tough to address.  There is a lot of information available on the Internet that can be very helpful reading.  Just do a search for ’paranoia in elderly’ and you will find over 667,000 results.  Remember university and medical center sites do research and document their findings in reports; blogs are opinions unless they are documented and backed up by research.



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