It's Not Personal: When a Loved One with Dementia Distrusts You

Posted: 11/2/2018 12:04 PM by Interim HealthCare
By Jennifer L. Cook

A person with Alzheimer’s disease or another form of dementia can sometimes become suspicious, paranoid or even jealous of you and other people. It can be baffling and upsetting to encounter personality changes like these in a loved one who up until then was perfectly trusting.
Take, for example, the husband who drove his wife to the doctor and waited for her in the waiting room. All seemed well until the next morning, when she awoke convinced that the doctor had abused her and furious that her husband hasn’t defended her. When he tried to explain to his wife that nothing happened, she became more enraged.
Or the grandmother who accused her teenage granddaughter, following one of her after-school visits, of stealing money from her sewing room. The granddaughter’s denials only inflamed her grandmother, who banished her from the house and threatened to call the police.
What provokes these reactions, and what’s the best way to deal with them?
Catherine Tedder, RN, senior manager of program development and implementation at Interim HealthCare and a certified PAC (Positive Approach to Care) trainer, provides these insights and tips.
Remember that the reaction is a symptom of the condition. Emotions like fear, anger, anxiety, paranoia and agitation are symptoms of the altered perceptions and understanding that arise from having a failing brain. In other words, those emotions are the dementia speaking, not your loved one. If your mom accuses you of stealing, for instance, seeing her paranoia and distrust as symptoms of her illness may help you gain some perspective and avoid getting angry or hurt.
Take your loved one’s concerns seriously. Even when their story seems crazy, denying or dismissing it will likely make matters worse. Instead, ask questions, listen and acknowledge their emotions. After all, your dad really believes that the new caregiver is plotting to change his will. Expressing your support and sympathy — without confirming their suspicions — can go a long way toward helping your loved one get past the fear and paranoia.
Try distraction. Leverage your loved one’s interests to try to distract them when they’re agitated. For instance, you could calmly say, “Let’s work on this puzzle for a little while.” Or if it’s getting close to lunchtime, you might say, “What should we make you for lunch? Let’s work on this together.” However, even when distraction does work, be forewarned that it may not last.
Check with the doctor. In dementia patients, agitation or anxiety can sometimes be a first sign of a physical problem such as a urinary tract infection or pneumonia. Since these illnesses can make someone very sick very quickly, it’s worth putting in a call to their doctor.
Give yourself time off. It’s extremely tough if not impossible to care for a person with dementia 24/7 by yourself, especially when the person’s behavior is challenging. To preserve your emotional well-being, establish early on a group of family members and/or friends who are trusted by your loved one and who can come by to visit them and allow you a bit of time to rejuvenate, even if it’s just an hour to get a coffee with a friend, go to church, visit the library or simply get out and be by yourself for a while. You might also look into respite care, which provides short-term relief for caregivers, either in the home or at a facility. Respite care can give you time to go shopping and run errands or even take a vacation.
In the end, says Tedder, the best thing you can do for a person with dementia is be in the moment with them, doing together activities that bring them joy.
Jennifer L. Cook, an award-winning journalist based in New York’s Hudson Valley, is dedicated to helping improve readers’ health and wellbeing.