Supporting a Dementia Patient with Hallucinations, Delusions, and Paranoia

As dementia is a condition that affects the brain, people diagnosed with it are liable to experience paranoia, hallucinations, or delusions during the course of their illness. These conditions cause the patient to see, hear, and imagine things that are not based in reality. This can cause immense confusion, anxiety, frustration, and even fear for your patient. As their caregiver, you want to do your best to comfort and soothe them.

Dealing with these conditions in a patient that may already be confused and overwhelmed by their surroundings can be a challenging and overwhelming experience for caregivers. However, with the right strategies and support, it is possible to manage these symptoms and improve the quality of life for both the individual and concerned loved ones around them. In this article, we will outline some advice on how to cope with and support patients with dementia who are experiencing paranoia, hallucinations, and delusions.

Distinguishing Between Hallucinations, Delusions, and Paranoia


Hallucinations are perceptions of the world around oneself that are not actually real. However, they can be so convincing that the person experiencing the hallucinations may believe that they are real. The individual may experience having touched, seen, heard, smelled, or even tasted something during their hallucination. For example, someone experiencing a hallucination may see spiders crawling up the wall when there aren’t any there.


Delusions are firmly held opinions or beliefs that are factually incorrect. These opinions or beliefs can be about things, other people, or even themselves. Some examples of delusions are theft, believing an intruder is in the house, or even spousal infidelity.


Paranoia is a form of delusion that causes a person to believe that others are “out to get” them. They may feel that the world is plotting against them, that certain individuals hate them, or that they are being watched or targeted by someone.

What Are The Causes Of Paranoia, Delusions, And Hallucinations In A Loved One With Dementia?

An individual’s dementia may have reached a stage where they are not able to process memories or information correctly, which can lead them to false thoughts or conclusions. Memory impairment, the most well-known dementia symptom, may also cause paranoia or delusions. Medication is another possible cause of these conditions, especially if they seem to have appeared suddenly. Consult your care recipient’s doctor if they have recently started a new course of medication and began having these symptoms.

How To Manage Paranoia, Delusions, And Hallucinations

Stay Calm

It’s important to keep a level head for the sake of your loved one. It’s likely that your care recipient is going through a great amount of mental distress — remain attentive and calm to be a grounding presence for them.

Refrain from Arguing

Arguing may only distress the patient further. Rather than trying to disprove a vision or hallucination that feels extremely real to them, address their emotional state. Comfort them if they seem afraid. Try not to react if your care recipient blames you for something (i.e. “stealing” their favorite book).

Be Reassuring and Understanding

Try to look beyond their explanations and understand the underlying emotions they may be feeling. Acknowledge their fears and concerns, and gently comfort them. For example, if your loved one feels someone is watching them, you could say “I’m sure it’s scary to think you’re being watched by someone”. This response acknowledges their fear while avoiding feeding directly into their paranoia.

Investigate Your Environment

These conditions can be caused by something in their surroundings. Once you’ve acknowledged their fears and concerns, try to figure out the cause. Are they visualizing or hearing something that you’re unable to see? Are they only experiencing this at a certain time of day? Maybe the lighting at that hour casts shadows in the room that scare them, or the TV news reports on upsetting incidents at a certain time of day. Dementia patients may take such things literally and assume they are happening nearby or directly to them.

Use Distractions

After you’ve calmed your care recipient down, redirect their attention to another activity. Turn off the TV or radio if they are playing distressing programming. Engage them in something that offers a change in their environment or is mentally stimulating, such as puzzles, going for a walk, listening to music, or playing cards.

Consult Their Doctor

Talk to their doctor if these conditions worsen, as the cause may revolve around other medical problems or their medication. Do not stop your care recipient’s medication without first consulting their doctor.

Keep an Eye Out for Potential Concerns

If your care recipient seems frequently accusatory or upset with you, take steps to ensure that they feel safe around other caregivers and individuals in their household. In some cases of paranoia, there is a chance that the patient may have a rational reason for feeling the way they do — perhaps someone is stealing their things or treating them poorly, but they are unable to communicate this properly or remember who is doing it. Be mindful of their surroundings and people who interact with them, and make note of any suspicious behavior. If you suspect any cases of elder abuse, contact the National Center on Elder Abuse.


Paranoia, hallucinations, and delusions can be incredibly stressful states for your patient. The best way you can help them is by practicing sympathy, understanding, and kindness. Be mindful of their surroundings and environment when they are not necessarily able to deduce or communicate what may be bothering them. While these situations can be stressful for you both, taking steps to ease both your minds can do wonders to soothing your patient’s fears and alleviating your own concerns.

More Posts

All posts

Become a part of the Evva community!

Stay updated about latest news, upcoming releases, and caregiving tips from the Evva community.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.