Alzheimer’s Caregiving

Alzheimer's and Hallucinations, Delusions, and Paranoia

Due to complex changes occurring in the brain, people with Alzheimer's disease may see or hear things that have no basis in reality.

• Hallucinations involve hearing, seeing, smelling, or feeling things that are not really there. For example, a person with Alzheimer's may see children playing in the living room when no children exist.
• Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.
• Paranoia is a type of delusion in which a person may believe—without a good reason—that others are mean, lying, unfair, or “out to get me.” He or she may become suspicious, fearful, or jealous of people.

If a person with Alzheimer’s has ongoing disturbing hallucinations or delusions, seek medical help. An illness or medication may cause these behaviors. Medicines are available to treat these behaviors but must be used with caution. The following tips may also help you cope with these behaviors.

Hallucinations and Delusions

Here are some tips for coping with hallucinations and delusions:

• Discuss with the doctor any illnesses the person with Alzheimer’s has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.
• Try not to argue with the person about what he or she sees or hears. Comfort the person if he or she is afraid.
• Distract the person. Sometimes moving to another room or going outside for a walk helps.
• Turn off the TV when violent or upsetting programs are on. Someone with Alzheimer’s may think these events are happening in the room.
• Make sure the person is safe and can’t reach anything that could be used to hurt anyone or himself or herself.

Paranoia

In a person with Alzheimer’s disease, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:

• Where he or she put something. The person may believe that someone is taking his or her things.
• That you are the person’s caregiver. Someone with Alzheimer’s might not trust you if he or she thinks you are a stranger.
• People to whom the person has been introduced. He or she may believe that strangers will be harmful.
• Directions you just gave. The person may think you are trying to trick him or her.

Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

Here are some tips for coping with paranoia:

• Try not to react if the person blames you for something.
• Don’t argue with the person.
• Let the person know that he or she is safe.
• Use gentle touching or hugging to show you care.
• Explain to others that the person is acting this way because he or she has Alzheimer’s disease.
• Search for things to distract the person, then talk about what you found. For example, talk about a photograph or keepsake.

Also, keep in mind that someone with Alzheimer’s disease may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with Alzheimer’s. For more information, visit Elder Abuse.

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For More Information About Hallucinations, Delusions, and Paranoia in Alzheimer's

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017