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Does anyone know how long a person with significant Dementia, (Vascular and Alzheimers) will have paranoia? My LO has been in ALF for a few months and most of the time happy there and very fond of the staff.(She has severe memory loss, knows almost no personal information, is in a wheelchair from fractured spine and hand, can stand briefly, and is urinary incontinent. Was recently so weak she could barely get out of bed. Gets confused on how to turn wheel on wheel chair)

Only lately she's been wanting to go home and now is upset about lots of things. She is upset about things that make no sense. She wants to know who is doing this to her, but she can't say what it is. She says she's sorry for causing this problem, but she can't say what the problem is. One minute she has the paranoia, the next, she's fine and doesn't have it. She wants me to get the bottom of who is doing this to her, but she can't say what.

What's so odd is that her energy level is much better than before and she seems more alert. She's also on an antidepressant that seems to be helping the depression and pain. Now that she's feeling better, I guess she has more energy to be paranoid.

I just wonder if this goes through a cycle. Could she continue with the paranoia until she is no longer able to communicate verbally?

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Unfortunately this is not just a phase, but a part, of her condition. It will go on until her memory and ability to communicate deteriorate further - if it does. It all depends on what kind of dementia she has (Alzheimer's is a type of dementia). I have managed several dementia units in ALs and nursing homes and have quite a bit of education in this area. There are many good suggestions above such as distracting her with tv programs, music or other activities she enjoys. Distraction is an excellent weapon and the first one I'd choose. Yes, there are medications, but some of them will leave her in a stupor and others may not work well depending on what type of dementia we are dealing with. The staff may or may not have the time, skill, motivation to engage her properly with distractions. You can help in this during your visits. She is not able to change. Its up to YOU to be patient and answer her the best you can - the mistake many make would be trying to reason with her. Her ability to reason is lost and is not coming back. Distraction into something else works best. Does she have a picture album of good times with family to look at. Her long ago memories may still be there. Conversations about the best can work well. Is her room filled with familiar things that will reassure her and perhaps help her feel at home? Pictures from her home, knick knacks - again, stuff she's had awhile. My heart goes out to her as she tries to make sense of her world - and to you as you witness and try to deal with it. The Alzheimer's Assoc can be very helpful also and they have many videos, pamphlets and books.
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It sounds like you are doing all the right things and you are just going to have to wait it out. I am positive that her paranoia is not bothering the AL staff because what your mother is going through sounds as "normal" as Alzheimers/Dementia gets. I know the distress is difficult, but redirection and medication (as you are already doing) seemed to be the only thing that worked well with my mother. My Mother always forgot to worry if I got her a Starbucks Latte.
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the paranoia will get worse till death do you part. In my layman's opinion. Meds may help, maybe ....
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Honestly, I would begin searching for a memory care unit for your mother. She may not be allowed to remain in Assisted Living once she cannot be managed without skilled level care as Alz symptoms progress.
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Confusion and paranoia have many causes. There is a lot of helpful information here but in addition I can say that paranoia can be caused by her failure to comprehend everyday activities. This can be compounded by hearing loss and poor vision. When the mind is trying to understand things there is a mental process that fills in gaps in information. In her case she may not fully comprehend all of the daily activities going on. Her mind may be filling in the missing information with bad information causing her to have fear and paranoia. It helps to explain everything even if you feel you just explained it recently.

In regards to watching television, of course shows with detailed plots are most difficult to understand but even comedy and entertainment shows can be difficult to follow. Game Shows are very good at holding attention spans. Although it might be difficult to grasp the entire shows concept game shows are generally upbeat. They are easier to follow in some ways because when show participants win everybody is happy. The audience applauds and cheers them on. This creates an upbeat mood that can be infectious and tends to keep an Alzheimer's patient engaged longer. You can ask the facility if they subscribe to the game show network.
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An SSRI will improve the depression in 6-8 weeks, but she may also need an anxiolytic. She should be easy to redirect and reassure by simple positive suggestions. Relaxing music helps, so do movies and TV programs with a positive/humorous theme.
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I agree with the others that the things you are describing are "par for the course" as far as many dimentia patients go, but, there might be ways to keep her more comfortable. My Mom had lifelong anxiety which is much worse at this point in her life. She has a psychiatrist that sees her regularly and has tried diffent combos. of meds. Right now she is on Seroquel with Depacoate(which is supposed to help level out mood swings. She is doing pretty well but her nursing home staff and I keep an eye out and note any patterns of behavior which might indicate she needs a change. One thing, though, my Mom is in a NH, so they can keep her safe if any of the meds make her sleepy or unsteady, not sure of the supervision level in an assisted living. I would ask for a psych. to evaluate her and express your concerns. Hope this helps. Prayers.
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My Mom goes through this too! Maybe see if she can take Zyprexa it does help quiet a bit but has some bad side effects also. I just try to reassure her everything is alright, I am not leaving her and lots of hugs and kisses. Tell her about her Dementia/Alzheimer again just be honest and try to reassure her. God bless!
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Honestly, I would begin searching for a memory care unit for your mother. She may not be allowed to remain in Assisted Living once she cannot be managed without skilled level care as Alz symptoms progress.
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Sunnygirl1, sounds like a UTI to me and so common in those places, did she get checked for that? I went through this for a year with my Mother, she lives with me, and it was a rough year. Yes, where do they get the energy? Their minds are in a fast confusing motion I think!! Finally once Mom tried to walk up the hill from my home I called a neurologist. He put her on depakote sprinkles and she was a different woman, oh why did I wait a year? At first she slept and slept but after about a month was accustomed to the drug and she stayed on it for a few years. each time I tried to wean her off of it the aggitation and energy and paranoia came back. Finally she came off of it . It was a life saver for us. Its actually used for dementia patients but is a brain calming seizure medication. The neurologist said its safe for dementia/alz and he doesnt believe in using seraquel or any other antipsychotics on the elderly. Maybe you can ask her doctor and get her straightened out. Believe it or not, my mom was happier on medication , than off of it, so dont be afraid of it, they need it.
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