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It is common in dementias.
It also could be medications he's on, not working right in his system [bad side effects].
It also can be related to things changed in his environment, including chemicals like laundry or cleaning products, exhaust fumes coming in the air ducts, etc.
I've even heard of someone dosing an elder with hallucinogenic drugs, causing it.
There might be medications and/or nutritional things that could help.
If it is related to something in his environment, which can be changed, that could help.
Please check with his Doctor, and maybe do some simple sleuthing of the environment he's usually in just before or during the paranoia episodes.
I 'm sure there are meds to help control it .He must be going through h*ll with it .
Sorry he's in that situation .poor guy .