What if delusions are about caregiver?

I suggest you document everything..my mother was admitted to memory care,añd the facility tried to keep her saying she could saying she wanted to stay,and could make her own decisions..this was after they got her financial records .and when I finally got her on the phone after calling for.a week,she wanted to know why haven't I be got her. The police came after they lied and said I refused to leave.and I'm under tinvestigaton by adult protective service now,because my mom saying I hate her and pushed her around.,however I'm the one with bruises..it's so heartbreaking..,

Delusional: Imho, an elder's caregiver will typically bear the brunt of the elder's criticism since they are the ones who ensure that they receive proper nutrition, take their medications, et al. It is completely unfounded.

Install cameras like I did for my 97 yr old dad.

I installed Nest Cameras in the home so I could view what was going on anytime I want 24 7.

It puts your mind at ease.

Also, make sure lived one doesn't have a (UTI) urinary tract infection.

I am fully aware of all the things you are supposed to do with dementia people - distract, don't argue, etc., etc., etc. but there is a limit. I have learned, the hard way, this does often not work and what the do and say can be terribly cruel and affect others who care for them. I think if the limit has been reached, and nothing stops them, medication or other, then the caretake has the right to explode and "put them in their place". It will shock them and at least for the moment, it may subdue them and they will forget. But at least the caretaker is letting off steam that is harmful. I know many won't agree - but no one for any reason should be subjected to abuse from anyone, no matter who or why.

Yes, delusions are frequently about the caregiver. As long as the caregiver can continue to safely deliver care, then nothing should really change. If the caregiver feels threatened or finds the comments emotionally distressing, then the deluded person's doctor should be notified. Consistent routines, lots of slow and careful explanations, and patience are the most helpful for folks who have a hard time discerning reality.

My mom accused my husband and me of going through har purse, (which had $5 in it, which I put there, as well as lipstick). I learned to curse the disease and not the person. My mom never had accusations like that before Alzheimer's. Best of luck.

Oh yes…My mom while in a short stay at Memory Care {Lewy Body flare up} told me I had written her a long hateful letter saying I hated the whole family and I was causing issues. She was so angry. That was not true. She was having episodes of delusions/hallucinations. She also told staff that all 4 of her children have died. It was in the newspaper. Two died as young children. I am a very devoted loving caregiver. I visited 3x week outside her building during Covid lockdown and we talked on Facetime sometimes for 90 min in the winter outside her window. With Lewy …mom struggles with what is real..some days she is great…some days I am the enemy. I accept my role. My brother has always been the golden child. That is ok. Somedays my feelings are hurt and I cry in privacy but my goal is to get my mom to her finish line…..in peace, and as much joy as possible..Good Luck..

What are the delusions that are directed at you? Are you accused of theft? Abuse? Does the person think you are someone else? How are these delusions affecting you? Certainly some delusions can be hurtful when directed to the caregiver. There is no one answer to your question. Cite some examples. Above all, do not argue or try to dissuade the person of their belief. Meanwhile, copy the following URLs. They may help.

https://teepasnow.com/blog/how-to-respond-to-unfounded-accusations-when-dementia-is-involved/

https://dailycaring.com/responding-to-4-common-dementia-accusations-stealing-poisoning-being-held-prisoner/

You are correct, it is difficult and it will be difficult to assess. In general much of the delusional and acting out involves those directly involved with care; the paranoia that they are acting against one. This is very common, and for instance may manifest with the person entering into in-facility care and being convinced people caring from them are "watching" them or "stealing from" them.
The sad thing is that in the case of a new caregiver or a new care facility there MAY BE instances where the person who suffers from dementia is prey to those who may take advantage of them.
This all makes assessment of the situation extremely difficult. I had such a situation when my brother, suffering from probably early Lewy's by diagnosis entered into care and believed someone stole from him. This turned out NOT to be the case, but he was very convinced and because he was ordinarily very bright and "with it" there was a tendency to want to believe him, all the while ALSO believing that what he was describing was very unlikely.
I wish you luck in combing out the facts in your own case. If this "caregiver" is family, them you will already know the person, but if a stranger you will have more difficulty in discussing this with your elder.
More information from you regarding the exact situation (s?) may be useful for our own input.