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My wife is 75 and according to her neurologist has advanced dementia. I have a live-in caregiver who is great with Lisette, and most of the time Lisette is really glad the caregiver is here. Lisette is able to do most things with help, but can't read or write any longer and has trouble with vocabulary. She has had intermittent paranoid delusions for a couple of years, but they usually haven't lasted long. Over the past couple of months they have become more frequent and last for a few hours at a time. Sometimes she thinks I am going to kill her or run off with someone. Sometimes she thinks the caregiver is going to kill her. Sometimes she thinks a stranger is going to kill her. If her delusions were harmless I would humor her, but while they last she is scared to death, and it makes it hard for me and the caregiver to take care of her. Finally, she has been in a delusion since yesterday morning afraid that she has a stalker who is going to kill her. She spent much of today in bed with the lights out so no one could see her. Any suggestions?

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I posted the question.. The doctor increased her Seroquel by 25%. After a couple of days she was able to leave the bedroom. She is still paranoid, but it is not as extreme. Thanks everyone for your guidance.
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Some medications will actually cause these bouts of delusional paranoia. My husband was in the geropsych department for 2 weeks where he was constantly observed and his meds were adjusted to eliminate this problem. You should speak with her doctor to see if this is a possibility. I spoke with several people with family in there and common meds were causing serious problems. They affect people differently.
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Andrew, I wish paranoia and fear didn't accompany Alzheimer's, but many times they do. The only ways I know to handle it are to discuss the problem with her doctor right away and to try to help address her fears when they happen. The doctor will probably prescribe something a bit stronger than Ativan because her fear is so great. I hope she will have good results with a sedative. You have probably tried to reassure her already. If she thinks someone is after her, try to reassure her that you won't let anything happen. If she thinks you or the caregiver are going to kill her, reassure her that you would never do that because you love her. It may help some.

These things pass. This is a particularly hard thing to go through. It is sad that you are having to go through it. If you need support we are always here. Many people here have been through these things, so will understand how you are feeling. Delusions can be tough things to handle.
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Anxiety meds, like Ativan (lorazepam) are good for occasional bouts of paranoia, but if she has been like this for 48hrs straight call the MD and get better medications like Xanax or similar.
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