When a Loved One With Dementia Becomes Paranoid

"Nearly half of people living with dementia will experience delusions or hallucinations at some point—many of which take the form of paranoia or mistrust. As the brain changes, the areas responsible for memory, reasoning, and social interpretation begin to misfire. The person loses track of what happened, when, or why, and the mind fills in the blanks with stories that feel emotionally true, even if they're not factually accurate."

"Your loved one with dementia may be feeling: Fear of being abandoned or unloved Loss of control and independence Confusion that feels threatening Shame or panic when corrected Their brain is trying to restore safety by making meaning out of fragments. That's why reasoning rarely works: The logical circuits (frontal lobes) are impaired, while the emotional ones (amygdala, limbic system) are still highly active."

Paranoia and delusions affect nearly half of people with dementia as memory, reasoning, and social-interpretation areas deteriorate. The brain fills gaps in memory with emotionally plausible stories, so suspicion reflects attempts to make meaning, not malice. Common feelings include fear of abandonment, loss of control, confusion, shame, and panic when corrected. Logical reasoning often fails because frontal networks are impaired while emotional systems remain active. Effective responses join the person's reality, validate emotions, and gently redirect toward safety. Humor, improvisation, and a calm, steady presence can lower fear, rebuild connection, and restore trust over time.

Read at Psychology Today