Simply reading the combination of words “delusions and dementia” can be a bit intimidating, but caregivers of those who suffer with dementia understand how quickly a seemingly simple situation can turn into a complex, confusing problem for patients with dementia, and if the patient experiences delusions, then the situation can spiral out of control. Simply put, patients with dementia perceive the world a little differently than the rest of us and when these patients think that they hear something that is not there or believe something that is not true, they experience delusions. Fortunately, in the early stages of dementia, the patient can typically recognize when he or she experiences a delusion and almost shake it off; however, in the later stages, individuals may project an increasing amount of stress and agitation regarding what is reality and what is not.
Delusions differ completely from hallucinations in that delusions tend to be false impressions of what occurs in the present; whereas hallucinations tend to involve a complete sensory experience that did not occur. Typically, those with dementia might experience a delusion and believe that a trustworthy individual has suddenly changed temperaments and is now trying to hurt them, when in truth, no change has occurred. Therefore, as caregivers, it is important to stay as informed as possible regarding the care and mental state of the patient.
Should someone with dementia experience a delusion and express signs of concern, anxiety or fear, avoid trying to explain or apply logic to the situation. Instead, “Employ the 3 R’s Reassurance, Respond and Refocus” to calm and empathize with the patient. Try reassuring the patient that all is safe and well, yet respond to his or her claim so that the patient feels heard and understood. For example, offer these words, “You seem upset about the noise outside the door, but it was just the dog. You are safe.” Then, try to refocus the patient with a new activity that will distract from the distress he or she feels.
Those who suffer with dementia will likely experience delusions as a natural progression of the disease. Keep in mind that you always want to show respect to the patient and not diminish his or her self-esteem. Practice patience and remember to reassure, respond and refocus when dealing with someone who has dementia. As always, please stay in regular communication with the medical provider to ensure safety for the patient.