Dad has dementia and paranoia. How do I help him when he believes people are after him?

Paranoia, delusions and Capgras syndrome occur in Moderate Stage Lewy Body Dementia, which often goes hand-in-hand with PD. Please have your father evaluated by his PD physician, as there may be medications that will alleviate some of his symptoms.

Here are good articles from the home page/Care Topics of this website:

https://www.agingcare.com/topics/165/parkinsons-disease
https://www.agingcare.com/topics/12/lewy-body-dementia

He does not need to know its a therapist. The therapist could say he was just someone who visits residents just to talk. With Dementia you have to tell little white lies. And paranoia goes with Dementia.

It's so difficult to convince someone with dementia of anything. I agree with a little white lie about the person he talks to. It does not need to be known that he's talking to a doctor. Just make sure that the therapist doesn't identify themself as a therapist of doctor, just X (Joe, Sally, whatever).

If your dad has dementia, how do you KNOW he was being “ mentally abused”? My husband also has dementia and is in a long-term care facility and he also has delusions and I’ve come to believe and recognize the people with this problem often say things that are not accurate. For instance, my husband feels that his roommate is a member of the mafia and out to get him. I know for a fact that’s not true and I’m just curious how you know for a fact that your father was being mentally abused. Did you witness any of this mental abuse while you were visiting? Just curious. How do you know for sure that he won’t start saying he’s being mentally abused again at the new facility?. It’s a fine line between truth and delusion and we need to be very careful what we accuse people of doing to our loved ones. I’m not saying that it didn’t happen because I know it does happen but just be careful to know the facts before you react. Good luck

Your father's delusions are ingrained in his brain and resistive to any kind of reasoning or persuasion. Only anti-psychotic medicines may reduce their severity even though they won't cure them. However, anti-psychotic meds are dangerous in elderly patients.

Kmi7688: As your father suffers from dementia, perhaps talk therapy will not work. Speak to his physician about medication change.

I would enlist the help of a neurologist to evaluate and treat his dementia issues - both Parkinson's disease and (Alzheimer's) dementia. I would also enlist the help of a geriatric psychiatrist. Your dad might benefit from a mild anti-anxiety medication while he adjusts to his new home.

I would skip the therapy. Look up Teepa Snow. She really understands people with dementia and has lots of videos dealing with all sorts of situations. She’s like an Alzheimers whisperer!

Don't waste your time and money in therapy for your father. Lewy body dementia with psychosis is beyond the reach of therapy and psychotropic medicines. He needs to be in a locked unit, because he can become violent. You can't reason with him. His mind and judgement are gone. I know you want to protect and help him. Unfortunately, there is nothing you can do to stop him from sliding steadily to the his end. It's sad, but that's life. You're not the only one in this predicament. Birth and death are normal events.

Most of us don't understand the mechanics of dementia, and neither do many doctors, sadly. We have to do our own research & reading on the subject to figure things out the best way we can. I am linking you to the best info I've ever read on the subject, a 33 page article called Understanding the Dementia Experience by Jennifer Ghent-Fuller. You may learn a better way to deal with your dad through this article, and why he's lashing out, etc. You'll also learn that trying to convince an elder with dementia of YOUR reality is not going to break through to THEIR reality. I hope this helps you in some way; here is the link to the free download:

https://www.smashwords.com/books/view/210580

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.” For people to understand that reality and context as perceived and experienced by a person with dementia, is altered by the dementia; and, that their reality and context is continuously changing as the dementia progresses, requires learning and an attitude shift; it is not ‘common sense.’

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

Wishing you the very best of luck with a difficult situation.

You don't, he has dementia. Therapy won't help a broken brain.

Possibly could ask the Doc about anti-anxiety meds?

Enter his world. Tell him you'll keep an eye out on these people and protect him from them maybe?

Lashing out, delusions, paranoia, often times violence are all part of LBD.
It is difficult to medicate. Reasoning with someone with dementia is often impossible and a great way to frustrate both you and the person you are trying to reason with.
I truly do not think therapy will help.
The correct medications may help.
The doctors and any other medical personnel that are treating him must each time be made aware that he has Parkinson's, and LBD. (medications often given to other persons with other dementias can not be given to someone with LBD. Because of that I would make sure of the proper diagnosis.)
You can not convince him that he will not be locked up. you can reassure him that you will be there for him, that you will try to make sure he is safe.

My late father was diagnosed with LBD although there were physical similarities with Parkinsons. Personally, I believe he had Drug induced parkinsonism.
Anyhow, he suffered from delusions, paranoia, psychosis and violent outburst for a number of years but that all actually stopped after several episodes of inpatient psychiatric treatment to the point where his last years were quite calm and reasonably lucid. It all seems to be about getting the medication right and this needs to be done in a controlled and professional environment. I wish you all the best. It is a challenging process.