Alzheimer's / Dementia 5 Tips for Managing Dementia Delusions 11/5/2024 | By Terri L. Jones The best ways to communicate with our loved ones will change with the progression of dementia, especially if they have delusions. Seniors Guide writer Terri L. Jones shares five important tips for managing dementia delusions, based on her own experience and research. A couple days after someone shot at Donald Trump during one of his rallies, I visited my father and stepmother. While my dad and I were sitting in the living room, the news replayed a video clip of the incident. My dad, who has vascular dementia and rarely leaves home, excitedly announced that he and my stepmother were there. Pointing at the screen, he said, “See that guy with the red hat. We were sitting right beside him!” I simply listened to my dad’s account of his experience at the rally and offered the occasional “Really?” and “Hmm.” And then as quickly as possible, I changed the subject. However, when my father had made the same claim to my stepmother the night before, she had told him that it didn’t happen. Her dispute of his account hadn’t convinced my dad that he was wrong, but instead gave him anxiety about why he thought it had happened in the first place. By the time I arrived the next day, he’d forgotten my stepmother’s rebuttal and firmly believed the delusion again. Suggestions for managing dementia delusions 1. Don’t disagree Delusions can cause those with Alzheimer’s and other types of dementia to feel fear, anxiety, and paranoia; however, delusions can also be pleasant, comforting, or simply innocuous false beliefs. Although it may be difficult not to challenge your loved one’s skewed sense of reality, often there’s no harm in letting them believe what they believe. In fact, most professionals believe that it’s beneficial not to correct someone who is delusional in order to prevent further confusion and even aggression. “Little lies do have a place here,” explains Carolyn Fredericks, MD, a neurologist who treats people with Alzheimer’s disease and other memory disorders at Yale Medicine. “It’s because they live in a different reality than we do. And going along with that reality, if that’s something that you feel comfortable ethically doing, is really reasonable.” But after you resist the tendency to disagree, then what do you do? Below are a variety of different strategies that you can use in managing dementia delusions. 2. Distract them The easiest route is to simply allow your parent or spouse to express themself and then divert their attention to another activity or topic of conversation. If their delusion has been brought on by something they’ve seen on television, like my father had with the Trump rally, turn off the program. In some cases, those with dementia can believe that what they’re viewing onscreen is actually happening to them right there in the room. 3. Acknowledge their feelings Your loved one may have a delusion that causes them anxiety or fear, such as believing that someone is breaking into the house. If this happens, ask how they feel and assure them that all the doors are securely locked and that you will always be there to ensure that they are safe. “If you approach things in a compassionate, empathetic, and supportive way, that can diminish some of the emotional output,” says Arman Fesharaki-Zadeh, MD, a behavioral neurologist and neuropsychiatrist with Yale Medicine. “And there’s always an emotional component to these reactions.” If there is a risk of harm to you, someone else, or themselves in response to this imminent danger, keep anything they could use as a weapon out of their reach, and don’t ignore this kind of delusion. Protect yourself and your loved one and immediately seek advice from a medical professional. 4. Join their reality If there’s no harm in playing along, then by all means, join their reality! When my husband’s grandmother, who had dementia, couldn’t recall who he was (but was sure she had seen him before!), he would pretend that he was struggling to come up with her name too. He’d start guessing different names and eventually land on “Grandma,” which usually made her remember him as well. Professional actor Karen Stobbe used improvisation, a technique where actors come up with storylines as they go along. Improv allows you to step into your loved one’s world, be in the moment and go with the flow. These techniques helped ease communication with Stobbe’s mom, who had been diagnosed with Alzheimer’s. “So often, we focus on changing the behavior [of the person with Alzheimer’s] when we need to change ours,” explains Stobbe, who started a nonprofit, In the Moment, to facilitate care for and communication with those with dementia. Related: Using improv to communicate with people with dementia 5. Keep the conversation flowing One of the core tenets of improv is, instead of saying “no” and causing interaction to screech to a halt, say “yes, and …” instead. This strategy would’ve come in handy a few years back when my dad was in the hospital. At that time, while lying in his bed in ICU, he was certain that the nurses’ station was the counter at McDonald’s. He kept talking about all the people ordering lunch and that woman (the nurse) who was serving them. Instead of saying “No, Dad, you’re in the hospital,” I could’ve improvised and asked, “Yes, and what would you like for lunch: a Big Mac or a Quarter Pounder?” Read More Terri L. Jones Terri L. Jones has been writing educational and informative topics for the senior industry for over 10 years, and is a frequent and longtime contributor to Seniors Guide.