May have delusions or unfounded suspicions

  All Alzheimer's Symptoms

When it happens

Mid mild to early severe stage, depending on the individual, but especially during the moderate stage

Why it happens

As brain deterioration continues, someone with dementia loses awareness of having problems. When things are seen or experienced that he or she can't explain with the help of logic and memory, there's a tendency to "fill in the gaps" by making up what seem like plausible explanations. Accusations of infidelity, theft, and deliberate cruelty are common ways suspicions are expressed.

What you can do

  • Remember that accusations are ultimately caused by the disease. Try not to take them personally, even when they malign your character.

  • Assure aides, friends, and others who are the target of suspicious accusations that you know the reality of the situation.

  • Briefly state the truth, which can sometimes reorient a confused person. Try empathy: "I'm sorry your wallet is missing." Or, "That's terrible."

  • Try not to belabor the point, though. Don't argue or spend a lot of time using rational logic to explain the reality. Your loved one is unable to follow logical thinking.

  • Try to switch the conversation into an entirely different direction.

  • Realize some of the underlying reasons for suspicious accusations: Things that have been misplaced and forgotten are called "stolen." New faces in the house (such as aides, who aren't recognized or remembered from time to time) or a spouse leaving the house on errands (during which time the person with dementia loses track of time) are considered proof of "affairs." A forgotten visitor has "written me off."

  • View accusations as, in part, a cry for reassurance. The person is feeling unmoored and anxious. Provide extra comfort not about this specific matter but in general, with extra physical contact and attention.

  • Keep a record of incidents; you may need this to bring to his or her doctor if the problem escalates. Medications are a last resort for dealing with delusional behavior.

  • Be prepared for a delusion that's insisted on one day to be forgotten the next. Sometimes this skewed thinking comes and goes.