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Handling Dementia-Related Agitation and Paranoia

How to calm an agitated, fearful person who has dementia

By Family Caregiver Alliance

As the condition of a person with dementia worsens, so does troubling behavior such as agitation and paranoia. Caregivers may see an increase in the patient's irritability, sleeplessness, physical aggression and suspiciousness of others.

Caregivers can minimize these problems by understanding what triggers the behavior and developing some strategies to calm the person.

Coping With Agitation

Agitation may be triggered by a variety of things, including environmental factors, fear and fatigue. Most often, agitation is triggered when the person experiences “control” being taken from him. Here are a few ways to minimize agitation:

  • Limit caffeine, sugar and junk food.‬
  • Reduce noise, clutter or the number of persons in the room.‬
  • Maintain structure by keeping the same routines.
  • Keep household objects and furniture in the same places. Familiar objects and photographs offer a sense of security and can suggest pleasant memories.‬
  • Try gentle touch, soothing music, reading or walks to quell agitation.
  • Speak in a reassuring voice.
  • Do not try to restrain the person during a period of agitation.‬
  • Keep dangerous objects out of reach.‬
  • Allow the person to do as much for himself as possible. Support his independence and ability to care for himself.‬
  • Acknowledge the confused person’s anger over the loss of control in his life. Tell him that you understand his frustration.‬
  • Distract the person with a snack or an activity.
  • Allow the person to forget the troubling incident. Confronting a confused person may increase anxiety.‬

Dealing With Paranoia and Trust Issues

It's unsettling for a person with dementia when he or she sees a loved one suddenly become suspicious, jealous or accusatory.


Remember, what the person is experiencing is very real to them.  It is best not to argue or disagree. This, too, is part of the dementia. Try not to take it personally.

Here are some additional tips:

  • If the confused person suspects money is “missing,” allow her to keep small amounts of money in a pocket or handbag for easy inspection.‬
  • Help them look for the object and then distract them into another activity.
  • Try to learn where the confused person’s favorite hiding places are for storing objects, which are frequently assumed to be “lost.”
  • Avoid arguing.‬
  • Take time to explain to other family members and home-helpers that suspicious accusations are a part of the dementing illness.‬
  • Try nonverbal reassurances like a gentle touch or hug.
  • Respond to the feeling behind the accusation and then reassure the person. You might try saying, “I see this frightens you; stay with me, I won’t let anything happen to you.”‬

Handle Dementia-Related Behaviors With Compassion

By Family Caregiver Alliance

MissionFamily Caregiver Alliance is a public voice for caregivers, illuminating the daily challenges they face, offering them the assistance they so desperately need and deserve, and championing their cause through education, services, research and advocacy.    Who We Are Founded in 1977, Family Caregiver Alliance was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. Long recognized as a pioneer in health services, the alliance offers programs at national, state and local levels to support and sustain caregivers.National, State and Local Programs Uniting research, policy and practice, the alliance established the National Center on Caregiving to advance the development of high-quality, cost effective programs and policies for caregivers in every state in the country. The National Center on Caregiving sponsors the Family Care Navigator to help caregivers locate support services in their communities. Family Caregiver Alliance also oversees Link2Care, an Internet support and information system for clients of California's system of Caregiver Resource Centers and operates the Bay Area Caregiver Resource Center in the six-county San Francisco Bay Area. In that capacity, the alliance's staff social workers work closely with families caring for ill or elderly loved ones. Our services, education programs and publications are developed with their expressed needs in mind, to offer real support, essential information, and tools to manage the complex and demanding tasks of caregiving.

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