Understanding Fear and Paranoia in People Living with Dementia –

Fear and paranoia in people living with dementia can sometimes appear irrational or unfounded, but there are often underlying reasons that, with some detective work, can be identified and addressed. While these behaviors may not always stem from unmet needs, they often arise from the brain’s altered ability to process information, coupled with environmental or sensory triggers that can make ordinary situations seem frightening.

For example, a resident might insist that someone is standing in their closet, refusing to enter their room because they feel frightened. On the surface, this may seem like paranoia. However, closer observation could reveal an explanation—like a coat hanging on the door that, in the dim light, casts a shadow resembling a person. Once the coat was removed or the lighting adjusted, the “person” disappeared, and the resident felt comfortable entering the room again.

 

Watch this interesting video from Nelly Jane Selby, MA, Trainer and Marketing Manager for the Center for Applied Research in Dementia 

— MONTESSORI MINI LESSON — Responsive Behaviors: Fear and Paranoia

 

How to Approach Fear and Paranoia

Listen and Observe:

Take the resident’s concerns seriously and pay attention to their specific descriptions or behaviors. What they’re experiencing may seem very real to them, and there could be a logical explanation behind it.

Investigate the Environment:

Look for potential triggers, such as shadows, reflections, unfamiliar objects, or changes in routine that could be misinterpreted.

Validate Their Emotions:

Acknowledge their feelings without dismissing them. Saying, “I understand that this is upsetting” helps build trust and comfort.

Problem-Solve Together:

Work with the resident to make adjustments, such as changing lighting, rearranging objects, or removing potential triggers. Small changes can make a big difference.

Create Reassurance:

Once the issue is resolved, reassure the resident by showing them the adjustment and reinforcing their sense of safety.

The Role of Detective Work in Care

While fear and paranoia can sometimes seem random, understanding that these behaviors may have a basis in the environment or sensory experiences allows us to respond with greater empathy and effectiveness. Solving these “puzzles” not only reduces distress for the resident but also creates a more positive experience for caregivers.

Your patience and thoughtful approach make all the difference in helping residents feel secure and supported.

 

 

 

 

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Beyond the Behavior: Managing Responsive Challenges with the Adapted Montessori Method