There is no cure for dementia-related psychosis. However, there are steps you can take to help you and your loved ones live with the disease and its symptoms.
“Delusions are known to be difficult to treat, whether or not they are related to dementia,” says Dr. Carolyn Fredericks, a neurologist at Yale Medicine who treats people with Alzheimer’s disease and other memory disorders.
“The question is: how can you and [your loved one] Live with their false beliefs, or see people who are not there, or whatever their psychotic symptom may be, in a way that is as calm and peaceful as possible? “
Here are some strategies that might help.
Change the subject
People with dementia often forget where to put things. This can trigger delusional thoughts about intruders or theft. Fredericks says this is her brain’s way of understanding her memory loss.
You think, “I cannot find this item. So someone must have stolen it, ”she says.
Your first urge might be to convince your loved one that no one has taken their belongings. But confronting them or denying their reality is not a good idea. Instead, try to help them find their lost item or get them to focus on something else.
“Redirecting or distracting the person is often very powerful,” says Fredericks. “Once you really hire them over the deception, you can get stuck there.”
Acknowledge their feelings
Delusions from your loved ones can seem very real and frightening. You should take a moment to recognize your emotional state before moving on to another topic.
“Maintaining a tone of calm and caring is really one of the most important things family members can do,” says Fredericks.
Some helpful things to say are:
- “I’m sorry you’re scared. Let’s sit and have a cup of tea and turn on all the lights.”
- “I’m so sorry to hear this happen. But can you help me fold this pile of laundry?”
- “That sounds scary. Oh, that’s a nice sweater you’re wearing. Who gave you this?”
Do not be offended
Your loved one may change how they treat you or forget who you are. They might accuse you of infidelity or think you are a stranger in their home. It can be hurtful. But try not to take it personally.
“This delusional thought process is part of the DNA of the disease,” says Dr. Arman Fesharaki-Zadeh, behavioral neurologist and neuropsychiatrist at Yale Medicine.
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Do not jump to defend yourself even if your loved one is really hostile. Instead, says Fesharaki-Zadeh, you should first help them feel safe. Tell them you know it’s scary that they don’t recognize you.
After that, he says you can give them some “flashing moments”. These are things like old pictures or video clips with fond memories.
“That could be a disarming and compassionate way to turn them back into reality,” he says.
Keep familiar faces
People with dementia may not be able to keep an eye on new faces very well. This can create problems when you have various household helpers to take care of the care. Your loved one may be more comfortable with someone they know helping.
Fesharaki-Zadeh says you can get well-known characters to “do layers”. For example, a spouse or child could be there for a certain number of hours. Then a grandson or friend comes in. This is not always possible. But he says there are groups out there who can provide financial help if you want long-term care for family members with dementia.
For more information, see the National Family Caregiver Support Program website.
Create a routine
People with dementia tend to be better at dealing with structure. Your psychotic symptoms may improve if your everyday life doesn’t change much.
“This predictability provides a sense of comfort and an anchor to the environment,” says Fesharaki-Zadeh.
Here are some of his tips:
- Wake them up at the same time each day.
- Let them go to bed at the same time.
- Keep meals on a schedule.
- Have them go to the bathroom at set times.
Include activities that they enjoy doing. This can be sewing, cooking, listening to music or going for a walk.
“And when it comes to exercise,” says Fesharaki-Zadeh, “I cannot stress how therapeutic it is enough.”
Remove trigger
You should avoid people, places, or things that make your loved one’s psychosis worse.
James Lai, MD, assistant director of clinical affairs for geriatrics at Yale School of Medicine, says it’s also important to look for subtle things that could affect your loved one’s behavior. He says that some everyday things can be stressful or confusing for people with dementia.
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“A big TV with people can seem very real,” he says. “You say they hallucinate. But actually a television with a person speaking out of a box seems like someone is in the room and standing there. “
Lai also suggests minimizing reflections in windows and persistent noise from other rooms.
“You can close the blinds at night,” he says. “And having the radio on all the time is not a good idea.”
Take a look back
You shouldn’t ask someone with dementia what they had for breakfast 2 days ago. But childhood events could be a fun topic.
“They may have lost their short-term memory, but they have no problem talking about the time they went to summer camp,” says Lai. “It’s something you’ve been talking about for years.”
What people with dementia remember can vary. But Lai says older memories – where they grew up, where they used to work – stay the longest. It will take some trial and error to find the right topic for your loved one. But if you do, you can bring it up during stressful times.
“You can talk about it over and over again from day to day,” says Lai. “But it can be a new thing for them. And it’s easy to talk about. “
Remove dangerous objects
Fredericks says people with dementia should never have easy access to guns and bullets. And you might also want to keep sharp things like kitchen knives out of reach.
“If someone has psychotic symptoms and thinks there are intruders in the house all the time – and you’ve seen them swing a knife in the kitchen in the middle of the night – you don’t want someone to come in and check your stove and let them go.” Your loved one will believe that this is someone who will bring you, ”says Fredericks.
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