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COPING STRATEGIES
HALLUCINATIONS AND PARANOIA
Delusional behaviours can take a number of forms
- delusions - beliefs that are contrary to fact but remain persistent and are held to despite all evidence to the contrary
- hallucinations - seeing or hearing of things that others can not see or hear
- paranoia - unrealistic, blaming behaviour
These behaviours can be frightening for others and sometimes personally hurtful. Family and friends can be falsely accused of persecution or theft or rejected as having any relationship to the person. Such behaviours may be difficult to accept. The temptation is to avoid the unpleasant situation by avoiding the person. However, the person desperately needs the reassurance and reality orientation provided by familiar faces.
As with most disturbing behaviours, this may be a phase of the disease, but there are other factors that can contribute to the problem including
- psychiatric illness concurrent with Alzheimer's Disease (Alzheimer's Disease is not a psychiatric illness)
- side effects of medications
- lack of oxygen to the brain due to anaemia or respiratory disease
- fever, illness or constipation
- dehydration
- impaired vision or hearing leading to misinterpretation of sights and sounds
- unfamiliar people, places or sounds or change in routine
- removal of familiar objects such as money or jewellery
Try
- a medical check-up to eliminate possible medical problems - include tests for oxygen, sugar and electrolyte levels
- having doctor adjust medications
- seeking psychiatric evaluation to see if medication could be helpful
- having vision and hearing checked - diminished hearing can result in hearing unintelligible noises that can in turn become auditory hallucinations
- checking for bruising arround head and face that could indicate an unwitnessed fall
- keeping to routine as much as possible
- explaining unusual noises or objects before they can be misinterpreted
- distraction with a favourite activity
- non-verbal reassurance - a physical touch or particular tone of voice may be more effective than talk
- taking note of favourite hiding places - people often forget where they have put things and accuse others of taking them
- allowing a person who is used to carrying money to keep small amounts of money
- helping to look for lost items
- keeping spare sets of frequently lost items like glasses and keys
Avoid
- lighting that casts shadows that could be misinterpreted
- changing the environment too much - where changes are necessary, include some familiar objects
- getting drawn into argument - this is likely to result in increased agitation
- directly disagreeing with a false idea and arguing; state what you know to be true and then try distraction
- removing items value by the person
- too much caffeine or alcohol
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