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Dementia-related psychosis: strategies that help

Dementia-related psychosis: strategies that help

There is no cure for dementia-related psychosis. But you and your loved ones can take steps to help you live with the disease and its symptoms.

“Delusions are difficult to treat, whether they are related to dementia or not,” says Carolyn Fredericks, MD, a neurologist at Yale Medicine who treats people with Alzheimer’s disease and other memory disorders.

“The question is: how and [your loved one] living with their false beliefs or people who are not there or whatever their psychotic symptom is, living as calmly and peacefully as possible? “

Here are some strategies that can help.

Change the subject

People with dementia often forget where to put things. This can lead to misleading reflections on intrusions or theft. Fredericks says that’s the way the brain makes sense of memory loss.

They think, “I can’t find this item. That’s why someone has to steal it, ”he says.

Your first desire might be to convince your loved one that no one has taken their things. But it’s not a good idea to confront them or deny their reality. Instead, try to help you find the missing item or focus on something else.

“Redirecting or distracting people is often very powerful,” Fredericks says. “As soon as you’re really involved in the scam, you can stop there.”

Validate their feelings

The deceptions of your beloved seem very real and frightening. You should take a moment to acknowledge their emotional state before switching to another topic.

“Maintaining a calm and caring tone is one of the most important things that family members can really do,” says Fredericks.

Here are some helpful things to say:

  • “I’m sorry to feel scared. Let’s sit down for a tea and turn on all the lights.”
  • “I’m sorry to hear that’s happening. But did you help me fold this pile of laundry?”
  • “That sounds scary. Oh, it’s a nice sweater you wore. Who gave you that?”

Don’t be insulted

Your loved one may change how they treat you or forget who you are. They may accuse you of infidelity or think you are a stranger in their home. That can be a big pain. Try not to take it personally.

“This deceptive thinking process is part of the disease’s DNA,” says Arman Fesharaki-Zadeh, MD, a behavioral neurologist and neuropsychiatrist at Yale Medicine.


Do not jump to defend yourself, even if your loved one is really an enemy. Instead, Fesharaki-Zadeh says the first thing you should do is help you feel safe. Tell them that they don’t know you because it’s scary.

After that, he says you can give him “some flash bulb moments”. That’s old photos or video clips of happy memories.

“That can be a disarming and compassionate way to get back to reality,” he says.

Keep familiar faces around

Those with dementia may not be able to keep up with new faces very well. This can cause problems if you have different home health care providers. Your loved one feels more comfortable if they know someone who helps.

According to Fesharaki-Zadeh, you can have “take” familiar characters. For example, a spouse or child may be there for a certain number of hours. Then a grandchild or friend enters. That is not always possible. But he says groups that can provide financial support if they want to provide long-term care to their families with dementia.

For more information you can visit the website of the National Support Program for Family Caregivers.

Create a Routine

People with dementia tend to be better off with structure. Their psychotic symptoms can be alleviated if not changed a lot in daily life.

“This anticipation provides comfort and an anchor for the environment,” says Fesharaki-Zadeh.

Here are some of his tips:

  • Wake up at the same time every day.
  • Let them go to sleep at the same time.
  • Keep meals on schedule.
  • Let them go to the bathroom at certain hours.

Add activities they like. It can be sewing, cooking, listening to music or going for a walk.

“And when it comes to physical exercise,” says Fesharaki-Zadeh, “I can’t stress too much how therapeutic it is.”

Remove Triggers

You want to avoid people, places, or things that worsen your loved one’s psychosis.

James Lai, MD, head of the geriatric clinic at Yale Medical School, said it’s important to look for subtle things that can affect your loved one’s behavior. He says some everyday things can be stressful or disorienting for people with dementia.


“A big TV with people seems very real,” he says. “You’re saying you’re hallucinating. But the truth is that a TV talking from a box looks like someone is in the room, standing up. “

Laik also recommends reducing window reflections and constant noise from other rooms.

“You can close the shadows at night,” he says. “And having the radio on all the time isn’t a good idea.”

Look Back

You shouldn’t ask him what he ate for breakfast in 2 days. 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 camp,” Laik says. “It’s something they’ve talked about for years.”

What people with dementia remember can change. But Laik says older memories – where they grew up, where they worked – tend to stick together for the longest time. Trials and mistakes will be needed to find the right topic for your loved one. But once you do that, you can create a time of stress.

“From day to day, you can talk about it over and over again,” Laik says. “But it can be a new thing for them. And it’s easy to talk about it. “

Remove dangerous objects

Fredericks says people with dementia should never have easy access to guns and bullets. And you may not even have access to sharp things like kitchen knives.

“If someone has psychotic symptoms and thinks they’re constantly intrusive at home – and you see them marking a knife in the kitchen at midnight – you don’t want someone to go in and check your oven and your loved one believe it’s someone to get it,” Fredericks says.

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