Even so, it's devastating to hear your loved one accuse you of terrible things or to watch them be overwhelmed with fear and/or anxiety. You have to be patient with them and remind yourself that it's the dementia. Not them. Their dying brain is telling them things that are very real to them. They are not trying to hurt you.
Logic and reason don't work when someone believes a delusion. So you shouldn't even try to explain why it isn't true or try to show them that they are wrong. Their brain is damaged and is no longer able to process logical explanations. Reason will only upset them further.
Instead, try to validate their feelings. Let them know that you are on their side. It will calm them and make them feel safer. Then you can redirect them to another topic or distract them with something they enjoy.
The top four dementia delusions are 1) abuse, 2) you're a stranger, 3) someone's after me, and 4) there are bugs everywhere. So if one of these issues come up, you can use these suggestions as a starting point. You, however, know your loved one best. So you may need to experiment, but you will know how to validate and redirect them better than anyone.
- Abuse - "He's attacking me! You're hurting me! Stop! Get away from me! Help!
Sometimes an accidental startle can trigger a natural "fight or flight mode" and cause panic! You don't even have to have dementia to feel attacked! But to your loved one, even if you are only trying to help, their fright can overwhelm them and they can feel like they are being attacked or abused.
If so, immediately back away and give them some space. Keep your voice calm and use soft soothing tones. Stay at a "safe" distance and go to eye level so you can make eye contact. Apologize and ask if they are alright. Give them time and then try again with a more calm approach.
2. Who are you?? I don't know who you are and I want you out and away from me!
It's heartbreaking, but dementia patients can often get confused about the identity of the people around them. YOU have to remember that they can't "try harder" to remember. It doesn't help to tell them who you are or how you are related. They are already confused and possibly scared. This may only further confuse them. For example, if you tell them you are their spouse and the spouse they remember is 40 years younger, they can go from confused to terrified!
Instead, remain calm and try a response like: "You must be close to them. Tell me more about them." Or, "They just called and they are at the store. They will be back in a bit and asked me to keep you company." Or even, "Let's see if we can find them. I'll go look..." Sometimes, just leaving the room for a few minutes can reset their brain and they will have a completely different reaction when you get back.
3. Someone is after me! They're following me! Someone is watching me! They are going to "get" me!
Just the general disorientation and confusion of dementia can cause someone to feel afraid. It may even cause their eyes to play tricks on them as dementia changes their perception of vision. To reduce fears, keep the room well lit to reduce shadows and close the curtains before dark so reflections won't form. That way they won't see "people" in the shadows or mistake furniture for a person.
Again, you have to be on their side. Ask them what is happening. Tell them you will stay with them to make sure they are safe. Pretend to call the police to send a car to patrol the house. Double check the locks on the doors and windows.
4. Seeing insects on food or everywhere!
Your loved one may even refuse to eat because they see "bugs" everywhere or they think they are crawling all over them. Again, there is no point in arguing because their brain has convinced them it is real. Instead, try to "solve" the problem.
Provide "bug spray" so they can get rid of anything they see. Plain water is safest if they see "bugs" on food. Otherwise, try plain water with just a few drops of essential oil to spray. Or try lotion, especially if they feel "itchy". If they "know" of a certain remedy, tape a picture onto your bottle. If they know how the bugs are getting in, make a point to pretend to seal the spot.
Keep in mind, these 4 delusions as well as others, are very real to your loved one. Always support your loved one and validate their fears. Never take it personally when you are "accused". In your loved one's mind, it is very real.