Someone suffering from paranoia can be difficult to care for as their delusions and fears can be extreme.  Imagine what it would be like not knowing who you can trust.  The ever-present anxiety must be exhausting, and it can get in the way of their care routine.  Some of the more common fears associated with paranoia include the following:

People are stealing from them.  This can be exhibited by insisting on keeping certain items with them. They may start  hiding personal belongings or other items. If they forget where they’re hidden, it reinforces their belief of being a victim of theft and the cycle continues.   They may make repeated calls to the police.

They’re being poisoned. This could be the reason behind their refusal to eat or drink what’s prepared for them. They may also refuse medications for this reason.

People are plotting against them. This fear becomes magnified if their sense of hearing is failing, because they may misunderstand what is said or believe everyone is whispering so he/she can’t hear their plot.

Family or friends are actually strangers in disguise. This could result in fearful and angry outbursts, uncooperative behavior, hiding, and withdrawal. In a worst case scenario, they could become violent.

Spies are watching them. This could be part of a delusion that they’re extremely important.  You may find them in a darkened room with the blinds or curtains drawn. They may refuse to leave the house.  It’s also likely you’ll discover electronics such as computers, televisions, radios, lamps, phones, etc. dismantled as they search for evidence of spy technology.

Others want to bring harm upon them. They may isolate themselves and/or keep weapons at hand for protection.

Their mind is controlled by the government or alien beings. This could also be the result of delusions regarding their intelligence and imagined high standing in society. Auditory hallucinations (hearing voices) are apt to feed into their belief.

What causes paranoia? It’s not an illness in itself, but rather a symptom of an underlying problem such as:

  • Schizophrenia
  • Psychosis
  • Dementia / Alzheimer’s
  • Enzyme imbalance
  • Toxicity related to failing liver or kidney function
  • Personality disorder
  • Extreme anxiety or prolonged stress
  • Lack of sleep
  • Dehydration
  • Drug addiction
  • Traumatic experience

It’s sad, and sometimes frightening, to watch someone you love living in fear. Here are a few suggestions to help you handle this challenge:

Avoid arguing with them or trying to prove them wrong.  Reasoning rarely works and it could result in their loss of trust in you.. They may act as though they see your point, but do they really, or are they just playing along to throw you off track?

Check your body language and tone of voice. Relax your muscles so your hands are open, your jaw and face are at ease, and your arms are at your side or folded in your lap. Speak in a calm manner. You don’t want to raise any alarms with them by your unintentional actions.

Remind yourself that their fears are real to them. Acknowledge their concern, but don’t dwell on it. Divert their attention to something pleasant such as their favorite activity, book, TV show, etc.

Learn where their favorite hiding places are. It’s not unusual for a paranoid person to hide something and move it repeatedly until they no longer remember where it is.

Be sure they’re getting enough fluids. Keep an unopened bottle of water or their favorite beverage within easy reach. Let them choose what foods they want to eat.

Keep weapons such as knives, guns, bats, and anything that could be used to cause bodily harm away from them. Paranoia may lead them to initiate defensive and/or offensive actions. Think “safety first” and remove yourself if necessary.

Make note of their behavior on their care plan, and include anything that might have triggered it.  Relay this information to their physician, who may prescribe medications to alleviate the symptoms.

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