“Someone stole my purse!” Barbara pushed her walker into the dining room to make her announcement with as much volume as she could muster. Her eyebrows jumped and her eyes bugged to emphasize the seriousness of the accusation. Several residents peered down the hall, perhaps expecting to see the culprit racing away with the purse tucked under their arm. No such villain appeared. However, Barbara would not be placated, so a purse search began.
Some background information: Barbara’s purse was an ancient affair with one handle, 
containing three tissues (two used) and a lip balm. It went missing at least once a day, and declaring it stolen was her default. Barbara’s dementia often manifested in paranoid behaviour.
Paranoia
“Paranoia is an unrealistic fear or concern that harm is imminent or that others are out to get you.” 1. Sylvia brought me into her room and whispered that “they” were watching her through the air conditioning vents. Convinced that staff kept track of her this way, she felt uncomfortable in her room. George refused to eat because the food was poisoned.
How do you cope with these behaviours?
Take it seriously. Barbara’s care partner came and gently led her back to her room. Together they searched drawers until the purse appeared. Although Barbara declared loudly that looking in drawers wouldn’t help because it had been stolen, her care partner knew all her hiding places. When it was discovered, Barbara was thrilled and hugged it and then her care partner–crisis averted until next time.
I climbed on a chair and put plastic cups in the air conditioner vents so “they” couldn’t watch her and Sylvia happily had a nap in her room. I offered to taste a small portion of 
George’s food before he ate any and after a few meals he was reassured and my snacking discontinued.
The key is to understand that the delusion is real to them. If your manner is respectful and looking for solutions, most people will calm and work with you.
Hoarding and Rummaging
Hoarding may come from a need for control or depression mentality or just liking to have a lot of “stuff.” People hoard napkins, tissues, briefs, newspapers, food–you name it. Food is the most dangerous as it quickly becomes rancid. It may take two people to deal with the situation. One needs to distract the elder and the other does a search and rescue. They rarely remember bringing food to their room so aren’t upset when it is gone. For other items, I usually skimmed off a layer or two of whatever they were hoarding and kept enough to keep them happy. It’s a balancing act and you may need to sacrifice your concept of tidy.
Rummaging is difficult because it isn’t only restricted to rummaging among their own things. When elders live in community they sometimes go room to room to rummage. They have no boundaries or filters telling them this isn’t theirs and the words “Somebody stole my purse!” may be correct! Close monitoring, returning items and giving them something to rummage in (such as a basket of socks which need matching) can sometimes help.
Suggestions for dealing with all behaviours:
- Remain calm. You may feel ready to scream, but a calm demeanour often brings the temperature down for everyone.
- Could there be an unmet need behind the action?
- Is there something in the immediate environment that could be modified to calm things down?
- Be proactive and include some exercise as a part of every day.
- Some behaviours come from boredom, so look for activities for your elder to be a part of. Food preparation, folding laundry, simple gardening are all possibilities.
- Reminisce together with old photo albums. You may be surprised who they remember.
- Music can lighten a mood or bring back memories.
- Pets are amazing in so many ways. If you don’t have one, perhaps one can visit, or you may interact with animals on your walk. OR…I had great results with a robotic cat (they come in dog form, too) on my desk. It was motion sensitive and would start to move and meow when people came near. Residents stopped and petted and talked to it all the time and it was a great favourite. (Many staff continually got freaked out by it, I have to admit!)
- Maintain your sense of humour. This is key.
All of these behaviours are challenging. Some may require medication as well as other interventions. When looking for solutions, keep at the foremost of your mind that your elder is a person to be loved and respected as they deal with the ghosts in their minds.
- https://www.verywellhealth.com/paranoia-delusions-alzheimers-disease-98563
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Great message. Yes, remember to love and respect.
That is so real and cute.
I can learn from this my self🌹