Dementia-Related Psychosis: The Caregiver’s Role

Treatment for dementia-related psychosis is different for everyone. But one thing is certain: as a caregiver, you play an important role in your loved one’s care plan. With your help, they can have a better quality of life for as long as possible.

Monitor their behavior

Your loved one might be acting in a strange way. Their behavior can be harmless.

For example, it’s common for people with dementia to think they are not at home. James Lai, MD, assistant chief of clinical affairs for geriatrics at the Yale School of Medicine, says people with dementia might even go to their rooms to collect certain things. If all they want to do is pack a bag and unpack it, he says that’s okay. You can even help.

“As long as these [delusions] are not stressful, you can participate, ”says Lai. “If you always tell them what they’re doing is wrong, or if you try to remind them that they are not going to this place, I think you will find that it creates more stress and anxiety. . “


It is not always possible to calm a loved one on your own. They can be really upset or pushy.

“This is where you want to involve your doctor,” Lai says.

But the symptoms of psychosis are not always frightening for people who suffer from it. Christopher van Dyck, MD, director of the Alzheimer’s research unit at the Yale School of Medicine, says people with Lewy body dementia often see animals or people who are not there. really. But these beings tend to be non-threatening and even comforting.

“The person having [the hallucination] can live very happily with additional dogs in the house, ”he says.

Watch for warning signs

It is not always easy to tell if your loved one is having an illusion or hallucination. They may not know it themselves. Lai says to watch for the signs, as if they:

  • Move things
  • Being upset or aggressive in certain situations
  • Are afraid to enter a room
  • Avoid certain people or places


And sometimes psychosis can be a sign of other medical issues, Lai says. This is especially true if the symptoms come on out of the blue. Your loved one might not be able to tell you that they are not feeling well.

He says you should call the doctor if you notice:

  • Sudden changes in behavior, mood or personality
  • Weightloss
  • Lack of appetite
  • Gaze periods
  • Lots of falls
  • Severe sadness or bad mood
  • Much more sleep than usual

Work with their doctor

You can help your loved one get to their visits on time. And you can make sure they get their hearing, eyesight, or general health checked. But that’s not your only role. Arman Fesharaki-Zadeh, MD, behavioral neurologist and neuropsychiatrist at Yale Medicine, says caregivers are a vital source of “objective session-by-session updates.”

He suggests that you should keep an eye out for things like:

  • What time do symptoms appear?
  • Do they come at sunset?
  • Are they happening around some kind of change?
  • Is a new person causing them?
  • Is your loved one really anxious and scared in certain situations?

Write down all the information you have and bring it to their next meeting. Fesharaki-Zadeh says it will help you and your doctor look for patterns that might make your loved one’s dementia-related psychosis worse. You may be able to alleviate some symptoms if you can find and avoid certain triggers.

Carry out the treatment plan

Your loved one may need medicine for their dementia or other health problems. You’ll need to make sure they’re taking it the right way.

If possible, Lai suggests that you give them a role to play in their treatment routine. For example, put medicine in a machine that spits out the medicine when a button is pressed.

“Giving back some control tends to be a good thing,” he says. “Even if it’s small.”

Carolyn Fredericks, MD, a neurologist who treats people with Alzheimer’s disease and other memory disorders at Yale Medicine, says the drugs likely won’t get rid of delusions. But it can help alleviate symptoms that make psychosis worse, such as restlessness or confusion.

Some of these drugs come in patch form, she says, “which can be helpful if the person is suspicious and doesn’t want to take pills.”

Get help for yourself

Caring for someone with dementia is hard work. You might feel like you are the only one who can or do it. But it makes caregiver burnout more likely. It is a state of physical fatigue or mental exhaustion. This could lead to medical problems which could include anxiety and depression. This can affect the quality of the care you give to your loved one.


“Even the best caregiver in the world needs rest and personal care,” says Fredericks. “This is how you become a good caregiver, giving yourself a chance to be well.”

There are a number of ways you can get additional help. Ask your doctor:

  • Home health aids
  • Senior centers
  • Daycare for adults
  • Long term living facilities

Fesharaki-Zadeh suggests that caregivers contact groups like the Alzheimer’s Association. You can access a large network of dementia-related support.

“These are the people who are in the trenches facing these problems,” he said. “They can be very helpful and very therapeutic.”

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Jothi Venkat

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