How To Respond When Dementia Patients Believe They Are Being Watched
People with dementia sometimes firmly believe someone is watching or spying on them, even when no one is. This is a delusion, a false belief not based in reality, often caused by memory loss, mixed-up memories, or brain changes that make rational thinking hard.https://www.carehome.co.uk/advice/delusions-in-dementia-and-mental-health-conditions It can feel scary for them, like thinking neighbors are following them or strangers are hiding in the house.https://www.usagainstalzheimers.org/alzheimers-talks/coping-hallucinations-delusions-dementia
Stay calm and do not argue or tell them they are wrong. Arguing can make them more upset because their belief feels very real to them.https://www.medicalnewstoday.com/articles/hallucinations-and-dementia Instead, listen to what they say. Acknowledge their fear by saying something like, “That sounds frightening. I am here with you.” This helps them feel heard and safe.https://www.hey.nhs.uk/patient-leaflet/delirium-and-dementia-care-in-hospital/
Reassure them gently without feeding into the delusion too much. Offer comfort through touch if they like it, such as holding their hand, or stay close by their side. Check the area they are worried about together, but keep it light, like, “Let us look around to make sure everything is okay.”https://www.medicalnewstoday.com/articles/hallucinations-and-dementia
Distract them with a simple activity to shift their focus. Suggest going for a short walk, moving to another room, or doing something they enjoy, like looking at old photos or listening to music. This often helps the feeling pass.https://www.usagainstalzheimers.org/alzheimers-talks/coping-hallucinations-delusions-dementiahttps://www.medicalnewstoday.com/articles/hallucinations-and-dementia
Make sure the space is safe. Remove anything sharp or risky they might grab if scared, and keep doors and windows secure to ease general worries.https://www.medicalnewstoday.com/articles/hallucinations-and-dementia Watch for patterns, like if it happens at night when they are tired or bored, and try to build a routine with good sleep, less noise, and daytime activity.https://www.hey.nhs.uk/patient-leaflet/delirium-and-dementia-care-in-hospital/
Use the IDEA approach: Identify the behavior, educate yourself on triggers like confusion or illness, and adapt by changing the environment or routine.https://www.usagainstalzheimers.org/alzheimers-talks/coping-hallucinations-delusions-dementia If the belief is new or very strong, talk to a doctor. It could be a sign of infection, medication side effects, or something else needing a check. Doctors might suggest therapies or, in severe cases, medications like antipsychotics, but only after trying other steps first because of risks.https://www.medicalnewstoday.com/articles/hallucinations-and-dementiahttps://www.carehome.co.uk/advice/delusions-in-dementia-and-mental-health-conditions
These steps help keep everyone safer and reduce stress for caregivers too.
Sources
https://www.carehome.co.uk/advice/delusions-in-dementia-and-mental-health-conditions
https://www.usagainstalzheimers.org/alzheimers-talks/coping-hallucinations-delusions-dementia
https://www.medicalnewstoday.com/articles/hallucinations-and-dementia
https://www.hey.nhs.uk/patient-leaflet/delirium-and-dementia-care-in-hospital/
