Paranoia and delusional behaviors oftentimes develop in people with Alzheimer's disease or other causes of dementia. It takes a measure of understanding of these behaviors to know how to effectively respond and how to continually cope with this conduct.

Paranoia is an unrealistic fear or concern that harm is imminent, or an extreme and unreasonable suspicion of other people and their motives. Your mom may accuse you of stealing some of her possessions, for instance, or have a tremendous amount of mistrust in you through accusations and insults. You as her caregiver will be the target and possibly the trigger for these behaviors, which can be upsetting and unnerving for you.

Additionally, your mom may share these fears with other family members and friends, causing them to doubt your care and prompting embarrassment and distress on your part.

Delusions are fixed false beliefs that are not easily changed.

Paranoid delusional behaviors are common in people with Alzheimer's disease. The person fully believes his or her delusions are real. Keep in mind that the person with Alzheimer's has lost any sense of reasoning or logic; therefore, no amount of convincing your mom that her accusations are false will resolve the situation.

As the disease progresses and the brain deteriorates, the affected person becomes more confused and what he or she hears or sees can be misconstrued. Coupled with sensory impairments, paranoid delusions can easily escalate.

Reassurance is the key in calming or reducing the paranoid behaviors, though it will probably not stop them. Since these delusions are real to the person with Alzheimer's, it is important to validate those feelings.

Get into your mom's reality. For instance, if your mom accuses you of stealing her money, it might simply be easier to apologize, to tell her that you were just borrowing it and you forgot to tell her and that you will return it as soon as possible. You are not only validating her feelings, but you are also settling her fears and offering her some reassurance that her money is not really missing, which calms her and gives her some peace.

Try to understand the nature of her distress. Was she a suspicious and distrustful person prior to the onset of the disease? If so, her paranoia may become more aggravated. Look at the times of day the delusions are occurring. Are they occurring later in the day, around the time of "sundowning," when most behavior expressions escalate? Do they occur after an episodic event such as after a daily bath or when she is removed from her familiar environment or when she has had a particularly tiring day?

Environment can play a big factor in calming delusions. Keep your mom's environment and routines structured and familiar. Place clothing, money and other personal items back in the same place after they have been used. As your mom gets more suspicious, she may hide these items, thinking they are at risk of being stolen, and then she is unable to find them, thus compounding the problem and feeding the delusions further.

Additionally, when she is in her accusatory moods, try to distract and redirect her with things she enjoys. Take a walk, look at old photos or dance. Keep her interested in an activity that promotes her self-esteem and empowerment.

Depending on the severity of the delusional behavior, you may want to seek the advice of a physician. Look at your mom's list of medications and discuss them with her doctor. Some medications have serious side effects, so keep that in mind in her management of care.

Questions about Alzheimer's disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer's Services of the Capital Area at advice@alzbr.org or visit the organization at 3772 North Blvd., Baton Rouge.