Editor’s Note: The following column

was previously published June 3, 2023.

Thanks to breakthroughs in medicine and nutrition in recent years, we are living longer than ever before. But this increase in life expectancy also brings an increase in the number of diseases, injuries and impairments that affect older adults. With this in mind, we at the Salem Visiting Angels office have created this series of articles to keep our older population and their families informed and to offer some practical advice for meeting the challenges faced by seniors and those who care for them.

While paranoia is not a common part of the aging process, some research suggests that up to 23 percent of the aged population suffers from some form of anxiety, hallucinations or feelings of persecution associated with the mental disorder at one time or another. There are a variety of physical conditions which may lead to symptoms of paranoia, but many of these can be treated effectively when medical intervention is sought.

Paranoia is categorized as a mental condition in which the sufferer is constantly worried or anxious and can feel threatened or oppressed. The person may feel mistreated and think that other people are plotting against him behind his back. Sometimes people suffering from paranoia believe that friends or loved ones are stealing from them, and in extreme cases they may even irrationally believe that people are trying to kill them.

Sadly, in some cases older adults with paranoia may believe that family members don’t care about them because they haven’t visited recently or the person does not remember their recent visit.

Although many times those people closest to the delusional person may be perceived as the “threat,” in other cases these perceived threats may not even be real. Instead, they are a total fabrication of the sufferer’s mind, and hallucinations often accompany feelings of paranoia. In others, common noises, lights or occurrences that are not normally threatening can be misinterpreted by the paranoid mind and become a source of intense, irrational fear.

These feelings of dread, frustration, mistreatment and persecution persist even though no evidence exists to support them. In fact, in some cases the delusional person’s brain may misinterpret their environment or may even fabricate evidence to support their claims.

A variety of health-related causes can lead to paranoia in older adults. While some are long-term problems, others are easily treated. People with Alzheimer’s Disease and other types of dementia often exhibit paranoid tendencies, as do those with brain tumors or people who have suffered a stroke or other kinds of brain damage.

Paranoia often accompanies other psychiatric conditions, and many times it can be the result of medication side effects or misuse, especially when medications meant to treat psychosis are not taken properly. Use of illegal drugs can also result in paranoia.

Dehydration or other conditions caused by excessive heat can lead to paranoid tendencies, and urinary tract infections are one of the most common causes of paranoia in older adults.

Friends or family members caring for a loved one who becomes paranoid should discuss the problem with the person’s doctor or another medical professional. These trained individuals will look for the underlying cause of the paranoia and prescribe an appropriate treatment when possible. In some cases symptoms can be reversed with treatment, such as antibiotics for urinary tract infections and IV fluids for dehydration.

In other cases of psychosis, medications can be prescribed to reduce anxiety and feelings of being threatened or persecuted. Paranoid symptoms left untreated can get worse with time, resulting in even more disruptive thoughts and behaviors.

Caring for someone with paranoid tendencies can be difficult and frustrating. Caregivers should do their best to remain calm and assure the person that they are safe. Paranoid symptoms can be frightening for the person experiencing them, and acknowledging that the things they are seeing, or hearing or thinking are real to them can help restore their sense of calm.

Caregivers should do their best to avoid becoming angry or upset during tense situations, even if they are presented with facts or accusations that are clearly not true. Arguing often leads to increased agitation and aggression, which only makes the situation worse. Instead, they should try redirecting the paranoid person by changing the topic of conversation, putting on music or engaging in some other activity that may help to calm the person and take their mind off their fears.

Information provided by Visiting Angels, America’s choice in homecare. Visiting Angels’ non-medical homecare services allow people to continue enjoying the independence of their daily routines and familiar surroundings. To set up an appointment for a free in-home consultation, call 330-332-1203.