Expert: Michalene Peticca - 9/23/2006

Question
My husband has recently begun to exhibit paranoia directed toward our adult son who lives with us.  He suspects him of stealing and of trying to hurt him physically.  I am concerned that he may physically attack our son as he talks about it and keeps a heavy object nearby "just in case."  Otherwise, he is still able to carry on most activities of daily life and needs no reminders in physical care, grooming, etc.  Could this be temporary or does my son need to move for his own safety.  He is a great help to me in the care of his father.

Answer
Hi Sue,

Thanks for writing me.  It sounds like you are very busy caring for your husband whom i assume does already have an Alzheimer's or Dementia diagnosis?

Unfortunately, this "paranoia" can be quite common in the disease process. Misperceptions about family members, old friends and even strangers can occur.  Hopefully, this is just a "phase" in the disease and it may subside, however, there is no known time line for that to happen.

What is important here is that your husband is somehow "mixing" your son with either someone from the past whom he was fearful of...from a person on TV, that now he has "transposed" that person to your son, or just a "bad feeling" he is getting.   It is ALL the disease and how it is affecting his brain.   

I would strongly suggest that you stay calm and reassuring when your husband expresses his fears.   Try to do a lot of family type activities (going out to dinner, church, rides in the car, etc.) so that your husband connects your son as a close companion.  Repetition is the key for security.   Make sure you don't "scold" your husband for his fear.  It is truly real to him.  However, i would try to remove any dangerous tools,etc. that could be used as weapons.  Lock up the knives as well.   

Second, if his paranoia starts to become much worse, please see your family physican and ask about an anti-anxiety medication such as Lexapro or Ativan.  In small doses, this may allieviate some of the fear.

I hope this helps and please accept my admiration for you and your son to care for your husband.

Best Regards,

Michalene Peticca, MA