Dementia and paranoia seem to go together hand-in-hand. Just try to imagine how frustrating and frightening it must be to live in a world where your things constantly disappear, someone else is in control of your money, conversations often don't make sense, and you wake up every morning in a strange place. This is the world of the dementia sufferer. Is it any wonder that suspicions and "paranoia" often accompany Alzheimer's disease and the related dementias?

Three years after being diagnosed with "dementia" Annie G. still knows her home, but she tends to confuse what she sees on the television with reality. As a result, she is frightened of the nightly battle with criminals that she believes is occurring right outside her door. She hides her valuables, and then forgets where she hid them. When she can't find her treasures she is convinced that thieves have entered during the night and stolen them.

John W. was in charge of the family finances from the day he married more than 50 years ago. John doesn't realize it, but he has a dementing illness, and his wife has taken over the household affairs. Until she took a Post Office box, John regularly rummaged through the mail, moving, losing or throwing away vital paperwork. John is losing interest now, but for quite a while he was angry with the mailman for losing his mail.

Is it a wonder that people with Alzheimer's Disease or another dementia might become paranoid and lose trust in their environment and the people who care for them?

Don't Argue - Arguing with a confused person's "fact" may increase agitation and anger, and may lead to a catastrophic reaction. Instead, acknowledge the feeling: "I know it's frightening when you can't find your _______. I'll help you look for it."

Make a List of Favorite Hiding Places - Never throw out the trash without first checking for hidden items.

Try Distraction - A new activity in a different room may divert attention from the anxiety of the moment. This rarely works if emotions have escalated, however.

Keep Spares - If certain items are disappearing time after time, keep extras on hand to use until you find the "lost" item. Buy in pairs or even triples if possible.

Try to Keep Caregivers Consistent - New faces may be targets for suspicion because the explanation of who they are and why they are there is forgotten.

Avoid Announcing Appointments or Events - If your elder worries excessively about missing an appointment, wait until it's time to get ready to go.

Reduce or Eliminate Clutter - Remove excess items from closets, cupboards and drawers. "Lost" items stashed in a shoe are easier to find if there are only two pair to check.

Remove or Lock Up Valuables - This will protect aides and family members from suspicion.

Advise Family Members and Home Workers About Typical Behaviors - Let them know that they may be accused and that they should not take accusations personally.

Schedule a Medical Check-Up - Rule out other medical and psychiatric problems or the possible side-effects of medications already prescribed. In some cases where paranoid behavior is causing major problems additional drug treatment may be appropriate.

Listen Carefully - If your elder with dementia has a new behavior or a new concern, listen. Sometimes things really are stolen. Sometimes abuse is real.