As a rank beginner in the field of eldercare I was excited to finally be turned loose to make my first independent home visit. It went well, I thought, until I returned to the office. At the door I was met by my supervisor. She informed me that she had just logged an official complaint from the client I had left not 20 minutes earlier: The client's teeth were missing. The teeth were there before I arrived, and they were now missing. The conclusion was obvious.

I was devastated. Later the dentures were found by the client's daughter, wrapped in a napkin and stuffed in the toe of a slipper. Everyone had a good laugh, but I'll never forget the feeling of shock and indignation I felt at being unjustly accused. Lucky for me it was teeth (who would want those?) and not an expensive piece of jewelry that went temporarily missing.

People who have Alzheimer's or other dementing illnesses must struggle with their personal reality that every moment is a new moment. There is often no memory of the moment that went before. Things inexplicably disappear when you have no memory of having moved them. When your things are constantly disappearing, the "logical" solution is to hide them in a safe place where no one will find them. And then they are "stolen" again.

When your memory perversely retains the information that something is scheduled, but you can't remember whether this is the time or the day, you will ask someone. And ask, and ask, because you can't remember that you already asked or what the answer was.

Just try to imagine how frustrating and frightening it must be to live in this confusing world where things disappear, someone else is in control of your money, conversations often don't make sense, or your brain doesn't recognize the home where you've lived for many years. Is it any wonder that suspicions and "paranoia" often accompany dementia?

Things That May Help:

1.  Don't Argue - Arguing with a perceived "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."

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

3.  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.

4.  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.

5.  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.

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

7.  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.

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

9.  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.

10.  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.

11. 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.