When Dementia-Related Psychosis Isn't Treated

Medically Reviewed by Neha Pathak, MD on March 09, 2021

Seeing, hearing, and believing things that aren't real can be a part of dementia. Psychosis is the name for these symptoms.

Psychosis affects almost everyone with dementia at one time or another. It can be even more troubling than memory loss to both the person with dementia and their caregiver.

Psychosis is more than just upsetting. It can lead to all kinds of problems if it's left untreated. Although there's no cure for dementia-related psychosis, medicines and other therapies can stop the unpleasant thoughts and feelings, and avoid problems like these.

Relationship Issues

Psychosis makes people angrier and more aggressive. You might say or do things that are out of character for you, like yell at your partner or child for no reason.

Though you don't mean what you say, your words can have a lasting harmful impact on your relationship.


Dementia can make it hard to tell the difference between what's real and what's fake. You might see people or hear sounds that don't exist. It can be embarrassing to admit that you see or hear something that no one else does.

Some people with dementia keep these experiences to themselves because they're afraid that people will judge them or mock them.

It can be lonely when you feel like no one else understands what you're going through.

Poor Sleep

Nighttime can be a scary time for someone with psychosis. Shadows on the wall or sounds outside are easy to mistake for monsters or somebody trying to break into their home.

Psychosis is just one part of dementia that can interfere with sleep. People who are able to get to sleep may confuse their dreams with reality.

Hospital or Nursing Home Stays

Psychosis symptoms can be just as upsetting and stressful for caregivers as they are for the person with dementia. These symptoms can make it hard for you to manage your loved one's care.

In some cases, caregivers send people with dementia to hospital emergency rooms because they just don't know how to handle their loved one's symptoms.

The behaviors can become enough of a problem that you need a longer-term solution for your loved one. Psychosis and other mental health problems are the biggest reason why people with dementia end up in nursing homes.

Hospital and nursing home stays can be expensive. The burden of paying for these can fall on you or your family if your loved one's health insurance won't fully cover them.


Psychosis can make people dangerous to themselves or those around them. For example, someone who believes their caregiver is stealing from them or is trying to hurt them might fight back and become violent. Episodes like these can lead to run-ins with the police and legal system.

Someone who is out of touch with reality can also pose a danger to themselves. For example, a person who believes that killer bees or a bear is chasing them might jump out of a window or climb over a balcony railing to escape.

Worse Outcomes

One of the most important reasons to treat psychosis is because people with psychosis can get more severe symptoms. In fact, they can die sooner than people without those symptoms.

Show Sources


Alzheimer's Association: "Sleep Issues and Sundowning," "Suspicions and Delusions."

American Family Physician: "Behavior Disorders of Dementia: Recognition and Treatment."

American Journal of Geriatric Psychiatry: "Distress Associated With Dementia-Related Psychosis and Agitation in Relation to Healthcare Utilization and Costs."

American Journal of Psychiatry: "Neuropsychiatric Symptoms as Predictors of Progression to severe Alzheimer's dementia and death: The Cache County Dementia Progression Study."

Brain & Life: "What is Dementia-Related Psychosis?"

CNS Drugs: "Management of Dementia-Related Psychosis, Agitation & Aggression: A Review of the Pharmacology and Clinical Effects of Potential Drug Candidates."

National Institutes of Health: "Health care costs for dementia found greater than for any other disease."

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