We examined how family caregivers react, and what interventions they use in response to delusions exhibited by relatives with dementia in a community setting. Structured interviews were conducted with 68 family caregivers whose relatives were described as experiencing delusions based on the BEHAVE-AD or the NPI. Quantitatively, we cross-tabulated the type of response to delusion by the type of person providing the response and by the type of delusion manifested. Qualitatively, we analyzed open-ended responses to understand the types of caregivers’ responses to delusions, the contextual circumstances, and the impact of the responses. Caregiver responses to delusions included “Explaining that the delusion was wrong” (34% of responses), “Trying to calm down” (27%), “Agreeing with the delusion” (13%), “Distracting” (12%), and “Ignoring” (10%). Responses including “Anger, yelling or scolding,” were rare. The vast majority of reactions were by family caregivers of the persons with dementia. The relative frequency of the type of reaction tended to be consistent across delusion types. The qualitative analyses added some categories of reactions, but mostly highlighted issues to be considered when examining responses and their efficacy, including the use of multiple responses, and the manner and mood in which responses are conveyed. To cope with delusions, family caregivers develop intuitive intervention techniques. Understanding those interventions and reactions by caregivers and their relative efficacy can inform guidance programs for family caregivers. Improved support for family caregivers has the potential to positively influence the behavior of caregivers and older adults with dementia and improve their respective quality of life.

我们检查了家庭照顾者的反应，以及他们使用哪些干预措施来应对社区环境中患有痴呆症的亲属表现出的妄想。对 68 名家庭照顾者进行了结构化访谈，他们的亲属被描述为经历基于 BEHAVE-AD 或 NPI 的妄想。定量地，我们根据提供反应的人的类型和表现出来的妄想类型，对妄想的反应类型进行交叉列表。定性地，我们分析了开放式反应，以了解照顾者对妄想的反应类型、背景情况以及反应的影响。照顾者对妄想的反应包括“解释妄想是错误的”（34% 的回答）、“试图冷静下来”（27%）、“同意妄想”（13%）、“分散注意力”（12%）、和“忽略”（10%）。包括“愤怒、大喊大叫或责骂”在内的回应很少见。绝大多数反应来自痴呆症患者的家庭照顾者。错觉类型的反应类型的相对频率往往是一致的。定性分析增加了一些反应类别，但主要强调了在检查反应及其有效性时要考虑的问题，包括多重反应的使用，以及传达反应的方式和情绪。为了应对妄想，家庭照顾者开发了直观的干预技术。了解照顾者的这些干预和反应及其相对功效可以为家庭照顾者的指导计划提供信息。