Paranoia is a frequent visitor as we age.
I think it’s because the old know they [ok we] are vulnerable.
For those with dementia there’s a greater feeling of susceptibility.
Your p.w.d. may seem unaware of having a malady, but s/he senses that there is something off.
Paranoia seems like a way to protect ourselves when feeling susceptible.
It may be a misguided approach to imagined threats, but it is a tradition as we get older.
Burt’s paranoia appears to center around food, although he has declared that an aide is killing him.
On some occasions, he is being slain by one of his hallucinations. As in, that guy (not) yesterday was murdering him.
The paranoia is a delusion, so why not have it exercised by a hallucinatory agent.
Thankfully, the fear is generally perfunctory and passes. It has not stopped him from eating.
Even after he says that it’s poison I am giving him, he usually opens wide for the next bite.