False beliefs and delusions in dementia

What are false beliefs and delusions?

Everyone has different personal beliefs. These include things like religious or political beliefs, and beliefs that we have developed through our experiences and life lessons 

At times, many of us have beliefs that may not be true. For example, someone might believe their neighbour doesn’t like them, even if there’s no evidence. But we usually have some control over our beliefs, so they don’t have an undue influence on our lives. 

When someone has dementia, however, they may lose the ability to think logically about whether their beliefs are true. These false beliefs, also called delusions, can become very powerful and upsetting. 

Common false beliefs and delusions include: 

  • thinking that someone is trying to steal from them 
  • thinking that someone is trying to harm them 
  • believing that their partner is being unfaithful 
  • thinking they’re living in the past – for example, that they still go to school or have a job 
What causes false beliefs and delusions in dementia?

The changes to the brain that happen in dementia can cause people to have difficulty recognising people, places and things. For example, they may not recognise a friend who visits them, and think there’s a stranger in their home 

Dementia can also affect people’s memory. They might forget where they left something and believe it has been stolen. Or they might forget that their partner has gone shopping and think they are with another man or woman. 

Delirium – a sudden onset of confusion, often with an underlying physical cause such as an infection – is another possible cause of false beliefs and delusions. If you notice a sudden change in someone’s behaviour or thinking, or if they appear more confused than usual, make an urgent appointment with their GP. 

Signs of false beliefs and delusions

Signs of false beliefs and delusions in people with dementia include: 

  • claiming that someone is stealing from them or trying to harm them 
  • hiding possessions to keep them safe
  • phoning the police frequently 
  • refusing to open the door or answer the phone 
  • talking in whispers, and saying things such as: “They can hear us” 
  • trying to carry out activities they used to do, like going to school or work 
  • mistaking people’s identities  
  • believing they’re in a different place 
  • reliving past traumas or events 

It’s important to remember that sometimes, the claims the person with dementia is making may be true, and someone could be stealing from them or taking advantage of their vulnerability. This needs to be carefully checked before you conclude that what they are saying is a false belief or delusion. 

Helping a person with false beliefs and delusions

False beliefs and delusions feel very real to the person with dementia. They may become angry or upset if you challenge themwhich can make it hard to care for them. 

However, there are ways to help a person who is experiencing false beliefs or delusions.  

  • try to explain what’s happening without challenging or correcting them. You could say something like: “The thought that someone has stolen your purse must be very distressing. Let’s see if we can find it in case it was accidently misplaced”   
  • speak in a calm, reassuring way to ease their distress
  • try to involve the person in doing something they enjoy as a way of distracting them
  • if these strategies are not working, try just ‘going along’ with the person until they’re calmer and/or have moved onto a different topic

It’s also a good idea to arrange a medical check-up to rule out other physical or mental health problems, and to review any medication that may be causing false beliefs and delusions 

Can false beliefs and delusions be prevented?

It’s not always possible to prevent false beliefs and delusions in a person with dementia, but these tips might help. 

  • agree on places to keep important items like keys, handbag and wallet, so you know where to look first if they think something has disappeared 
  • keep spares of essentials that might get misplaced, such as glasses or keys 
  • make sure they have regular eye and hearing tests – difficulties with sight or hearing can increase confusion 
  • encourage them to eat and drink regularly 
  • try to keep to a routine and limit changes to their environment 
  • keep photographs of them and close family/friends at different life stages around the house, to help them recognise the time they’re living in 
Support for you

It can be very upsetting if the person you care for is accusing you of something you haven’t done.  

Our Admiral Nurse Dementia Helpline provides free, confidential support. You can call 0800 888 6678 (Monday-Friday 9am-9pm; Saturday-Sunday 9am-5pm) or email helpline@dementiauk.org. 

The following pages may help you understand more about false beliefs and delusions and offer some suggestions for coping with the situation. 

Changes in perception and hallucinations in dementia

Things to try when someone with dementia stops recognising you

Life story work

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