Many people with dementia become confused and disorientated at times. This may lead to them believing things that are not true – known as ‘false beliefs’ or ‘delusions’. Our dementia specialist Admiral Nurses explain why this might happen, and how you can help the person you care for.
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
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 appearmore confused than usual, make an urgent appointment with their GP.
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.
False beliefs and delusions feel very real to the person with dementia. They may become angry or upset if you challenge them, which 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.