3 Things in Dementia That Look Like Lying (But Aren’t)

A man with dementia drove his car through the front of a building.

Afterward, he still insisted he was perfectly safe to drive.

If you’re his family, what does that look like?

Denial?

Stubbornness?

An outright lie?

But what if his brain was actually telling him that he was still a safe driver?

There are several symptoms in dementia that, from the outside, look a lot like lying. But once you understand what is happening underneath the behavior, it becomes easier to see that the person is not trying to deceive you or ignore reality.

You’ll hear them called anosognosia, confabulation, and delusions. Three different things happening in the brain, and none of them is a lie.

Here’s the most important thing to keep in mind:

A lie requires someone to know what is true and intentionally tell you something different.

In the three situations below, that is not what’s happening.

And once you understand that, it can change the way you respond.

1. “I’m Perfectly Safe to Drive”: Anosognosia

Anosognosia is when someone is not aware of their limitations, their difficulties, or even their condition.

This is where some of the biggest safety battles in dementia care happen.

Your loved one genuinely believes:

• They are still safe to drive
• They can still manage the finances
• They can still live alone safely
• They don’t need help

Meanwhile, you are looking at everything that has happened and thinking:

How can they possibly think they’re fine?

Maybe they’ve been scammed out of thousands of dollars.

Maybe they’ve almost set the house on fire.

Maybe they drove their car through the front of a building.

That last one was a real patient I worked with when I was at the hospital.

This is exactly why anosognosia can look so much like denial or lying.

But anosognosia is different from someone knowing they’re struggling and not wanting to admit it. With anosognosia, the person genuinely does not recognize that anything is wrong.

Why anosognosia can look like lying

When you or I try to do something and it becomes obvious we can’t do it well, our brain notices.

We might think:

“I guess I’m not as good at this as I thought.”

Or:

“I probably shouldn’t be doing this anymore.”

That check is something the brain does for us. And with anosognosia, the brain changes of dementia take away the ability to do it. It’s not that your loved one is looking at the evidence and refusing to accept it. Their brain isn’t showing them the evidence at all.

You are looking at the scam, the burned pot, the crumpled bumper and thinking:

How can they not see this?

They’re not looking at the same picture you are.

That’s why arguing with them about the evidence rarely creates insight. There’s nothing for the evidence to land on.

2. “The Neighbor Brought Me Flowers”: Confabulation

The second thing that can look a lot like lying is called confabulation.

This one is about memory rather than awareness.

The simplest way I can explain it is this:

The brain doesn’t like a blank.

When the brain reaches for a memory and can’t find it, it sometimes fills that empty space with an answer that isn’t accurate.

But the person is not sitting there thinking:

“I have no idea what happened, so I’m just going to make something up.”

That is not what is happening.

Instead, their brain creates an answer to fill in the missing information, and the person has no idea that the answer is wrong.

So your loved one can look you directly in the eye and say:

“The neighbor came over yesterday and brought me flowers.”

But you know nobody came over.

There are no flowers.

From your perspective, that did not happen.

From their perspective, it’s just as real as any other memory.

That is what makes confabulation so confusing for families.

Does dementia make people make up stories?

A lot of what sounds like “making up stories” is actually confabulation.

The person isn’t trying to fool you. They’re remembering something that did not happen, and they have no awareness that the memory is false. They don’t know the truth to begin with, so there’s nothing to lie about.

There are other reasons people with dementia can seem to lie, too, and I go through more of them in why do people with dementia lie.

One important note, though:

Not every incorrect statement from a person with dementia is confabulation.

People with dementia can get facts wrong just like you and I can get facts wrong.

It is easy in dementia care to blame every mistake, odd comment, or inaccurate detail on the dementia.

Sometimes people are simply mistaken.

3. “You’re Stealing From Me”: Delusions

The third thing that can look like lying is a delusion.

A delusion is when a person strongly believes something that is not true and is not based in reality.

Some common examples include believing:

• Someone is stealing from them
• Their spouse is cheating on them
• Someone is trying to harm them
• Someone is trying to get rid of them
• The home they are in is not really their home

From your perspective, there may be no evidence at all that any of these things are happening.

But the belief feels completely real to the person with dementia.

And that is where things can become incredibly difficult. If you’ve noticed your loved one remembers the false belief in vivid detail but forgets what actually happened, here’s why delusions can feel so real.

What Is the Difference Between Confabulation and a Delusion?

This is where families can understandably get confused.

Both can involve someone saying something that is not true.

But they are not the same.

Confabulation is mainly about memory.

The brain is filling in a gap in memory with information that is inaccurate.

A delusion is mainly about a belief.

The person strongly believes something that is not true.

For example:

A person who is confabulating might say:

“The neighbor brought me flowers yesterday.”

They may say it once, and you may never hear it again.

A person experiencing a delusion might say, again and again:

“You’re stealing from me.”

The same belief keeps coming back.

So one is about filling in missing memory.

The other is about a repeated false belief.

Stop Asking “Why Are They Lying to Me?”

Real life is not this clear-cut.

You are probably not going to be in the middle of a stressful moment thinking:

“Oh, that’s definitely confabulation.”

Or:

“That sounds like anosognosia.”

It isn’t always easy to tell whether something is anosognosia, confabulation, a delusion, a simple memory mistake, or something else. And you don’t need to become an expert at labeling every single behavior.

What matters more is recognizing that something that looks like lying may not be deception at all.

So instead of asking:

“Why is my loved one lying to me?”

Try asking:

“What could be happening in their brain that makes this feel true to them?”

If your loved one genuinely believes what they are saying, they aren’t trying to deceive you. They’re responding to the reality their brain is giving them.

And once you start looking at it that way, you can move to the next question:

What type of response might actually help here?

Should You Correct Someone With Dementia When They Say Something That Isn’t True?

One of the most common instincts is to correct.

You want to explain.

You want to show them the evidence.

You want to bring them back to what you know is true.

But with anosognosia, confabulation, and delusions, that usually doesn’t work.

In fact, it often makes the situation worse.

If someone genuinely believes:

“I am still a safe driver,”

showing them all the reasons they are unsafe won’t create the insight you are hoping for.

If they genuinely remember the neighbor bringing flowers, telling them:

“No, that never happened,”

can quickly turn into an argument.

And if they strongly believe someone is stealing from them, presenting evidence that proves otherwise rarely makes the belief disappear.

That does not mean you have to agree with something that is not true. You can respond to what the person is experiencing without saying that their belief is correct. (If you’ve ever wondered where that line is, I wrote about whether lying to someone with dementia is ever okay.)

The goal is not to convince them that they are wrong.

The goal is to ask:

What response is most likely to help this person right now?

A Quick Note About Concerning Claims

Not every unusual or upsetting statement should automatically be dismissed as dementia.

If your loved one says someone has harmed them, stolen from them, threatened them, or done something unsafe, take the concern seriously and look into it.

Dementia can cause false beliefs and inaccurate memories, but that does not mean every concerning statement is false.