She tells you she hasn’t eaten, and she just ate. Or she tells you a relative came to visit the other day, and that relative has been dead for ten years.
Careblazer, I know this can be frustrating and confusing. But what looks like lying in someone with dementia is not intentional deception.
Their brain is changing. That affects how they remember things, how they perceive things, and how they interact with the world around them. So when you ask why people with dementia lie, the answer is that it’s not lying.
Here are five of the most common reasons it can look that way, and what to do when it happens.
1. Dementia and Memory Loss: It’s Not a Lie
Dementia often affects memory, a lot of times short-term memory.
So your loved one may tell you they’ve just eaten, because they think they’ve just eaten. They simply don’t remember. In their mind, the meal may have just happened.
Or the opposite. They may have just eaten and tell you they haven’t, because their short-term memory is so poor they don’t remember eating.
They’re not trying to lie.
2. Confabulation: Filling in the Gaps
The second reason is something called confabulation. This is where the brain fills in gaps in memory with false information.
It’s like the brain is trying to write a story, but there are missing pages. So it makes up details that go along with the story. Your loved one is filling in the gaps with things that make sense, whether or not they happened.
3. Anosognosia: When They Don’t Know They’re Sick
The third one I’ve talked about a lot, and that’s anosognosia. This is when someone isn’t aware of the problems they’re having. They’re not aware of their disease, their deficits or their limitations.
So they might tell you they’re totally fine. Nothing’s wrong. They can do everything on their own.
To the rest of us, that looks like a lie. But their brain doesn’t make that connection. They really aren’t aware of how much help they need.
I go deeper into confabulation and anosognosia, and how both differ from a delusion, in 3 things in dementia that look like lying (but aren’t).
4. Self-Preservation and Emotional Needs
Here’s one I haven’t talked about much. Sometimes what seems like lying is actually a way of coping.
Your loved one might deny needing help with personal hygiene because they’re trying to hold on to their dignity. They might say they’re fine when they’re not, and they know they’re not, because they’re trying not to be a burden.
It’s more about self-preservation than lying to get away with something.
5. Altered Perception of Reality
Someone with dementia might tell you they talked to a relative who died years ago. For them, that relative may really have visited recently. For whatever reason, that memory feels very real and very recent.
Their perception of time has shifted.
If your loved one seems to be living decades in the past, I walk through how to respond in why people with dementia think they’re living in the past.
How to Respond When Someone With Dementia Lies
Start with what not to do. Avoid confrontation. Avoid arguing. Avoid correcting.
All of these strain the relationship. And a strained relationship makes it harder for you to give them the care they need.
- Don’t accuse them of lying.
- Don’t try to get them to admit the truth.
- Listen to what they’re saying, and show them you’re listening.
- When an opportunity comes up, gently redirect to another topic.
If redirecting hasn’t gone well for you before, I cover the common mistakes in how to redirect difficult dementia behaviors.
A calm, supportive approach is a good rule of thumb for lots of different behaviors. Your loved one may be feeling confused, scared or unsure. Your patience, your demeanor and your body language mean a lot in those moments.
Why It Helps to Stop Seeing It as Lying
Just imagine if your memory was so poor you couldn’t remember what happened ten minutes ago. Or your sense of time was so skewed that you thought someone who’s been dead for ten years visited you the other day.
These are significant brain changes. We don’t see them on the outside. But they are truly happening.
When we think someone is lying to us, it makes us frustrated. It makes us upset. It changes the way we interact with them, and not in a good way.
But when we can see it for what it is, brain changes, very complicated brain changes, we can come to these moments with much more compassion. Most of the time, there’s no need to correct the person or point out that what they’re saying isn’t true.
Often your loved one is just trying to make sense of a very confusing world.
When it feels like you’re hearing things that aren’t true every single day, staying calm is hard to do on your own. Inside the Care Collective, we work through moments like these together every week: what’s happening in the brain, how to respond in the moment, and how to take care of yourself while you do it. You can learn more here.
