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Dementia Confusion: The Alternate Reality in Alzheimer’s Disease

February 15, 2023
confused senior man

Dementia confusion can lead to a senior experiencing an alternate reality, something that can be extremely challenging for family members.


Dementia confusion, a common occurrence in Alzheimer’s, can result in recent memories being forgotten or altered, while those from the more distant past frequently remain unaffected. This may cause prior occasions to make more sense to someone with dementia than the present. Creating an alternative reality can be the senior’s way of making sense of the present through past experiences.

Seniors with Alzheimer’s disease very often have problems expressing themselves, and sometimes their alternate reality has more to do with a expressing a feeling or need than with the words they are saying.

For example:

  • “When will my wife be home?” This question could be more about the person’s need for affection or acceptance or a home-cooked meal than it is about wanting to see his wife, who died many years ago. An effective reaction to learn more might be, “Why do you need to see her?”
  • “I need to deliver all these casseroles to our neighbors before the end of the day.” Despite the fact that these casseroles do not really exist, the words could actually signify a need for purpose in daily life or wanting to be engaged in an activity. A suitable response to find out more could be, “Why did you decide to make casseroles for the neighbors?”

Maintaining a log of these kinds of events may help you see a pattern in the senior’s dementia confusion. The more you listen in and pay close attention, the easier it will be to comprehend the thinking behind the alternate reality and the most effective way to react.

Is It Okay to Play Along?

Providing the scenario is not going to be dangerous or improper, it is perfectly fine to go along with the senior’s alternate reality. Doing this isn’t going to make the dementia worse. Bear in mind, the person’s reality is genuine to him/her and playing along can make your loved one feel more comfortable.

If the situation is inappropriate or may possibly cause harm to the older adult, try to react to the perceived need while redirecting your loved one to something less unsafe or more appropriate.

Bear in mind the following three actions:

  1. Reassure the older adult.
  2. Respond to his/her need.
  3. Redirect if necessary.

Also, call on the award-winning caregiving team at Home Matters, providing specialty Beaverton dementia care and care throughout the surrounding areas. Our care staff are available to offer compassionate, professional respite care services for family care providers who could use some time away to rest and recharge. Call us any time to learn more at 800-298-5140 and to find the location nearest you.

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About the author

Tyler Williams

As an Area Owner and Operator of a Home Matters Caregiving franchise, I am committed to ensuring exceptional outcomes for our valued clients and caregivers. My passion for elevating our service quality is matched by my role as a blogger and social media manager for the franchise, where I share insights, updates, and foster community engagement. Prior to senior care, I used my strategic communication and brand development skills as the Marketing Director of a regional bank. My diverse experience supports my commitment to excellence and innovation in both healthcare and digital communication.
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