Changes in Reality and Dementia

[Updated: 24th March 2017]

Why doesn’t my dad/mum/husband/wife/partner recognise me, family or our home anymore?

Why are they forgetting more?

These are questions we hear regularly from carers as dementia advances. It normally means the way a person with dementia sees, feel, hears and experiences the world has changed, they are losing more memories and their reality is different to ours.

Forgetting and Losing Memories

When a person forgets more recent memories, it can seem like the person is in a different reality, for example, not recognising their own home and insisting they want to go home. The person with dementia may believe that their children are still young, even when they children are now adults. A person with dementia may think that their parents are still alive, long after the parents have actually passed away.

Understanding Memory Loss with Dementia

The above can be explained using an analogy where memories are represented by books stored on a bookshelf. The books (memories) are stored by time.

Earliest childhood memories are represented by the books on the bottom shelves.

As you move up the bookcase, the books represent more recent memories. Recent memories are represented by the books on the top shelf.

With dementia, the bookcase wobbles and the books on the top shelf (the most recent memories) fall off first and are lost. As dementia progresses, books lower down on the bookcase (older memories) fall off and are lost.  books and memory in dementia analogy

If a person with dementia has lost the recent books (memories) from the top shelves, they have no memories of the present day to the last 20 or 30 years. In their mind/reality, they are living 20 or 30 years ago.

If the memory of someone passing away has been lost, the person with dementia will believe that person is still alive.

If the book (memory) about moving homes 25 years ago has been lost, and the person no longer recognises anything in their current home, they believe they are not at home. When they are asking to go home, the person with dementia is probably thinking about a previous or childhood home: a memory stored in the books at the bottom of the bookcase, which they can still find and remember.

For most people, going along with or entering their reality as opposed to contradicting them, will reduce upset and disorientation.

Related post

Meeting Someone with Dementia in their Reality