coping with dementia

Coping with Dementia: Work within your Loved One’s Reality

By Debbie Selsalvage Posted on January 15, 2021

A delusion is a false belief that persists in spite of evidence to the contrary; an idea or object that is perceived incorrectly by the delusional person.

Dementia symptoms often include delusional thinking, meaning that the person with dementia may perceive things quite differently than they really are. 

Within a world where what we see, touch, hear, smell, and believe can be validated by scientific observation, delusions are considered dangerous.  Has anyone ever benefited from being delusional?  Most of us would emphatically answer, “No!”

But the world we call “normal” can be quite different from the world of our loved ones living with dementia, and I am going to suggest that it is not always helpful for care partners to dismiss, deny, or denounce their delusional beliefs and behaviors.

Work within your Loved One’s Reality when they have Dementia

People with dementia can totally lose recent memories, but may have strong and even accurate memories of an earlier time in their life; frequently during their early adulthood.  While our reality remains grounded in the present, theirs becomes a facsimile of their past. 

As a care partner, when we see evidence of this, we should not treat it as a dangerous or harmful delusion, but remind our self that their reality is as real to them as ours is to us. 

By trying to understand their reality and work within it, we can actually help our loved ones living with dementia.  Rather than correct their misconceptions and argue about what is “real,” try to enter their reality and encourage them to talk about it.  This is what we call Validation Therapy.  Don’t argue; agree.  Don’t correct; validate!

I know of a woman in a memory care community who spent many hours each day talking to herself in a mirror.  Rather than feel pity for this “delusional” behavior, the staff spoke with her and learned that she thought she was talking to her sister.  They also noticed that she seemed most happy and calm during and after these conversations. 

young content woman among gentle purple flowers
Photo by Maria Orlova on

Her behavior was doing no harm, so they did not discourage it.  In fact, when she seemed anxious or agitated, they took her to the mirror to talk to her beloved sister.  By indulging her “delusion,” they protected her dignity and elevated her quality of life.

A care partner’s task is not easy.  We must be grounded in our own reality to keep our loved ones safe and secure, but we must also understand and enter their reality to validate their beliefs and feelings. 

As the health of our woman in the story declined, finally she could no longer walk and had to be placed in a wheel chair.  When this happened, the understanding staff of her community lowered the mirror on the wall so she could continue to enjoy wonderful conversations with her sister! 

This, my friends, is not delusional thinking.  It is truly compassionate care. 

About Debbie Selsavage

Debbie Selsavage is a Certified Trainer and Consultant in the Positive Approach to Care and a Certified Dementia Practitioner.  She authors a monthly column to assist caregivers in coping with Dementia. Her company, Coping with Dementia LLC is dedicated to making life better for individuals living with dementia.  Contact Debbie at [email protected].


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