When it happens
Moderate-stage dementia, especially deep into it
Why it happens
Memory impairment, the force of habit, a lost sense of time, and strong emotions (which help memories stick longer in the brain) eventually conspire to make someone with dementia lose a sense of reality. Past and present swirl together. So a retiree may feel an urgent need to "get to work" or meet a deadline, or the person may talk about a long-dead relative as if she were in the next room.
Also, early memories tend to be retained longest, making them vivid in the person's present.
What you can do
Avoid correcting the person, if you can. It sets the stage for defensiveness and upset without really making a practical difference.
Go along where you can. Ask yourself if it really matters whether the person is in a different location from where she believes she is or whether her mother is deceased and therefore not coming to lunch.
Use distracting techniques. Start a new activity, move to another room, change the subject of conversation. Many of these confusions are forgotten, or only remembered in certain circumstances.
Reorient gently without pointing out the error. To someone who thinks the visitors are her own children: "Here are your grandchildren . . . look at what your grandchildren Max and Ava have brought."
- If you can, enter the person's reality. Help someone who wakes up agitated about going to work by saying something like, "Oh no, dear, today is Saturday. You get to sleep in."