Why do people with dementia make false accusations?

Caring for a loved one with dementia can be both rewarding and deeply challenging. One of the more difficult aspects caregivers face is dealing with paranoia and false accusations. While these behaviors can feel hurtful, it’s important to understand the underlying causes and learn how to respond in a way that supports both you and your loved one.

The Neurological Causes of False Accusations

False accusations arise from changes in the brain caused by dementia. These changes affect how your loved one perceives reality, leading to misinterpretations of everyday events.

🧠 What’s happening in the brain?

• Memory loss and confusion: When they misplace an item, their brain might conclude that someone has stolen it.

• Anxiety and fear: The inability to recognize familiar faces or situations can feel threatening, causing them to lash out.

• Cognitive decline: They may struggle to distinguish between past and present events, leading to misunderstandings.

These accusations aren’t personal attacks—they are a symptom of the disease.

Common Accusations You May Encounter

Here are examples of accusations caregivers often hear:

• "You stole my wallet!"

• "You’re trying to poison me!"

• "You’re keeping me prisoner in my own home!"

• Accusations of infidelity or other inappropriate behavior.

• "You hate me and want me to die!"

While these words can feel upsetting, it’s crucial to remember that they stem from your loved one’s fear, confusion, and frustration—not malice.

5 Ways to Respond to Paranoia and False Accusations

1. Don’t Take It Personally

Although challenging, try to separate the accusation from your emotions. These behaviors are not about you—they’re a symptom of the disease.

✅ How to respond:

• Stay calm and take a deep breath.

• Reassure them instead of defending yourself.
  💬 Example response: “I can see you’re upset. Let’s work together to find your wallet."

2. Avoid Arguing or Using Logic

Reasoning with someone whose brain no longer processes logic effectively often escalates the situation.

✅ How to respond:

• Let them express their feelings without challenging their beliefs.

• Focus on validating their emotions.
  💬 Example response: “I know this is frustrating. I’m here to help.”

3. Use Simple, Straightforward Responses

Complex explanations can overwhelm and agitate someone with dementia.

✅ How to respond:

• Keep your answers short and direct.

• If possible, redirect their attention to another activity.
  💬 Example response: “Let’s look for your wallet. I’m sure it’s around here.”

Pro Tip: Learn their favorite hiding spots for commonly misplaced items. This can save time and reduce stress.

4. Validate Their Feelings

To your loved one, their fear and confusion are real. Dismissing their emotions can make them feel unsupported.

✅ How to respond:

• Acknowledge their emotions with empathy.

• Reassure them using calming language.
  💬 Example response: “I can see you’re scared. Don’t worry—I’m here to keep you safe.”

5. Seek Support and Document Behaviors

Caregiving can be emotionally taxing, especially when dealing with false accusations.

✅ Steps to take:

• Join a support group to connect with others who understand your journey.

• Use tools like our FREE dementia tracker log to document behaviors, triggers, and interventions.

Pro Tip: Sharing these patterns with your doctor can help guide non-pharmacological or medical interventions.

Caregiver Ground Rules for Dementia Behaviors

Before implementing strategies, keep these essential principles in mind:

1️⃣ You cannot change the person. Adapt to their behavior rather than trying to control it.
2️⃣ Consult a doctor. Behavioral changes may stem from medical issues, like infections or medication side effects.
3️⃣ All behavior has a purpose. Look for the need behind their actions.
4️⃣ All behavior is triggered. Identify potential triggers to address the root cause.
5️⃣ What works today may not work tomorrow. Stay flexible and creative with your responses.

Practical Tips for Caregivers

Here’s a summary of actionable steps to navigate false accusations:

• Reassure and redirect: Focus on calming their emotions rather than proving your innocence.

• Be prepared: Know their favorite hiding spots for misplaced items and keep a record of patterns.

• Communicate with others: Inform family members or professional caregivers about these behaviors.

• Document everything: Use a behavior tracking tool to identify patterns and effective interventions.

You Are Not Alone

False accusations and paranoia are some of the most emotionally challenging aspects of caregiving. Remember, these behaviors are a symptom of the disease—not a reflection of your care.

🫂 Join the Conversation:

• Connect with others who understand your journey in the Dementia Caregivers Academy Facebook Group.

📚 Resources to Support You:

• Download the FREE Dementia Signs Tracker to document and manage behaviors.

• Explore the Dementia Caregivers Academy Course for in-depth strategies and support.

💜 You’re doing an incredible job. Even on the hard days. Especially on the hard days.

Want to be part of a bigger community?

Join our private Facebook community for dementia caregivers; it's a kind, supportive space with others just like you. It's free to join, just follow this link (opens in a new window).

PS.

This video is also posted on our YouTube Channel!