Why is my uncle with dementia holding a pen like a cigarette and pretending to smoke?

Your uncle’s behavior of holding a pen like a cigarette and pretending to smoke is likely related to his dementia. This type of action is called “confabulation” or “phantom behavior,” where a person with dementia acts out familiar activities from their past[9].

For someone who used to smoke, the motion of holding and smoking a cigarette was probably a deeply ingrained habit. As dementia progresses, it can affect a person’s memory and ability to recognize objects. Your uncle may be mistaking the pen for a cigarette because it has a similar shape and feel[9].

This behavior could also be a form of comfort or stress relief. Many people with dementia experience anxiety or agitation, and mimicking a familiar action like smoking might help them feel more at ease[9].

It’s important to respond to this behavior with patience and understanding. Trying to correct your uncle or take the pen away might cause frustration or confusion. Instead, you could offer a safe alternative activity that involves similar hand motions, like holding a stress ball or fidget toy[9].

If this behavior becomes frequent or causes distress, it’s a good idea to consult with your uncle’s doctor. They may be able to suggest strategies to manage the behavior or address any underlying anxiety[9].

Remember, this type of behavior is common in people with dementia and is not harmful as long as your uncle isn’t actually smoking. It’s just one of the ways dementia can affect a person’s actions and perceptions of their environment.