People with dementia often believe that people who have actually passed away are still alive because their brain’s ability to process time, memory, and reality becomes impaired. This leads to confusion about when events happened and difficulty distinguishing past from present.
Dementia affects the brain areas responsible for managing time perception and memory. The damage disrupts how a person understands the flow of time—what happened recently versus long ago—and this can cause them to live mentally in an earlier period of their life, a phenomenon sometimes called “time-shifting.” For example, they might think it is decades earlier than the current year or believe they are still living in a previous stage of life when certain people were alive. Because their short-term memory is severely compromised, they cannot update their understanding based on new information or recent events. So even if someone has died years ago, the person with dementia may recall them as if they were still present[1].
Additionally, dementia impairs reasoning and analytical skills needed to interpret reality accurately. The brain struggles not only with remembering facts but also with making sense of those facts within context. This means that even if told repeatedly that someone has died, the person may not fully grasp or retain this information due to ongoing confusion and forgetfulness[1][2].
The emotional impact of dementia also plays a role in why patients hold onto beliefs about deceased loved ones being alive. Dementia can cause feelings like fear, loneliness, or distress when faced with loss or change in relationships. Holding onto memories where those people are still around can provide comfort—even if it conflicts with reality—because it helps preserve identity and emotional security amid cognitive decline[3][4]. Sometimes behaviors such as calling out for someone who has passed away reflect unmet needs for connection or reassurance rather than deliberate denial.
Moreover, changes in self-identity caused by dementia affect how individuals perceive themselves relative to others around them. Since identity is shaped by relationships and roles (like being a spouse or parent), losing track of these roles due to memory loss can make it harder for patients to accept permanent losses like death[2][5]. They may revert mentally to times when those relationships were intact.
In summary:
– Dementia damages brain functions related to **memory**, **time perception**, and **reasoning**, causing confusion between past and present.
– Patients often experience “time-shifting,” believing they are living at an earlier point in life.
– Short-term memory loss prevents updating knowledge about deaths.
– Emotional needs drive holding onto comforting beliefs about loved ones being alive.
– Changes in self-identity linked to relationships make accepting death more difficult.
This complex interplay between cognitive impairment and emotional coping mechanisms explains why many people living with dementia continue believing that deceased individuals remain alive despite evidence otherwise.
