Dementia is a condition that affects the brain and changes the way a person thinks, remembers, and behaves. One of the most difficult things families often face is when their loved one with dementia starts to get confused about who people are, especially family members. This confusion can be very upsetting, but it is a common part of how dementia progresses. When someone has dementia, their brain is not working the way it used to, and this can make it hard for them to recognize even the people they have known their whole lives[1].
In the early stages of dementia, a person might forget names or mix up details about people they know. They might forget what someone said in a conversation or not remember a recent event. At this point, they usually still know who their close family members are, even if they have trouble remembering small things. But as dementia gets worse, the confusion can become more serious. Someone might start to forget who their children, spouse, or siblings are. They might look at their own child and not realize it is their child, or they might think a grandchild is their own child[1].
This happens because dementia damages the parts of the brain that are responsible for memory and recognition. The brain is like a computer, and dementia is like a virus that slowly corrupts the files. Over time, the files that store memories of people, places, and events start to get lost or mixed up. The person with dementia may still feel that someone is familiar or safe, but they cannot remember exactly who that person is. They might call a daughter by the name of a sister, or they might think a caregiver is a long-dead relative[2].
Sometimes, a person with dementia will mistake a family member for someone else from their past. For example, they might see their wife and think she is their mother, or they might believe their son is a friend from childhood. This is not because they are being stubborn or difficult. Their brain is genuinely confused, and they are not able to make sense of the information they are seeing. This kind of confusion is a sign that dementia is getting worse and that the person needs more support and care[1].
Confusion about family members can also be linked to changes in how a person sees and understands the world around them. As dementia progresses, people often become more disoriented. They might not know what day it is, what year it is, or even what time of day it is. They might think they are in a different place or time, and this can make it even harder for them to recognize people. For example, someone might think they are back in their childhood home and expect to see their parents, even though their parents have passed away. When they see their own child, they might think that child is their parent[1].
Speech and communication problems also play a role in this confusion. People with dementia often have trouble finding the right words or understanding what others are saying. They might not be able to follow a conversation, and this can make it harder for them to connect with family members. They might repeat questions, forget what was just said, or use the wrong names for people. This is not because they are not trying, but because their brain is not able to process the information the way it used to[2].
Personality and behavior changes are another part of dementia that can make confusion worse. Someone who was once calm and easygoing might become agitated, anxious, or even aggressive. They might lash out at family members, not because they want to hurt them, but because they are scared, confused, or frustrated. They might not recognize the person helping them and think that person is a threat. This can be very hard for families to deal with, but it is important to remember that these behaviors are a result of the disease, not the person’s true feelings[1].
In the later stages of dementia, confusion about family members can become even more severe. A person might not recognize anyone, not even their spouse or children. They might forget important events from their own life, like weddings or the birth of a child. They might not know where they live or what their own name is. This is a sign that the disease has progressed to a point where the person needs constant care and supervision[3].
It is important for families to understand that this confusion is a normal part of dementia. It does not mean that the person no longer loves their family or that they do not care about them. The person with dementia is still the same person inside, but their brain is not working the way it used to. Families can help by being patient, gentle, and reassuring. They can use simple words, speak slowly, and give the person time to respond. They can also use familiar objects, photos, or routines to help the person feel more secure[2].
Medical experts say that confusion about family members is a common symptom of dementia and is often linked to the stage of the disease. In the moderate stages, people may start to forget names or mix up relationships. In the severe stages, they may not recognize anyone at all. This is why it is important for families to seek medical advice and support as the disease progresses. Doctors can help families understand what to expect and how to care for their loved one[2].
There are also things families can do to help reduce confusion. Keeping a calm and predictable environment can make a big difference. Familiar faces, routines, and objects can help the person feel more secure. Families should avoid arguing or correcting the person, as this can make them more upset. Instead, they can gently redirect the conversation or change the subject. They can also use touch, like holding hands or giving a hug, to show love and support[2].
In some cases, confusion about family members can be made worse by other medical problems. Infections, dehydration, or changes in medication can all affect how a person with dementia thinks and behaves. Families should watch for any sudden changes and talk to a doctor if they are concerned. Regular medical check-ups are important to make sure the person is healthy and comfortable[2].
Dementia is a challenging disease, but families are not alone. There are many resources and support groups available to help. Talking to other families who are going through the same thing can be very helpful. Doctors, nurses, and social workers can also provide advice and support. The most important thing is to be patient, kind, and understanding. The person with dementia is still a person, and they still need love and care, even if they do not always recognize their family[2].
[1] https://livingdevelopments.com/2025/11/20/what-are-signs-that-dementia-is-getting-worse/
[2] https://kitesseniorcare.com/articles/understanding-dementia-stages-a-medical-guide-for-families/
[3] https://www.dementia.org.au/about-dementia/alzheimers-disease-everything-you-need-know/
