When a loved one with dementia repeatedly asks about people who are no longer around, such as deceased family members or friends, it can be deeply confusing and painful for caregivers and family. This behavior is common and rooted in the nature of dementia’s impact on memory, perception, and emotional needs.
Dementia, including Alzheimer’s disease, progressively impairs the brain’s ability to form new memories and retrieve recent ones, while often leaving older, long-term memories more intact for a longer time. This means that a person with dementia may live mentally in a past era where those people were still alive and present. Their brain struggles to update or reconcile current reality with these older memories, leading them to ask repeatedly about people who have passed away or are no longer part of their daily life[3][4].
One key reason for these questions is that dementia affects the brain regions responsible for memory and recognition. The hippocampus, crucial for forming new memories, is often damaged early in Alzheimer’s disease, causing recent events to be forgotten quickly. Meanwhile, older memories stored in other brain areas may remain accessible, so the person’s sense of time becomes disordered. They may believe they are still living in a time when those loved ones were alive, and their questions reflect a genuine attempt to connect with their perceived reality[4].
Additionally, dementia can cause confusion and anxiety. Asking about absent people may be a way for the person to seek comfort, reassurance, or to express feelings of loneliness and loss they cannot otherwise articulate. They might not understand or remember that those people have died, or they may forget conversations where this was explained. Repeated questioning is often less about the factual answer and more about emotional needs, such as wanting to feel safe, loved, or connected[1][4].
From a neurological perspective, some people with dementia experience prosopagnosia, or face blindness, where they cannot recognize familiar faces, even of close family members. This can exacerbate confusion about who is present and who is not, leading to questions about people who are missing or deceased[4].
Caregivers often face the dilemma of how to respond to these questions. Directly confronting the reality of death or absence can cause distress, confusion, or agitation. Many experts recommend approaches such as “therapeutic fibbing” or “validation therapy,” where caregivers gently redirect or respond in ways that provide comfort rather than insist on factual accuracy. For example, telling the person that their loved ones are well and will visit soon can soothe anxiety without causing repeated grief[1][2].
Psychologists and dementia care specialists suggest “entering into the person’s reality” rather than trying to reorient them to the present. This means engaging with the memories and feelings behind their questions, asking open-ended questions about the people they mention, and celebrating those memories. This approach can transform repetitive questioning into meaningful communication and connection, reducing frustration for both the person with dementia and their caregivers[3].
Caregiver emotional wellness is crucial in managing these situations. Responding with patience, empathy, and kindness helps maintain a calm environment. Caregivers are encouraged to avoid frustration or corrective responses like “don’t you remember?” which can increase agitation. Instead, collaborative responses such as “Let’s talk about your sons” or “Tell me more about Oklahoma” can validate the person’s feelings and provide comfort[5].
In summary, when a loved one with dementia asks about people who are not around anymore, it reflects the complex interplay of memory loss, emotional needs, and altered perception caused by the disease. Understanding this helps caregivers respond with compassion and strategies that prioritize emotional well-being over factual correction.
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**Sources:**
[1] DailyCaring, “When Someone with Alzheimer’s Says ‘I Want to Go Home’: 3 Ways to Respond”
[2] Threads.com, Discussion on telling a mother with dementia about a deceased sibling
[3] Upworthy, Psychologist’s advice on talking to people with dementia and entering their reality
[4] Dementia UK, Explanation of recognition loss and memory issues in dementia
[5] Steamboat Pilot & Today, Caregiver advice for managing dementia-related behaviors
