When a loved one with dementia repeatedly tells you they are late for something, it can be confusing and distressing. This behavior often stems from the cognitive and emotional changes caused by dementia, rather than an actual event or appointment they need to attend. Understanding why this happens requires exploring how dementia affects memory, perception of time, anxiety, and brain function.
Dementia is a brain condition that impairs memory, thinking, and behavior. It is not a normal part of aging but results from damage to brain cells caused by diseases such as Alzheimer’s, vascular dementia, or other types of cognitive impairment[4]. One key symptom is difficulty with memory, especially recent events, which can cause a person to feel disoriented or confused about what is happening around them[4].
**Memory Loss and Time Perception**
People with dementia often struggle to remember recent events or appointments, leading to confusion about whether they are late or on time. Their internal sense of time can become distorted, making it hard to accurately judge how much time has passed or when something is supposed to happen. This can cause them to repeatedly express concern about being late, even if there is no actual event pending[4].
**Anxiety and Emotional Distress**
The feeling of being late can also be a manifestation of anxiety or fear. Dementia can cause emotional changes, including increased anxiety, agitation, and restlessness[1]. When a person with dementia says they are late, it may reflect an underlying feeling of unease or a need to be somewhere safe or familiar. This can be triggered by confusion, fear of missing out, or a sense of losing control over their environment[1].
**Brain Changes Affecting Behavior**
Dementia damages areas of the brain responsible for mood, behavior, and cognitive function. This damage can lead to repetitive behaviors and statements, such as repeatedly saying they are late. The brain’s impaired ability to process information and communicate clearly means the person may not realize they have already expressed this concern or that it is unfounded[1].
**Unmet Needs and Physical Discomfort**
Sometimes, the repeated statement about being late may be a way to express unmet physical needs or discomfort. Pain, hunger, thirst, or side effects from medications can cause agitation and distress, which might be communicated through repetitive phrases or behaviors[1]. Checking for underlying medical issues is important if this behavior appears suddenly or worsens.
**Difficulty with Problem-Solving and Familiar Tasks**
Dementia also impairs problem-solving skills and the ability to manage daily tasks. A person might forget the steps involved in getting ready or leaving the house, leading to frustration and the feeling that they are late or behind schedule. This difficulty can make them anxious about time and prompt repeated statements about being late[3].
**Environmental and Social Triggers**
Changes in routine, unfamiliar environments, or social situations can increase confusion and agitation in people with dementia. If a loved one is in a new place or facing unexpected changes, they may feel unsettled and express this by saying they are late for something, even if no appointment exists[3].
**Differentiating from Other Conditions**
It is important to distinguish dementia-related behaviors from other conditions like depression or delirium, which can also cause confusion and repetitive statements. Depression in older adults can mimic dementia but usually develops gradually and includes persistent sadness. Delirium is an acute, fluctuating state of confusion often caused by illness or medication[2]. A healthcare professional can help differentiate these conditions.
**Caregiver Strategies**
Understanding that the statement “I am late” is often a sign of confusion, anxiety, or unmet needs can help caregivers respond with patience and reassurance. Instead of correcting or arguing, gently redirecting the conversation, providing comfort, and maintaining a calm environment can reduce distress. Checking for physical discomfort or medical issues is also crucial[1].
In summary, when a loved one with dementia keeps telling you they are late for something, it reflects the complex interplay of memory loss, altered time perception, anxiety, brain changes, and possible physical discomfort. Recognizing these underlying causes can guide compassionate and effective responses.
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Sources:
[1] Parc Provence Memory Care, “What Is Agitation in Dementia?”
[2] The Supportive Care, “Cognitive Impairment vs Depression: How to Differentiate in Elder Care”
[3] Elder.org, “Dementia Care – 11 signs of Alzheimer’s”
[4] Dementia Australia, “About dementia”
