False Beliefs and Accusations in Dementia

Medically Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed February 2026)

Confusion, delusions and hallucinations are not always caused by dementia.

They can also be signs of:

• Infections such as UTIs

• Pain or untreated illness

• Dehydration

• Side effects of medication

• Sudden medical emergencies

• Delirium (people with dementia can also experience delirium)

Do not make assumptions. Always seek medical advice if these symptoms appear suddenly or worsen.

Sudden or severe delusions and hallucinations should never be ignored. If symptoms appear quickly, worsen rapidly, or are accompanied by changes in behaviour, sleep or alertness, seek medical help immediately.

Infections, dehydration and medication reactions are common triggers and can be life-threatening if untreated. Many carers are told “this is just dementia” when in fact something else is going on.

Trust your instincts. You know when something is not right.

Most people know dementia affects memory and daily tasks. Fewer people realise it can also change how someone perceives reality.

Many people with dementia experience:

• False beliefs

• Suspicion and paranoia

• Seeing or hearing things that are not there

These are often grouped together as symptoms of stress or distress alongside behavioural changes. Experts sometimes use the term behavioural and psychological symptoms of dementia *BPSD). They can appear at any stage and vary depending on:

• The type of dementia

• Which parts of the brain are affected

• The person’s personality and life experiences

Around 9 in 10 people with dementia will experience some of these symptoms at some point.

Hallucinations involve seeing, hearing, feeling or smelling things that are not actually present.

They can be:

• Comforting, such as talking to a deceased loved one

• Distressing, such as seeing intruders or hearing shouting

Visual hallucinations are particularly common in Dementia with Lewy bodies (DLB). These are often vivid, detailed and recurring, and may involve people or animals.

For carers, it can be unsettling to witness someone reacting to things you cannot see. For the person with dementia, the experience feels and seems completely real.

Delusions are beliefs and ideas that are not based in reality but feel absolutely true to the person experiencing them.

In dementia, these beliefs are often:

• Paranoid

• Suspicious

• Focused on fear or betrayal

They commonly lead to false accusations, which can feel personal even though they are driven by brain changes.

It is common for someone with dementia to believe:

• People are stealing from them

• Others are watching or plotting against them

• A partner is being unfaithful

These beliefs can cause intense fear and anxiety. The person may jump to conclusions and become wary of everyone around them, including close family.

Being accused repeatedly can be emotionally exhausting.

This video explains a little more about delusions (especially at the 2 minute mark).

False accusations of stealing are one of the most common and painful dementia-related behaviours carers, family and friends face. They often happen because memory loss makes it impossible for the person to track where belongings are. When something goes missing, the brain fills in the gaps with suspicion rather than uncertainty.

Damage to areas of the brain responsible for reasoning and judgement also means the affected person cannot weigh up alternative explanations. The emotional brain takes over, and drives the story. This is why accusations often target the people closest to them, the ones they depend on most.

Understanding that these accusations are rooted in brain damage, fear and confusion, not reality, can help carers and relatives respond with less defensiveness, even though it still hurts.

Delusions are fixed beliefs. Logic, facts and reassurance rarely change them.

If you are wrongly accused, your instinct is to defend yourself. Unfortunately, arguing usually increases distress and confusion.

Trying to prove the belief is wrong often:

• Escalates anger

• Reinforces fear

• Makes the person feel unheard

Being accused of stealing, lying or betrayal by someone you love can feel devastating. Many carents feel hurt, angry or bewildered by these claims especially when others do not really understand what is happening behind closed doors.

It is important to understand that these feelings are completely normal. It is entirely natural to feel hurt and shaken even if the cause is illness. Make sure to talk to someone safe about what you are experiencing because bottling it up can lead to mental health problems like burnout.

Try and limit how much emotional stress you take on and step back if you begin to feel overwhelmed. Ask a health professional for advice and support. There is no shame or failure in taking a break to protect your own mental health even though you still care deeply.

These beliefs are not deliberate fabrications. They are caused by changes in the brain and can be distressing for everyone concerned including the person who believes them to be true and those that are being wrongly judged. 

It is highly unlikely that you will be able to convince someone experiencing a delusion that they are mistaken and their beliefs are not true.  The very definition of delusions is that they are fixed and unshakeable.  

If you are wrongly accused you will naturally want to straighten things out, but arguing is unlikely to help. Nor is logic or reason.  These are all more likely to add to the confusion and distress of the person who is experiencing the delusion and living in a very different reality.

What can help:

• Stay calm and avoid confrontation

• Gently change the topic or activity

• Accept their perception of reality without reinforcing it

• Respond to the feelings rather than facts

• Offer reassurance without agreeing with the belief

If items are mislaid, help locate them and keep possessions stored in consistent places to reduce repeated accusations.

Not every accusation is automatically false.

Sometimes beliefs reflect:

• Real events happening now

• Past experiences resurfacing

• Situations the person could not previously express

Listen carefully and explore concerns without dismissing them outright.

Some medications, often called antipsychotics, may be used in severe cases.

They are not suitable for everyone and can increase the risk of serious side effects, including stroke.

Doctors usually recommend them only when:

• Distress is severe

• There is risk of harm

• Other approaches have failed

Always discuss risks and benefits with a medical professional.

Medically reviewed by Dr Jackie Gray, February 2026