Advice when someone with dementia doesn’t recognise you

Dementia is a progressive illness and people with the condition lose more abilities and memories over time. You may have met people who, when discussing their loved one who is living with dementia, say, “He doesn’t know who I am.” While it emotionally complex and never easy, below is a some introductory advice for when your loved one living with dementia does not recognise you, plus helpline numbers for further guidance.

Why can people with dementia not recognise friends and family?

People living with dementia often regress in their mind to an earlier time in their life. They might only remember you the way you looked decades ago and not recognise you now, or they may not recognise you at all. As dementia can cause difficulty with time perception, they may even confuse you for somebody else, particularly if you look alike; for example, you may be their daughter but they consistently think you are their sister.

Dementia can also affect the brain’s ability to recognise faces. Prosopagnosia, also called face blindness, is something that people can be born with or acquire due to damage to the brain. Dementia damages the brain and so, in some cases, the person can no longer look at a person’s face and be able to translate what they are seeing into an understanding of who the person is.

Can people with dementia get their memory back?

Dementia gets worse over time, so in many cases, once a person’s loved one can no longer recognise them, there is a possibility that they never will again. It is possible that they will recognise you less and less until they stop knowing who you are altogether.

Dementia is not always predictable though, so they may recognise you sporadically or it may have been a one off.

If your loved one is struggling with face recognition, they might still be able to recognise you by your voice, your smell or even the way you move.

Some people with dementia can be fixated on a particular memory, false belief or even something that they are hallucinating for some time, then forget all about it. So, if your loved one has spent the last couple of weeks insisting you are their father rather than their husband, this could pass.

Ways to cope when your loved one with dementia does not recognise you

Time your visits

People living with dementia are often more confused at certain times of day. They may experience sundowning or try to follow old routines as their mind takes them back in time. If they live in a care home, have a chat with the staff and see if they can spot a pattern of when your loved one is at their most lucid. Visiting at these times could increase your chance of them recognising you.

Wear clothes or scent that they associate with you 

If you wore a particular shirt or aftershave for years, wearing these when you go to visit your loved one may help them to recognise you. If they only have memories from long ago, you could even dig out some clothes that you used to wear then.

Introduce yourself and give them time

It’s a good habit to get into to always introduce yourself when you walk into the room where your loved one is. Even if you’ve just nipped out for a minute, saying, “Hi Mum, it’s only me again, Penelope” can help them and save them some mental fatigue.

If you burst into a room and launch into a conversation they can be overwhelmed and find it harder to place you, so always walk in slowly and try to maintain eye contact.

Try to prompt their memory

Photos are one of the best ways to nudge someone’s memory. Decorate their environment with plenty of photos for them to look at throughout the day. You even create a timeline on their wall to give them a visual guide of how time has passed and how their loved ones have aged.

Validate their feelings

It’s common for people with dementia to get people and scenarios mixed up in their memory. For example, they could get other residents in their care home confused with old friends or even you. While many of their beliefs may not be true, the feelings they have about them are real, so show interest in their story or comfort them if they are distressed.

It can be okay to correct them and might be a good thing, but don’t push too hard if they are adamant that they’re right. They may then remember feeling frustrated with you but not the reason why, and hold onto this feeling in the future.

Allow yourself to mourn

Having someone close to you treat you like a stranger can be surreal and upsetting. It’s not a betrayal to them to allow yourself to mourn the loss of the person they were and the relationship you had.

As well as speaking to family and friends, you may benefit from one of the below helplines or by joining a support group for people in a similar situation. You can find out what support is available in your area through the Alzheimer’s Society or forums for carers, families and friends of people living with dementia (links below). You may also find counselling useful if you have complex feelings about your situation.

Try not to take the things they say to heart

People with memory problems can invent things to fill gaps in their memory. Sometimes this is intentional because they are embarrassed that they don’t remember, often they are simply confused or experiencing confabulation.

They may say things that are hurtful to you as a result of confabulation or just because they have forgotten, such as, “You can’t be my husband, he’s much better looking than you,” or, “You’re not my son, he died!”

Remember that it is dementia talking and that your loved one is not hurting you intentionally. Also look for the cause of why they are being mean to you; they might be confused or afraid and are using this as a defence, or even experiencing some physical pain and cannot express the way they feel.

Consider changing how you communicate

If your loved one doesn’t recognise your face, but does recognise your voice or even your handwriting, you may be able to adapt how you communicate with them. They may be much more receptive to you over the phone, or if they only remember you when you were younger, you could try writing them letters and enclosing a photo of you in your younger days in each one as a reminder.

Be wary if this behaviour is sudden

If your loved one suddenly doesn’t recognise you and is significantly more confused, they may have another health problem. Urinary tract infections or dehydration can cause delirium, so you may want to speak to their carers about your concerns.

Helplines

Alzheimer’s Society	0333 150 3456	Find support near you	Forum: Dementia Talking Point
Dementia UK	0800 888 6678
Age UK	0800 678 1602
Alzheimer Scotland	0808 808 3000
Carers UK	Forum: Join Carers UK
Mind	Forum: Side by Side