Week 8 - The Situation

The Gentle Ethics of Caregiving

Helping families navigate the hardest caregiving moments

Week 8 — When Confusion and Delusions Begin to Increase

Day 2: A Common Caregiving Situation & What Is Happening Inside the Brain

Yesterday we talked about how confusion and delusions can begin and why they can feel so unsettling for caregivers.

Today, let’s look at a situation many families experience.

The Situation

A daughter is sitting in the living room with her father.

It is early evening.

He suddenly looks toward the hallway and becomes tense.

He says quietly,

"There’s someone in the house."

The daughter looks—there is no one there.

She gently tells him,

"There’s no one here, Dad. You’re safe."

But instead of calming, he becomes more upset.

"No, I saw them. They were just there."

He grows anxious, scanning the room, clearly unsettled.

The daughter feels unsure.

Do I correct him?
Do I go along with it?
How do I calm him down?

What Is Happening Inside the Brain

These moments are not simply confusion.

They are the result of changes in how the brain processes information.

Changes in Perception

The brain may misinterpret visual or auditory input.

Shadows, reflections, or familiar objects can appear unfamiliar or threatening.

What your loved one is seeing or hearing may not match reality—but it feels real to them.

Memory Gaps and “Filling In”

When the brain cannot recall or process information clearly, it may attempt to fill in the gaps.

This can lead to:

• believing someone is present
• recalling events that did not happen
• confusing past experiences with the present

The brain is trying to make sense of incomplete information.

Loss of Reality Orientation

The ability to distinguish what is real versus not real can become impaired.

This means:

• logical explanations may not be processed
• correction may not be understood
• reassurance must come from tone and presence—not facts

Emotional Brain vs. Logical Brain

In these moments, the emotional part of the brain is often more active than the logical part.

This is why:

• fear feels intense
• reassurance needs to be emotional, not factual
• arguing or correcting can increase distress

Why Correcting May Not Work

From a caregiver’s perspective, it feels natural to say:

"That’s not real."

But to the person experiencing it:

It is real.

Correcting them can feel like:

• being dismissed
• not being believed
• increased fear

This can escalate the situation instead of calming it.

Why These Moments Matter

These experiences can lead to:

• anxiety
• fear
• agitation
• confusion

How a caregiver responds can either:

• calm the situation
or
• unintentionally increase distress

Caregiver Insight

Professional caregivers often focus on validating the feeling, not the belief.

Instead of correcting the situation, they respond to the emotion behind it.

For example:

"That sounds scary. I’m here with you."

This approach helps the person feel safe—even if the belief remains.

Try This Today

If a moment of confusion or delusion occurs, try:

• staying calm
• lowering your voice
• offering reassurance
• avoiding correction

Notice how your tone and presence affect the situation.

Awareness Questions

• Does your loved one become more upset when corrected?
• Do they seem fearful during these moments?
• Are there certain times of day when this happens more often?
• Does your presence help calm them?

Questions for Today’s Reflection

• How do you typically respond in these moments?
• Do your responses seem to calm or escalate the situation?
• What feels most challenging about these experiences?

Tomorrow we will explore the safety and reality of confusion and delusions, including when these moments may pose a safety risk and how caregivers can respond appropriately.

Because sometimes the most important thing you can offer is not correction—

but calm, steady reassurance. 🤍