Q&A: Not recognizing themselves in the mirror

This question was posed in a dementia forum the other day. I think it’s a good question not only for family members and care partners, but also for the wider public to hear. So many times, people think dementia is all about memory loss. Dementia is about a lot of cognitive changes, and memory loss is usually the most common. This Q&A helps to let care partners know about at least one change which is not unusual and helps the general public to realize that dementia is about more than forgetting.

My husband looked in the bathroom mirror this morning and asked “Who’s that?” I knew people with dementia got to where they couldn’t recognize OTHER people but never expected this. Is it “common”???

This is not an uncommon symptom of dementia. This symptom typically is in the more advanced stages of dementia, which may be years after diagnosis for some. The fact that they are indeed grayer/balder/weight has changed/hygiene and appearance routine has changed coupled with them thinking they are in the middle of their life results in a shock and not recognizing the reflection. When you think you are 40 and see someone who is in their 70s looking back at you, it’s difficult to process.

This also happens in cognitively healthy older adults, who do not recognize the way they look in pictures or occasionally in the mirror. Or that someone after a prolonged illness sees themself in the mirror again and doesn’t recognize how much they’ve changed. The difference is that the cognitively healthy older adult still recognizes that it is a version of them and can reason and understand that it is in fact them. The person with dementia cannot reason in the same way because their brain has changed. Their logic and abstract thinking have been affected.

Some of the other responses to this question included stories of their loved one talking to the people in the mirror, waving at them, having to paint over or otherwise cover up mirrors, removing mirrors from the home, stories of loved ones having different friends in each different mirror throughout the house, people fighting with the people in the mirrors, feelings of paranoia about people watching them, difficulty getting a loved one into cars (due to the car mirrors), and more.

So, while it is not uncommon that mirrors become something confusing for someone with dementia, not everyone will react the same way.

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