Lying is wrong ... right? Not always, say dementia care experts. In fact, so strong is the support for benevolent white lies over harsh honesty when it comes to protecting loved ones’ mental and emotional health that there’s even a term for it: therapeutic fibbing. Yet caregivers can still struggle with the ethics and negative feelings that come with lying to someone who trusts them to care for and love them.
“Answering with a fib (your husband is at work) or engaging in their reality (yes, the Brooklyn Dodgers are fantastic this year!) can reassure and validate the person,” notes Teleia Farrell, Community Relations Director at YourLife™ of West Melbourne, a new Memory Care community coming soon to West Melbourne, Florida. “Most importantly, it spares them the unnecessary pain, sense of loss, and confusion that some truths would inevitably cause.”
In this post, we’ll consider 5 scenarios in which therapeutic fibbing is not only acceptable but also the kind alternative when caring for people with dementia.
1. When the Truth Will Hurt:
Your mother asks when her parents are coming to get her.
A simple “they’ll be here soon” will spare her the fresh heartbreak of receiving the devastating news of their deaths “for the first time” every time. Once she’s reassured that she has not been abandoned, follow up with an engaging activity or distraction. By the time “soon” comes, most people with mid- to late-stage dementia will have moved on.
If your mother asks about her parents again an hour later – and an hour after that – remember that she thinks it’s for the first time. Expressing frustration at what she considers a perfectly normal question could make her feel confused, scared, or ashamed for upsetting you.
2. When the Truth Will Spark Anger or Paranoia:
Your dad insists on going home to one that no longer exists.
Telling Dad that his home no longer belongs to him can cause confusion and a sense of loss, much like a death, but it can also cause anger and resentment – towards you. He may blame you for selling it behind his back, accuse you of stealing the profits or even accuse you of lying to him about the sale so he can’t leave. Instead, say you’re enjoying his visit, invite him to stay for dinner, and tell him you’ll take him home after.
3. When the Truth About Her Illness Will Upset Her:
You mom wonders why she’s so forgetful or can no longer accomplish simple tasks.
Reminding her that she has dementia may be met with embarrassment, obsession over future decline, or even angry denial. Instead, chuckling, “It’s okay, we all have our days! Here, let me help you with that,” will make her feel less alone and safe from judgment.
4. When the Truth Will Make Him Feel Incapable or Like a Burden:
Your dad says he’s taking the car to the store.
Whether you’re 16 or 96, driving is synonymous with independence. Telling your loved one he no longer has a valid driver’s license snatches away that sense of independence. Reminding him that he gave up his license and sold his car years ago won’t make sense to him. So instead, tell your dad you need to pick up a few things yourself and that you’ll be happy to do his shopping for him. Then ask him to make of list of items he needs.
This list can serve as a distraction or let you know that he’s anxious about something, like running out of his favorite cereal, for example. If that’s the case, show him the box and reassure him that he has plenty for breakfast or tell him you’ll get more and then do so.
5. When the Truth Will Make Him Feel Confused, Disoriented or Depressed:
Your dad announces he’s voting for Eisenhower this year.
Playing along like it’s 1952 makes your loved one feel safe, competent, relevant, and connected to the world. Forcing them into the present (i.e., decades into the future) is bewildering, upsetting, and frightening for someone who genuinely believes it's 1952 and that they have their whole life ahead of them. When people with dementia are confronted with real-age awareness but don't remember that they've lived full, rewarding lives, they can become sad and depressed, thinking about everything they "missed out" on or "failed" to accomplish. (This type of time warp is common and explains why people with dementia don’t recognize their adult children. In their minds, their kids aren’t born yet or are still little.)
So instead of informing your dad of the current presidential candidates, experts recommend engaging in validation therapy. Tell him you like Ike, too, then ask him questions about his life as it related to the 50s. You might learn some interesting family history or fun stories you haven’t heard before!
Remember, there’s always a chance that your loved one won’t accept your answer or accuse you of lying. If this happens, adjusting your responses – while being careful to avoid patronizing tones or “baby talk” – and continuing to reassure them with emotional sincerity can go a long way to making your loved one feel more secure in their world and like a valued part of yours.
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