“Don’t tell lies.” It’s a lesson your parents likely taught you at a young age. And yet, compassionate communication when interacting with someone with memory loss sometimes necessitates the need for “therapeutic lying.”
Therapeutic lying or fibbing, as it is sometimes called, is when you tell a fib or bend the truth to fit the reality of a person who has dementia. This compassionate act is not about deceiving your family member; you are simply helping your loved one to feel safe, secure and comfortable.
Individuals with memory loss are often scared and acting out of fear. They are frightened because they no longer recognize their surroundings or believe their family members are strangers, and unfortunately, in some cases, honesty is not always the best policy. This is because their brain may experience a different version of reality. Dementia damages the brain and causes progressive decline in the ability to understand and process information. Forcing someone to abandon their version of reality and join “our real world” can cause confusion, pain, anxiety and anger. As a caregiver, you can address and eliminate some of these fears through therapeutic lying. Here are some examples in which the fib is used so as not to cause unnecessary pain, anguish, worry and/or agitation:
Person with cognitive impairment: “Where is my husband?”
Caregiver (knows the person’s husband is deceased): “He’s not here right now, but I’ll let you know when he arrives.”
Person with cognitive impairment: “I don’t have a doctor’s appointment. There is nothing wrong with me.”
Caregiver (knows the appointment is with an oncologist): “It’s just a regular check-up.”
Person with cognitive impairment: “Why can’t I drive my car?”
Caregiver (knows the car was sold because driving would be dangerous): “Your car is in the shop for repairs.”
Using therapeutic lying as a technique to communicate with a loved one with dementia can take some getting used to. Telling even a small lie to your loved one can leave you with feelings of guilt. Even in the advanced stages of dementia, your loved one may experience moments of lucidity and there is a risk he or she will realize you lied and feel angry or betrayed. Some dementia experts believe lying under any circumstance is demeaning and shows a lack of respect. Therapeutic lying can take a toll as the caregiver may have a natural reflex not to lie, especially to a parent, and the emotional hurdle of overcoming that feeling can be difficult.
Dementia experts advise caregivers to use their intuition to determine if therapeutic lying is appropriate when providing care for their loved ones. If you do not feel comfortable using this communication technique, other approaches to consider include:
- Instead of agreeing or disagreeing with your loved one’s statements, try distracting or redirecting him or her to another topic.
- Allow your loved one to believe his or her reality as long as he or she is happy and not in danger.
- Only use therapeutic lying when it is necessary for your loved one’s safety or when it will enhance his or her quality of life.
For more information, call (760) 776.3100 or visit www.cvalzheimers.org.