Why Experts Recommend Lying to Someone with Dementia

lying to someone with dementia

Stepping into their reality isn’t the same as lying

When your older adult has Alzheimer’s or dementia, their brain may experience a different version of reality because of the damage their disease has caused.

Dementia care experts recommend stepping into your senior’s reality rather than trying to correct them or bring them back into ours. That’s because their brain is steadily losing the ability to process information. Forcing them to join us in the “real world” only causes confusion, anxiety, fear, and anger.

This technique takes some getting used to because going along with your senior’s new reality can feel like you’re lying to them. But the reality is that honesty is not always the best policy when it comes to someone with dementia.




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Telling the truth can be cruel

Most of us are taught from a young age that any kind of lying is horrible and dishonest. On top of that, we’re told never to lie to parents, spouses, and people we love and respect. So when we hear about lying to someone with dementia, it seems cruel and wrong.

But always sticking to the truth, especially about an emotional subject, is what’s most likely to cause your older adult pain, confusion, and distress.

Plus, their problems with short-term memory mean they probably won’t remember the conversation, so it will come up again. Telling the truth each time forces them to experience the fear and anxiety over and over again.

The disease prevents people from properly processing and retaining information. Is it necessary to cause them so much distress, especially when the truth you tell them is likely to be misunderstood or quickly forgotten?

 

Therapeutic fibbing helps you step into their world

An effective way to step into your older adult’s reality is to agree with whatever they say or tell harmless untruths. Experts call this therapeutic fibbing. It means saying things that are not true to avoid causing your older adult distress and to make them feel safe and comforted.

In many ways, it’s similar to telling a friend that you love the thoughtful gift they gave you, even if you don’t actually like it. Telling the absolute truth in that case wouldn’t change the situation and would only hurt your friend.

Here are two simple examples that illustrate the difference between being completely truthful and using therapeutic fibs.

1. Being completely truthful
Your mom: School is over. My mommy is coming to pick me up now. I need to go outside to wait for her!

You: You’re 89 years old. You haven’t been to school in decades. And don’t you remember that your mom died 25 years ago? You don’t need to go outside because nobody is coming to pick you up.

Your mom: What? What do you mean my mom is dead? No! She can’t be dead!! I saw her this morning! She told me she would pick me up!!! I need to go outside to wait!! (She’s crying, agitated, and screaming.)

2. Using therapeutic fibbing
Your mom: School is over. My mommy is coming to pick me up now. I need to go outside to wait for her!

You: Oh yes, it’s almost time to go. Your mom asked me to give you a snack first so you won’t get hungry on the way home. Let’s have some juice and crackers.

Your mom: Ok, I’ll have a snack.

You: (Use this distraction as an opportunity to occupy her with the snack and a fun activity until she lets go of the idea of meeting her mother.)

 

Bottom line

Always telling the truth to someone with Alzheimer’s or dementia is most likely to upset or hurt them. Therapeutic fibbing is a technique you can use to step into their new reality and spare them unnecessary pain and distress.

Using untruths to validate their feelings and reassure them is not the same as lying for a malicious reason.

 

Next Step  Why it’s not helpful to force someone with Alzheimer’s or dementia back into our reality

 

Recommended for you:
3 Ways to Respond When Someone with Alzheimer’s Says I Want to Go Home
4 Ways to Respond When Someone with Alzheimer’s Keeps Repeating Questions
Q & A: Should You Correct Someone with Alzheimer’s?

 

By DailyCaring Editorial Team
Image: Female First


28 Comments

  • Reply August 4, 2017

    Eileen Grover

    I have a 50 year old daughter who was recently diagnosed with CADASIL. Rare genetic brain disorder of strokes deep in the brain. She is in early stage dementia. I would like to know if anyone is aware of groups for this type of illness where she could go for recreation or just someone to relate to. She has a doctorate in psychology but had to give up her job. I try to keep her occupied by taking her on errands and social events with me but she needs her own friends. She moved to California from Philadelphia 20 years ago and even though she kept in touch with a few, their lives have gone in different directions. Has anyone else dealt with this situation and how did you handle it?

    • Reply August 5, 2017

      DailyCaring

      Hi Eileen — I’m so sorry about your daughter’s condition. It’s wonderful that she has you to look out for her best interests and to help her live as full and happy a life as possible.

      We found a couple of websites for people affected by CADASIL. This one has links to a variety of CADASIL support groups on Facebook, for her and for you — http://curecadasil.org/cadasil-support-resources/

      This site has additional information about support groups for both patients and caregivers — http://www.cadasilfoundation.org/coping.html

      I hope some of these groups will be a good place for your daughter (and you) to get support and find people going through similar challenges ❤

  • Reply July 20, 2017

    Becca

    I’m devastated. I’ve read the article and the comments. I understand intellectually what you’re saying…My Mum is in an Aged Care facility in our old home town in QLD. (boring, unsophisticated, narrow – but more importantly AFFORDABLE for her) I am (her daughter and only relative who gives a *** at all! – but who lives in another country now:( So my ability to be with her is pretty limited. I take care of her business etc though and can do that from here mostly. I had to move her a year and a half ago from Sydney back there and found a lovely Retirement Unit – a step up in quality from her apt. in Sydney(!) that she could afford. I thought her sister and nieces in our old hometown would step up and at least visit with her once in a while…but they only abused me and accused me of being a “criminal” and of “elder abuse” in spite of my constant contact with her Home Care Supervisors and Assessors stating she was doing well with an active life etc etc… They had decided that they knew best and she should go straight into a 24/7 facility – but I knew she could have a little more time to live independently…- long story…anyway – after a year and a 1/4 of her Dementia becoming more progressed, I realized on my trip out that she could then, finally, no longer cope alone – even with Home Care and Meals On Wheels…. – I had to (after NO CRISES by the way!!!) move her into a Residence. I timed it perfectly, if I say so myself:) But NOW – every time I call her after only a few months there she “lets me know” she can’t stay there – she’s decided she has to move back to Sydney (the life of her dreams – sophisticated Sydney – friends, theatre, beauty, adventure…) I totally get it. She had made a wonderful life there and the surroundings for her now must be dull and lonely. I’ve a couple of times explained that even if I could move her back there in spite of cost – she could no longer just venture out on her own without an escort ($$$$)…it breaks my heart and I realize I just leave her feeling depressed…Do I really have to lie now to that extent? I guess I’m answering my own question, huh? How to do it? Do I say, “You know, I’ll do some research on suitable Residences for you Mum…I’ll look into it…? And try to leave it there? She’s got spunk, my Mum – she won’t let it go….I so appreciate that I stumbled across this page. I’ve read the whole page with much appreciation. Any help you can offer me in ways to field this “decision” she’s made, would be most appreciated. xo

  • Reply June 4, 2017

    Carol

    It’s hard to go to their reality when they are trying to stab you with scissors or throwing fireplace logs at my father! And the doctor says nothing is wrong…..I try creative truths and distractions when I can, but I need to keep him and me safe!

    • Reply June 5, 2017

      DailyCaring.com

      Yikes! When violence is present, it’s a different situation that requires stronger intervention. It will help to immediately remove and lock up any sharp objects or anything that could be used as a weapon. The top priority is safety for the person with dementia, the family, and any hired caregivers. If this doctor isn’t helpful, I’d recommend finding a different doctor who is more experienced in treating dementia. Things are clearly not ok and it’s important to find a solution before someone gets hurt — that could mean carefully experimenting with behavioral medication or even a move to a memory care community.

  • Reply June 3, 2017

    linda cywin

    I am taking care of a person with early onset dementia from a attempted suicide 4 years ago. I think it has progressed she has called cps and the police on my father saying that he mistreats her(he does not he actually goes the other way he does too much for her). Emma displays many of the symptoms of lying, aggression, some times it looks like she fakes it because she will do this in front of my dad or other males but not in front of me or my sister. Is that something emma does to get attention or are we right in thinking she can control it and chooses to do it front of men as apossed to women. I want to the right thing for her but don’t know what it is when i think i have done the right thing it turns out not to be the right thing. Emma has alot fustration with my sister who has tried to help her she seems genuielly grateful but than she gets upset and calls my sister a bitch my sister as a result has stepped back from things because she has opened her heart to help and the same results happen. Emma responds to me positve so i have taken back some of her care. Emma has been baker acted several times because of threats of suicide and she can get physically violent with both herself and others. At this present time i have my plate full as i am also caring for my aging father and my sister who has cancer i just need alittle advice and help so that all the people i am caring for goes smoothly sorry for the rant but i would love some information reguarding what i should do for emma and a result my family who benefits when emma is doing well.

    • Reply June 4, 2017

      DailyCaring.com

      This is a tough situation. It’s great that you’re taking such good care of Emma, despite the challenges. There could be many factors that influence her behavior. Since she had attempted suicide before, it’s likely that she has unresolved mental illness that is not helping the situation. Dementia symptoms plus mental illness is a tough combination. She’s most likely not doing these things on purpose — dementia is likely the cause. She could be afraid of men, which is why the behavior happens when men are caring for her, but not with you or your sister. Or it could be that she just feels more comfortable with the two of you. She could be getting upset for many reasons, like if she’s in pain, uncomfortable, hungry, needs to use the toilet, etc.

      It sounds like she may need help from a doctor who is experienced in tough dementia cases. She may need some medication to help her with the mental issues + dementia symptoms, but this takes careful experimentation to find out if specific medications could help or if they make the situation worse. If her violent behavior is endangering herself or you and your family, the safest thing may be to move her to a memory care community where they’re better equipped to care for her. Safety is the most important thing.

      You’ve got a lot on your plate caring for your dad and your sister too. I hope you can get some help so you can make sure to take care of yourself too 💜

      These articles may be helpful in understanding and reducing the difficult behavior:
      http://dailycaring.com/video-difficult-alzheimers-behaviors-solved-with-expert-communication-tips/
      http://dailycaring.com/dealing-with-difficult-alzheimers-dementia-symptoms/
      http://dailycaring.com/7-ways-to-respond-to-mean-dementia-behavior/

  • Reply May 30, 2017

    Mona Wilson

    My mother in law moved in with us last August when she could no longer care for herself. She has good days and bad days as well as sundowners. I see progression and we visit the Dr on a regular basis so we have meds up to date. When we have visitors she does better and seems to be more herself. For this reason we send her to daycare five days a week. I’ve tried to explain to her children that this is how to treat her but they don’t remember and just say what they like. any sugestions?

    • Reply May 30, 2017

      DailyCaring.com

      It sound like you’re doing a wonderful job finding ways to keep your mother-in-law happy, engaged in life, and safe. I’m sorry to hear that her children aren’t trying to learn about her disease and the best ways to interact with her. They may be in denial about her declining health and cognitive abilities. This article has suggestions to help you deal with family members who are in denial — http://dailycaring.com/3-ways-to-deal-with-family-in-denial-about-seniors-needing-help/

  • Reply May 30, 2017

    Shelia

    My 89 y.o. Mother has dementia and we recently had her license revoked. She was fiercely independent to that point and has not taken the loss of her DL very well. It’s been almost two months and she still constantly calls me and my siblings demanding to have her car returned. She threatens to call the police but cannot find the number. She has also threatened to discontinue her meds and refuses to go to her doctor because he was the one who signed the revocation papers. She refuses to have any of us take her places became she wants to drive herself. She also lies to her caregiver who comes in 2 hrs per day saying she can take care of herself and her home…which she cannot.
    When she calls asking where her car is, we acknowledge her anger and then tell her that the car has been sold. We then just say we are not going to talk about the car anymore and try to change the subject which does not always work. She continues to be very angry. Any suggestions?

    • Reply May 30, 2017

      DailyCaring.com

      I’m so sorry to hear about what’s happening. It sounds like your mother is having a hard time dealing with the big changes happening in her brain and in her lifestyle. It’s hard to lose the independence that driving provides on top of everything else. It’s great to acknowledge her anger and let her vent. The dementia probably makes it difficult for her to process and come to terms with what’s happening. It’s very common for people in the earlier stages of dementia to insist that they don’t need help. Helping her cope will probably take extra time and a lot of patience on your part.

      It might help to arrange other ways for her to get around so she doesn’t feel stranded. Here are some tips on finding alternative transportation options — http://dailycaring.com/4-tips-to-get-an-elderly-person-to-stop-driving/

      This article might be helpful too — http://dailycaring.com/4-tips-to-deal-with-seniors-who-refuse-help/

  • Reply April 28, 2017

    Bonnie Duncan

    This is an excellent website and resource for all of us caught in this nasty web of a disease. My Mother, lost her Husband 4 months ago. She had spent the last 30 years taking care of her Husband who had suffered two strokes and a brain bleed. His first strokes were in 1981 and 6 years ago was the brain bleed. He was mentally sound, but he was physically unable to walk for the last couple of years and could help transfer him self. He was the mental being and Mom was the Physical. It was so hard to see them struggle AND refuse to have help until the very end.

    • Reply April 29, 2017

      DailyCaring

      I’m so glad our articles are helpful. It sounds like your mom took wonderful care of her husband. I hope her own health hasn’t suffered too much.

  • Reply March 11, 2017

    Elaine Mawhinney

    Do you think this still applies when the person is believing something untrue and is already distressed about it? I happily agree with my Mum when she tells me that she’s had her handbag since she started work (75 years ago). However, when she starts telling me that her deceased husband (my father) is out happily carousing, I can’t go along with her and allow her to continue believing that and being continually upset. My strategy has been to gently tell her that Dad is happy because he is in heaven and she has nothing to worry about, then change the subject. Seems to work. I’m not game to enter that reality with her. What do you think?

    • Reply March 11, 2017

      DailyCaring

      I think the number one priority is to help someone with dementia feel as happy and safe as possible. It sounds like you’re doing the right thing because your response is working well. When her version of reality is causing distress, you’re right to try to redirect her to happier thoughts.

  • Reply February 22, 2017

    nj

    Similar to the example you gave, in the latter stages of the disease, my 90 year old mom would search her building for the way out telling us that school was done and her parents were coming to pick her up. She also tried to call them on her phone (which she could no longer figure out other than to hold the handset). At first, if I explained reality to her, it resulted in a lot of emotions and I quickly stopped. I had a really hard time telling her an outright lie though. So, I ended up telling her that her parents were both “out of town” (heaven is out of town, right?) and that they knew she was safe with us (me and building staff) until they got back. Then I suggested something we could do together. She accepted that answer and we would work on a craft project together which was always calming for her. Sometimes she would worry about where she would sleep while her parents were away and I ended up telling her they had a nice room here (in her building) as though it was a hotel (she and my dad did a lot of traveling in the past).

    • Reply February 22, 2017

      DailyCaring

      Those are such wonderful and kind ways to respond to your mom’s needs and worries! It sounds like she was able to relax and feel safe, which are the top goals 🙂

  • Reply February 21, 2017

    Susan

    My mom might be in the early stages – she reminds us every time of the spot where she used to pick up my granddaughter for school every time we go by there (an example) and it gets old fast. She constantly wants attention and will even lie to relatives about how she’s being mistreated which has gotten APS called on us three times already – only to have them tell her she’s lucky she has us. How do I respond to her attention-seeking and constant reminders of things she doesn’t seem to want US to forget?

  • Reply November 16, 2016

    Sherri

    My mom had Alzheimers. It would help when we would play music from her era. It seemed to calm her down if she started to get irritated. I would also bring in pictures of her when she was little and she would go on for hours with stories. After she passed, my dad started with it. He would have difficulty remembering that she passed and would ask for her. I would have to tell little lies like “mom is taking a nap but she said to give you a kiss on the cheek for her” or “she’s getting her hair done and she’ll be in shortly but only if you eat your lunch and take a nap”, etc. Anything that would distract him and keep him calm.

    • Reply November 16, 2016

      DailyCaring

      You are amazing! These are such wonderful things to say that made your mom and dad feel happy, safe, and loved. Thank you for sharing these tips!

  • Reply October 31, 2016

    Marathon John D Gaffney

    I think ALZ patients can see RIGHT through the caregivers;We give them less credit then they deserve/get even though they still have their long-term memory in tact!!!

    • Reply November 1, 2016

      DailyCaring

      In the early stages, someone with Alzheimer’s or dementia is still able to use logic and reason. That’s not the right time to use these suggestions. It really depends on how far their condition has progressed. These ideas are better suited to the time when a person with dementia has been significantly affected, has poor short term memory, and primarily needs to feel validated and safe. Alzheimer’s and dementia affect much more than just memory. These conditions attack the brain itself and erode the connections and pathways that are essential for proper brain function. Even if someone has their long term memories deep inside them, it won’t help their day-to-day function.

  • Reply August 31, 2016

    Jeanette

    My mother has Alzheimer’s. We like to call it ‘creative truths’. When she asks about her parents. We tell her they are in the town they are buried. (Not that they are deceased) She accepts that and moves on. She also comments that she is sure her mother is NOT happy about being there. lol! Choose to smile!

    • Reply August 31, 2016

      Connie Chow

      “Creative truths” — love it! It’s wonderful that you’ve found a calm, reassuring way to answer a tough question.

  • Reply May 28, 2016

    Cheryl

    I look,forward to your daily tips

    • Reply May 28, 2016

      Connie Chow

      Thanks Cheryl! We’re so glad you find them helpful.

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