Therapeutic Fibbing: Why Experts Recommend Lying to Someone with Dementia

therapeutic fibbing

Stepping into someone’s reality isn’t the same as lying

Honesty is not always the best policy when it comes to someone with Alzheimer’s or dementia.

That’s 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. 

That’s why forcing someone to abandon their version of reality and join our “real world” can cause confusion, pain, anxiety, fear, and anger.

So, dementia care experts often recommend a technique called therapeutic fibbing. It helps you step into their current reality and spare them unnecessary upset and distress.

This technique takes some getting used to because going along with your older adult’s new reality can feel like you’re lying to them. But using white lies to validate their feelings and reassure them is certainly not the same as lying for a malicious reason.

We explain why always telling the truth could be cruel, how therapeutic fibbing helps you join their reality, and share two real-life examples of how to use therapeutic fibs to provide comfort and reassurance.




Advertisement

 

Telling the truth could be cruel

Most of us are taught from a young age that any kind of lying is horrible and dishonest, especially lying to family and anyone we care about and respect.

So when we hear about using therapeutic fibbing to lie to someone with dementia, it seems cruel and wrong.

But always sticking to the truth, especially about an emotional subject or something trivial, is more likely to cause your older adult pain, confusion, and distress.

Dementia prevents people from properly processing and retaining information. Plus, having short-term memory issues mean they’ll probably soon forget the conversation, so it will come up again.

Telling the truth each time forces them to experience fresh distress over and over again. 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 reality

An effective way to step into your older adult’s reality is to use therapeutic fibbing. It means agreeing or saying things that are not true to avoid causing someone distress and to make them feel safe and comforted.

In many ways, this technique is 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 doesn’t change the situation and would only hurt your friend’s feelings.

Here are two examples that illustrate the difference between being completely truthful and using therapeutic fibbing. While your specific situations will be different, the same principles of gently going along with their reality and finding a distraction will apply.

Example 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 she’s not 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.)

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 while we wait.

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 or forgets about the idea of her mother picking her up.




Advertisement

 

Example 2
Being completely truthful
Your spouse: I need to go to work now. I’m already late.

You: What do you mean? You don’t have a job. You retired 20 years ago. And remember, you have Alzheimer’s now. Stop trying to go out.

Your spouse: Why would you say that!? You’re lying and trying to keep me prisoner! Why are you trying to stop me! I’m leaving, get out of my way! (They’re angry, agitated, and banging things around.)

Using therapeutic fibbing
Your spouse: I need to go to work now. I’m already late.

You (option 1): That’s right, I almost forgot. Well we can’t have you going off without a good breakfast. Don’t worry, you have plenty of time, I forgot to change the clock after the time change. Give them a meal if it’s the right timing or a snack if it’s not. While they eat, have a pleasant chat about a topic they enjoy to distract them from the idea of going to work. Or, when they’re distracted enough from eating, talk about an enjoyable activity you’ll do together when they finish eating to set up the next transition.

You (option 2): That’s right, I almost forgot. Let’s get your jacket, it’s a bit chilly today, and make sure your lunch is packed. Here, I’ll help. Gently lead them to get their jacket and find a pleasant distraction along the way: look out the window and start talking about the birds, stop in front of  a partially completed fun activity like a puzzle, stop for a drink of water, etc. When they’re engaged in something else and become distracted, they’re likely to let go of the idea of going to work.

 

Recommended for you:

 

By DailyCaring Editorial Team
Image: Angels Senior Home Solutions


87 Comments

  • Reply September 19, 2019

    Annette A Edwards

    What if the delusions and accusations are directed toward you , the wife and caretaker, and they are sexual accusations of many kinds? I find it very difficult to agree that I am doing things which I am not doing, especially in this area.

    • Reply September 20, 2019

      DailyCaring

      I’m sorry this is happening. The damage that dementia causes in the brain can often make a person paranoid.

      It’s not necessary to agree, but it is important to stay calm and try to understand the emotion behind what they’re saying, not the exact words. The articles below give examples, like when a person with dementia makes accusations about their money being stolen or that they’re being poisoned.

      You’ll have to experiment with what works best to defuse your situation. For some people, hearing a brief denial of the accusation and being distracted and redirected to another activity will work. In other cases, any kind of acknowledgement of whatever they’ve said could cause them to get even more upset, angry, and fixated on the idea.

      Here are a couple of articles with tips on how to distract and redirect when false accusations are made:
      ​– ​8 Ways to Deal with False Dementia Accusations https://dailycaring.com/8-ways-to-deal-with-false-dementia-accusations/
      — Responding to 4 Common Dementia Accusations: Stealing, Poisoning, Being Held Prisoner https://dailycaring.com/responding-to-4-common-dementia-accusations-stealing-poisoning-being-held-prisoner/

  • Reply September 14, 2019

    Wendy Petersen

    I wish I had had this website when my mother had dementia! It is such a difficult disease to deal with and my father could never “go down the rabbit hole,” as I called it. It was a bit like playing Alice in Wonderland, and I had no problem with it, but dad insisted on the truth at all cost. Consequently, half the time mom didn’t know why he was mad at her.

    We had to just try it and see, having somewhere to go to get advice would have been so helpful. On the good days I was her daughter – both adopted and not (I’m not adopted) Other days I was a friend/caregiver or whoever she decided on. I loved her whoever she thought I was, and at night when she wanted to “go home,” I always told her that it was cold/dark/late outside and the nice people in the house had made up a bed for her, and we could go home the next day….. she was always happy with that idea, and quickly forgot.

    • Reply September 14, 2019

      DailyCaring

      So glad you found us! You clearly did a wonderful job caring for your mom, it can be tough to get in the mindset to join their reality. That’s a very kind and comforting way to answer her request to go home — thanks for sharing!

  • Reply September 10, 2019

    Andrew

    Is it lying when you sit on the floor with your child and pretend to be a prince, a monster, or a car? I have a 75 year-old client that believes he has a dog. Is is lying for me to play along with him? In both of these cases, I am meeting the person where they are and connecting with them in a healthy way. There are facilities that mimic the real world or a small village where dementia patients live comfortably without questioning their surroundings and display no anxiety about being there. Is this lying? I think we have to think about what the ultimate objective is here. Are you only attempting to preserve your own moral principles for your own purpose, or are you attempting to provide sensitive, compassionate care for a damaged human being in need.

    • Reply September 10, 2019

      DailyCaring

      That is a wonderful perspective! Thank you for sharing your experience 💜 We absolutely agree, the priority is to meet the person where they are and to be as compassionate and kind as we can.

Leave a Reply