How to Lie to a Loved One With Dementia (and When to Do It)

Most of us learn not to lie to our parents from a very young age, but if your people have dementia, lying may be the most caring thing you can do. More than 90 percent of senior care managers surveyed recommend that caregivers use benevolent half-truths as part of their overall care strategy for people with dementia.

“We call them ‘fictions’ or therapeutic evidence,” explained Katherine Cherkas, program director for the California Central Coast Alzheimer’s Association .

Unlike most lies, the goal of telling fiction is not selfish. “You confirm their reality … You would do it when it is in the interests of the person you care about, and not in order to promote your own plans or manipulate the situation,” Cherkas said.

Practical lie

As dementia progresses through stages of memory loss, disorientation, and confusion, the person with dementia usually becomes unable to manage their daily activities. But they often do not realize the extent of their disability (or do not realize it all), insisting that they are okay, making potentially catastrophic life decisions, whether it be reckless driving or giving their bank account information to some jerk. selling “survival”. food “(true story). It is then that inventions become decisive.

You can tell a loved one that their car is still in the store if they insist on reckless driving or are gently nudging them into making sound medical decisions. “If you are caring for a person who refuses to go to the doctor for a neurological examination because he is convinced that everything is fine with him, you can say something like:“ Our insurance company requires this, ”Cherkas said. “It puts the blame on the outside entity, so not everything depends on the caregiver, at least not in the mind of the person you care for.”

Learn to say yes, and instead of no, but

Accepting this is part of effective dementia care. This is not a disease to fight and return from. Unless some medical breakthrough happens in the future, Uncle Joe will never be what he was – a head full of damaged and dead neurons makes that impossible.

“The reality of a person with dementia can be very different from your reality,” Cherkas says, “so you have to accept their reality, because they simply cannot accept yours.”

Embracing insane reality can mean playing along with strange notions instead of arguing about them. Dementia patients who believe in strange things are probably not just making up stories; they may have delusions and even hallucinations, and you are not going to argue with them. So, if your grandfather says he was once the king of Siam, you both would be better off asking him about his throne room instead of claiming that he was a bus driver. Apply these improvisational skills and hit the road.

Emotions and dementia

The profound distortions of memory that accompany dementia can lead to a time lag effect. According to Cherkas, “with memory loss comes a kind of spatial uncertainty. The distance between memories is getting very, very blurry, so you’ll hear a lot of people say things like, “Oh no, my mom is dead!” although they are over 80 and they are talking about what happened a long time ago. “

Remembering distant events as if they just happened can be deeply unsettling, even frightening, and your job as a caregiver is to try to smooth it over, not force your loved one to “face reality.”

“I was caring for a patient who asked several times a day where her father was,” Cherkas said. “Her two daughters were very embarrassed to lie to their mother, so every time she asked, they said, ‘Your father died 60 years ago.’ The poor woman experienced this mourning over and over again, every day. She had a form of dementia, but her emotions were not minimized. So that she would feel the death of her father as painfully as the first time she heard about it. “

What are they really asking?

People with dementia often ask the same question over and over. However, unlike you or me, they are probably not trying to get information; they may be trying to communicate some other need. So if you’ve answered this question truthfully once before, try focusing on the emotions behind it rather than the question itself.

If MeeMaw asks, “What happened to my puppy?” Over and over again, she could truly ask for the comfort her puppy brought her. Or maybe she just wants to talk about how handsome this little rascal was. Saying something like “Let’s talk about your puppy” is a much more useful answer than “She was hit by a truck for the ^hundredth time in 1976.”

If the repeated question is a fact, some seniors have had success with Alexa, Siri, and other voice-assisted gadgets. These things will tell you what day it is, as many times as you ask, play the same Bobby Darin song 46 times in a row and tell silly jokes all day without getting upset.

A thin line between lies and truth

None of these tips are intended to empower caregivers willy-nilly to deceive people with dementia, and it does not apply to professionals with ethical responsibilities and training different from those of “civilians” with dementia. … Family caregivers must balance their needs (a difficult task that can be severely debilitating) with the well-being and dignity of family members. No matter how far away someone seems, you, as a person, owe them as much honesty and attention as you show empathy for them.

“It is extremely difficult to follow this line,” Cherkas said. “Especially when it comes to controversial issues such as discussing a diagnosis, changing lifestyle, or moving a loved one to a medical facility. The point is to make the person living with dementia feel grounded. To maintain their level of dignity and respect. “