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To Fib or Not to Fib: The Ethics of Therapeutic Fibbing and Dementia

“Honesty is the best policy.” From a very young age, we’ve heard this touted by teachers, parents and other authority figures – and when we’re young, we strive to follow it. As we get older, “honesty” begins to shift into little white lies and other untruths that can be kinder when complete honesty isn’t really beneficial. When you’re a caregiver to a loved one with dementia, honesty can evolve once again as you decide how to answer their questions – particularly when you know the truth would be more hurtful than helpful.

“The idea of ‘therapeutic fibbing,’ or telling falsehoods to help soothe and maintain the quality of life for patients, is a widely used technique in memory care,” says Erica Labb, Executive Director of Bridges® by EPOCH at Westford. While the idea may seem jarring or unethical to caregivers, it has been proven to make caring for someone with memory issues a lot simpler, she says.

“Many memory care communities offer play stations that allow residents to pretend they’re taking care of a baby, dressing up or doing woodworking, for example,” she says. “These comforting fictions can in time become real experiences to residents.” Some communities offer realistic baby dolls or animatronic animals that react similarly to how a real animal would. “We’ve seen that many residents become calmer and more relaxed when they’re caring for ‘their baby’ or ‘their pet,’ so it begs the question: does it matter that they can’t distinguish truth from fiction when it has positive therapeutic benefits?”

More often than not, therapeutic fibbing comes in the form of telling your loved one something that simply isn’t true. “While it may seem strange at first, there are times when these soft lies are really in your loved one’s best interest. If he or she becomes depressed, violent or angry when they’re told the truth, like if you have to keep reminding them that their spouse is dead, allowing the fiction can keep them calm. This can be a useful technique, so long as it doesn’t cause any harm to them or others.”

Reasons for Using Therapeutic Fibbing

Caregivers who choose to use therapeutic fibbing do so because they can see immediate benefits: their patient becomes calmer, happier or more satisfied. However, Erica encourages caregivers to use this tool only when it’s needed. Just as you would never constantly lie in any of your other relationships, so should you avoid fibbing as much as possible when it comes to your loved one with dementia. Here are some situations when caregivers might find it helpful to tell little white lies:

  • Enhance self-esteem or dignity. Dementia can cause some seniors with dementia to, shall we say, have an active imagination. A senior may boast about being a hero “in the war,” performing incredible feats like saving someone from a burning building or becoming a bestselling author. Sure, these tales may make you roll your eyes, but as long as these beliefs are harmless, they can be an opportunity for humor and a source of positive interactions between you and your loved one. Instead of bursting your loved one’s bubble, play along and ask questions. This can help them feel important, give them a feeling of purpose and increase their self-esteem, all of which will serve to make your loved one happier – and your caregiving job a little easier.
  • Decrease negative or harmful behaviors. Not all delusions are humorous or harmless. Your loved one may forget that their loved ones have passed away, or that they are no longer employed. This can become agitating when they’re reminded of the reality, and may end up processing the loss as if it were newly fresh (which, to them, it is). Instead of relieving these negative feelings time and time again, therapeutic fibbing can help resolve their questions in a harmless way. You can say, “Dad’s at the store” when she asks about her long-deceased husband. Or “you took the day off today from work.” Redirect their attention by suggesting an activity or bringing up a memory, so they have something else to focus on.
  • Create positive memories. Therapeutic fibs can be an opportunity to brighten your loved one’s day and spur an enjoyable activity. By going along with their reality, you can bring them a sense of joy and fulfillment they may not have felt for a while. If your loved one believes she is a world-class chef, make a fancy dinner together. Or if they once loved gardening, start a little container garden to tend.

When Therapeutic Fibbing Isn’t Helpful

There are some times when the truth – even if it hurts – is essential. For example, if your loved one believes he or she can still drive, it is your responsibility to make sure they don’t get the keys and put themselves (and others) in harm’s way. Or if they believe they are a famous gymnast and attempt to do their signature cartwheel – not recommended! You’ll want to use your best judgment and take situations on a case-by-case basis.

When it’s not advisable to fib, or if you simply don’t feel comfortable lying to your loved one, here are some ways to help keep them calm and happy:

  • Redirect their attention. Divert your loved one’s attention by suggesting a fun activity, putting on some favorite music or simply changing the subject. While this may not end their fixation, it can keep their mind busy on something else for a time.
  • Reminisce together. If your loved one is talking about someone who is no longer alive, ask them to tell a story about the person. This can bring up positive memories and allow you to bond with your loved one. Be prepared to redirect them if they ask where the person is in order to avoid negative emotions.
  • Show empathy and encourage them to talk about their emotions. By choosing not to tell therapeutic fibs, your loved one may be taken out of their reality, which can cause, anger, frustration or depression. When this happens, be patient with them, try to encourage them to talk about their feelings and support them in any way you can.

If you would like more information about therapeutic techniques for caring for a loved one with dementia, or want to learn more about our innovative dementia care programming, please contact us at 978.692.9541.

Innovative, Wellness-Focused Memory Care.

Bridges® by EPOCH at Westford provides assisted living memory care that is comfortable, positive, safe and engaging. Exclusively dedicated to caring for those with Alzheimer’s disease and other forms of dementia or memory impairment, we’ve created a wellness-focused lifestyle that promotes dignity and individual preferences. Our memory care professionals receive specialized and ongoing training designed to help residents maximize their independence in a secure, calm environment – making a truly positive impact on the lives of our residents each and every day.

Comprehensive Services

At Bridges® by EPOCH at Westford, we know no two residents are alike. That’s why we’ve designed our services to address the distinct challenges each resident faces. With comfort, safety and happiness as our top priorities, residents receive unmatched personalized attention, no matter the stage of memory loss.

Community Amenities

Bridges® by EPOCH at Westford features a beautiful residential design. Every inch has been thoughtfully designed to enhance the lives of those with memory loss. Soft colors, directional cues, aromatherapy and interactive life stations are placed throughout the community to create a peaceful and secure environment so residents may enjoy great comfort, familiarity and security.

Call us today at 978.692.9541 to learn more about Bridges® by EPOCH at Westford or to schedule a personal tour.

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