We’re taught from a very early age the importance of telling the truth. We hear this from our parents, our teachers, our employers and society at large. There are many, many adages and sayings about the truth: The truth shall set you free. Truth is the ultimate power. Truth is by nature self-evident. But is there ever a time when it’s okay to tell a little white lie – or maybe a big white lie? This is a question that caregivers of loved ones with dementia have asked and agonized about for many years.
“After so many years of it being drilled into our heads that we’re not supposed to lie, the idea of fibbing to your loved one with dementia can be incredibly uncomfortable,” says Amanda Jillson, Executive Director at Bridges® by EPOCH at Nashua, a memory care assisted living community in Nashua, NH. However, she says, a technique known as “therapeutic fibbing” can be not just beneficial, but an essential tool in dealing with your loved one with dementia … because sometimes, the truth can be more trouble than it’s worth. “If you’re taking your mother to a doctor’s visit, and you know she gets incredibly anxious over going to the doctor, is it better to be honest with her and cause her to become stressed and agitated? Or is it better to avoid or diffuse a difficult situation with a little creative communication?”
Recent research has shown that therapeutic fibbing can help reduce caregiver’s stress while also reducing the stress of the individual with dementia. However, it’s important to note that there are appropriate times to use this technique and times when you shouldn’t use it. Therapeutic fibbing isn’t a carte blanche to lie to your loved one and should never be intended as deceit.
“Think of therapeutic fibbing as a tool that can help your loved one feel comfortable and safe, much like providing them with a familiar object or activity to help soothe them,” says Amanda. “The word therapeutic means having healing powers, so this technique should always be used in that spirit. Think about it as an opportunity to spare them pain and anxiety and offer comfort instead.”
The Logic of Therapeutic Fibbing
Dementias such as Alzheimer’s disease cause the world to be a very scary place for your loved one. They struggle with short-term memory, have difficulty with rational thought, experience hallucinations and delusions and often can’t grasp simple logic. Trying to rationally explain something to them may simply not be possible due to the way the disease is causing their brain to work, and can actually agitate or frighten them more.
Think about someone who can’t remember that their spouse has died, and continually asks where they are or why they haven’t visited. What good does it to tell him or her, “Your spouse has been dead for 20 years.” and then have them relive the grief, loss and sadness again and again? Instead, you can deflect the matter by saying, “I’m sure he’ll come in a bit. Let’s go and get ice cream.” By deflecting the attention in a way that avoids pain, you can manage the situation – especially since the distraction may cause your loved one to forget that they were asking about their deceased spouse.
Therapeutic fibbing is also an excellent way to avoid confrontations that could be downright dangerous. For example, your father wants to get in the car and drive to the corner store. However, because of his dementia, it is simply not safe for him to be on the road. Instead of arguing with him that he can’t drive anymore, you can tell a little white lie to deter him: the car is getting new tires. You’ve lost the keys. Any little white lie that can allow you to then say, “since the car isn’t available, let me drive you.”
Navigating Ethics
Many caregivers can feel uncomfortable or find it difficult to tell therapeutic fibs because they see it as “wrong.” This is a completely natural feeling, and should definitely be thought about, because even though your loved one has dementia, they should be given the same respect and dignity that you would give any adult. Difficult conversations may be necessary, and it can cause upset, but sometimes it is essential in order to act in an ethical manner.
When considering the use of a therapeutic fib, it’s essential to ask yourself why you want to do this. Is it to spare your loved one pain or anxiety? Or is it simply to make your life easier? The former reason should be the reason why you tell a therapeutic fib – not the second. Remember, this technique is to benefit your loved one by providing them comfort and keeping them from being hurt … not simply because they’re being annoying, or you wish to avoid a difficult discussion.
Techniques for Properly and Successful Using Therapeutic Fibbing
- Step into their reality. Meet your loved one where they are – if they believe they are taking a train to meet their cousin who you know died years ago, it may be more beneficial to “go along” and redirect their thoughts or actions to help steer them back to “now.” Arguing about it or trying to convince them of the truth will only make everyone upset and frustrated.
- Ask yourself the reason “why.” Is the fib intended to help your loved one avoid unnecessary pain and suffering? If so, then you are doing it for the right reasons.
- Know when it’s essential to tell the truth. Letting Dad think he spent the afternoon dancing at the USO is harmless and hurts no one. However, if you’re having conversations about his future, such as care or living situation, keeping the truth from him can hurt more than help.
As experts in dementia care, the staff at Bridges® by EPOCH at Nashua is well-versed in the technique of therapeutic fibbing and has helped many caregivers and family members navigate this often-difficult subject.
For more information on techniques for using therapeutic fibbing, or if you have any questions about caregiving for a loved one with dementia, please contact us on our website.
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Bridges® by EPOCH at Nashua 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.
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