Do you tell a dementia patient the truth?
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Many caregivers wonder whether it's OK to lie to someone with Alzheimer's or another kind of dementia when they find that trying to convince their relatives of the truth isn't working. Show  Many years ago, it was thought that strict reality orientation should be used when Alzheimer's individuals became confused. In other words, if the person thought her parents were still alive, it was recommended that she be told the truth—that her parents were dead—in order to bring her back to reality. Obviously, this approach doesn't work, because it only upsets the person more. Alzheimer's affects the brain in such a way that trying to reason or use logic with the person no longer works. They've forgotten that their loved one died and being bluntly told this affects them as if it were the very first time they were receiving this news. They may begin to cry, ask how their loved one died and then worry about attending the funeral. Validation and RedirectionIn most situations of confusion, reality orientation is no longer recommended. Instead, it's recommended that we validate the person's feelings. For instance, if your father is upset and wants to see his own mother (who is no longer alive), he may miss his mother or may be thinking about something from the past that he wants to resolve. Try validating his feelings by saying, "It sounds like you're thinking about your mother. Tell me more about her." Often, the person will start reminiscing and forget why he was upset. By honoring his feelings, you're neither agreeing nor disagreeing with the idea that his mother is still alive. In addition to validation, redirection is a helpful approach to these situations. Redirection involves diverting your loved one's attention to something pleasant. In the above example, you could redirect your father to an activity that you know he enjoys, like listening to music or playing a simple game that is not overwhelming to him. When Therapeutic Fibs Are NecessaryAlthough lying isn't recommended as a regular approach, sometimes validation and redirection do not work. If your father insists on seeing his mother, and you find that he only calms down when you tell him that she's gone to the store, that's okay. There is no need to feel guilty about telling a "therapeutic fib" if he feels more at peace with the fib than with the truth. Some authors such as Naomi Feil, who pioneered the validation approach, feel that it's risky to tell therapeutic fibs because she feels that on some level, the person with Alzheimer's does know the truth; therefore, lying could threaten the relationship between the caregiver and the individual with the disease. However, others have suggested that this risk only occurs when the fib is actually an outrageous lie. For instance, if your loved one insists that there's a stranger in the bathroom, and you tell her, "Yes, that's your favorite entertainer, Wayne Newton, and he's come to sing for you!" there is a good chance that your loved one will be skeptical of your claim and perhaps even become distrustful of you. This is much different from a therapeutic fib such as, "I just checked the bathroom and he must have left because there's no one there now." A Word From VerywellWhen faced with this dilemma, remember to try validation and redirection first, since these approaches often do the trick.The bottom line is that if a white lie is the only way to make your loved one feel better in a particular situation, and it isn't hurting anyone, then you're helping your loved one by entering his world instead of forcing reality upon him. Keep in mind that this approach may only work temporarily; like all approaches to challenging behaviors, it should be monitored and adapted when it clearly is not working any longer. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
By Carrie Hill, PhD Thanks for your feedback! Should you tell a person with dementia the truth?The person undergoing the assessment for dementia should be allowed to decide if they want to know if the diagnosis is confirmed. In general, if a person is aware that they are going for a diagnosis they will be able to make that choice. It is recommended that a person with dementia be told of their diagnosis.
What should you not say to someone with dementia?I'm going to discuss five of the most basic ones here: 1) Don't tell them they are wrong about something, 2) Don't argue with them, 3) Don't ask if they remember something, 4) Don't remind them that their spouse, parent or other loved one is dead, and 5) Don't bring up topics that may upset them.
Is it okay to lie to a person with dementia?If you find yourself in difficult situations like these, it may be reassuring to learn that studies have shown that both people living with dementia and caregivers endorse the use of lies and deception as long as it is done to promote the person's best interest.
Are people with dementia aware of what they are doing?Alzheimer's disease progressively destroys brain cells over time, so during the early stages of dementia, many do recognize something is wrong, but not everyone is aware.
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