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Monday August 30, 2021

a dictionary entry for lying with the words "Compassion Over Truth"

Most of us have been taught that lying is wrong. Our parents, teachers, and friends impressed upon us the importance of always telling the truth. BUT what do you do when your husband with dementia asks you, “When can I see Mom?” And you know his mom has been deceased for 30+ years.

What do you do when your mom says, “I need to go home and get my daughter off the school bus.”? And you are the daughter, and you are a grown woman.

How about when your dad is insistent there are people upstairs in the house, but you know that no one is home but the two of you. What do you do? Do you insist on telling the truth and trying to make your loved one understand? Or do you take the compassionate route?

Many caregivers struggle with the idea of lying to their loved one. But sometimes, lying can be the most compassionate thing you can do.
First, to help us reframe our thinking, let’s call it something different. “Lying” has a negative stigma. There are lots of other terms you can use: therapeutic lies, fiblets, and “loving deception” (the newest one I’ve heard from Dr. Jason Karlawish in his book The Problem of Alzheimer’s).

Why would you fib to your loved one with dementia?

Your loved one with dementia has a “broken brain,” as Teepa Snow calls it. Their brain is damaged. Their brain cannot process information like ours. Their brain cannot retain new information. Your loved one is in their own reality. You cannot always bring a broken brain back to present reality, so always telling the truth can lead to arguments, confusion, and sometimes even grief and pain.

Let me be clear: I am not recommending you lie about everything to your loved one. I am recommending you use your healthy brain to determine what your loved one can handle.

An Example:

Person with dementia (PWD): Where is my wife? I thought she was just here.
You: Dad, you know Mom died 20 years ago.
PWD: What?! She is dead?!
PWD starts sobbing and grieving.

Telling the truth in this situation was not healthy for the person with dementia. He obviously didn’t remember that his wife was deceased and now is mourning her loss. And this cycle could repeat with him learning of the death over and over again.

A New Way to Handle the Situation:

PWD: Where is my wife? I thought she was just here.
You: Dad, Mom is out running some errands right now and will be back later. Would you like to get a little snack with me in the kitchen?
PWD: OK. Sure. I hope she gets back soon.

Now, I realize that the conversation may not always be this easy, but this is just an example. By not telling the person with dementia that his wife is deceased, which he clearly doesn’t remember, we save him the confusion and the grief. It’s new information to him – every single time. The kind response is to tell a fiblet and then redirect the conversation to another topic (snack).

Another Example:

PWD: Those cats are still under the bed making all kinds of noise. They are driving me crazy.
You: John, there are no cats under the bed.
PWD: Yes, there is. How do you not hear them? They have been meowing all day!
You: Look, there is nothing under there.
PWD: You don’t believe me? They must be hiding right now. They are under there all night.

Here we are just creating an argument. The person’s “broken brain” is telling him that there are cats under the bed. Maybe he recently saw a TV show with cats, or perhaps he saw a cat earlier in the day. Maybe there is a blanket under the bed, and he thinks it looks like a cat. No matter what, he KNOWS there are cats under the bed. Let’s look at another way to handle this.

A New Way to Handle the Situation:

PWD: Those cats are still under that bed making all kinds of noise. They are driving me crazy.
You: Oh goodness! I will see if I can get them out.
PWD: Well, its about time someone does something about them.
You: (Go into the room, and if your loved one is watching you take a basket with a sheet/towel to collect the cats and then walk outside to put them out. Come back in.) John, I caught the cats and put them outside. They won’t bother you anymore.
PWD: Finally!

Did you lie? Yep. Did the lie cause harm? No. Did the fiblet help John’s broken brain with the noisy cat crisis? Yes! Did you avoid an argument? YES!

Using loving deceptions does not come easy to most people. It can be hard to learn how to effectively communicate with someone with a broken brain. Keep in mind that a technique that works today might not work tomorrow, but you can always try something else and try this technique again later.

The bottom line – try to be understanding. Your loved one is struggling with a broken brain. They are not just trying to make life difficult for you, even though it may seem like it. Choose compassion in your communication and interactions.

Written by Sheri Wammack, LBSW