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This is a common question we hear from family caregivers.
A caregiver for a loved one with memory impairment says their loved one is making up all sorts of lies about a variety of things. Sometimes the lies are harmful, accusing someone of stealing money, being physically abusive and other times, the lies are about things that have happened in their life, trips they took (that they never took), career highlights (that aren’t true), outlandish stories and much more.

There are two possibilities:

• Yes, your loved one may be telling lies. It could be they have always done this, and it is just their continued pattern of behavior. In this case, the recommendation is to seek some professional help for yourself with a counselor to help you deal with their behavior. Additionally, consider separating yourself from the daily care – hiring an in-home care company, moving your loved one into residential care or possibly hiring a geriatric care manager to help ease some of the daily burden of caring.
• It could be that this is related to their dementia. Their dementia or, as I like to call it, their “broken brain” is causing them to seemingly lie about various things.

If it’s the latter, it’s best to gain some understanding around lying vs. confabulation (a very clinical term)

Lying – the verb “lie” means “to speak falsely or utter untruth knowingly as with intent to deceive” (dictionary.com).

Confabulation – “is a memory error where a person produces fabricated, distorted, or misinterpreted memories about oneself or the world. It is generally associated with certain types of brain damage or specific dementias. People who confabulate are not deliberately lying; they sincerely believe the information they provide to be true. It is a filling in of gaps in memory through the creation of false memories.” (dictionary.com). In fact, the person that is confabulating has no recognition that the information they are giving is not correct.

The difference between lying and confabulation is intent. Someone who is lying is intentionally misrepresenting or giving false information. The person who is confabulating is not intentionally making things up. When you are amid the stress of caregiving it can often just feel like your loved one is lying. It can be hard to separate the disease and realize that the person is lacking intent.

According to The National Council of Certified Dementia Practitioners in the “Understanding Confabulation in Dementia” article, there are two primary types of confabulations:

• Provoked: “occurs when a person fabricates information in response to direct questions.” This would be when someone asks the person with a “broken brain” a question that needs a factual response. For example, “What did you do today?” or “What was the highlight of your career?”
• Spontaneous: “involves the unsolicited production of false memories without any apparent trigger.” This could just be the person with the “broken brain” telling a story and conversing and the information is not actually factual.

Someone with dementia oftentimes cannot remember a full sequence of events.

* They may remember bits and pieces of story from their own life while interspersing details from a TV show.

* It could be that they put bits and pieces from two or three stories together to make a new one or they may incorporate bits of someone else’s story that they’ve heard.

* It could be that they blame you, the caregiver, for stealing their dentures when in reality they hid them in the drawer to “keep them safe” and can’t remember doing so. To that person with the “broken brain,” it only makes sense to them that you stole them because you are the only person around and they can’t find their dentures.

Tips to handle these behaviors:

• Try not to take it personally. In your own brain and heart, try to separate your loved one’s dementia and understand that any untruth is not to be deceitful. It is just their brain trying to fill in the “blanks” caused by dementia.
• Avoid confronting your loved one. They are in a separate reality, so it is important to remember that they do not realize the information is untrue.
• Avoid leading questions. Questions meant to encourage conversation can often put the individual on the spot to answer. This leads to their brain trying to fill in those gaps with false information.
• Step into your loved one’s reality and validate. Alleviate their worry, if you can. If their untruth is not a big deal, don’t argue and instead focus on validating your loved one. For instance, if your loved one thinks someone stole her purse, say “well…let’s look for it” and then help “look for it” while redirecting their attention. If your loved one believes a blanket is now missing from the bed (even though it isn’t) just say, “there was something on it, so I am washing it, and I will put it back.” The individual will most likely forget about the blanket at that point.
• Redirect their attention. One of the best tips that I can give in dementia care is to learn to redirect the line of thought. Change the subject to something else. Talk about what you will have for dinner or what the dog is doing. Or even something as simple as “oh look, a butterfly.” Redirection will, hopefully, get your loved one’s mind on something else.

In caring for someone with a “broken brain” remember they are most likely not trying to be deceitful or cause problems. Dementia is causing problems for them. They are truly doing the best they can to make sense of a world that no longer makes sense. The more we educate ourselves about why things are happening the way they are with dementia, the better we can respond and make adaptations.
Does this mean that it will be easy when your loved one is telling untruths, especially hurtful ones? No, of course not. It may still hurt and it’s helpful to remind yourself – this is the disease. Plus, it never hurts to talk with a friend or attend a support group that can understand.

To attend a Page Robbins Support Group, check out our latest dates here. 

WRITTEN BY SHERI WAMMACK, LBSW