Jul 28, 2015

Is Lying To Someone With Dementia Better Than Being Truthful?

Lying To Someone With Dementia | Alzheimer's Reading Room
Is Lying To Someone With Alzheimer’s Better Than Being Truthful?

How you reply and what you say to someone with dementia varies with the circumstances. But a patient demeanor, soft voice and a smile can maintain the calm atmosphere that’s so important.

We are taught as toddlers to tell the truth. No lying. No embellishing. No misdirection.

But very few situations are black and white as all of life is a shade of gray.

Being factually “truthful” isn’t quite so simple nor is it always the best response.

Welcome to the murky realm of socially appropriate filtered communication!

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By Elaine C. Pereira
Alzheimer's Reading Room

We’ve all heard this classic tale.

Wife to husband, “Does this dress make me look fat?”

The husband is between the proverbial rock and hard place, especially if the dress does accentuate her being overweight.

He can circumvent the “fat dress” question with a variety of responses that literally skirt the truth without hurting her feelings. But unless he tells her “Yes. It does,” technically he’s lying.

Lying vs Thoughtful Responses

I speak at presentations regularly and during one Q & A session recently, a woman in attendance asked me an interesting question.

“My mother has mild to moderate Alzheimer’s. Should I outright lie to her when she asks me ‘Is John dead?’ or ‘Why can’t I go home?’”

I sensed the woman was anxious and that there was a story here.

So I asked. “If you do answer her questions honestly, how does your mother behave?”

“Sometimes stressed or she’ll say ‘You’re mean’ or ‘I don’t believe you.’ I don’t think I’m helping her by being so direct with my answers.”

Truthfully, people rarely tell the truth! White lies, half-truths, vague replies, answering a question with a question are commonplace.

Sometimes we bury our replies in layers of vague words so as not to hurt someone’s feelings; but typically it’s to keep out of trouble, blame someone else or embellish our accomplishments.

Maintaining a calm, patient, individual centered atmosphere is critical to people with memory loss. Their reality, although anything but real to us, is the lens through which they see and process their environment.

Not only are memory and behaviors adversely affected by the neurological decline from Alzheimer’s, language is as well.

Custom Search - How to Understand the Difference between Alzheimer's and Dementia

Calm Trumps Truth

To the daughter in the audience and everyone interacting with the deeply forgetful, I recommend responding as honestly as possible without igniting an avalanche of negative behaviors and emotional fallout.

You gain nothing by upsetting someone with a truth that they likely won’t remember nor possibly are no longer processing.

Reply examples from I Will Never Forget.

Truthfully Disastrous:
“They won’t give me my drapes back.” (Mom’s) voice resembled a hiss.
From my warped perspective, I thought that if I could convince Mom that traverse drapes had never existed in her apartment, she wouldn’t feel so angry that someone had lost them. Wrong!

I made one more disastrous attempt. “You never had traverse drapes in this apartment, Mom.” Calm but too confrontational. 
Immediately, she burst into tears and buried her head in her hands, her shoulders shaking hard in an emotional outburst.

Thoughtfully Misleading:
(The night before Mom’s move to an assisted living center)
“What’s going on,” (Mom asked) “I feel you are planning something. Am I moving?”

If I answered honestly, what would she say? Would she remember the conversation tomorrow?
“It would be better to have you closer to me.” (I replied)

“That would be nice.” Pause. “Am I moving soon?”

“I think that would be best.”

Truthful but Cautious:
(Mom) asked me about Dad. “Have you seen Wayne today?”

“No.” I answered. 
“He’s dead, isn’t he? I haven’t seen him in a while.” 
Like seven years. Yep, that’s a while, Mom. “Yes,” I responded honestly. 
“I thought so. How is it that you know that, but I don’t know that?”
How did she suddenly string fifteen words together in two separate statements, with appropriate voice intonation, when she had barely spoken for weeks? I told her that she had known once but that her memory was not always reliable.

Listen Before Speaking

How you reply and what you say to someone with dementia varies with the circumstances. But a patient demeanor, soft voice and a smile can maintain the calm atmosphere that’s so important.

Really listen to what they’re saying/asking and formulate a response that’s as close to the truth as possible without sending them into a downward spiral laced with distress, and deliver it respectfully!

Conversation tips:
  1. Keep your tone of voice pleasant.
  2. Watch for negative body language: eye rolls, frowns, pumped fist and use positive gestures: extended palm, hand squeeze, smile.
  3. Remain patient.
  4. Think before speaking and keep it simple.

A Daughter's Story of Her Mother's Arduous and Humorous Journey through Dementia

Elaine C. Pereira donates from each copy of I Will Never Forget to support Alzheimer’s research.

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