Your loved one with Alzheimer’s tells you her sister is coming to take her to lunch at noon. You know her sister has been dead for many years, but instead of correcting her, you suggest she take a shower and get dressed for her outing. Why? You realize that by the time she’s ready to go, she’ll have forgotten she said her sister was coming and she’ll settle in for a quiet day.
Without realizing it, you used a technique called “therapeutic fibbing” to gently guide your senior from the world in her head to the real world where you’re responsible for her well-being.
What not to do with Alzheimer’s and dementia patients
Presenting those with memory disorders with facts they don’t understand is not only futile but can at times be cruel. When you disrupt their reality with truth – facts you think they need to understand – it can cause distress, agitation and anxiety.
When having a conversation with a senior with Alzheimer’s or dementia, it’s best if you don’t:
- Correct them when they say something wrong
- Argue with them about their error
- Ask them if they remember a person, event or place
- Remind them that someone they’re talking about is dead
In all of these situations, therapeutic fibbing would be a better choice because it allows the person to feel safe while you as a caregiver distract and redirect them.
Meet your loved one in their reality
The Alzheimer’s Association recommends the practice of therapeutic fibbing, which they say is the kindest way to reorient Alzheimer’s and dementia patients. Those with Alzheimer’s and other memory disorders often live in the past, where they find comfort in memories of loved ones who are no longer alive and events that happened during their happiest years. As a result, they can become agitated and anxious when well-meaning but blunt caregivers correct their internal reality.
Mary Kay Mahoney has a degree in gerontology and works at Bella Villaggio Senior Living in Palm Desert, California. In addition to her experience at senior living communities, she cared for her own mother when she had a memory disorder and can attest to the benefits of not always being truthful:
“Therapeutic fibbing is all about meeting that person in their reality,” she said, “because no matter how hard you try, you cannot change a person’s dementia or Alzheimer’s disease. So what do you do? What is the most loving thing to do? My own mother said to me, ‘I can’t afford my care. Will [the memory care facility] kick me out?'”
Rather than explaining her mother’s finances in detail and possibly confusing her more, Mahoney told her, “‘Mom, you’ve taken care of me my entire life; now it’s my turn to take care of you.’ I saw the relief come over her face. She asked me this many times, and it was the right thing to say because each time I saw relief.”
Mahoney believes therapeutic fibbing is the best option for families and caregivers to communicate with their loved ones with memory disorders.
“I worked with a son in a community that refused to lie to his mother,” she explained. “Every time he visited her, he left crying, and it took her caregivers most of the afternoon to calm his mother down because he couldn’t ‘lie.’” In this case, the son couldn’t meet his mother in her reality, which was disturbing and disruptive to her and caused him unnecessary pain.
Distract instead of disagreeing
It can be challenging for some caregivers to lie to their seniors, especially if they’re family members and share the same history. It’s a natural impulse to correct someone, so if you prefer not to fib, another option is to distract your older adult. You can tell them a story about the person they’re expecting to see or take them for a walk in the fresh air to change their focus.
You may find it hard to keep from correcting your loved one, but it’s much kinder and ultimately much easier for you to adjust to their reality instead of trying to make them understand what the truth is.
Caregiving for someone with Alzheimer’s or dementia is a physically, mentally and emotionally taxing task, and you should do whatever you can to reduce the stress and challenges for both you and your loved one. Therapeutic fibbing is a gentle way to help your loved one feel safe in a world that feels very unfamiliar.