Q: My wife has dementia, and people keep telling me I should lie to her. That doesn’t feel right. We’ve always been honest with each other, and I don’t want to betray that now. Is it ever okay to tell a “little lie” to someone with dementia?
A: Many dementia care experts recommend using what are called “fiblets” or “therapeutic little lies”. At first, this may feel uncomfortable, especially when you have always valued honesty in your relationship. It may help to think of these responses not as lies but as a way of communicating with someone whose brain can no longer process information in the same way.
When someone has dementia, their brain changes. A brain scan will often show a loss of brain tissue. It can help to visualize that picture in order to better understand why your loved one is not reacting the way they used to.
As dementia progresses, continuing to correct someone or insisting on providing factual accuracy can unintentionally cause anxiety and stress. Sometimes the most compassionate thing you can do is to provide information in a way they can understand, making them feel safe and secure, rather than focusing on the objective facts.
For example, if someone has dementia and asks you when their mother will be home, even though their mother died years ago, it is suggested not to correct their memory. Rather than remind them that their mother is dead, thus causing them to experience grief and loss as if they were first learning this news, you can use a fiblet. You might say, “I am not sure when she will be home,” or gently redirect the conversation by saying, “You must be thinking about your mom. What was your favorite thing to do together?”
Inviting someone to reminisce about positive memories can be very comforting. Perhaps ask what her mother’s favorite meal was to make, or if she has a favorite memory with her mother. These conversations can bring a sense of familiarity that provides comfort.
Oftentimes, the questions that we think require concrete answers are really an expression of an emotional need. When people ask for their mothers, it is usually because they are seeking the comfort and warmth their mother represented for them.
You can respond to the emotional content of the question by providing some attention, positive reminiscence, and reassurance.
Responding to your wife in a way that reduces her anxiety and avoids conflict can be the goal. Just as you would tailor your explanation to a young child’s developmental level, dementia care requires adjusting communication to match a person’s current ability to understand and process information.
Every person with dementia is unique, and their abilities and needs change over time. The best responses will be based on the current stage, the situation, and the person’s emotions and ability to process information. With practice, it can become easier to respond to the emotions of your wife in a way that will encourage her comfort, reduce her stress, and focus on her well-being, rather than on the facts themselves. This approach reflects your love and care for her and honors your relationship.
Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.
