But where’s the LINE when it comes to LYING in dementia care?


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Let’s talk about a difficult concept here – where’s the line when it comes to lying? When you’re communicating with the person living with dementia, where does the line exist? I talk about this all the time. When I discuss my phrase, Embracing Their Reality™, which is my trademark phrase, the problem that I have is I sometimes see people using this phrase or a similar phrase, and they’re not really using it the right way. So while I would like to be for it to be attributed to me, I also want to make sure that we are describing different types of dementia care communication differently, and not just lumping it all into one basket, because there are different methods in the dementia care community. And we need to talk about them as separate things because they are different.

Most of the time when I’m teaching Embracing Their Reality™ people are like, “Wow, this makes sense. I like this. I get it. This is the only thing that’s worked for communicating with my loved one, living with dementia.”

Occasionally I’ll have people say, well, that’s lying. And then on the other side of that, sometimes I’ll have people who don’t fully understand what I’m teaching and they’ll say, well, I teach the exact same thing and then you hear them talking about it. And you’re like, okay, well actually you’re telling people to do A, B, C, and D, but don’t lie to somebody with dementia. So, it gets pretty confusing. You know, you can do this, this and this. Like you can live in somebody’s world. You can embrace somebody’s reality, but also you don’t want to lie.

No. I think that when we’re teaching this stuff to a caregiving audience, there’s a certain level of respect that I want to give them – my audience is an intelligent audience.

You all are an intelligent audience. And I think sometimes when an expert in a field is teaching something, they feel like, okay, I’ve gotta dumb this down. I’ve gotta make this digestible for a mass audience. And that’s not how I feel about this because I’ve taught my concept of Embracing Their Reality™. When a person living with dementia says to you, “where’s my mom?” Instead of just going, oh, sounds like you miss your mom, which is not embracing their reality, redirecting the conversation is distracting. Most of those are attributed to Tepa snow, which is not the same thing as embracing their reality. When you’re embracing somebody’s reality, you are literally finding out where their world is by asking them and using context clues and going wherever it is that’s ever true for them in that moment. And when you’re doing that, when you’re living in somebody’s world, you’re getting rid of the word lying. You’re not worried about it anymore. I tell my audience to take the word lying and throw it away.

Don’t worry about it because if you’re doing what’s true for that person, you’re doing the right thing. And that’s okay if you’re still freaked out by this. But I really recommend if you are interested in trying this to dive into more of my literature and what I write and what I talk about and try it for yourself and see that it works.

I swear it works when you do it the right way. And you don’t assume that what was true for the last week is true for them this week. You rediscover that information and then you do that new reality. But when I’m teaching this to an audience, my audience isn’t dumb. And I think a lot of times, again, when you’re an expert, people are afraid to get up there in front of a crowd or on their blog or wherever, and really say what they want to say, because they’re afraid it’s going to be misinterpreted. But I’ve taught this in so many places. So many times in so many different methods of communication, blog, podcast, YouTube, you know, public speaking, web events and had such a wonderful reaction from that. I know it works and I know people can understand it.

People get it.

If you describe it the right way and you give it the right examples and you, that people ask questions and you work with them, they can get it. But if you are not giving somebody actual tools – like I give people actual questions to ask a person living with dementia, to find out where their reality is – you’re not doing that kind of thing, I think it’s tough. Dementia care is a gray area. It’s a dance and we’re not making it any less confusing when we’re saying stuff like, well, you can do this, but if you do this other thing, then that’s a lie. I’ve gotten into this conversation a couple of times with different professionals who said, you know, when I agreed with one of my residents, that the building was on fire and pulled out my phone, got a fire truck noise playing on YouTube. That was a lie. And what I should have said to this resident who was terrified the building was on fire was, sounds like you’re afraid of fire. How would that have been helpful? I don’t think that would’ve been helpful. We have to do what’s true for that person. No matter where their reality is, take the word, lie, and throw it away.

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1 thought on “But where’s the LINE when it comes to LYING in dementia care?”

  1. I am dealing with my mother who is in a nursing home stating that she is ready to go home. She states she went there on her own because she was bored but is now ready to go home and sit on the porch. How would I get in her reality and get her to not get angry about not being able to go home?

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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