Is it ever OK to lie to someone with dementia?

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Transcript:

I’m often asked if it’s ever okay to lie to someone with dementia. And my answer is to simply take the word lying, and throw it away. I know that sounds crazy, but when we first learn about dementia, we always learn about redirecting and distracting people and validating them. But all of these theories don’t solve some inherent problems. And some of these inherent problems come up when someone with dementia is asking you a direct question such as, “where is my so-and-so? Where’s my mom?” This person’s mother’s been dead for years. And the worst thing you can say, of course, is she’s dead. Don’t you remember? Right? That’s the worst thing you can say. But saying something like, oh, sounds like you really miss your mom. I mean, that doesn’t really solve the problem. And maybe sometimes that person will engage in conversation with you and, you know, eventually, they’ll come to the conclusion that a loved one is dead.

I always teach people to take the word lying and throw it away. What I tell caregivers all the time is to instead embrace someone’s reality. When we embrace someone’s reality, we understand that their world has changed and that we need to change with it. And this can be really hard for people to understand because dementia care is not black and white, right? It’s like very much this gray area. And if it’s a gray area, then how do we know that it’s okay to lie? So what I’m saying is to just get rid of the word lying. Because if you look at it this way, if their reality is that they’re, you know, 30 years old and still working, and their parents live nearby, and your reality is that they’re 90, their parents died years ago and they have dementia, who is to say that their reality is wrong?

Right? Because if it’s true for them, we also want it to be true for us as well. And maybe that sounds crazy. I mean, maybe their reality is totally different than ours. That’s okay. We want to go over to their reality. We want to embrace their reality, whatever that reality is. And so when somebody with dementia asks us a direct question like, where is my mom? The worst thing you could say again, is, she’s dead. Instead, we want to say, where do you think your mom is? And then they’ll tell us their answer. Whatever their answer is, is the correct answer. So if they say she’s dead, she’s dead. If they say she’s at the store, she’s at the store. If they say she’s at work, she’s at work, whatever. And all you’re going to do is say, that sounds about right. She must insert whatever they said here, and you can use this again and again. Because 20 minutes later they’re going to ask, and you can say it again. Now, people go, but Rachael, isn’t that lying? No. You’re embracing their reality. If their reality is that she’s at work, that’s where she is. It’s not our job to correct someone’s reality or try to.

It’s so hard because dementia care is a gray area. So saying you always just want to redirect them to a new conversation. Well, that’s not always going to work. You really have to embrace their world. You have to go over there, even if that reality doesn’t make any sense. So again, take the word lying, and get rid of it. The word fibbing, white lies, whatever. I don’t care. We want to switch it with this term. Embrace someone’s reality instead.

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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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