Lying to somebody you care for is generally difficult. It stays on our conscience and can make us feel like we are being cruel. Caregivers of people with dementia (PWD), however, find themselves doing it almost every day. For those of us living with and actively caring for PWD, we may sometimes justify lying as a “necessary evil” to avoid confrontation and simply “give them away to their illusions.” After all, who wants to be the one to tell their loved one that the pet they are adamantly searching for passed decades ago? It would just confuse and upset them even more.

Following this line of thinking, what we should aim to do instead is reframe this strategy as “stepping into someone’s reality.” This is not the same thing as lying.

PWD have a harder time understanding and processing information because dementia damages their brain. Thus, forcing them to abandon their current perception of the world around them may exacerbate their agitation and cause them to feel more fear and anger.

In a technique known as “therapeutic fibbing,” caregivers of PWD avoid causing their care-receiver more distress by validating their emotions and going along with what they say. This ultimately proves to be more effective and less harmful than explicitly stating reality to correct them, given that PWD experiences short-term memory issues.

At the end of the day, stepping into older adults’ reality makes them feel safe and comforted instead of sad and confused. This is what we ultimately want for our loved ones, whether they have dementia or not.

Here are two example interactions, one representing complete truthfulness and one displaying therapeutic fibbing in action:

Example 1: Being completely truthful

PWD: I’m looking for my husband. He should have called and he is going to pick me up soon but he is not picking up. Can I use your phone?

You: Your husband passed away 12 years ago. You cannot leave this facility so I can take you back to your room.

PWD: What do you mean he’s dead? He can’t be, I just got off the phone with him! I’m going to go outside to wait for him.

In that situation, the situation would escalate and you would have caused needless anxiety and agitation for your PWD. Let’s take a look at the better option of therapeutic fibbing.

Example 2: Therapeutic fibbing

PWD:  I’m looking for my husband. He should have called and he is going to pick me up soon but he is not picking up. Can I use your phone?

You: Oh, he actually just called me and said he’s on his way! Let’s take a walk as we wait for him. Maybe we could get some snacks prepared too!

PWD: Ok, that sounds good.

In this situation, the PWD will be occupied with the activity at hand and let go of her previous idea.

Remember that honesty is not always the best policy when the tradeoff is your loved one’s feeling of security. Specific situations will be different, but the same goals apply when it comes to maximizing the comfort and minimizing the distress of PWD as you care for them. We hope this guide was helpful!