Thoughts on "The Therapeutic Lie"?

A therapeutic lie refers to telling a dementia patient anything they need to hear to keep them calm and relaxed in any given situation. Not using "morals" "ethics" or "The 10 Commandments" which do not pertain to Alzheimer's and brain diseases in general. It does no earthly good to remind these elders of OUR reality, such as their parents died in 1970, 10,000x, so we make up therapeutic fibs or stories to suit the situation. It's the kindest thing we can do.

My mother with Alzheimers sometimes says to me, "You are such a good person, your mother must be proud of you." Of course I don't correct her and say that SHE is my mother. I simply say, "Yes, she is proud of me and I learned it all from her." Dementia and Alzheimers patients retain their emotions if not the facts. Mom recognizes me as someone who loves her. It doesn't matter if she remembers I'm her biological daughter or not.

Examples:

Parent with dementia says "I want to go home". Your reply "We need to talk to the doctor about that" or "The doctor needs to sign off on that".

Parent with dementia claims that someone is stealing from them:

"I'll look into that, mom. I need to talk to the laundry person about that".

Person with dementia says you are the devil and have been a rotten child your whole life (while you are the person paying bills, talking to doctors, managing their lives).

"I'm sorry you feel that way, Dad. Tell me what I need to change".

Yes, you are entering THEIR reality.

I see therapeutic lies as something that will not cause pain, suffering, or distress to a loved one. And yes, you meet them in their reality.

When my mom first began dealing with serious memory issues I tried to "fix" it by telling her the truth which often involved bringing her into "reality." I quickly realized that this caused her a lot of mental and emotional anguish and pain and I stopped. Therapeutic fibs are now a go to and they mostly work.

Say whatever needs to be said to keep them calm and then don’t give it another thought.

You didn’t cause their situation. You’re doing your best and have nothing to feel badly about.

Wishing you peace during this difficult time.

I couldn't agee more with the responses so far. I made the mistake of imagining that my husband's reality was the same as it had been. Nope. Keeping him calm, feeling safe, respected and not isolated -- those are what he and others like him seem to need. His (expletive) son, 65-years-old and in a different state, talks to him every evening and gets showtimed; especially since the son only talks about how wonderful he and his kids are, so that hubby only has to say, "Yes!" or "Great!" Hence he thinks his father doesn't have dementia and has accused me of forcing him to live in an awful place (it's very nice, actually, and the help is wonderful) for some cruel stepmotherish reason of my own. He actually accused me of trying to kill him with negativity. He seems to think I'm hoping he'll die so that I can wallow in his wads of cash. He'll be lucky if there is enough cash to get him through to his death (he's 93 but very healthy). Amazing how a 65-year-old thinks the needs and state of a 93-year-old are the same as his. Meanwhile I am (according to my doc and my psychiatrist) in a state of PTSD -- horrible, crushing depression, anxiety, fatigue -- I've truly felt as though I may not live through the year.

Anyway, back to the subject: I think part of the kindness of helping a LO end the journey as peacefully as possible is to affirm his reality as much as possible. They are already frightened, confused, and feeling completely helpless. Being told "No, you're wrong, this other thing is the truth" may BE the truth but...how does it help them? Only if it helps or is absolutely necessary should you try to get them to accept something that is true when they don't want to.

If you are with someone who sees something that is not there or thinks that he or she is in a different place than they really are or wonders when they are going to go home when they are already home or is just confused and thinks you are somebody other than who you are.. If those versions of reality held by your loved one don't hurt anyone else, why bother trying to correct it? Agree with that person's reality. That's all they have. I think it would be cruel to try to convince an already confused person that their reality is not true. You will never have peace for your loved one or yourself if you continually try to force " the truth" on someone who is past understanding what that means. My husband, now deceased, used to hallucinate and see birds flying around in his bedroom. Of course they were not there. But what I told him was that those birds were special, and therefore only he could see them. I felt good about that answer because he was content with it. And that's all you want when someone is infirm, their contentment.

I’m an only “child” age 66 and my parents both 92 are roommates in a nursing home. Dad dx Alzheimers 2014, Mom 2019. She is worse cognitively than he. When I visit i tey to “read the room” get a feel for their moods and respond to their questions accordingly because therapeutic lie might be my best route on Monday and truth might be the best route Thurs. Mom is tougher because she drilled it into my head when her mom had Alzheimer’s that I always tell her the truth if she ever developed Alzheimers but as other people have stated why would i agitate her. The staff is very responsive and my only advice is see that your LO’s meds are doing the best possible. A slight increase in prozac has made mom much more comfortable with her thoughts.

I happen to be a voluble, and if I do say so myself, rather gifted liar (stage training) and my only addition to some of the wholly worthy responses already here is to plead with everyone who resorts to this technique to STOP referring to this very sound type of therapy as LYING or FIBBING.

If you are doing this you have experienced the torment of interacting with someone who no longer uses reason or experience or reality testing to deal with thoughts produced by a declining brain/sensory system.

Those of us who attempt to provide comfort and solace to such victims need not define nor explain the techniques we employ, and certainly don’t need to apologize for them.

I still cherish (and tear up a little actually) when I listen a tape of my recently deceased LO calling to be sure I’d let her mother (deceased some 50 years previously) know that she’d be late coming home from work. I was my privilege EVERY TIME, to let her know I’d done what she’d asked.

I enter my mother's world and lie constantly to keep her calm. Examples:

Q: "Why isn't anyone helping me get ready for school! I'm going to be late!" A: "You won't be late. Classes are cancelled. The water main burst so they closed campus until it's repaired."

Q: "What time are my parents coming to get me? They promised to take me home this weekend."
A: "They called to postpone until next weekend as there's a severe storm forecast."

Q: "I want to see my (dead) brother! Get him!"
A: "The combine broke so he had to rush to town for parts. Then he'll harvest until late, to beat the rain."

Harmless. And enough to satisfy her. Although I suspect my mother processes much more detail than the others I've seen with dementia. Her world is all over the timeline but she's still very articulate and can often pass for being ok, although she is late stage.

I'm in a bind right now because my mother thinks I'm helping an assassin who's trying to shoot her. Haven't visited lately because she becomes hysterical and rages at me. Had to be sedated last time. I can't seem to talk my way out of this one.