Alzheimer’s Truth and Lies

Listed prominently in one of our clients chart and reinforced for all caregivers to see is the note: “If Jane asks where her husband is, tell her he is at the hardware store and will be back soon.” Jane’s response is typically, “I should have known, it’s where he can always be found when not with me.” This response always brings a smile to Jane’s face and many delightful stories associated with the hardware business.

Jane’s husband had owned a hardware store, and even after he sold the business, he could be found visiting the new owners and pursing the aisles. The family’s on-going joke was that they would bury him there. So we helped the family come up with a good Fibit (lies that are therapeutic).

You see, Jane’s husband had passed two years ago, and Jane would frequently forget. Prior to changing our story, every time Jane asked this question the caregivers in her memory unit would respond with the reality, that her husband had passed two years prior. Jane would find this very upsetting, reliving his death and the emotions associated with it, wondering how a loving wife could forget to attend her husband’s funeral, even questioning if it actually happened. There’s really no way to gently tell someone their spouse is dead….whether that death occurred yesterday or ten years ago.

When working with people with Alzheimer’s or to other types of dementia, we offer “stepping into their world and seeing it from the perspective of the person with dementia”. Unless your loved one is in the very early stage of memory loss and wants to be reminded of a date, time or other reality based topic, join their journey rather than force reality on them. Keep this in mind and consider it when determining if a Fibit is right to use with your loved one, as well as what response to use.  

In recommending the use of a Fibit to those with memory issues or cognitive impairments consider two criteria:

  1. Does telling the truth increase stress and anxiety?
  2. Does the Fibit response alleviate this stress and anxiety; maybe even bring about joy.

Clearly this was effective for our client, Joan; it may not be for everyone. Each situation needs to be evaluated individually. Honesty is one of the best qualities in a human being and most of us shutter at the thought of telling a perceived lie, especially to our parents that embedded the importance of honesty into us. But sometimes, dementia changes the rules and honesty isn’t always the best policy when it causes pain and anxiety.

In the below video panelists share differing thoughts during a discussion on Feb. 7, 2019, entitled “Is Dishonesty in Dementia Care Wrong” Angnieszka Jaworska, a philosophy professor at UC Riverside, underscores the importance of respecting a person’s autonomy. Bioethicist David Magnus and Dr. Marina Martin, both at the Stanford School of Medicine, discuss whether the act of lying may cause one to be less honest more frequently. Frankly, I don’t believe this to be a concern if you follow our recommendations for use of a Fibit.

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