“You want me to lie to my Dad?”

“You want me to lie to my Dad?”

Yes. Well, no not really. I like to consider it a therapeutic fib, rather than a “lie”. Some may consider it a lie. I don’t really care what we call it as long as it is done taking their brain changes in mind with the focus on what is most supportive for the person living with dementia. 

Following a recent presentation on “Transitions Along the Journey of Dementia”, a participant came up to discuss her situation. She shared that her father, who is now living with moderate dementia, repeatedly asks about his parents. To date, she has explained that his parents are deceased. She went on to tell me that in order to disrupt the pattern of this repetitive question, earlier that day she had placed photographs of both of his parents’ grave stones on his dresser mirror. After hearing me talk about “joining the journey” rather than “reality orientation”, she asked me if I thought she should remove the pictures.

I mustered as much compassion and gentleness as possible as I looked her in the eyes and said “Yes, please remove those pictures”. I encouraged her to consider the deeper meaning of her father repeatedly asking about his parents. Did he have a good relationship with his parents? Could it be possible that instead of wanting the “truth” regarding his parents’ being alive or not, he missed and loved them and wants to connect with the positive feelings of those parental relationships. She followed me that far but gave me a dreadful look and the inevitable “You want me to lie to my Dad” line when I asked her to take that one step further.

“Tell me more about your dad” I went on. Was there anything he did with either of his parents that was especially meaningful for him? She shared that her father used to enjoy going to baseball games with his father. As we ventured down this path, I asked her to “try on” the following reply when he asked about his parents… “They are not here right now, however, I was just thinking about how you and PaPa love to go to baseball games. That Yankee game you saw where Babe Ruth hit a home run…. Wow. I bet that was quite a game!” I encouraged her to start him down a positive memory with a starter like that, explaining that through this approach, she could help him obtain what he ultimately needed – connection, familiarity, love, positivity, shared experiences.

It’s not about misleading or “LYING”. It IS about listening with dementia-sensitive ears and seeing with dementia-sensitive eyes and responding accordingly with compassion and love. For some, it is important to focus on reality-orientation and helping our loved one with dementia join us in our reality. The problem with that approach is that it can be upsetting for the person living with dementia. Can you imagine being told that your parent is dead repeatedly and because of the changes in your brain it is new information each time you hear it? Consequently, you relive the shock and sadness with each explanation. I don’t know about you, but this sounds like hell to me.

Are you a care partner who finds yourself in a similar situation - where you are constantly ‘informing’ your loved one with dementia of a reality that is different than their perception because you feel this is the ‘right’ thing to do? If so, I’d ask you to step back and review the outcome of that truth-telling. Does it result in a positive or negative experience for the person living with dementia? Be honest, this is not a hard question. If each time you truth tell, they end up in tears and agitated, I challenge you to give this a try. Step 1 – consider the deeper need they are expressing. In the scenario above, the father misses the love and comfort of his parents. Step 2 – Try to offer a similar emotional experience for them by redirecting them to positive experiences – helping them recall experiences when they felt really loved by describing a special memory or making them feel extra special in that moment through an expression of love. Step 3 – Observe the outcome and determine if it is positive or negative. If you find that the outcome is that they are pleasantly distracted rather than tearful, shocked, and agitated, I’d say that is a good outcome.

Each person living with dementia is unique and the outcome may differ in each situation, but my hope is that this example will help ignite creativity in those of you caring for someone living with dementia to consider alternative responses when these tricky situations that may take us off-guard arise. As a care coach, I help families dealing with these scenarios daily. If I can help you as you care for someone living with dementia, please reach out. I’m here to help.

Take good care, friends.

Aging Care Coach

Rebekah Wilson, MSW