Therapeutic Fibbing
Therapeutic fibbing is a technique used when caring for patients with dementia, especially Alzheimer's patients. It involves telling the patient a white lie in order to prevent increased anxiety, hurt, and emotional damage. Its purpose is to protect and not to cause further harm or upset.
When children are small and something happens in life that they cannot process, we sometimes alter the truth to protect them from something they either cannot understand or would cause them undue upset. So too is the case with patients with dementia.
Dementia care is truly a daily struggle and difficult to navigate. It could be an emotional landmine if the truth were told to a patient who has no recollection of reality anymore. Consequently, therapeutic fibbing is a helpful tool in a caregiver's arsenal.
Here are some examples of what can be said:
Situation: A dementia patient believes that she is going to be visited by relatives who have been dead for many years and is worried that they will not be able to get access to her house.
Solution: Mom, I have left a key with the neighbor, and Aunt Martha and Uncle Bert know to ask the neighbor for it. Everything is taken care of.
Situation: A patient with Alzheimer's want to drive but is no longer capable of doing so and, in fact, has had his driver's license revoked but does not remember that.
Solution: Dad, I took your car to the shop to have a tune-up. How about I drive you to the store?
Situation: The elderly dementia patient does not recognize his own house as being his home.
Solution: Dad, your house is being fixed up and you will be returning to it soon. What's your favorite thing about your house?
Situation: The patient is not keeping up personal hygiene, refusing to bathe or shower.
Solution: Mom, I'd like to take you shopping. Don't you want to look and feel your best by getting cleaned up and dressed up?
There are times when honesty is not necessarily the best policy; also, lying is not always a bad thing, as in cases like these.
Since people with dementia are unable to change what they perceive to be reality (a reality that is unique for each patient) it is essential that caregivers meet them where they are. By letting them enjoy what they perceive to be reality, there is less upset, anxiety, outbursts, and general disruption of daily life. It also enables the caregiver to provide better support and lessens stress and fatigue associated with caring for dementia patients.
In general, lying is not a good thing. But when caring for a patient with dementia, therapeutic fibbing is an act of love and the kindest lie of all.
Sleep disturbances are frequently a symptom of Alzheimer's. One of the best solutions to this problem is using blackout window curtains to ensure the patient is producing enough melatonin to get optimal quality/quantity of sleep.
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