I was making a routine visit with a client when she was repeatedly asking me to go home. We talked for a while as I tried to find out why she was so insistent about going home today of all days. Eventually, we had a moment of silence where we were holding hands for about 1 minute before she broke the silence when she sighed and said, “you’re one of the good ones.” Flattered, I still asked what she meant. (A large part of my job is being a special kind of detective). She said “Some people lie. They tell you what they think you need to hear. But they lie.”
Lying, fiblets, telling a script: these are all examples of telling something that is different from the truth and assuming that someone with dementia will believe it. Here are a few reasons why it is important to understand why lying to someone with dementia should be used sparingly.
1. THE AMYGDALA.
The amygdala is the part of the brain that is responsible for attaching emotional memories to an experience. A person with dementia may not remember who you are, what your name is, etc. but they will remember how you made them feel. How do you feel when someone lies to you?
2. MOMENTS OF CLARITY
A person with dementia, like all of us, will have moments of clarity as well as moments where we are a little less clear. It is in these moments of clarity, however, that a person with dementia will recognize a lie then form that emotional memory of us.
3. THE TYPE OF DEMENTIA
Not all types of dementia present with short term memory loss. A little white lie such as “We will go home after dinner” may seem harmless, but a person with a type of dementia other than Alzheimer’s, may remember this. There are many types of dementia and while they’re all progressive, each has a unique set of symptoms
So now that you have a better understanding of why it is not always OK to lie to someone with dementia. I can acknowledge that sometimes we all get into a panic. Someone with dementia is upset, we don’t know how to respond, we’re in a hurry, etc. But let’s discuss a few ways we can attempt to avoid a lie.
One of the most important techniques I discuss is validation. There are many ways to validate feelings both verbally and nonverbally. I recommend starting with non-verbal. This refers to your body language, the expression on your face, and the tone of your voice. I usually change my emotion to match the person’s and pause for a moment to allow them to react to my non-verbal response. Next, I say a statement such as “I can tell you’re unhappy.” Or “I can tell you’re frustrated.” This is an important step.
2. TALK ABOUT IT.
You can try using statements that spark conversation. Most of us have heard of saying “Tell me about your home.” Or “Tell me about your husband..” or whatever subject the person is talking about. But you can take it a step further to the planning. “Tell me about what you’d like to do when you get home.” This can also help you determine if the person may be hungry, thirsty, tired, or simply just want to read a book, go for a walk, or maybe help prepare a meal! Encourage the person with dementia to talk about the experience behind the action.
Redirecting to another task, activity, or subject, can be necessary but usually occurs after validation and conversation about the subject has occurred. This can help you determine what to redirect to. It could be any of the activities named above, or something different such as a favorite song.
When all else fails, a lie may be necessary but be sure to know the person with dementia. Will they remember the lie? Will they remember you negatively for telling a lie? If you must lie, stay as close to the truth as possible, however, lying should be the last resort rather than the “go-to” technique.