Why and How to Avoid Therapeutic Lying to People with Memory Loss

Sunrise Senior Living  |  August 22, 2018

If you know someone with Alzheimer’s or another form of dementia, it can feel challenging at times to connect with your loved one. Whether they ask difficult questions you’re not sure how to answer or focus on events from long ago, it may seem at times like they’re in their own world.

One tactic that caregivers often use is therapeutic lying—telling “white lies” in order to temporarily placate the person with memory loss and, as a caregiver, doing what they believe may help to avoid any further confusion or frustration.

For instance, someone with Alzheimer’s might ask where their mother is, even though she passed away 20 years ago. The caregiver, not wanting to upset the person by telling them that their mother is no longer here, may reply that their mother is at the store, or out of town for the week. This prevents the person with dementia from once again hearing the painful truth.

Therapeutic lying can be easy, and it can soothe a senior in the short term. But it’s not the best way to communicate with people experiencing dementia.

“When you think about it, the term is, in and of itself, an oxymoron. When we lie and fib, how can that be considered therapeutic?” says Rita Altman, Sunrise Senior Living’s senior vice president of Memory Care & Program Services. “When we lie to someone, we risk losing their trust.”

Whether it’s a move away from home and into an assisted living community or the passing of a family member, it can seem unnecessarily distressful to expose our loved ones to potentially uncomfortable facts of a particular situation. But it’s important to remember that seniors are a strong and resilient group of people—and that includes those with memory loss. Experts from the University of Arizona’s Center on Agency found that “older adults actually have a higher level of subjective well-being than individuals in any other age group.”

 “Think about all they’ve lived through in their years—the wars, the economic crises, the losses they’ve coped with,” says Altman. “They’ve come through all of this relatively successfully. Through all of their obstacles, they’re gaining a lot of wisdom and strength. That resilience is what allows seniors to deal with change and so often come out stronger.”

Though it seems harmless, therapeutic lying neither preserves the dignity of a person with memory loss nor gets to the heart of what they really desire. They have the same basic human needs as all of us. They want someone to listen to them with empathy, ask them open-ended questions, and mirror the emotions that they are expressing.

Rather than redirecting or using therapeutic lies, caregivers should adopt the Validation Method. Developed by renowned author, social worker, and founder of the Validation Training Institute, Naomi Feil, Validation is an empathetic method of communicating with seniors experiencing memory loss.

“We should validate their feelings,” says Altman, who was trained by Feil and is one of about a dozen certified Validation masters worldwide. “Instead of lying, we should meet the person where they are. We should use empathy and try to step instead their shoes and feel their needs.”

For example, when a person with dementia asks where their mother is, it’s best not to lie and tell the person that their mother will be back soon. Your loved one may go along with this in the short term, but they know on some subconscious level that it isn’t really true. Falsehoods like this can, in fact, erode the trust between you and the senior and make it harder for them adapt to their current situation.

Instead, center yourself and take some deep breaths so that you can be fully present and empathetic for your loved one. Try saying, “It must be really hard for you to not be able to see your mother. I can tell that you really miss her. Can you tell me about her? Was there ever a time when you needed to see your mother and couldn’t?” When you hear how they got by in the past, you can help them tap into those same coping techniques in the present.

Here are a few more scenarios where the Validation Method can help:

  • Your loved one may accuse you of stealing some of their precious items, which they have in fact hidden away in an effort to guard them. It would be easy to tell them that you took their family pictures to get framed, for example. But instead, say, “That picture means a lot to you. You really love your family. What kinds of things did you like doing together?”
  • If your loved one expresses anxiety about moving into a memory care community, you may be tempted to tell them that it is a temporary arrangement. But this will inhibit the person from settling into their new home. Rather, ask them what they liked about their previous residence and what fond memories they have there. And, let them know you can always explore other options if necessary. By being honest, you grant the senior a sense of control over the situation.
  • Your loved one may mistake you for somebody else, such as their partner. Rather than correcting them or simply going along with it, enter into their reality and allow them to express their feelings. Say, “You really miss your husband. I can tell you loved him very much. What was he like? What was the best thing about being with him?”

Validation will take more time and effort than therapeutic lying or redirecting. But, it can make a significant positive impact because it allows the person with dementia to be involved and feel heard. This results in meeting the person’s needs with a real human connection, rather than an artificial conversation based on white lies.

“It’s so valuable because it gives the person the opportunity to really express their feelings and concerns, and that gives them relief,” says Altman. “It’s just like with all of us—when we voice something that’s concerning us, we feel better.”

Listen to The Senior Caregiver Podcast          

Are you looking for more tips on caring for someone with memory loss? In Episode 1 of The Senior Caregiver podcast, Rita Altman covers the different stages of Alzheimer’s and gives tips on using the Validation Method in both verbal and nonverbal communication. Click here to listen!

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