A “Little White Lie” or Fib is defined as “a harmless or trivial lie, especially one told to avoid hurting someone’s feelings.”  A person living with dementia often has significant short-term memory loss, confusion, and time disorientation.  Is it better to tell the truth and discuss “reality” or fib to reduce their anxiety?

Guilt be Gone

We all feel the pang of guilt when we fib on a direct question.  Our rationale may be exactly as a “little white lie” is defined—to avoid hurting someone’s feelings.  We also fib to avoid having an unwanted or complicated discussion.  People living with dementia have likely lost significant ability to store, retain, access and process information and memory.  The memories they have define their current reality.  Reframe your answers as “lies or fibs”—think of them as relating reality to them.

Relating Reality to Them–3 Things to Consider

When providing information on “difficult and repeated questions” (ie Where’s my car? Where is Jack (husband)” who died 8 years ago), here are three inputs:

  1. Current reality and state: What answer would make the most sense to them in their current reality and state?  Are they anxious or relaxed? How have they been reacting to information lately (accepting? Combative?). Do they have any unmet needs (food, fluids, elimination, etc)?
  2. Kindness: Reality can be harsh.  How do you phrase your information kindly?
  3. Peace: Difficult questions can illicit anxiety—how do you bring them peace?

Where is my car?

John has significant short-term memory loss.  He can no longer drive but insists he can.  When he asks his kids to drive, they say “Dad, you can’t drive anymore” further agitating John.

  1. John’s reality (not real reality) is he can drive. He becomes combative when directly told he cannot drive.  John also has almost no short-term memory so he doesn’t remember the doctor told him he can’t drive.
  2. One option (“truth”) is to have the doctor write a letter telling John he can no longer drive (hopefully in a nice tone). The family can show John the letter when he asks.
  3. Another option is simple to “redirect”. “Jane (the daughter) has to take it to the shop.”  In the moment, this reduces John’s anxiety.  He will not remember the car is in the shop.  Perpetual redirects can be effective but should be coordinated with family.

In either case, the family should make ever effort to provide transportation so that John can still get around and have some semblance of independence.

Where’s Jack (my husband)?

Sometimes, reality (telling the truth) is the best answer but doing it in such a way to relate to their reality. Jill has dementia and often asks where her deceased husband, Jack, is.  Jill has some long-term memory recall but little short-term recall and is often confused about timing on events.

  1. Jill’s reality is she does not recall Jack’s passing and is confused he is not “there.” She may become very sad or anxious if someone bluntly says “Jill, he died.”
  2. A kind way to approach the question is to get a picture of Jack and ask Jill what where some of the things she remembers about Jack.
  3. Normally, these discussions can open the opportunity to bring peace to Jill by saying “Jack is in heaven looking down on us. He’s always with you.”

Hopefully these strategies and approaches help you calm the person living with dementia and bring peace to the family.