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How Therapeutic Fibbing Can Help with Caring for a Patient with Dementia & Alzheimer’s

By Home Care Assistance, 9:00 am on

It is time to take your loved one with Alzheimer’s or other forms of dementia to a doctor’s appointment, but he or she refuses to go? As you explain why the appointment is necessary, their stress and agitation increase and verbal and even physical resistance ensues. Before such situations occur, we must ask ourselves if it is OK to fib to our loved one to get them to the doctor’s office?  To take them to lunch or a movie then drop by the doctor’s office on the way home without warning? The answer to these two questions is yes.

Therapeutic Fibbing Can Reduce Stress, Anxiety, and Agitation

It is important to realize that your loved one with dementia often lives in a world of fear.  Once familiar faces, places, and activities can become strange and even frightening.  People with dementia often withdraw into past memories for comfort, even to the point of forgetting they have cognitive impairment making “new” people, places, and experiences that more frightening.

According to the Family Caregiver Alliance, “Meticulous honesty can lead to distress when someone has dementia.”  Research shows that “therapeutic fibbing” can reduce the stress, anxiety, and agitation a loved one with cognitive impairment faces when encountering what used to be everyday tasks and responsibilities.  Research also shows that therapeutic fibbing decreases stress for the caregiver as well.

Therapeutic Fibbing Can Help Make Communication More Effective

Communicating effectively with your loved one who has dementia or Alzheimer’s is vital, but it is even more important to communicate with them in a manner that proactively helps avoid these situations in the first place and therapeutic fibbing can achieve that.  For example, instead of constantly reminding a loved one that their parents or a best friend have passed away, assure your loved one that they are well and will be “be here soon” or “are on vacation and send their love.”  If dementia has regressed to the point that childhood memory is now your loved one’s safe harbor, comfort him or her with the knowledge that a treat or toy awaits them after a visit to the dentist or doctor.

Fibbing Can Help Mitigate Emotional Pain

Sometimes it is difficult for a caregiver to “lie” to their loved one, especially when one is raised with the value of always telling the truth.  Deception can be spiritually and emotionally taxing to the caregiver in such circumstances.  Yet keeping in mind that the greater good is achieved by preventing unnecessary emotional pain and suffering on a loved one almost always eases and dissipates such self-doubt and guilt.

One way around such ethical dilemmas is to avoid the fib and the stress when possible by not feeling the need to correct mistakes of little or no consequence to the loved one’s health and well-being. For example, they may call their pet cat by the name of a long gone pet or they may talk about a conversation with a friend they haven’t spoken to in decades.  Correcting your loved one at such times can create stress and can make them feel down on themselves for not realizing their mistake.

Try Distractions When Moral Dilemma is an Issue

Another way around these dilemmas is to engage in distraction.  For example, if your loved one is beginning to get apprehensive about a situation, remind them that his or her favorite television show is about to begin (keeping episodes recorded on the DVR or on a streaming service watch list is quite useful here).  Similarly, simply telling a story, asking an unrelated question, or offering to do something they like to do are effective distractions to ease their concerns.

Of course, such techniques are not always called for and truth and “reorientation” are necessary.  For example, reminding the loved one of their current location, the date, the identity of the primary caregivers, or the need for medication is appropriate when done in kindness and love.

Adaptability is the Key When Caring for A loved one with Dementia or Alzheimer’s

Caregivers offering senior home care have to learn the art of how to balance these different approaches with their loved one.  What works for one person may not work for another. The idea here is for the caregiver to adapt as circumstances dictate in order to achieve the goals of providing the love and support a loved one with dementia needs so that they are as stress and anxiety free as possible.  This, in turn, will ease the stress in the caregiver as well.