To lie or not to lie?

In Ian’s four stage approach to meeting someone’s needs, the last of these is the use of a ‘therapeutic lie’. Not everyone will know when (if ever) it is appropriate to lie to someone living with dementia. He has also produced some guidelines on this, which we have included in the link below.

Ian has considered the difference between a good lie and a bad lie. In the example he uses in the video in the previous step, a woman worried about her children will not be easily distracted from this concern.

A good use of a therapeutic lie would be one which matches her life story and would remove her fear. So in the example Ian gave, telling her that her sister will be picking up the children today would be appropriate and would not cause distress.

A bad lie might shift a person’s attention, for example by telling them they need to go to their room because their daughter will arrive soon, but it will create a new expectation and could add to distress later on. A bad lie would also be one which doesn’t match the person’s life story, such as saying a person’s (deceased) husband is playing golf at the moment, if this was not something he did.

We asked all of our experts and carers involved in the course what they thought about going along with a person’s erroneous beliefs. Their responses were really varied and included:

  • doing what is needed to avoid confrontation
  • telling a person what you understand is the reality
  • distracting or changing the subject
  • deflecting towards a related topic to avoid directly contradicting
  • seeking outside help
  • keeping upsetting things from the person
  • telling a therapeutic lie if it reduces distress or avoids danger

By thinking about the four stage approach, we can decide which course of action is most likely to reassure the person and meet their needs. Telling a ‘good therapeutic lie’ might be one of the solutions you find works in certain circumstances.

What is your view?

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This article is from the free online course:

Dementia Care: Staying Connected and Living Well

Newcastle University

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