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Ingleside at Rock Creek Blog

IRC Blog
Posted: Wednesday, August 5, 2020

Telling the truth to a loved one with Alzheimer’s. Are there exceptions to the rule?

When caring for a loved one with Alzheimer’s, the challenges often increase with the progressiveness of the illness. But for some, there is one form of interaction they may struggle with - and that is accepting that honesty isn’t always the best policy.

We’ve all been taught to be truthful in our relationships. But memory loss, confusion and an inability to respond accurately to their environment causes those with Alzheimer’s to experience a different reality.

And when your reality and theirs collide, it can be kinder to not hurt them with the truth.

When to consider exceptions to honesty

1. If your loved one is no longer able to maintain a cognitive presence in the world, it’s unreasonable and impossible to insist that they abandon their reality. The best advice is to be aware and compassionate of where they are and join them there.

2. A common symptom of a cognitive illness is having difficulty with processing information and making sense of the world. The struggle itself is frustrating to them. If they no longer remember that their brother or sister is gone, forcing them to face that truth repeatedly is painful.

3. Consider whether the truth will help or hurt them. For example, if they become anxious that they’re going to be late for a job they haven’t had in 20 years, it can be better to assure them that you’ll help them get there on time and then distract them from their thoughts.

Suggestions for bridging the two realities

Although there are times when caregivers feel helpless when interacting with their loved ones, there are steps you can take to create a more positive outcome. Consider these suggestions:

1. Try to understand what they’re feeling
If someone is looking for their long-lost mother, they may actually be feeling unsure or scared. What they may be looking for is someone to comfort them or make them feel safe. Instead of arguing that their mother is no longer living, try to discover a way you could respond that might help fill those needs.

2. Use distractions to help them move on
Those struggling with Alzheimer’s will often let go of a thought if they’re distracted. Let them know you understand and will do what you can to help. If they believe it’s time to go to work, try reminding them that you haven’t packed their lunch yet and distract them with another activity while they wait.

3. Weigh the options before you respond
Adapt your response to where they are in their illness but also ask yourself if bending the facts would save them from a painful moment or memory. Can they process and handle the truth of your answer to their question? Challenging their beliefs can lead to arguments, frustration and feelings of being misunderstood.

4. Sometimes a lie is kinder
If they continually ask for their deceased mother, telling them she has died will likely bring them understandable pain. It will also cause confusion as they attempt to process this information. If you continue to answer them in this way, they will have to suffer the pain of this loss over and over.

Use of therapeutic lying

Not always being honest, or what is referred to as therapeutic lying is recommended by many health professionals. Used at the right time, it can reduce anxiety for both your loved one and yourself. At times, avoiding the truth can help support the person’s reality.

This practice can have a positive impact on both the health and the emotional well-being of your loved one. Some situations where it can be most effective include:

1. When it involves their health and safety
If you need your father to go to the doctor but he always reacts negatively to the request, you could instead tell him you’re going to his favorite restaurant or park. You’ll still go to the doctor first but will keep your promise about the other activity.

2. When it helps them avoid confusion
Your loved one may no longer be able to recognize what is real and what isn’t. By insisting that your reality is true, they likely will become agitated. Imagine someone telling you right now that what you know to be true, such as where you are and what you’re doing, isn’t real. That’s what it feels like to them.

3. When it preserves their dignity and emotional state of mind
Instead of challenging what they say, agree that the kids are at school or their deceased wife is at the store. One caregiver related that her honesty policy caused her to retell and remind her father that her mother was dead every time he’d ask. She stopped when she realized he would always quietly go into his room and grieve.

4. Keep adapting your responses
As a caregiver, you’ve no doubt learned that being flexible is key. Part of the Alzheimer’s journey is the ability to adapt to your loved one’s needs and current read of reality. If they want to drive to the store but are no longer capable, instead of reminding them of yet another loss, it’s much kinder to tell them the car isn’t working or you’ve lost the keys. Anything you can do to make their life a little easier or happier is worth the effort.

Ingleside at Rock Creek Memory Support Assisted Living

We understand the challenges of caregivers who may struggle with the right response or in deciding whether they should always be truthful with their loved one. While it may seem wrong on the surface to engage in therapeutic lying, it might help to ask yourself if honesty will only cause them pain, especially when there will be no benefit.

We hope you’ll find these tips and suggestions helpful and if you would like more information on how to best interact with your loved one, please reach out to us.   

Call (202) 905-0018 if you have any questions or would like to schedule a personalized tour today.



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