Therapeutic Lying With Dementia Patients - page 2

Therapeutic lying is the practice of telling little 'white lies' or fibs to prevent from agitating the patient with dementia. Even though some of us were taught to never lie to any patient under any... Read More

  1. Visit  Enthused RN profile page
    2
    I wish I knew this 2 years ago when my grandma experienced the loss of her last sibling. My aunts kept trying to re-orient her and saying that her sister died. This went on every 15 seconds for a long time. She would forget after 15 seconds, ask what happened to her sister again, and then strongly re-act in horror the same exact way every time. We just didn't know better. It was definitely an eye-opener. Now with that experience combined with what is recommended nowadays (therapeutic lying), I will never try to re-orient someone in the late stages of AD. I'll also make sure to educate family members on the benefits of living in their reality. Thanks for another great article Commuter!
    vintagemother and TheCommuter like this.
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  3. Visit  Gold_SJ profile page
    2
    In complete agreeance with this, I was taught that not breaking a dementia individuals 'reality bubble' was the most therapeutic for their mental health and feeling of well being. Which I believe to be true, if a lady is nattering on about how she just put all the chickens in their pen and if I knew if she remembered to put the soup ladle out? I don't see any harm with going along with her reality at that point in time. At most it'll make her smile or chat about something else, reorientating would create confusion and self doubt. Why bring that on a person unneeded? There really is no benefit it could bring her that I can see.

    I think there is a difference between going along with a persons perception and lying. To me it's like playing a game with a four year old in imaginery play. We're not (with intent) lying when we're agreeing that the cup of water is quicksand, it's more we're going along with a perception that makes them happy. It encourages happiness, imagination and good memories for the dementia sufferers I think, compared to harsh truths that won't bring about anything but pain and distress.

    Really liked this article, thanks for articulating it so well.
    TheCommuter and decembergrad2011 like this.
  4. Visit  wooh profile page
    5
    Quote from Gold_SJ
    To me it's like playing a game with a four year old in imaginery play. We're not (with intent) lying when we're agreeing that the cup of water is quicksand, it's more we're going along with a perception that makes them happy.
    That's how I think of it as well. I used to have so much fun with my LOLs at the nursing home. Being in "their world" was much nicer than my world, the nursing home.
  5. Visit  brownbook profile page
    1
    I also went to nursing school during the Jurassic. It was drilled into my brain "always orient the patient to time, person, and place."

    This is a different situation, but I will never forget working med/surg and having an alcoholic patient who thought I was someone else and he was somewhere else (I can't remember the details). I spent the whole night trying to reorient him, reminding him of my name, his name, and where he was. It went over like a lead balloon.
    TheCommuter likes this.
  6. Visit  JustKizzy profile page
    0
    Sep 23 by JustKizzy I
    I could have sworn I commented here in Sept. as well, but... this has helped so much I'll do it now I was looking for anything new on this subject as we are still so lost, and it brought me back here... this has been so great for us. I have brought my family around to Therapeutic Lying as it makes their visits SO much less... I dont know, frustrating? Their personalities are still there, and easier to find when you 'pretend'; unfortunately, only some of the caregivers at the center even bother to try. I'm going to cheat and repost my comment from this article on not arguing http://allnurses.com/geriatric-nurse...ia-747317.html ... again; Bless you all. This is so hard.
    I know I'm years late to this discussion, however...
    God bless you all... it takes a very special person to do your job.
    I am not a nurse but, both of my parents are in a LTC facility with severe dementia. This issue of reorientation is very real for me; their health is very good (not even general geriatric issues) and we could conceivably carry on like this for years. The difference in their day-to-day mental health is very obvious depending on who is working their ward that day... reorienting NEVER works, and avoidance only causes more distress. The best caregivers take that extra two minutes to listen and placate and cajole. This is a no restraint facility, so they use drugs that specifically warn of dangers in use in elderly patients... very frustrating. Mom is in a locked ward; Dad is on a short hall (as they don't have a ward for males). The issues of reorientating and not letting them visit each other when family isn't there have caused all sorts of grief. Seems like it would be much easier on all involved to take 10 minutes to let them see each other and have a cup of tea than to argue for 3 hours and purposely avoid letting them have contact. Thank you for this article and all the comments; it is so reassuring and feels like validation!
    On the lighter side;
    They are in their 90's and spend most of their time in the 1940's; Mom was an RN and Dad a pilot in WWII. Mom is redirected with 'charts' of her own to review and 'making rounds' and spends her time comforting other patients... when she's not firing the 'girls' and sending exhausted aides home to rest, or 'lazy' aides off to clean "If you have time to lean, you have time to clean!" Dad often thinks he's in an military hospital, and is only redirected with reminders that he needs to 'recover' in order to return to his wife.
    This is such a sad, sad disease.
    Thank you, again, to all of you who choose to help these patients have some peace, and maintain a wee bit of dignity.
    Just,
    Kizzy.
  7. Visit  newhospicern profile page
    3
    Quote from JustKizzy
    Sep 23 by JustKizzy I
    I could have sworn I commented here in Sept. as well, but... this has helped so much I'll do it now I was looking for anything new on this subject as we are still so lost, and it brought me back here... this has been so great for us. I have brought my family around to Therapeutic Lying as it makes their visits SO much less... I dont know, frustrating? Their personalities are still there, and easier to find when you 'pretend'; unfortunately, only some of the caregivers at the center even bother to try. I'm going to cheat and repost my comment from this article on not arguing http://allnurses.com/geriatric-nurse...ia-747317.html ... again; Bless you all. This is so hard.
    I know I'm years late to this discussion, however...
    God bless you all... it takes a very special person to do your job.
    I am not a nurse but, both of my parents are in a LTC facility with severe dementia. This issue of reorientation is very real for me; their health is very good (not even general geriatric issues) and we could conceivably carry on like this for years. The difference in their day-to-day mental health is very obvious depending on who is working their ward that day... reorienting NEVER works, and avoidance only causes more distress. The best caregivers take that extra two minutes to listen and placate and cajole. This is a no restraint facility, so they use drugs that specifically warn of dangers in use in elderly patients... very frustrating. Mom is in a locked ward; Dad is on a short hall (as they don't have a ward for males). The issues of reorientating and not letting them visit each other when family isn't there have caused all sorts of grief. Seems like it would be much easier on all involved to take 10 minutes to let them see each other and have a cup of tea than to argue for 3 hours and purposely avoid letting them have contact. Thank you for this article and all the comments; it is so reassuring and feels like validation!
    On the lighter side;
    They are in their 90's and spend most of their time in the 1940's; Mom was an RN and Dad a pilot in WWII. Mom is redirected with 'charts' of her own to review and 'making rounds' and spends her time comforting other patients... when she's not firing the 'girls' and sending exhausted aides home to rest, or 'lazy' aides off to clean "If you have time to lean, you have time to clean!" Dad often thinks he's in an military hospital, and is only redirected with reminders that he needs to 'recover' in order to return to his wife.
    This is such a sad, sad disease.
    Thank you, again, to all of you who choose to help these patients have some peace, and maintain a wee bit of dignity.
    Just,
    Kizzy.
    Kizzy- is there no way they can keep your parents together? It's sad that they have them separated!
    vintagemother, NurseQT, and nu rn like this.
  8. Visit  JustKizzy profile page
    6
    Hi newhospicern... It is so sad. However, dementia is an evil host. They also have Sundowner's. That being said, they have to both be on the same page, so to speak, at the same time... or all hell breaks loose. Living in the past as they do, they don't always recognize the other in their old age bodies, and tend to reject any inkling that THAT is who they're looking for. While still at home, Mom would have nights when she refused to go to bed in the same room with 'that man' as it was inappropriate. There are many days when Dad is ready for Mom to 'go back to her house' (when she's talking nonsense and he can't follow) and go looking for his wife. They just don't understand anymore. Evil, I tell you, it's just evil. I cry all the time at the lack of dignity, and the injustice, of it all.
    I like to end on a light note; There are days when they sit and chatter, hugging and kissing, and shine as themselves. They've been married 73 years. Mom can't use colored lipstick anymore (because it ends up all over the place lol) but she still uses her reflection in my father's eyes to apply her lip balm. "Look at me, Bob." "What, dear? Oh.. always, love." <3
  9. Visit  brillohead profile page
    3
    Quote from JustKizzy
    They've been married 73 years. Mom can't use colored lipstick anymore (because it ends up all over the place lol) but she still uses her reflection in my father's eyes to apply her lip balm. "Look at me, Bob." "What, dear? Oh.. always, love." <3
    This is probably one of the sweetest things I've ever heard in my entire life, and I'm a crusty old broad, so that's no small period of time we're talking about!!!
  10. Visit  NurseQT profile page
    1
    I have always used "therapeutic lying" when it comes to my residents with dementia who would only become distraught if I told them them the truth. We had one sweet little lady who was always looking for her husband "Joe", if someone told her that Joe was "gone" it was like she was hearing it for the first time, she would begin to cry inconsolably for a time and then ask the next person if they knew where Joe was.. We learned that Joe had loved to golf and it was easier and kinder to tell her that Joe was out golfing with "the guys" then it was to tell her that Joe had passed away years ago. One nurse even took the time one evening to "call around" looking for Joe. They spent about 15 min by the phone and this nurse made multiple calls and left multiple messages. This resident was calmed by the fact that Joe would get his message and call back soon and she was able to go to bed. Afterwards I asked the nurse who it was that she had actually called, and she said "oh I was calling my home number and leaving the messages on my machine. I know no one is home and could leave messages without anyone answering! I have about 10 messages waiting for me at home now but that's ok!"
    DizzyLizzyNurse likes this.
  11. Visit  pfongk profile page
    2
    We had a resident the other day screaming out for help in the dining room the other day, stating that she was worried about the chicken for dinner and she didn't have enough time to get everything done for dinner in 6 hours. Nothing seemed to be working until I told her that I'd put it in the slow cooker and to just enjoy her lunch and not worry about it. She didn't mention the chicken again.
    NurseQT and DizzyLizzyNurse like this.


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