Lying to Dementia Patients

chrisrn24 · Nov 21, 2013

It's called therapeutic lying.

Now if your patient is alert and oriented its cruel to lie. But for most dementia patients it's not cruel, in fact it's better IMO than reorienting.

I could not remind a patient that her husband was dead every shift I work. I just say things like "your husband is down the hall in your room, we will go see him later." The resident always forgets within minutes.

TSgtRodrigues, BSN, RN · Nov 21, 2013

If your patient has Dimentia you are supposed to go with "their truth." If they are not lucid and their truth is that their mom & dad are alive, then you agree with that. In the case of Dimentia patients, telling them their parents are dead would be "lying" because "their truth" is that their parents are alive & well!

loriangel14, RN · Nov 21, 2013

It's much more effective to redirect without upsetting the patient. I have one that is always asking if I have seen his Mom and Dad. I always say "no I haven't but if I do I will send them your way". Sometimes it easier to just let them be their own world than to try and reorient them every 5 minutes. If they don't remember that soemone is no longer alive it's only upsetting to them to hear it.

amoLucia · Nov 22, 2013

It's much more effective to redirect without upsetting the patient. I have one that is always asking if I have seen his Mom and Dad. I always say "no I haven't but if I do I will send them your way". Sometimes it easier to just let them be their own world than to try and reorient them every 5 minutes. If they don't remember that soemone is no longer alive it's only upsetting to them to hear it.

This is exactly as I have responded to demented pts. I consider it 'therapeutic fibbing' as someone else posted it here on AN. I'm really NOT lying.

The blunt truth hurts these pts which no one wants to do. Their very short term memory requires repetition and redirection is often difficult if they are distraught. So a gentle therapeutic fib is the more desirable approach for me.

One thing - I do like to see this addressed in care plans & care conferences so all staff are on board and they can feel more accepting of this approach as some staff (esp newbies like you) have concerns with this approach.

cardiacfreak, ADN · Nov 22, 2013

Why would you try to redirect them every 5-10 minutes, it is much more hurtful to them and IMO is more cruel than telling a therapeutic lie. I love that phrase by the way.

Bbo.W · Nov 23, 2013

Is it lying if they don't remember 5 minutes later? ???? No. So give them a good night, tuck them in, and earnestly promise to send X family member around to see them in the morning. Reorientation is cruel.

K+MgSO4, BSN · Dec 8, 2013

Option 1 you tell the truth. Result, an upset pt who may try to run off, hit you or who spends the next 6 hrs wailing. Remember when you were a child and you started to cry, you may of forgotten what upset you but continued to cry. Same for this pt.

Option 2 you lie. Result the pt continues along their day. Mum has gone to the shops, picking your brother up from sport practice, hanging out washing. Then I will turn the conversation to something else, do you want a drink? Play a game of cards? Can you lay the table?

Here.I.Stand, BSN, RN · Dec 8, 2013

I remember being 18, taking my CNA class, and learning about reality orientation. I started working in our local LTC right after I finished high school. The staff overall were good, but this was NOT a homelike facility. We're talking painted cinder block walls--bright glaring white in the hallways; lime green, powder blue, or salmon in the rooms.

We had one resident who had been a farmer, a delightful man, and completely confused. He woke up at 4:30 every a.m. because it was time to milk the cows. He wasn't distressed, just matter of fact that it was time to milk the cows.

I remember knowing what my CNA book taught, but thinking "What good will it do this man to remind him that after a life of rural WI farming, he's now in a nursing home w/ cinder block walls, sharing a room w/ a man who's just as confused as he is?"

I told him he'd milked the cows for years, his sons have it taken care of, and he can go back to sleep.

TiffRN82 · Dec 8, 2013

My view is, if every time they asked about their loved ones that have passed, we told them they were no longer living would be like the fresh trauma of loosing the loved one every single time.

skylark, BSN, RN · Dec 16, 2013

I usually just redirect.

So they ask for mom or dad.

How many times have I heard the "When is mommy coming to collect me?" question!!

I ask them where we are.

We talk about the local area, how long they lived here, where their house is/was

We talk about the weather, and take a look out the window for landmarks that they recognize.

We'll talk about the time of day, the next meal, the season, etc.

I have no research basis for this, but its been my experience that if they are comfortable being oriented to place and approximate time, then the 'person' questions tend to go away.

Sometimes its difficult because their answers are half truth and half disoriented.

Just today an elderly lady told me that she was 'eighty - something', but that her son was ten and her husband left her 'on this train' and she missed the station where she was supposed to get off.

And another asked me "What time will be it be eight o'clock?"

Penholder · Apr 2, 2014

I work with this everyday.

Dementia patients are not in our reality. They are in their own. Our job is to be able to make them comfortable where they are while maintaining quality of life and a normal routine.

I get asked "When am I leaving", "Where is the bus", "Where is my husband/wife" every night. I meet them where they are at. Often I ask the patients how old they are to understand their thought process more.