Lying to Dementia Patients

[jamd11]

Hello!

I'm a new nurse and have little experience when it comes to this slippery slope in nursing.

I am wondering.... is it ok to tell a white lie for the comfort of the patient??

Say they are extremely confused, have a short term memory of about 5 minutes and continuously come to the nursing station asking for their mother and father (but they are 90 years old obviously their parents are no longer with us).

I had a bad experience when I was a student in first year. The ethics class told me to never lie so when a patient came to me and asked where he mother was I told her she was no longer alive- lets just say that did not end well. I have read many research articles for and against this and was just looking for some real life experiences in dealing with situations like these!

TIA

[momamma]

Well, actually you have to handle it in a different way. I worked with elderly and mentally ill before and you don't necessarily have to lie. So when the patient asked where her mother was you could say "Well, I haven't seen her around today but if I do I will let her know you're looking for her." That way you don't crush the patient because they truly don't understand and you didn't lie. Plus it gives you an opportunity to redirect them and put their mind on something else. Hope this helps.

[MrChicagoRN, RN]

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.

Redirection works very well.

and when they are asking about their dead spouse/parent etc?

"I haven't seen him, but if I do, (or isn't here now, etc) I'll be sure to let you know right as soon as I see him/her"

It's not a lie, but a statement answered in a way that is acceptable to the patient.

[angikat]

At first it's very difficult to determine what to do, so redirection is the best while being calm and reassuring. However, after you learn your patients you will find some you can reason with. Each individual needs to be approached differently but usually a calm reassuring tone will keep them calm. Some you actually can give the truth to but others you have no choice but to redirect them. I have made it a point to never lie but I will avoid the truth if I need to.

Sent from my iPhone using allnurses. Angi/LPN (?RN)

[NICUlove62]

I am a CNA in a dementia unit. My advice is to go along with what the resident/patient believes to be true. Redirect the resident/patient to refocus energies and keep spirits up. If someone asks about a spouse who is passed away, I usually ask questions about him/her and what his/her career was. You can always lead the questions back towards the anxious resident/patient. I have a resident who was a labor and delivery nurse and she always "sees" babies in her room and believes she needs to care for these babies. I will go to the chair and pick up the (invisible) baby to give to her. She appreciates it and rubs my hand, thinking it is the baby. Do what you can to keep the person with dementia calm and refocus their concern. Often, just having someone to talk to and a hand to hold will lessen the anxiety.

[Ruby Vee, BSN]

This may be an unusual case, but for my demented mother, telling her that her husband is dead makes her happy. She thinks he's out running around with some floozy, and when you tell her he's dead, she's relieved. At least he isn't cheating on her or trying to divorce her. I've told the staff at her NH over and over, but they still tell her "He's not here right now," which makes her go off on a tangent about him cheating. For a long time, she was able to use the telephone and my cell number was on her speed dial. I remember going through the grocery line one time (a LONG line) when my mother called.

Mom asked where Dad was, and WHY wouldn't anyone give her his phone number.

"He's dead, Mom."

"Are you SURE?"

"Yes, Mom. I'm sure. I was there. You were there, too."

"But how do you know he was really dead?"

"I'm a nurse, Mom. I know dead when I see it."

"Oh, I'm so glad. I thought he was cheating on me."

"No, he's not cheating on you Mom."

"Why won't anyone give me your father's phone number?"

"He's dead, Mom. He's been dead for two years."

And around and around. I got a lot of strange looks in that grocery line!

[pfongk]

Just remember not to do what I did when I first started out. I told a resident that had dementia that their mother wasn't with us any-more and they got very upset. After lunch that day, a community nurse comes in with the 105yr old woman that was living at home with minimal help to see her daughter. Lo and behold it was the resident who I told her mother had died. Oops

[pmabraham, BSN, RN]

Good day:

If it helps your moral compass, think if it as role playing where you are playing in their world.

Thank you.