Therapeutic fibbing..?

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So i'm at clinicals in a LTC building and We had to do some validation therapy. This lady had told us she was crying because she thought her husband was being buried today and she was not able to say goodbye to him. We later learned from the manager that her husband passed years ago and she did in fact say goodbye.

Now my question is..

When she stops crying and stops believing her husband died today, does she realize that she wasn't thinking clearly or does she forget the whole episode or what?

I'm guessing she has dementia of some sort but she did not live in the dementia unit so I was a little confused.

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Specializes in Psych.

The resident more than likely had dementia, and with that comes memory loss. As you work more with the geriatric population you will see this more and more. She probably will forget the episode, although it is hard to know. Those that have dementia often live in the moment, and their moment may be totally different than the one you're in. You will also realize that correcting them does no good, they often become more upset, either with themselves or you for trying to convince them they are wrong. In their mind it is reality. It is very sad, but it is true. Good luck with your clinicals!

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Redirection is often the kinder, less disruptive approach to a situation such as that. Yes, you may in fact be lying to them, but which is worse? A lie that helps them feel better, or the truth which may make the situation escalate. She won't remember it anyway. What she might do is have a happy afternoon instead of an upset one.

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Redirection is often the kinder, less disruptive approach to a situation such as that. Yes, you may in fact be lying to them, but which is worse? A lie that helps them feel better, or the truth which may make the situation escalate. She won't remember it anyway. What she might do is have a happy afternoon instead of an upset one.

Yeah that makes sense i'd rather make them feel better than worse. Thanks

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The resident more than likely had dementia, and with that comes memory loss. As you work more with the geriatric population you will see this more and more. She probably will forget the episode, although it is hard to know. Those that have dementia often live in the moment, and their moment may be totally different than the one you're in. You will also realize that correcting them does no good, they often become more upset, either with themselves or you for trying to convince them they are wrong. In their mind it is reality. It is very sad, but it is true. Good luck with your clinicals!

Do you know how often they have these episodes? like I'm guessing some may have it a couple times a day or do they have it like once a day or once every few hours? I'm also guessing it depends on the severity of their condition?

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Specializes in Psych.

I think it depends on the severity of their situation, and the individual. They probably have these episodes several times a day, or that may be their norm.

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My mother had dementia and she would usually ask me every 3 months "Where is my husband?" I would then tell her he died and she would always ask "Why didn't anyone tell me he died?". Of course, the reality is that she attended his Memorial service. She didn't get upset when she was told that he had died. If she would have been upset about it, I would have lied and said "He is out of town right now visiting relatives."

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Specializes in Gerontology, Med surg, Home Health.

I am an honest straightforward person when dealing with staff and families. But I don't see the harm in telling lies if it is going to spare a resident with dementia from feeling horrible. We've done all sorts of things from telling the woman who was waiting for her father to pick her up that he called and is coming after dinner to pretending to be the secretary of a woman's husband to let her know he was running late to calling my phone and getting an 'answering machine' and leaving a message. I've been a cousin, a daughter, a wife, and (my personal favorite) a member of the French Resistance to ease the mind of a demented resident.

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Specializes in geriatrics,wound care,hospice.

Research validation. The core of this very humanistic approach to cognitive impairment(acute or chronic) is to accept an invitation into someone else's heart and mind for awhile. Accept that this person is frightened,angry,in despair,lonely,lost,searching,and they are looking to you for some assistance in reorganizing their thoughts. Instead of focusing on particulars"you're husband's dead,you're children are grown,you live here now...",affirm the emotion they're expressing"you must miss him,tell me about all those kids,what was your house like..."while attempting to redirect physical energy-keep walking with them(if searching or pacing),sit them down with you if they keep coming to you(you may remind them of someone,or just have good energy!). Sometimes the driver is physical-pain,elimination,hypoxia,infection. A LONG time ago we used to do something called"REALITY ORIENTATION'-yeah,just as it looks-too rigid,truth based,one size of REAL for everyone. Validation feels so much better now. Redirection is less about lying than it is about getting them off an unfamiliar path they've wandered onto,and back to a more familiar place.

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Specializes in LTC, Memory loss, PDN.

memory loss et related processes progress over long periods

most memory or cognitive patients don't live in special units

most memory units require a fairly high level of physical functioning

redirection. as said above, is much more humane than to have a

patient re live a traumatic loss over and over

fairly new out of school, i struggled with fibbing to patient's

about medication

one of my patient's was the administrator's family member

the pt. would refuse medication, but accept "vitamins"

so we were supposed to say "these are your vitamins"

i told the admin, who was also a RN with many years clinical experience

that i didn't feel comfortable with that

the admin told me, that she understood my need to be honest with

the patient and would not require me to say vitamins, but she

wanted me to think about two things

was the patient able to make an informed decision? and

what would i do if it was my family member?

i started giving vitamins

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