With the end-of-year holiday season right around the corner, gatherings with family and friends may become more frequent in the lives of people with dementia and the caregivers who support them. As a dementia caregiver, this may be leaving you with concerns about how your loved one will handle the many anticipated interpersonal physical interactions and conversations. And, vice versa, you may anticipate that your loved one with Alzheimer’s disease or another form of dementia will leave friends and other family members feeling awkward when out-of-context comments are made by the person with dementia.
When is Therapeutic Fibbing Needed?
For example, what should you do if your loved one with dementia asks why her mother (who has long since passed) is not present at the Thanksgiving gathering? Or, what if your loved one with dementia, who no longer has a driver’s license, insists on driving to the holiday party?
When these types of awkward moments happen, your loved one with Alzheimer’s disease or another form of dementia may be experiencing a delusion, hallucination, catastrophic reaction, or simply not be able to comprehend the reality of the situation. As a collection of symptoms related to cognitive decline, dementia blurs the line between perception and reality, bringing with it increased concern, stress, and frustration on the part of the person with the disease.
What is Therapeutic Fibbing for People with Dementia?
Rather than contributing to the anxiety being felt by your loved one with dementia, this is when the practice of therapeutic fibbing can be used. Therapeutic fibbing is agreeing to or saying things that are not true to avoid causing someone distress and to make them feel safe and comforted. It really is the compassionate thing to do according to the experts at St. John’s. “We will not argue with a resident about whether or not he/she recalls a certain memory as there is a strong likelihood that he/she does not remember and being reminded about an event and the lack of memory about it can cause negative feelings,” says Mimi DeVinney, dementia care specialist at St. John’s, about how staff responds to residents in St. John’s Beyond Memory Program.
Mimi does caution that “not arguing” with your loved one with dementia is not the same thing as fibbing or lying and encourages caregivers to use other techniques like redirection as a first course of action. She also says that looking for the unexpressed need, which is often the root cause of the conversation or behavior, can be helpful in determining ways to respond.
It is also understandable that this idea of not being completely truthful with a loved one who has dementia can be disconcerting to caregivers, especially when we live under the societal norm of “honesty is the best policy.” However, research has indicated that the technique of therapeutic fibbing can not only reduce the stress of those with cognitive impairments, it is helpful to reduce caregiver stress as well.
Some Fibbing is Therapeutic
It is helpful to remember that your intention in using therapeutic fibbing is not to deceive your loved one, but rather to help them feel more comfortable, relaxed, and in a supportive environment. By using this technique you are helping to comfort your loved one’s fear about a situation. Imagine the stress and grief your loved one with dementia would experience in having to re-live the death of a spouse or parent over and over again as you explain to him/her that the person is deceased and will not be coming to visit. Meeting your loved one in his/her reality with a statement like, “You will see your mom shortly; she has not arrived yet. Let’s go have breakfast and wait for her to come,” is an example of a therapeutic fib that is appropriate and properly utilized to avoid anxiety in the moment.
As you gather together with family over the holidays, including your loved one with dementia or Alzheimer’s disease is beneficial and important for his/her well-being. Knowing how to handle challenging moments or conversations can help everyone to be better equipped to support people with cognitive impairments.
If you have more questions regarding how to manage the holidays with your loved one with dementia or when it is best to use redirection or therapeutic fibbing, reach out to Ask Mimi.