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Therapeutic Fib

 REGINA D. Posvar LPN,RNA
REGINA D. Posvar LPN,RNA

Q: Dear Ms. Regina, My mum has asked me questions about her dementia and whether she will get better. Dr told me to be honest with her, so we had very good conversations. The doctor told her the truth about her illness. I was told by a caregiver that I should not tell her the truth, that she will be upset. Did I do the right thing?

A: It is always best to start off with the truth to actually see how she will respond. If she is upset with the information you are giving her, then you must decide if stressing her with the answer is the best way to respond to her need. Some people are ok with the information and respond well, others do not. Be a detective with your mum. If she responded well when you told her then it is safe to say you can tell the truth again. The moment she becomes distressed about information, you will address her emotions about it. What is her worry about it? Assure her that she will be safe and she is loved. When you address the emotion behind the question, you are not in a position to lie to her. What happens is she is comforted and forgets the direct question.

Therapeutic fibs have had controversial debates for decades now. When is it right? Is it right?

In a world that stresses truth, the idea of not being completely truthful with a loved one who has been diagnosed with Alzheimer’s disease or other cognitive impairment is understandably discomforting for caregivers.

We have all seen too many times that brutal honesty can lead to distress with someone with Alzheimer’s. Alz.org asked: “If saying you’re going to the doctor leads to resistance, isn’t it OK to say the two of you are going out to lunch and then ‘coincidentally’ stop by the doctor’s office on the way home?”

This report along with many others has labeled this as a creative communication technique and is very effective when dealing with anxiety experienced by someone who has dementia. Many people support this technique while others still struggle with guilt. There are alternatives to the “Therapeutic fibbing” that will fall under the “Creative Communication” such as addressing the emotion behind the question, creative distractions such as reminiscing, or going for a walk.

Whether you use fibs, no response, distraction, or a combination, the important thing is not to lose sight of the reasons these techniques are being used. A person with dementia continually needs support, love and reassurance. By sparing them further anxiety and upset, even for a moment, you are providing them with these gifts.

Caregivers often have stress with these moral challenges within their own selves in responding and caring for their loved ones with dementia. These “creative techniques” will also help reduce their own stress as well as their loved ones. The important thing to remember for caregivers is that we have the ability to step back and think about what our loved one may be stressed about; they do not. We have the ability to help relieve our loved ones from stress, they do not. We also have the ability to learn and change our perspective so that we ourselves can cope with our reality, they do not.

We as caregivers are doing the best we can and we often neglect our own selves. If “Therapeutic Fibbing” is too stressful for you, it is ok to use another method to avoid telling a truth that will put them in more stress. It is also ok to give yourself permission for the “therapeutic fibbing” when you need to. Know that you are doing these things in love and kindness and understand you are an Angel of Love to your loved one. Thank you! 

Senior joke ~ “It’s not forgetting things completely that bothers me – it’s remembering that I’ve forgotten to remember something that drives me mad!!”

I look forward to hearing your questions or suggestions to help share Alzheimer’s Awareness. Next Class is in November.

Send questions to angelsofthewest@outlook.com or call/text to 486-4509

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