Why therapeutic fibbing is not actually lying to your loved one who has dementia

By Laura Oldaker, The Gift of Caring

I’m always a sucker for romantic Nicholas Sparks novels, my favorite being, of course, The Notebook.  In the story, (spoiler alert!) The main character reads from his notebook the love story of Noah and Allie, to a fellow female resident of the retirement home he lives in; she, who obviously suffers from dementia, listens intently to this stranger who reads the story to her... later in the narrative, we realize what he is reading is actually their love story, he is Noah and she is Allie.  

Last week in our blog we talked about reminiscence therapy, and the positive effects of using it with our loved ones living with dementia, another technique I recognize being used in this love story is what experts call “therapeutic fibbing” or its actual term, “validation therapy”. 

People who suffer from dementia have their memory affected. The area in the brain where new information is stored is affected and they are typically not able to process what you and I may think is the “real world”; experts recommend the use of this therapy for our loved ones who have transported themselves to another reality. The key here is empathy- placing ourselves in their shoes, and transporting ourselves where our loved one is, helps them feel validated and secured; By going along with their statements, ergo using “white lies” you avoid causing them unnecessary stress and upset that the actual reality may cause them. 

A few years ago I worked with a client who was caring for her mom, Anita. Sarah had promised her mom that she would always be honest with her, so every time Anita would ask where her husband was (Sarah’s Dad had passed away five years prior) Sarah would try to bring her back to reality by saying “Mom, Don’t you remember? Dad died a few years ago” Anita was crushed every single time she would hear that her beloved husband of 57 years had died and would cry and mourn him as if she had just heard this information for the first time… And honestly, because of Anita’s advanced dementia, she was!!!   

Sarah felt bad to lie to her mom because she was trying to keep the promise she had made to her, but after a while, she started using validation therapy, the next time Anita asked about her husband, Sarah’s answer was “he’s at work, but let’s go ahead and plan what to make for dinner for when he gets home” they made a sandwich, sat at the table and ate it, and started to talk about how beautiful the weather was, then they went outside for a short walk and enjoyed some time together… What a difference this made for Sarah and Anita!   

Therapeutic fibbing validates the person we are caring for, and it opens a window for us to connect with our loved ones.  As hard as it may be for us to get used to this at first, you know you are not doing it maliciously! It gets easier, especially when this opens opportunities for us to learn about our loved ones and their experiences they haven’t shared with us! 

I wish real life with this condition was as predictable as are portrayed in some films, like the love story between Noah and Allie. But as family caregivers know, the only thing that is predictable if you are living with dementia (or love someone who does) is that each day will be different; caregiving is hard enough, give yourself permission to be creative when caring for your loved one, especially remember than when the difficult moments come, it’s not them, It’s the disease. And as family caregivers we have an arsenal of tools and techniques we can try, some will work for you and your loved one, some may not. Just keep trying, and enjoy the moments of connection like the ones we see Noah and Allie have, although they may few and far in between, they are totally worth it.