Understanding how
to support someone living with a Dementia is not always straightforward. As
memories disappear, the way a person experiences the world can shift, and what
feels real to them may not match the present moment. This means we are
sometimes navigating a reality that is different from our own.
This piece shares
an insight into how care teams respond in those moments, focusing on something
known as therapeutic lying, and why it can sometimes be the kindest approach.
Through Pam’s story, we explore what it means to step into someone else’s
reality to help them feel safe, understood and at ease, and why insisting on
the ‘truth’ can sometimes cause unnecessary distress, rather than comfort.
Therapeutic Lies in Practice
A therapeutic lie is a thoughtful, compassionate response
used to reduce anxiety and meet someone in their current reality. If a person
asks for their mother, father or loved one, forgetting that they are no longer
with us, correcting them may re-open grief or make the loss feel as though it
is happening for the first time.
Softly reassuring them that their loved one has popped out to
the shops can provide comfort and emotional safety. Alternatively, gentle
redirection of the conversation, or asking if they would like to go for a walk,
can help them focus on something else and reduce anxiety.
Rather than focusing on factual accuracy, therapeutic lying
is about protecting someone’s emotional world. By not correcting or challenging
their reality, we can reduce feelings of confusion or distress. Instead, we
meet them where they are, offering reassurance and support so they can feel
safe and understood.
Pam, 80 years young and living at Edenmore for just over four
years, has a learning disability and lives with a Dementia. For her, comfort
comes from a place that might surprise others but makes perfect sense within
her world.
Reassurance, connection and touch are deeply important to Pam. She
is soothed by holding hands and becomes anxious if she does not feel close to
someone. When she feels overwhelmed, lying down with her favourite soft toys,
especially Tony the squirrel, helps her settle.
When Pam was very young, she won Tony in a lucky dip, a story
that she shares often with those around her. He has stayed with her ever since,
becoming something she is deeply attached to. To Pam, Tony is not simply a soft
toy, but an incredibly real and important relationship in her life.
For someone living with a Dementia, objects, people or
routines may take on a strong emotional meaning, and these attachments can
bring a sense of reassurance and familiarity.
Tony also plays an important role in supporting Pam’s health.
If she does not feel like eating, the team will offer a little food to Tony
first, which can often encourage her. If she doesn’t want to drink water, they will
try pouring it into her small doll’s tea set and offer it to Tony, which can
also gently prompt her to drink. These routines have been created by the team
and come from their understanding of Pam’s history and what is most important
to her.
When Tony’s stuffing began to come out, and his ears and arms
became worn, there was a concern that losing him could cause Pam real upset.
Clinical Lead Teresa, who enjoys sewing, took him home and carefully stitched
new ears and arms onto him. Tony was returned safely to Pam, restored and
whole, preserving not just a soft toy, but a source of comfort and continuity
in her day-to-day life.
For people who
may not understand how important this relationship is to Pam, it may seem like
the right thing to do to tell her Tony is ‘not real’ and try to correct her
perspective. But by recognising how important Tony is to Pam, and respecting
that her connection to him is a very real relationship in her world, the team
help her to feel safe and secure, rather than causing confusion and upsetting
the way she understands and experiences things around her.
Is it Right to Lie?
There is not always a simple answer when it comes to whether
telling the truth or offering a therapeutic lie is the ‘right’ thing to do. There
are moments that ask us to consider what will best support someone’s wellbeing
and the focus shifts from being right, to being kind.
Therapeutic lies, when used thoughtfully and responsibly, are
acts of care. They allow people like Pam to feel safe, valued and emotionally
held in a world that no longer behaves as it once did - recognising that, in
moments of confusion, Pam’s version of the truth is the one that matters most.
Edenmore Nursing Home provides 24-hour nursing and
residential care, supporting each person to continue living a life that feels
meaningful and true to who they are.
