Validation, honesty, and lying

Discussion in 'ARCHIVE FORUM: Support discussions' started by river_, Dec 12, 2007.

  1. river_

    river_ Registered User

    Oct 15, 2007
    33
    UK
    How honest are you with the person(s) you care for?

    Do you re orientate them often?

    I find there are times it is much easier to go with their reality.

    Resident: "When is my daddy coming back?"

    Me: "Later on, your staying for your dinner, are you hungry?"

    Resident : "oh yes"

    This goes a lot different if another resident intervenes and tells her her dad has been dead for years!

    When I first started caring for people with dementia I was very honest now I am much less honest and feel I am a better carer.
    My aim is to support quality of life and going with their reality keeps them happy in that moment.

    Do you all think this is right?

    As my grans dementia advances I think there will come times when I am not honest with her and may even lie. Does anyone else do this with a loved one?

    My mum will find this very hard cus she feels it is respectful to be honest, like I felt when I started.

    Is there a good reson for avoiding the truth? Like quality of life in the moment?
     
  2. christine_batch

    christine_batch Registered User

    Jul 31, 2007
    3,388
    Buckinghamshire
    A little white lie here and there if it is going to make our loved one more comfortable in their herrendous world, I would do it. Christine
     
  3. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    I use think like that , but after I saw the distress mum gets herself into I change my mind , I would rather like you say

    Yes in those moment , you really learn what a moment is when you live with someone with AZ , so to give them a peace full moment is better then keep giving then a distressful moment with the truth
     
  4. sue38

    sue38 Registered User

    Mar 6, 2007
    10,856
    Wigan, Lancs
    A few weeks ago my Dad asked me to be honest with him and I was. BIG MISTAKE :eek: The scene that followed nearly ended up with all of us in A & E. So I don't lie to him as such, but go along with what he says, prevaricate, change the subject, pretend I don't understand what he's talking about (a ploy he uses when he doesn't want to listen) etc.

    I have no qualms about it, perhaps I should?
     
  5. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,661
    Kent
    My attitude to dementia is, wherever possible, keep the peace.

    The only time I`m honest, even knowing it will cause upset, is when health and safety are at risk. Even then, I know whatever I say will be forgotten as soon as I`ve said it.
     
  6. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,418
    Generally, when confronted with someone who is delusional but does not have dementia, the accepted practice is to try to get that person to accept that their delusions are just that. If you don't do that it can work against a possibly successful resolution. As someone working in the field, you may sometimes come across professionals to feel that that practice applies to everyone, even if they have dementia. The ultimate goal when you have a delusional non-dementia sufferer is to turn that person around so that they can go on and become happy productive members of society. Here's the important point though: someone with dementia, delusional or not, is not going to get better. In many ways, dementia care is palliative care - you try to improve the current situation.

    Frankly, constantly telling someone that their parents are dead, for example, is mental cruelty - why should that person be expected to suffer that grief over and over again? Who benefits from that? The "teller" who feels virtuous that they've told the truth?

    I think that most people come to this realisation slowly and come to terms with it. Normally honest people do find it difficult to lie like this and that understandable. Even when they recognise the need, there may be occasions where, caught unaware, they tell the truth. The people who truly irritate me, though, are those who know and understand the reality of the dementia sufferer but still insist on telling the truth because "they can't lie". Grrr.
     
  7. gigi

    gigi Registered User

    Nov 16, 2007
    7,788
    East Midlands
    It is difficult to lie-but I agree with Jennifer. You have to consider what benefit there will be in telling the truth-especially when it will be forgotten 5mins later. And if the truth causes pain each time then it is cruel. I've learnt this from experience. For weeks I tried to reinforce the truth with my husband that he would never drive again-hoping he would accept that.It did cause him anguish and I now feel bad that I did that to him.He still believes that he will drive again and when he does he will have a new sports car:eek:I've stopped telling the truth. If I can change the subject I do. If I can't I ask him what colour,what sort and where we will go in it. It makes him happy to dream-and we're all entitled to that! The conversation is soon forgotten -until the next time. I just keep thinking it's like a new conversation for him each time.
     
  8. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,661
    Kent
    We`re planning holidays we can never go on.

    My husband also admires parked cars he passes, and tells me which ones he would like, the colour, the engine size and the fact it must have power steering. The insisting on power steering relates to his driving before he gave up. His explanation for the couple of bumps he had, was that the power steering was faulty. Something he has not forgotten.
     
  9. Mameeskye

    Mameeskye Registered User

    Aug 9, 2007
    1,669
    NZ
    This was one of the areas I had disputes with my sibling and his wife about. They felt that you had to re-orientate to reality but this only caused my Mum distress. I took a much softer approach and would in many cases "stretch" the truth and these days, where it calms my Mother, I enter her reality. If her reality is distressing her I try and re-orientate her to my reality gently.

    eg early days when in residential home she did not want to stay. Siblings appraoch "this is your home now and this is where you will stay!" (Upset for weeks by this..as my sibling couldn'tcope!)
    Me: The doctors say that you need a little more help at the moment but when you are well enough you can go home (OK I knew that she would never be well enough but she did not but if she had been she would have been able to go home...therefore no lie) You couldn't do x/y/z for yourself now could you? Mum responds in affirmative and agrees easier in home and everyone is happy.

    It is hard although I have had to tell her my father was dead on a number of occasions as she has been confused by his absence and really upset by this. Often as I told her it calmed her rather than upset her. I tried at all times to be gentle and then use distraction techniques. As for relatives who have been gone much longer she is generally arranging meetings / has seen them so I just go with the flow!

    The home staff agree that the best approach is only to use re-orientation when a resident is upset or endangered by the reality their minds are creating.

    It is kindness not a lie

    Mameeskye
     
  10. gigi

    gigi Registered User

    Nov 16, 2007
    7,788
    East Midlands
    Electric windows and air conditioning are also a must!!:)
     
  11. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    We lies to my dad on a daily basis.

    As Jennifer has so rightly pointed out, usually when someone is delusional, you don't go along with those delusions because it reinforces them and can prolong the illness.

    However, someone with dementia isn't going to get any better - although delusions may resolve themselves or wax and wane over time.

    This is also coupled with their reduced cognitive capacity, which means that they will simply not be able to grasp an idea different to the "groove" their brains have got stuck in. Or even if they do, it will be forgotten, and you're back at the start.

    Arguing, reason, logic are all pointless. Someone with dementia doesn;t have those capacities.

    It;s better for all concerned if you just go along with things, even when they are absurd.

    Dementia can also bring with it behavioral problems, so arguing is much more likely to provoke a catastrophic and possibly even violent response.
     
  12. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,418
    That's an interesting point Nebirorth - I do wonder if many of the people who end up being labeled "violent" or :challenging" end up that way because people either haven't realised that it is valid or don't have the time to enter their reality at least on a limited basis.
     
  13. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    15,975
    Toronto, Canada
    I am definitely an advocate of huge whopping lies, never mind little white fibs. I quickly learned to tell my mother that her parents were fine, same as always (deader than doornails) because a couple of times I told her her mother was dead and this caused floods of tears.

    I agree with Jennifer - telling someone people are dead over & over is mental cruelty. Honesty is a vastly over-rated virtue when it comes to dementia. I always found it impossible to lie to my mother when she was well, so with her dementia I did a lot of lying by omission. Everybody was happy.
     
  14. Lucille

    Lucille Registered User

    Sep 10, 2005
    542
    How true! Yes, I agree - having to lie can be the only way forward to keep the peace. However, I still don't feel comfortable doing it, but then needs must when the devil drives!
     
  15. germain

    germain Registered User

    Jul 7, 2007
    342
    I used to absolutely hate lying- now I don't think twice - just assess very quickly whether the situation calls for a lie because to tell the truth would cause SUCH hurt.

    How could I possibly repeat over and over

    your husband died ten years ago
    your parents died 30 years ago
    your dog died last year
    you'll be here for ever because we can't cope with you any more at home

    If I said any of that that - every single utterance would cause such pain - so I say

    dad's at work at the moment
    your Mum & Dad are on holiday but will be back soon - aren' they lovely for finding you this place to stay while they're away
    we're looking after the dog and he loves our cat
    as soon as you're really well you can go home

    Bitter experience has taught me (and appreciate that this is only my opinion) that the original saint/ pompous ass who said " never tell a lie" must have been such an un-utterably cruel person !
    regards
    germain
     
  16. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    The resurrection of long-deceased loved ones and relatives can be a big problem, because even if you manage to get over the fact that they are dead the chances are it will all be forgotten and you'd have to go through it all again.

    Imagine the horror of experiencing the loss of a loved one not just once, but on a daily or weekly basis.

    And what would be the point?
     
  17. peppa

    peppa Registered User

    Jun 5, 2007
    26
    london
    I'm glad so many people are owning up to not being truthful. We found it really painful over the summer when my mum was in hospital and very delusional for first time and we were told by the psychologist not to go along with it. We took him at his word and did tell my mum her mother died years ago, she got divorced 30 years ago, etc. etc. Often we tried to dodge questions, change the subject, but when someone looks you in the eye and asks whether their mother is still alive it's hard to make the decision about what to say. I think in future I won't spend so much time trying to re-orientate, as you say it is quickly forgotten anyway.

    peppa
     
  18. Taffy

    Taffy Registered User

    Apr 15, 2007
    1,314
    To converse with mum you have to join her world and this involves telling many untruths. I don't have a problem with that at all. Mum's world is her reality and I just find that things usually flow more smoothly if I agree or tell her lies. My only aim is to keep as much peace in her already miserable life. I am fortunate in a way because it is fairly easy to pacify mum and she usually excepts my solution to her problems eg, a couple of days ago mum said to me, I have some bad news (my thoughts...here we go) our mum died and I didn't want to tell you because it would upset you. I said, I'm sorry to hear that, mum said, but there is more bad news, terrible news... the undertaker wont give mum back. I said, done worry I'll get straight on to the boys (her brothers) and they'll sort this out. Mum was happy to accept this. Then she turned to another resident and said, I knew she would sort this out but take no notice of her calling me mum because she is my sister and now mum is dead I'm letting her call me mum so don't tell her the truth. I'm standing there. If my brother was there he would shake his head and walk away and think that I was encouraging her madness.

    The welfare officer at mum's home told me that when she first started in dementia care she found it difficult having to lie to residents and she was told to look upon it as creative thinking.

    I truly can't see the need to unnecessarily upset or antagonize. I wish you well, Regards Taffy.
     
  19. jaws

    jaws Registered User

    May 8, 2007
    27
    I couldn't agree with everyone more. What I try to do is not lie as such but use the conversation to talk about other things. For example, if dad says to me 'I want to go home to see my mom and dad' I say something like 'where do they live?' or 'what's the house like?'. Most of the time this keeps the communication going and he moves on to something else without too much distress. I know different things work for different people but I beleive that the main aim is to reduce his distress and encourage communication while he can still communictae with me eveen if he doesn't really know who I am!. Keep up the good work out there.
    XX
     
  20. Dave W

    Dave W Registered User

    Jul 3, 2005
    268
    Bucks
    Kindness first

    I have to agree with most of the posters here. I do lie to my Mum, because her truth is not reality any longer. I can't make her live in reality, but I can let her live in her truth is she's happy there. And I can change the subject too. Now that she doesn't have to deal with much of daily life anymore, she has less to cope and contend with, so she's calmer, less stressed and happier. I can't begin to imagine how life must feel to her, but I can make it happier and less distressing for her. Personally, I think bringing a degree of comfort into someon's life is more important under the circumstances than being honest with her. (I can't run away from a fairly grisly reality, but I can spare her most of the details.)
     

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