About the ‘therapeutic lie’

I was a spectacular liar when I was a kid. I wrote on the couch with a black pen and blamed my little brother. I splashed on gallons of my mom’s Ambush perfume one day, and then denied that I had done so even when I could tell that I reeked of the heavy scent. Everyone I knew was born nearby in Boston, including me, and that seemed so pedestrian, so I told all my neighborhood friends one November that I was actually from Baltimore and would be flying there for Thanksgiving to spend the holiday with my aunt. Little did I know that a neighbor would call my parents to say that she had a relative who worked for Eastern Airlines and I could get a discount on my flight to Baltimore. My parents were livid that I would make up such a story.
It is ironic, therefore, that in my work here at Live Oak Adult Day Services I am often called upon to tell what is called a “therapeutic lie.” The concept is well known to caregivers and professionals who interact with those who have Alzheimer’s Disease and other dementia issues. Basically, one does not argue with a person who has dementia if, for example, he or she insists that their mom is coming over, even though the mom actually passed away 40 years ago. Explaining that she died long ago can result in heartbreaking grief and anxiety for someone who is unable to clearly process the information. Since individuals with dementia often repeat themselves, the caregiver or professional would be telling them over and over again each day about the mother’s death. It feels cruel and it serves no good purpose. Instead of explaining or arguing, it is more reassuring to say, “Sure, but while we’re waiting for her, let’s make some coffee.” The outcome is usually a smile at the thought of doing something enjoyable, and they are distracted from worrying about Mom.
Seniors who have dementia can wander at times, especially in the afternoon or early evening, a phenomenon referred to as “sundowning.” It makes no sense to ask the individual where they are going, because they usually do not know the answer. The question causes anxiety and stress. You might see a staff member here casually walk beside a wandering senior, saying, “Oh good, I was heading that way, too, to get a drink of water. Are you as thirsty as I am?” A therapeutic lie in action. Then the staff member will start a conversation on any topic that comes to mind, to distract the person from aimless wandering.
Caregiving family members sometimes feel guilty engaging in therapeutic lies, especially if they are dealing with a parent. The thought of lying to one’s parents gives pause to many people. I remember a son who was so frustrated explaining to his mom over and over that the grandkids had grown up and moved away, so she could not visit them today. With encouragement he started telling her that he had just called them and they were looking forward to seeing her, too. The answer satisfied her, and the son was relieved of his fruitless explanations. He still felt a bit guilty that he hadn’t actually called the grandkids, but his mom’s relative calm made all the difference. “As long as she isn’t obsessing and upsetting herself for no reason, I can see the value of a little white lie,” he finally admitted.
Caregiving is stressful and rewarding and challenging. Each day is different. What works one day may not work the next. If an occasional therapeutic lie smooths over anxiety and wandering, it can be of such help to tired, but loving families.
Cheryl Huguenor is the program director at Live Oak Adult Day Services, 651 W. Sixth St. #2, Gilroy.  For more information about Live Oak call (408) 847-5491 or go to liveoakadultdaycare.org.