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Most carers of dementia patients will often have to deal with an ethical and moral dilemma, which is either causing the patient distress by telling the truth, or lying to them.
This occurs often in a situation such as where the person is thoroughly convinced that a family member or friend is still alive, and they want to see them, when they had actually passed away years prior. They can also believe that someone close to them, such as their partner, is deceiving them somehow or is an imposter. They will then sometimes refuse to take prescribed medication to keep them calm.
To avoid distressing the patient further, instead of telling them their loved one is dead, it may be easier for a carer to agree with them or lie to them. Some carers may decide that they won’t lie to a patient as they believe it is wrong, but may consider doing so in certain situations, for instance if the patient’s health is at risk. A carer should know how to respond to situations helpfully and appropriately, especially as the delusions the patients experience can often be complex and distressing, for the carer as well as the individual.
What is known as therapeutic lying is considered to be justifiable when caring for someone who suffers with dementia, for example when someone asks for their partner, not telling them they have passed on. There aren’t any specific guidelines in place for therapeutic lying, though carers and nurses are highly encouraged to be honest and open. Another example of where lying to a patient would be justifiable, is in a situation where the person is so distressed they are likely to become violent if they aren’t already. In this situation lying in an attempt to calm the person can preserve the safety of the carer and prevent the dementia sufferer from becoming even more distressed.
The Alzheimer’s Society doesn’t support therapeutic lying, believing that this approach isn’t flexible or personal. They believe that the behaviour of a patient can actually be used to further determine their needs at a particular time, for example whether they may be in pain or feeling particularly unwell.
What is universally agreed amongst healthcare professionals is that the feelings of the patients should be of paramount importance. At no point should therapeutic lying be used as an easy way out and where possible other approaches should be sought first. Sometimes simple distraction can help to ease situations and having aids such memory books available can help.
Whatever your opinion on the subject, it’s certainly not one that will be going away anytime soon. The number of people with dementia will continue to rise in the coming years as the population ages and care workers find themselves in ever increasing demand. At the moment there are not too many guidelines available which offer best practice advice, a situation that will surely change sooner rather than later.
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