Honesty is NOT always the best policy. I don’t like to call it a lie or to say I’m withholding the truth. I’m joining my patient in their reality and using fibs or fib-lets. Trying to re-orient a person to place and time can cause unnecessary anxiety and confusion. My 90 year old patient insists on getting up and going to work. I can respond with something simple like, “oh it’s Saturday and there is no work today.” The secret is that it’s really Wednesday. Or I can chastise this request and remind them that they have been retired for thirty years and ask them why didn’t they remember that. The second response can lead to an argument and cause anxiety while my patient processes the information. Accept your loved one for where they are in their minds. Don’t cause stress that can easily be avoided. Some individuals accept fibs better than others so prepare yourself to get creative and come up with a response that is believable for your loved one. Join them in their reality, stop asking them to join you in yours.
I love a good fib-let. A baby fib. If I can keep my patient calm and happy then it’s all worth it. Sometimes families can be uncomfortable with this concept. It feels odd and wrong to lie to your mother, father, or loved one. The fib is not about the lie, it’s about keeping the person calm and not cause unnecessary anxiety. At times it can be simple and other times it can turn into a more elaborate experience. I was prepping to send my patient to the hospital from the clinic, she asked me to call her parents to let them know. This patient was over 90 years old, and I told her I absolutely would. She smiled and thanked me, and that was it. One of my more creative moments involved making a fake pay-stub. My patient refused to eat dinner because she thought her job did not pay her for the week. She was irate and demanded her money. In her mind she was in her twenties and she was not going to let anyone take advantage of her. What did I do? I cut a piece of paper to the size of a check, wrote out, pay to the order of and their name and an amount I guessed would be her salary. She just wanted her pay check and then was happy to have dinner.
Do you feel guilty telling a lie to a loved one in an effort to help them? Do you agree with this approach?
Oh my goodness. You are so clever. I am not sure about the ‘lie’. This next comment may sound weird, but I’d wonder how God would view it. I’m willing to bet, he’d fully understand.
To me, it’s a part of your day. You are not only a nurse, but you have found beautiful, clever ways to interact and use psyche with your very tender patients. You know how to calm them down, and I’m sure their families adore you for it. I wish I could read more of your stories.
Note: I have a first cousin who has Alzheimer’s, but her husband still refers to it as Dementia. She has long past the point of dementia. She is hardly recognizable, cannot talk, walk or do anything for herself. She started showing symptoms of dementia years ago, and she’s only 65 years old.
Keep up the outstanding work.
God will bless you for your tenderness!
My mother was diagnosed 2 years ago, but we suspect she’s had dementia for longer. From the beginning we decided not to correct her on facts, to just go with the direction she takes. It leads to some fairly interesting discussions that we wouldn’t otherwise have, and she’s been open and willing to talk because she’s not been told time after time that she’s said something wrong. It’s hard, especially now that she’s creating stories out of dreams of or mixed up memories that meld into one another, but I feel it’s one of the ways I can support her when so much about this horrible disease is out of our control. Love the idea of your blog!
You’re doing the right thing. Be in her reality.