Gary's Guidance: Using Compassionate Deception for Ensuring the Safety and Well Being of Elders

November 2014

There is some controversy involving whether family members should lie to their aging parents.  When is it OK to lie, or under what circumstances modify the truth or facts?  To withhold or modify information being shared with someone who has Alzheimer’s disease can be therapeutic. Universally, we are taught to tell the truth, but when dealing with a parent with cognitive impairments a “white-lie” may be in order.  For instance, when an older adult with dementia insists on driving when it is known that they are no longer safely driving, one can make arrangements for the car to be serviced/ repaired, but with a plan for the car to be no longer available.  When asked when the car will be ready the question is answered by stating that parts are on back-order and it requires more time.  Using deflection while validating their frustration and concern about not having a car can be therapeutic.

Withholding information can reduce stress or anxiety too.  Telling a parent about family problems such as divorce, sickness, financial losses, or losing a job will only create stress over something that they have no control.  These real life circumstances can be complicated and delicate. It is best to consult with a professional geriatric care manager for guidance and support.  Telling a person with Alzheimer’s that a family member has died will be beyond their capacity to understand and process the loss.  If they are asking to see or talk to the deceased person it may be best to let them know that the person is important to them, but they are not available today.  Doing this validates the valued relationship, and also deflects away from the issue at hand.

In general, it is OK to use deception, deflection and validation in trying to reduce anxiety and protect the person with cognitive impairments caused by Alzheimer’s or another type of dementia.