Truth-Telling and Dementia

A New York Times article (among other sources) made reference to telling the truth to someone with dementia (Alzheimer’s)…

…or more to the point, lying to the person if the question would evoke a painful response or memory. Looking for your mother, Johnny? She’s been dead for 20 years!

And worse, the infamous, I just told you that ten minutes ago, tag line which is a back-stabbing, heart-tearing, mean-spirited and usually unintentional indication that the truth-teller is really exhausted with the burden of care-taking.

So, without the I just told you? line, the complicated response to Where’s my mother?? would be hard enough.

Since I opened the geriatric psychiatry program 34 years ago on Veterans Day, I feel that it?s time to come clean.

I lie to people with dementia all day, every day. I form an opinion using objective dementia assessments and a clinician’s intuition developed over thousands of patient contacts. I compare the question in question to the thousands of questions I have answered with lies and then I tell another lie if the truth serves no purpose.

  • Where’s my mother??
    • At the grocery store (safe answer)
  • When will she be back??
    • In 20 minutes (people with dementia lose track of time in ten minutes).
  • When can I go home?”
    • Tomorrow (there’s always tomorrow)
  • Why am I here??
    • To get your strength back. You’ve been sick.
  • You’re lying!
    • Yes, I am. Would you like a cookie?