Therapeutic Lying And Distraction – Is It For You?
Last week we defined and explained both therapeutic lying and therapeutic distraction. Both of these strategies have been incredibly important over the years caring for both of my parents, and I have no problem admitting that I use these means of “deception” to maintain the peace and comfort of Mom as she has slipped into severe dementia.
While I do not condone lying or misdirection of information in my real life, this is Crazytown, Boo Boo, and we do what we have to do. My primary functions are to keep Mom safe and calm as she moves through this final state of dementia as calmly and peacefully as I can engineer.
As promised, we continue the conversation this week with the various types of lies and distractions I have employed with both of my parents in my position as Mayor.
Medical Information Is So Technical
So, I think my first few therapeutic lies were medical, if I remember correctly. “What did the doctor say, Pat?” was the first question I remember answering inaccurately.
I was absolutely going to share the information with my parents, but I needed time to process the words of the doctor, and get some research done. I needed the answers before I could field the question. Things were really perilous when Pop had the kidney cancer, and the doctor called me into his office without my parents one day. His advice was to call my siblings home, because the surgery was quite dangerous considering Pop’s other health issues at the time. I asked a lot of questions, and ultimately did inform my siblings about the doctor’s advice. I never, however, told my parents about that private meeting.
Now, I don’t know if that was lying, a distraction, or just being shady, but they didn’t need to be burdened with that information. Pop came through the surgery quite well, but it stands out as the turning point in my position from part-time to full-time Mayor.
Over the last years of Pop’s life, and the past three years with Mom, I’ve completely taken over everything medical for them. Frankly, they lost interest in the constant tests and prescription changes, and fancy words about diseases and problems that just didn’t seem all that important to them anymore.
I absolutely never lie to Mom about medical facts, but I don’t share anything that she won’t treat anyway.
That Person Is Dead
This is one of the common dementia symptoms in the moderate stage that has gotten more frequent in the severe stage for Mom. She asks me every single visit about one or two dead people. It is always her mom (Nanny) and my dad (Pop). It’s either one or both of them that she wants. Even worse, she is most commonly angry because they haven’t been to visit her. I can always answer her first question completely honestly, because it is always “Have you seen _____?”. That’s a hard, fast and honest “Nope”.
Unfortunately, there are always follow up questions, and that is where the therapeutic distraction kicks in right away. She will press the issue, asking why they haven’t come to see her, or why they are lying to her about where they are. She tells me about their last visit, and what they said that upset her.
Why would I upset her and tell her they are dead? What, exactly, would that do to improve her day or her current mental position? In my opinion, the truth is cruel in this situation. One thing I never am is cruel.
They Are Home
Here is number two on the recurring hit parade that is Mom’s reality. “When can I go home?” or “This isn’t my home!”. One time, I walked in and she had packed all of her personal pictures into the seat of her walker because this wasn’t her house and she didn’t want all of her pictures in somebody else’s house. This was a problem, because it is those pictures that have the best chance in grounding her in reality, so she needs them up at all times to help her stay with the present.
Convincing her that the facility is her “home” is not always easy, and I find myself promising to take her someplace else very soon to calm her down.
The Gift Of Redirection
This is truly the heart of the matter to me, and the way that I keep the peace while balancing my ethics and morals in Mom’s dementia existence. I have become a master at redirection, sleight of hand, and verbal magic to keep her on an even keel most of the time.
I’ve got an answer for everything.
Not a shock to anyone who knows me.
No matter what fantasy or delusion she might have, I can spin it on its side and bring it back into focus for her in a way that isn’t scary or disrespectful. This is the true beauty of therapeutic distraction, and if you can master this skill, your trip through Crazytown while be much more pleasant.
A word of warning:
This doesn’t always work for people, and it literally will not always work. As I mentioned last week, it never worked on my mother in law, and my sister in laws literally just had to ride out the delusional storm holding on to their rowboat. Even with Mom, it doesn’t always work.
And if it doesn’t work. She. Gets. Mad.
I’m fortunate it’s still working fairly predictably in severe dementia, so I use redirection as often as I possibly can. When she asks about people, I ask her to repeat her favorite story about that person. When she asks about going home, I ask pointed questions about the different places she lived as a child. Complaints about the food lead to talking about favorite recipes, and questions about visiting people lead to conversations about past cruises.
I’ve got a redirection question for every occasion.
It is the single greatest weapon I have in my arsenal right now, and I hope it lasts for a long, long time.
“Stepping into the lie…”
I use this method, too! It doesn’t involve me lying at all, but it totally requires some playacting distraction that you might enjoy even less. This is that situation from last week when Mom cast me as a slut in a bar in the Old West. I just lean into the story. In my experience, Mom and I being in the genre of whatever TCM movie is playing is quite common, and we’ve been in Gone with the Wind and The Titanic over the last month. It doesn’t hurt anybody, and it can be really, really interesting depending on the fantasy world Mom is in.
Sweet Husband and his siblings used this method quite extensively with Eleanor, trying to help her keep calm and not panic over the terrifying delusions she suffered. Sweet Husband would hold her hand while they stood on the edge of the cliff, for example, just so she wouldn’t be alone in her fears.
Stepping into the lie might be a great way for you to continue a conversation with your loved one when you can’t jar them out of their fantasy or hallucination. Try it next time they are enjoying a field trip someplace else.
The Morals And Ethics Of It
This is a simple and short section.
- For medical professionals – They are professionally bound to give accurate information. BUT, with the proper paperwork, they can give The Mayor the information, and you can share it on your own terms and time.
- For The Mayor – You built this city, and you can govern as you see fit. You just have to sleep nights. Do what is right for you and your loved ones.
- For anybody else – I help my relatives with how to use therapeutic redirection and lying, so they can enjoy a peaceful and relaxing visit with Mom. If they aren’t comfortable with it, it will be a much more difficult and shorter visit. They can do as they please.
My Final Word
Regular readers won’t be shocked when I tell you to do what you think is best. Applications for Mayor are few and far between, so you need to do whatever you think is best for your loved one, and that decision can change depending on the situation. I keep most medical stuff from Mom, but rush to share good news about her grandchildren even if she doesn’t understand it. Whether that counts as a distraction or not, I don’t know.
I don’t judge how anybody does The Job. Find your own path, and walk it with pride. You’re doing an incredible job.
And if people judge me for ending every visit with “I’ll see you tomorrow” instead of a true timeline of my plans, that’s their problem.
THANK YOU FOR READING THIS FAR
Wow! You made it! Thank you for reading about therapeutic lying and distraction!
Hey, since you’re here! You may as well check out Part 1, here, or if you’ve read that, check out more dementia problems, here! Or maybe you want to hear more about Pop, here. Or, check out our other topics here! Either way, I appreciate you!
Please leave a COMMENT about any tips you may have!! Or comment with YOUR story! Any dementia stories? Let me know!
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Resources
https://www.caregiver.org/resource/ten-real-life-strategies-dementia-caregiving/
https://www.aplaceformom.com/caregiver-resources/articles/dementia-behaviors
https://www.pavilionhealthtoday.com/gm/is-there-a-place-for-therapeutic-lying-in-dementia-care/
https://www.alzheimers.org.uk/blog/lying-to-someone-with-dementia