Choosing Kindness Over Truth in Dementia Care: A Caregiver’s Dilemma
One of the most controversial topics in dementia care is lying—or as I prefer to call it, choosing kindness over truth. You’ve probably heard both sides of the argument: some people think it’s acceptable, while others—often with strong religious beliefs—adamantly oppose it. It’s drilled into us from a young age, whether through religious teachings or just the idea of being a “good” human, that lying is wrong. But today, I want to unpack this through the lens of caregiving for someone with dementia. Before jumping to conclusions, hear me out. This isn’t about deceiving for selfish reasons but about making caregiving smoother and, more importantly, kinder.
The Traditional Notion of Lying
When we think about lying in a traditional sense, it usually involves deceiving someone for personal gain, with little regard for the other person’s well-being. It’s selfish, and let’s be honest—it feels wrong. But what if I told you that in dementia caregiving, what some might call lying is more about reducing stress and anxiety for the person with dementia?
Rather than lying for self-interest, you’re aiming to protect them from unnecessary distress. Stick with me for a moment. I know this sounds like a stretch, but let’s dive deeper into the world of dementia and see why sometimes kindness takes precedence over cold, hard truth.
Living in a Different Reality
When caring for someone with dementia, we quickly learn they often live in a reality very different from ours. Take, for example, visual hallucinations. Imagine your loved one sees a stranger standing in their home, someone you know for sure isn’t there. If you immediately say, “No one is there!” you’re telling the truth—but to them, that’s not reality. In their brain, they literally see someone, and by denying it, you’re creating confusion, mistrust, and possibly more distress.
Who’s lying in this scenario? Is it you because they see someone you don’t? Or are they lying because you know the truth? This is where dementia caregiving gets tricky. The reality they experience often doesn’t match ours, and insisting on our version of truth can create unnecessary tension.
Joining Their World
What if, instead of correcting them, you joined their world? Yes, it might look like lying to an outsider, but it’s a much kinder approach. For instance, if they believe there’s someone in the room, you could say, “Let me take care of it, don’t worry.” You guide them away from the perceived threat, offer comfort, and solve the situation without confrontation.
To an onlooker, this might seem dishonest, but in dementia care, you’re simply easing their anxiety and joining them in their reality. It’s not about deceiving; it’s about showing compassion. The truth, in this case, does more harm than good.
The Kindness Approach: Example #1
Let me give you a more common example. Suppose your loved one with dementia asks repeatedly for someone who has passed away. Each time you tell them the person has died, they react as if they’re hearing the tragic news for the first time. They grieve. Over and over again.
Would you consider this loving or kind? Or would it be more compassionate to say, “I’m not sure where they are, but let’s look at some photos of them”? You shift the conversation, maybe sparking memories or starting a new topic. You avoid the constant grief spiral without directly lying about the death. You don’t need to hit them with the harsh truth every time. This method, in my opinion, is choosing kindness over truth.
Why People Struggle with Lying
When people struggle with the concept of lying in dementia care, it’s often because they haven’t fully considered the different reality the person with dementia is living in. They’re holding onto the traditional sense of truth-telling, which is understandable. But once you realize that your goal is to relieve anxiety and distress, rather than deceive, the concept of “lying” begins to shift.
Think about it: what’s more important—the technical accuracy of your words, or the comfort and peace of your loved one? In most cases, the kindest thing we can do is alleviate their distress, even if that means stepping away from the full, unvarnished truth.
The Kindness Approach: Example #2
Imagine another scenario: your loved one believes someone is coming over to visit. There’s no visit planned, but they’re anxious, pacing around, waiting. Instead of insisting, “No one is coming,” which might make them frustrated or upset, you can say, “Let’s get everything ready just in case.” You help them prepare, maybe setting out some chairs or tidying up. Then, you gently redirect their attention to something else—maybe suggest watching a favorite show while you wait. Eventually, the anxiety fades, and they’ve forgotten about the visit.
Did you lie? Technically, yes. But what’s more important is that you’ve diffused the situation with kindness, sparing them unnecessary distress.
Why Truth Isn’t Always the Most Loving Approach
Sometimes the truth, no matter how accurate, is simply cruel. This is especially true in dementia care. People with dementia are often vulnerable, living in a state of confusion, fear, and disorientation. So when the truth causes more harm than good, is it really the most ethical choice?
I don’t think that when we were growing up, learning that lying is bad, anyone was thinking about people with dementia—people whose brains no longer process reality the way ours do. Trying to force them to understand or accept our version of the truth only leads to more distress, and often, more difficult caregiving situations.
No One Right Way
Now, I want to be clear: there’s no one right way to approach caregiving. What works for one person might not work for another. But I’ve seen countless caregivers, including members of my Care Course, feel an immense sense of relief when they stop viewing these interactions as lying, and start thinking of them as choosing kindness over truth.
Instead of asking, “What’s the truth?” ask, “What’s the kindest response I can give?” This mindset shift makes a world of difference. Caregiving is hard enough without the added pressure of feeling like you’re doing something wrong by avoiding the full truth.
Your Turn: What’s Your Take?
Careblazer, I hope this perspective helps you. What do you think? Have you tried this approach before? Do you still struggle with feeling like you’re doing something wrong? Or have you been able to work through this over your years as a caregiver?
I’d love to hear from you in the comments. Let’s have an open conversation—there’s no judgment here, and everyone’s experiences are valid. Maybe together, we can help each other navigate this tricky, emotional terrain of dementia caregiving.
Want to watch the in-depth video that inspired this post?
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