This is a big topic in the land of dementia. Do we tell them the truth, and risk them being upset, over and over, and over again. You can imagine it, someone with advanced dementia has a close relative who has died, and the family and often religious, cultural and ethical dilemmas that arise.
There tend to be two schools of thought where there is no grey area of understanding.
- Tell them the truth at all costs, which gets them and you upset each time.
- The lieful truth, which is to tell them they are busy, doing something else, working, shopping, cooking, doing the washing….to spare their hurt.
Truth at all costs.
For me, the first option is selfish and serves no purpose whatsoever, unless they are in a position where dementia is not so advanced that they understand, at which point, this dilemma doesn’t actually arise. To tell someone who can’t remember, that their husband, wife, child, mother or father has died, means they hear it fresh each time, and relive that grief each time they are told, as if it’s the first time.
Let’s get something straight. This is cruel, and only benefits the person who is doing the telling. The person with dementia who is so far advanced as to have this upset them each time, does not need to suffer this continuing and relentless distress.
If you cannot get past this due to old-fashioned thinking, morality, ethics or anything else, remember that the person you are telling, no longer lives under those rules. It’s all about quality of life, and quality of life doesn’t involve deliberately choosing to upset someone with raw grief, over and over and over. If you’ve been doing this, please try to change, for the sake of the person you are telling.
The White Lie
The white lie, where it is believed, is the gentlest and best thing we can do for them. If they happily believe that a deceased person is shopping, cleaning or busy, their quality of life is improved. Emotions stay. Memories fade, but emotions stay. If they feel that grief over and over, they will forget the memory, possibly quickly, but that feeling of sadness will stay with them long after they’ve forgotten why they have the sad feelings, but they won’t be able to tell you they are sad.
The Grey Area
In my opinion, and you are welcome to not agree, is where someone is so upset by someone not visiting, that they don’t believe the white lie. They may gain some solace by knowing the truth, up until the time they don’t. As soon as it becomes in the slightest way distressing, upsetting, anger forming or even just a little bit sad, they don’t need to hear it ever again.
Quality of Life
When dementia is advancing, quality of life is the only way forward. If that means suspending our own beliefs to better the life of someone we love and care for, then we should put aside our own emotional beliefs to do the right thing for them. Choosing to hurt someone repeatedly, once you know what it is doing to them, is continuing to reduce their quality of life.
My own mother regularly asks where here mum and dad are. If she was told the truth, she’d be devastated each time, and with a seconds long memory, just how cruel and abusive would that be? They are always busy and I tell her that they’ll pop in soon. She stays happy and contented. That’s what it should all be about. Stages are irrelevant. Tell them what makes them smile.