What exactly is therapeutic fibbing?

When I first started working with the elderly, there was a practice of being very honest with people with dementia. Brutally honest. If they were calling for their mother, you would ‘reorient’ them and tell them their mother died thirty years ago. Sometimes it would result in the person mourning all over again.

So often in business you hear, “meet your customers where they are.” That is true with people with dementia. They may truly believe that their parents or spouse is still living or that they are still in charge of a large department and supervise many people. Telling them otherwise can devastate them. That is where the reasoning behind the practice of “therapeutic fibbing” came from.

The word “fibbing” is probably accurate. You don’t outright lie, but you don’t tell the whole truth. So, if Lucy has her coat on and tells you she is waiting by the door for her mother to pick her up to buy her new shoes. You would tell her that is exciting that she is getting new shoes, but it is warm in here. Let’s sit down and take your coat off while you wait. Then redirect. “Can we listen to music in the meanwhile?” Lucy will probably forget within a few minutes. If she doesn’t, you might suggest her mother is very busy with errands and will come as soon as she is able. Or Sam may tell you he needs to go help the men on his crew at the business he owned. Tell him you got a call that the job was postponed for today. Ask him if he can help you with something instead.

If you do practice therapeutic fibbing make sure you are being respectful and treating that person like the human being they are. Do not talk in baby talk. Do not patronize and tell them they are sweet when they are confused. Do not say, “What are we doing today Rose?” Simply, acknowledge their situation, do a little therapeutic fibbing, and then redirect.

No one wants to be lied to but forcing someone to relive a painful part of their lives a few times a week is cruel. By using some ‘fibbing’ you are maintaining someone’s dignity as well as sparing them from grief.