Is it OK to Lie to Your Loved One With Dementia?
For fifty years you've told each other the truth. You've built a relationship based on honesty, trust and respect. Then dementia comes along, and someone suggests that the kindest thing you can do is... to lie.
It's no wonder carers feel guilty.
I remember standing outside Mum's room in the rest home, taking a deep breath before going in. I never quite knew what I'd be walking into or what she'd believe. Generally, she thought Dad was having an affair, and that was why she was 'put' into the rest home. She felt abandoned.
I knew the truth—that she needed care around the clock because of her dementia, and Dad would never have an affair. But I also knew that explaining it usually left her distressed, confused, or upset. So I'd find myself searching for another explanation, one that would help her feel safe and heard.
Every time I did this, there was a little voice in my head saying, "This isn't honest, and I'm being disloyal to Dad." Yet the kindest thing I could do for Mum was to say, "That must feel terrible. I can see you're really sad. What do you think happened?" I hated being in that position.
For many of us, honesty is one of our core values. It's part of who we are and how we've lived our lives. If you've been with your husband or wife for forty or fifty years, you've probably built your relationship on always telling each other the truth. Suddenly, dementia asks you to do something that feels completely at odds with that, and that can be incredibly painful.
The disease changes the rules
One of the hardest things about dementia is that it changes what the brain can understand and therefore how you relate to each other.
When someone can no longer remember information, reason through a situation, or make sense of explanations, repeating the truth doesn't necessarily help. In many ways, the person is now living in a different reality—but it's a reality that feels completely real to them. Telling the truth can mean they experience the same grief, fear, or confusion over and over again. Imagine telling your wife every day that her parents died many years ago, only for her to experience that loss as if she's hearing it for the very first time. Or explaining for the tenth time that she can't drive anymore, only to see the same anger and confusion each time.
In those moments, we have to ask ourselves an important question:
What is my goal?
Once I started asking myself this question, my responses to Mum became much kinder to her. Instead of asking, "What's the truth?" I started asking, "What does Mum need from me right now?"Sometimes the answer was to communicate factual information. Other times it was to reduce distress, help her feel seen, and preserve our relationship.
I wish I could say I got it right every time, but I didn't. There were days when I simply couldn't do it end up and walking back to my car in tears, or furious with myself for not handling it better. Looking back, I realise I was learning. None of us is handed a manual for this, and we're all doing the best we can with an impossible situation.
Your values haven't disappeared
I think one of the reasons carers struggle so much is that it feels like we're abandoning our values. I don't think we are; we're simply being asked to express them differently.
Honesty is a wonderful value, but so are kindness, compassion and love.
Sometimes dementia forces those values into conflict, and there isn't always a perfect answer. Instead, we make the best decision for our loved one in that moment, guided by love rather than by rules.
It's called therapeutic fabrication
There's actually a name for this approach: therapeutic fabrication. It means saying something that isn't literally true to reduce distress or to help someone who can no longer understand reality due to changes in their brain. It can be helpful to know there's a term for it; it helps to release the guilt.
Therapeutic fabrication is about meeting them where they are, stepping into their reality, rather than trying to pull them back into ours. Sometimes that might mean saying, "The doctor wants you to stay here a little longer," instead of explaining that they're now living permanently in residential care. Sometimes it means responding to the emotion rather than correcting the facts. Every situation is different, and there are no hard and fast rules.
Be gentle with yourself
Dementia asks carers to make impossible decisions, and there are days when no option feels completely right. If you've found yourself choosing comfort over complete honesty and then lying awake wondering if you've done the right thing, please know you're not alone.
You're not trying to deceive the person you love. You're trying to care for someone whose brain no longer experiences the world in the same way, and that's one of the hardest acts of love there is.
So if guilt is weighing heavily on you today, I hope you'll offer yourself the same kindness you're trying so hard to offer the person you care for. None of us does this perfectly.
It took me a long time to stop defending Dad and upsetting Mum. But once I did, everything changed. We laughed more, Mum felt heard, and I stopped coming home feeling guilty after every visit.
We simply do the best we can with a disease that asks so much of everyone it touches.
