What is Therapeutic Fibbing in Dementia?

If you’re caring for someone with dementia, you may have heard about therapeutic fibbing. It’s a term that might sound strange at first. After all, aren’t we taught to always tell the truth? But when someone you love is living with dementia, things aren’t always that simple. Let’s dive into what therapeutic fibbing means, why it’s used, and how it can make a difference for you and your loved one.

In simple terms, therapeutic fibbing means telling a small lie or bending the truth to help someone with dementia feel calm, safe, and less confused. It’s not about being deceitful but about offering comfort when the truth would cause distress or anxiety.

Why Use Therapeutic Fibbing?

When someone has dementia, their brain doesn’t process reality the way it used to. They might forget people, events, or even where they are. If you always correct them or insist on telling the absolute truth, it can upset them, cause arguments, or make them feel more confused. Therapeutic fibbing allows you to step into their reality instead of forcing them into ours.

For example, if your mom with dementia keeps asking when her husband is coming home, but he passed away years ago, telling her the truth might only cause her pain. Instead, you could say, “He’s out running errands,” or “He’ll be back later.” This kind response spares her the heartbreak of reliving his death over and over again.

How Does Therapeutic Fibbing Work?

Therapeutic fibbing works because it meets the person with dementia where they are mentally. Dementia often causes people to live in the past or mix up timelines. By agreeing with their version of reality or gently redirecting their attention, you help them feel secure and understood.

Think about it like this: If a child is scared of monsters under the bed, you wouldn’t argue that monsters don’t exist. You’d check under the bed and reassure them that everything is okay. Therapeutic fibbing is similar—it’s about kindness and reducing fear.

What Does The Research Say?

In this study by Andrew Wheaton, the focus is on the ethical challenges nurses face when caring for people with dementia, especially when deciding whether to use therapeutic lies—small, well-intentioned falsehoods meant to prevent unnecessary distress. The research suggests that while nursing codes emphasize honesty, they may not always consider situations where truth-telling could harm the patient.

For example, if a person with dementia repeatedly asks about a deceased loved one, reminding them of the death might cause unnecessary grief. A therapeutic lie, such as saying the loved one is away, could be kinder in such cases. The study highlights that revising nursing codes to allow these lies under strict conditions could help nurses navigate these dilemmas and reduce emotional stress for both patients and caregivers.

Is Therapeutic Fibbing Ethical?

Many caregivers worry that lying to someone they love is wrong. This is a normal concern, but it’s important to remember the intent behind therapeutic fibbing. You’re not lying to deceive or harm; you’re doing it to bring peace and comfort.

Imagine if someone gave you a gift that wasn’t your style. You’d probably still thank them warmly because your goal isn’t to hurt their feelings. Therapeutic fibbing works the same way—it prioritizes kindness over strict honesty.

When Should You Use Therapeutic Fibbing?

Therapeutic fibbing is most useful in situations where telling the truth would cause unnecessary distress. Here are some examples:

• Repetitive Questions: If your loved one keeps asking the same question, giving a truthful answer might confuse or upset them. A simple, reassuring answer can help.
• Delusions: If they believe something that isn’t real, like thinking someone stole their belongings, agreeing lightly or redirecting can be more effective than arguing.
• Past Events: When they talk about people or places from years ago, going along with their memories can be comforting.

Questions You Might Have

Is It Okay to Use This All the Time?

No, therapeutic fibbing is a tool, not a rule. Use it when it makes the situation better. In other cases, you might redirect the conversation or gently guide your loved one back to the present.

How Do I Know What to Say?

It takes practice. Start by listening to what they’re saying and how they feel. If the truth would upset them, think of a kind and simple response that aligns with their reality.

Will Therapeutic Fibbing Work for Everyone?

Not always. Every person with dementia is different. What works for one person might not work for another. The key is to be patient and observe what helps your loved one feel calm and happy.

Practical Examples of Therapeutic Fibbing

• Scenario 1: Your dad keeps asking when he’s going to work, even though he retired years ago. Instead of explaining that he’s retired, you might say, “You don’t have to work today. It’s your day off.”
• Scenario 2: Your mom insists that her parents are coming to visit, even though they’ve passed away. Instead of correcting her, you could say, “That sounds nice. Let’s get ready for them.”

In both cases, the goal isn’t to mislead but to avoid unnecessary stress.

Key Points to Remember

• Therapeutic fibbing helps you step into their reality with kindness.
• It’s about reducing distress, not deceiving.
• Use it when the truth would cause confusion or pain.
• Every person with dementia is unique—what works for one might not work for another.
• Practice listening and responding with compassion.

Thanks for reading. I hope this article helped you understand therapeutic fibbing and how it can make caregiving a little easier. If you have any questions, feel free to comment below.