Is it ok to lie to help your LO?

ebplionis

Hi everyone,

My mother is not officially diagnosed (still waiting on the neuropsych evaluation) but we all know what is coming, as its been bad for a while, and seems to be getting worse.  She currently has been wandering at night knocking on neighbor's doors looking for my father (she refuses to believe my father is my father), and having terrible delusions especially at night which amplify her paranoia (people screaming at her, people playing terrible tricks on her etc). 

So after much deliberation her doctor prescribed a very low dose of an antipsychotic  to help her with these symptoms and sleep better at night. I know if I tell her its an antipsychotic she will refuse to take it, and she believes she is just fine.   I am thinking of telling her its a sleeping pill because it will help her sleep at night.  

Now, since adulthood, I have never, ever lied to my mother nor do ever lie to anyone else, not even fibs.  We don't even pretend there is a Santa with my children, I feel so strongly about lying.  It is killing me that I feel I have to.  I feel like I am having a moral and spiritual crisis because of it.   I know it is probably the only way to get her to take the medication and she will (hopefully) feel better with it, so its best for her.   

Has anyone else struggled like this?  Do I just need to make peace with myself?

Quilting brings calm

My LO refused to go back to the geriatric psychologist office after the intake visit.  Her PCP is handling things. He prescribed Xanax both to help her sleep and reduce her anxiety.  We have never never told her the name ( although the RAs  or nurse at the ASL might have).  I refer to it as her relaxation medication.  My LO calls it her relaxer medication.  I just do not want to get into the argument or have her outright refuse it. 

Yesterday she asked me if she was losing her mind.  There’s no way I’m answering that truthfully. 

MN Chickadee

Yes, it's ok. It is therapeutic fibbing, and sole purpose is to keep a sick person comfortable and safe. At a certain point a PWD's brain is too compromised for the truth. It is too damaged to process reasoning and logic and fact, so their loved ones find workarounds. It is the kindest approach, as anything else causes anxiety, fear, resentment, and sometimes for them to not even be safe. Telling her a fib to take her medication is you caring for her and doing right by her. I know it's hard to adjust after a lifetime of not lying to your parents, but you will get the hang of it. She isn't safe wandering and she isn't comfortable or happy with the delusions. Do whatever you have to/can to ease her suffering including fibbing about her medication being a vitamin or whatever she might be agreeable to. Some meds can be crushed and hid in pudding or similar, but check with a pharmacist because some absolutely cannot. You will likely find you need to fib about other things eventually. Go along with a delusions if they aren't harmful, don't correct or argue. We often end up fibbing about relatives not being dead because the person can't remember they are gone and grieves the loss over and over again as if it is news. What purpose does it serve? Agree that the grass is blue and the sky is green if it makes her happy. The rules of engagement are completely different with dementia.

zauberflote

If your spiritual and moral reason against lying is Christian, consider how best you may love her. I loved my mother by keeping her calm and content so much as I could. I told some whoppers, but I felt they were the kind of love she needed at that moment. 

I had to go along with her idea that I"had finally married that man I'd been living with" (for 40 years lol) but hadn't invited her to the wedding. I had to apologize all over the place. I think she forgave me right away, and from then on I made sure to refer to him as "my husband Name". Oddly, the kids weren't a problem, although she wanted the babies (30-somethings really) to visit. One did, but I think he was just that nice kid who was cheerful-- because he wasn't a baby!. 

Mint

I struggle with this also.

harshedbuzz

At this point, it is not about you, it is about your mom's comfort and security. It is a kindness to tell her whatever she needs to hear to feel loved, safe and secure. In this instance, kindness trumps "honesty".

That said, if the medication is meant to dial back the delusions and hallucinations that are haunting her nights and allow her to rest, calling an antipsychotic "something to help you sleep" is not a lie.

ebplionis

Thank you for this, its good to hear I am not the only one....wish life thus far could have prepared me better for this...

jfkoc

No Santa? No Tooth Fairy? No Easter Bunny? Lying is going to be especially hard for you but I still urge you to do it. However telling your mother that the Dr wants her to take it to sleep better is not a lie at all. Not even a half truth.

Why? Because telling the truth can cause distress for your mother so that is where your choice lies. There is where your moral dilemma lies.

You alone will decide what to do, I, for one, will stand behind your decision.

GothicGremlin

ebplionis - you aren't the only one.  I struggled (and continue to struggle) with this too. I think most people do.  But I think we need to make peace with it, our good care requires it.  I don't view what you said about the anti-psychotic as a lie - it really is acting as a sleep aid.

I can well imagine the other areas where you may not want to tell the whole truth. Sometimes re-directing the conversation can help.  The other day my sister asked me if she was going to die from Alzheimer's and it kind of took my breath away.  I re-directed.

Stuck in the middle

Sometimes lying is more than OK.  Like when it is cruel to tell the truth.  This appears to be one of those times.

(=Meow=)

I respect your "honesty is the best policy" mentality, and am horrified by some of the responses, there are practical, as well as moral/spiritual aspects, associated with lying to the mentally ill.

My father was a paranoid schizophrenia, family would lie to him all the time, worked hard to keep up the appearances of normality...while we kids were abused. 

Your LO may never become that bad, I bring it up because one of my sister's childhood friend's mother has dementia, and she was  very abusive to her granddaughter.  The solution to that situation was to let mom rot in dementia hell, sounds cruel, but I've lived the alternative. 

Boys end up mean, it's worse for girls, they end up self-destructive, lost a few very good friend that way, still miss them horribly 25 years latter.  No happy ending or justice for them. 

As painful as it may be for the person with dementia, the truth really will set everyone free. 

Jmeidinger

Yes it is okay.  It's not just okay it's necessary. 

I went through the same difficulties you're going through.  It bothered me tremendously to lie to my mother when I first started taking care of her.

But you absolutely have to pick your battles.  And "battling" isn't good for your LO with alzheimers.  That is how I finally gave in and realized I need to do this.  It is not good for your LO with Alzheimers to be in the constant stage of agitation that comes with you telling them the truth.  They are living in another reality.  You will not convince them they do not.  So you have to join them in their reality.  You just do.  You are the one who knows better, not them.

I'll give you an example.  Since mid December my mother became convinced I am her brother.  Recently she told the nurse on her weekly visit it bothers her that I call her mom "because I'm the youngest."   So I have started to call her "Sue."  That's weird and has been hard.  I have to catch myself at times.  But if it causes her less agitation and discomfort to think of me as her brother and for me to BE her brother, then I want to do that for my mom.  Moreover I HAVE to do that for my mom. 

That's only one of dozens of lies I have to live as her caretaker.     

I have watched her spend all day in a state of constant agitation and worry and anger when I try to force reality on her.  That's not helping.  In fact, it's cruel and at some point I started to realize it was tantamount to abuse to cause her so much mental discomfort by telling her the truth. 

My mom only recently went on anti psychotics as well.  I tried my damndest to avoid as many pharmaceuticals as possible.  My wife and I managed to redirect and work with her dementia as long as we could.  But there does come a point where it's unavoidable.  And my reason for doing it is exactly what you're struggling with.  Trying to help her sleep after she started going two days with no sleep up pacing and wandering the house.  *I* need to sleep too.  So I tell her the truth.  It's medication to help her sleep.

Jo C.

This is a situation that many of us find ourselves facing.   It is for me, difficult to lie, I value honesty very highly. I learned the hard way, that when necessary to tell a fiblet to my Loved One,  (LO), it was what was best for her and and not what was "best" for me.  To continue to rigidly stand on my platform was actually a self-indulgent exercise when I looked closely at it.  Her needs were a priority, not mine.  Big difference in that thought process.

The first time I told a fib to my mother, it felt as though the earth would open up and swallow me.  BUT . . . . what an enlightenment!  My fib (done with love) actually helped my mother.  I spared her a lengthy outburst of agitation and anger; I spared her not getting the help she needed.   In fact, my LO was calm, even and accepting.  What a surprise and what a relief to know she was alright and not going to spend hours lashing out and agitated and refusing the med or doctor's visit, etc. because I chose to use blatant truth rather than the loving kindness of a fiblet.

Our LOs have had permanent injury to their brains.  Their judgment, reasoning and logic has been gravely compromised.  No amount of reasoning, arguing or explaining can change that.  
 
 It is NOT about us and satisfying our own internal needs for whatever.  It is about our LO who is "ill."  It is about sustaining them, keeping them safe, avoiding major meltdowns, avoiding refusal for care, refusing meds, etc.; it is about supporting them as best, kindly and as lovingly as we can.

NOTE:  We must enter their world reality as they no longer function within ours.

A friend who is a successful Pastor discussed this with me and being a very experienced person, he also supported the use of therapeutic fibs when necessary as appropriate and kindly loving.

When I saw how very effective this tool was, and how it kept my LO from lengthy agitation, upset, anger, resistance or outright refusal of care needs, and how kind it was, I never hesitated again.  Not used willy-nilly, just as necessary.

An excellent source to read is to go online and Google, "Understanding The Dementia Experience," written by dementia specalist, Jennifer Ghent-Fuller.  It is a marvelous writing re dementia and the why's things are as they are as dementia begins and then advances.

Do move forward in good faith and knowing what you do is done for the best care for your mother.  You are where all of us are or have been, on the learning curve and there is much ongoing learning as we move forward with our LOs.

Do let us know how you are and how things are going, we are all here in support of one another and that includes you too!   Warm thoughts being sent your way from one daughter to another,

J.

windyshores

Therapeutic fiblets are a standard strategy for dealing with dementia.

Several times a day, my mother calls and asks to live with me (she is in assisted living). I tell her I am looking at apartments, and she says she can go to bed happy. Next morning, she forgets and calls again. The bedtime calls are especially effective at reassurance.

She likes her gin and before COVID I used to take her to stores that didn't carry gin, pretend to look for it, exclaim "Oh darn they don't carry it," she would be tired and say let's do it tomorrow. She would forget for a few weeks, rinse and repeat.

Cynbar

I have also struggled with this, and second all the excellent advice you have been given above. Two things have helped me come to terms with it. First, I never like to see my DH pained, or unhappy, or upset. Telling him the truth, like he is never going to drive again, is a gut punch to him every single time. Same thing if I have to tell him his mother died many years ago. It has become clear to me that nothing is gained by upsetting him with "the truth"over and over again, when a fiblet quiets him down. It's all about kindness. The second thing that has helped is realizing I can usually get by it without telling a total untruth. For instance, I tell him his mother is away and can't call, and he usually buys it. I tell him his Zyprexa will help him sleep, and this is also true although of course not the whole truth. You get the idea. It may be splitting hairs, but it has helped me accept what needs to be done for his comfort.

meiam

Alzheimer's has changed your mom's reality and must change your's too.   A strategy called the "Therapudic Fib".

It utilizes a "fib" but it is for the benefit of the patient (and often the caregiver's sanity), However, used as in this strategy it is easier to handle by caregivers that struggle with "lying"

So, in many cases this works.

1 Affirm her feelings,   " I know you don't like medicine"......But (here comes the fib)

2  Fib:  The doctor said this pill will help you rest better

2 redirect patient:   Would you like to take a nice warm shower tonight?

My sister actually believe that my mom will be mad when she finds out about a lie. Of course, my mom can't remember 5 minutes ago, but will obsess about something for hours.  my sister lives 500 miles away. I live with mom 24/7.  I have committed to make mom's last years pleasant.  That makes me know that telling her a fib is justified.  St Peter doesn't take off points for these fibs 

Best of luck

.

philipsmom

I struggled with this, too. The Bible condemns lying. I talked with my pastor and he said that being loving is more important than being truthful. Case in point: right now my mom is obsessed about her parents. She thinks they are alive (died decades ago) and wonders why they don't visit her. I dance around it with "they are busy" or "they can't leave their facility right now" or whatever works in the moment. My dad, on the other hand WILL NOT lie and tells her that they've been dead for years. This makes her go crazy with grief...each time he says it, its like she has to go through the grief over and over each time anew. Then the aides have to deal with her, then they call me and I have to deal with it. I'm trying to teach him therapeutic lying....it's important! and kinder to be loving with a lie than cruel with the truth.

smbren

I totally understand where you are coming from.  

I had difficulty when I first started to fib to my LO (my mom) or withhold certain information.  But the more I learned about the disease, the more I learned it was also best for her for me not to go into all the details when it wasn't needed.  This is especially true for things that would upset her, and for my mom this includes medications and doctors so I minimize the discussions as much as possible. 

I keep conversations brief.  Sentences short.  I try to make sure to convey the main point that is necassary quickly as if you are discussing it at length, or describing over many sentences, or asking it with many run on sentences, your LO is likely to get confused and forget the first thing you said.  So concise and to the point is best.  

For your example, if it was my mother, I would simply leave at this is to help you sleep better as you are getting up an awful lot at night and night getting a good night's sleep.  Let's try it for a week and then we can stop if you don't like it.  

There are many things I do for my mother or on her behalf.  As her medical proxy and her POA, this makes it much easier to do.  

Since one of your pain points is medications, I will recommend the Hero.  Something I have been using since last September to dispense my mom's meds.  It allows my mom the independence she wants to have when it comes to her meds.  But since she can't determine what to take and when properly, it became a problem even when filling the weekly pill boxes.  This device I fill, but she dispenses with the push of a button.  It has truly alleviated this huge pain point for us.  I assume pricing is the same when I started, but it was $30 a month but I am finding it well worth the cost!

And they offer (or did and assume still do) a 30 day money back guarantee. 

Here's a referal code.  I believe this gives you an extra month free
https://herohealth.com/referral/REFUGGT9OTUI?utm_source=hero_mobile_app&utm_medium=refer_a_friend