Fiblets causing problems later
I have read discussions of fiblets here and elsewhere, defined to be "an untold truth told to a person with dementia to make him feel better" or to make a PWD " is relieved and reassured"
Do you see a fiblet causing problems later? Let's say a PWD and I mutually knows a person, who has a terminal disease the PWD is not aware of. When asked about this person, I can fib: "I just spoke with him, and he's doing fine!" If I told the truth, the PWD will be upset.
But what about later on, these lies can start to pile up, and if my mutual friend is hospitalized or even dies, and the PWD wants to visit the person or asks about him, I guess the only thing to do is to continue with the fib, or find an excuse not to visit together. ("he's on a long-trip, so we can't go").
I think that a PWD will not remember the prior fib, so I don't need to worry about making sure the story is consistent, but if anyone has good experience or resources with fibbing, please let me know.
Comments
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Yes the sad truth is, by the time we are telling fiblets, most of our LO's are to the point that they won't remember the discussion anyway. My partner asked me today why she was "here," meaning in MC, and it has consistently worked to tell her she is there to get physical therapy on her back. She has no sense of time therefore doesn't realize the irrationality of it. But it feels to her like a sensible explanation. Hard to understand why it works, but it does.
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Thanks for your answer. I keep trying to seek some rational explanation or behavior, but like you said, I need to just make our LOs more relieved, and that's all I can do.
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I have had both good an bad experiences with fiblets. It is always a judgement call, especially around stages 3-5. If it is a fiblet that you need to use often it is best to be consistent, and to let family know what fiblet you are using for the really frequent ones. For example, my LO had a sister she loved dearly, who passed about 20 years before her memory started failing. When she started thinking her sister was alive, but not calling her because she was angry, it was too cruel to keep telling her her sister had passed. So we sent the sister on a month long trip to visit grandchildren, and let everyone know to give that answer. Other fiblets are one time, and do not have to be consistent. An explanation for something they are worried about-That noise? oh it is just ----. There are fiblets to comfort and fiblets to persuade. Even with a few bad experiences, I could not have coped without fiblets.
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In the early days I had to help my MIL acknowledge difficult truths about her disease. Other well-meaning friends and family thought they were being helpful when they said things like “forgetting is just part of getting older” and “I lose my keys all the time, too” . So MIL started depending on me to tell her what was true. I think a lot of us share this experience. it makes it even harder to transition from truth-teller to fiblet-master. But both are essential roles for us as this disease progresses
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I agree with the other posts. Some things need truth - 'you need to take your meds because it may be keeping you from having another stroke.' We omit the part that it is keeping the dementias more stable for now. But also as what forbarbara has said - fiblets are essential. We have told fiblets both for MIL's well-being, but also to basically keep the peace... but actually, maybe that is also part of well-being as to keep the agitation at bay.
and seeking rational - probably won't happen. We find ourselves attempting the rational at times, just human nature. Yet we know it is like trying to reason with a cat.
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I'm sorry but I do not agree with any of the "fiblet" stuff.
Over 60 years of marriage we've never fiblet and not going to start now. Maybe some pretty good whoppers though.
My wife is in late stages and she knows she has dementia and memory issues. Her younger brother and sister have passed years ago and if she asks I tell her they have passed and she's ok with that, forgets about the entire conversation within minutes. Whether you tell them the truth or not makes no difference, they're going to forget it in a short time. When she asks about all the meds she takes I tell her they are to help with her memory and spine stenosis. When I do her nails I show her how to use an emery board and she comes out and says she does not know how to do that. Never have to remember what I fibbed about. Truth may be hard for some to tell. Once you start with a lie you have to remember what you said.
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I think it depends on the LO with dementia. Many are better off, along with their caregivers, with well placed fiblets. As we accept and adjust to our LOs reality so does our caregiving. There’s no fixed answer. If saying the truth works, great! If a fiblet allows for some peace and comfort to one or all, great! Some things work, some do not. Kind of like parenting, sometimes you adjust your manner depending on the child. Wish there were strategies that were fool proof for all yet that’s just not the case. You dementia warriors are all doing your very best, I’m cheering every single one of you on and I’ve got Pom poms. Gooooooo team!
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Hi Cosmic - That is ok that the no-fiblets works for you. My mom also knows she has dementia, and knows that she is lacking in capacity. We don't need to use the fiblets for her, either. But there is an enormously, huge difference in the way my MIL sees the world, now, and the way my mom sees the world. We don't need to remember exactly what we have said with MIL, as she doesn't remember it, anyway. There is a difference in an outright lie to a friend, or family member, or even a co-worker. If we need to tell MIL something, or go along with something, in order to keep her more calm, then we call them fiblets, and we go with the flow. I do not feel bad about that.
One example - driving. My mom actually took herself off the road. She knew there was something wrong, and that she shouldn't be driving. MIL perception was that there is 'nothing wrong and why shouldn't she drive!??' She had gotten lost once. After we took her off the road, we found out it was several times, and then she finally admitted she came to an intersection and forgot what to do. She is used to not driving, now, which is great, but for a bit there, we had to tell her the car was incapacitated. At first, we had simply told her "you can no longer drive because it isn't safe". She would not only get totally depressed, but also would pitch a fit and lash out at anybody who was close. "The car is incapacitated and we are waiting on a part" - this was fully accepted and she was fine with that explanation. I say that is much kinder than telling her 'you can't!', as she couldn't accept that. mom knows, and can accept. MIL has anosognosia, and cannot accept. To her, nothing is wrong.
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Certainly does depend on one's LOs status and capabilities and we do what is kindest in the best interests for our LOs after they can no longer use reasoning and logic. We do what is kind even if our LO has no memory recall or retention.
I do remember one Member from some time ago. He insisted that NEVER would a fib be told despite his LO not being able to retain information as he personally highly valued honesty and truth and would not deviate from that.
So . . . when his wife would ask about her mother; each time she was informed that her mother was dead rather than being on a trip, etc. This caused his wife to become severely upset breaking down into sobs and being inconsolable. Next time she asked; he used his own inflexible position and told her the truth again and again and again and again; He seemed to be unable to understand how devastating this was for his compromised wife; he had his personal belief no matter what the end result and he stuck to it.
It was deeply and dreadfully upsetting for his wife as well as very unhealthy and affected her quality of life in those instances. With a bit of loving kindness and selflessness, it was absolutely preventable.
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It's a tough call, to be sure. I was never good at lying, and I don't like lying. However, now? I lie like a rug (I still don't like it though).
Some of the fiblets I've used:
-- when Peggy went into memory care I had to find a home for her cat. I told Peggy that her veterinarian has her cat and is taking care of her while Peggy is in memory care. I clued in the vet, and when the vet comes to see Peggy, she sticks to that story. It makes Peggy happy that she knows where her cat is (in the moment).
-- Lies by omission. My brother and I barely speak, and everyone knows that I don't think much of him. When Peggy asks about him, I have only nice things to say. She'll never know what I really think.
-- when she moved into memory care, I had to sell her car - no one was going to drive it, and I couldn't leave it parked in the memory care parking lot. I told Peggy it's in storage.
I have so many other fiblets, but I guess my point is if I told her the truth for any of these it would just upset her. She has no way to process any of this information, so why upset her by telling her the truth?
I'm cursed with a great memory, so I tend to remember all of my fiblets without much effort, but even if I didn't, it wouldn't really matter because Peggy's memory is pretty much non-existent.
None of this is good, and I hate it, but so far it's worked for us.
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You're right that you would probably just keep the fiblets going. I personally think that it's important to see how your LO reacts to them. If they are happy with the fiblet and can move on with their day, that's working how it's supposed to and it's fine. I never thought of this possibility, but my LO can still tell when we're fibbing! She gets anxious and annoyed when we do so we try not to do it too much. If there were something we thought we shouldn't tell her we would probably just try to avoid the topic altogether as that seems to work better. She sometimes becomes more calm when we explain things to her though. She wants the nurses at memory care to explain what's going on more, but I'm sure they've been taught not to.
But you don't need to feel bad for "lying". In your example, your LO would probably not be able to process or grieve the loss of the friend and would just be confused or panicky when they were told. It wouldn't benefit them. Keep track of what sorts of responses seem to make your LO most calm and comfortable and stick to those. Don't worry about the fibs growing. Your LO likely won't notice or catch on to later fibs if they have not caught on to the earlier ones.
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I’m in the camp of using fiblets, because depending on your LO’s cognitive and emotional status it is often the kindest way to handle a situation. DH asks about his car or bike? Answer: They’re safe in the garage. (Even though they’re long gone.). DH wants to go visit his grandma? (She died 25 years ago.). Answer: The weather is bad for driving today, let’s go later in the week. DH tells me he’s married to B, his high school girlfriend. Answer: I’m happy for you, I always liked B. DH tells me he wants to meet his buddies at his old college hang-out bar. Answer: Great idea…who do you think will be there tonight? (Knowing that by tonight he’ll have forgotten all about it.). For me priority number one is keeping DH calm and happy, so if a fiblet achieves that, I’m all for it.
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You have to roll with the punches. What works today may not work tomorrow. It depends on stage and type of dementia; some lose memory before other skills and vice versa. Usually by the middle of stage 5 or so it doesn't really matter if the PWD can detect a lie because their loop is short. If you told the truth and said the friend had died the PWD would probably still ask to go see them 5 minutes later either way so you withhold that truth in the future to not force grieving over and over like it's brand new info. You say what brings comfort in the moment because most PWD literally live in the moment. It is definitely trickier in the earlier stages. I think that's why so many PWD are irritable, anxious and angry in stage 4 and 5. Their brains are damaged enough to not recognize their deficits but they are still somewhat tracking what is said and what is going on around them. So strategies change as we go. I always found the art of distraction equally useful. No matter what the approach is you'll be repeating yourself a hundred times a day.
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Team Fiblets for Lyfe.
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Kindness trumps all.
I am not someone who found fiblets difficult or troubling. Like so many other things about dementia-- it's not about me or what I feel, believe or want.
By the time you are creating a therapeutic narrative, your LO will not likely hold onto details for very long. The best fiblets are simple. Sometimes "I don't know" or "I'm not sure" is the best answer. It's generally best to avoid a lot of details. When told something that is taking something away, it's best to blame someone or something else-- a doctor, the DMV, Medicare rules, COVID restrictions, supply chain issues, etc.-- rather than ascribe the change to their cognitive shift. By doing this, I could offer validation for the unfairness of it all (which was not a lie). Where possible, I talked about changes as something we hoped would be temporary-- that the doctor would be satisfied with his progress in rehab (what we called the SNF) soon and discharge him home.
IME, I found fiblets worked from the midstages. In the mid-stages, he often wanted to vent and discuss. By the later stages, I was able to offer the fiblet and redirect to a happier topic. YMMV.
HB
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Like HB, I use Dr’s and Covid as a reason for why mom can’t do certain things. I sometimes wonder when they stop being fiblets and just become lies? I sometimes feel guilty, but at the same time realize I’m the only one who remembers the lie. I’m feeling guilty about something that is being done in the best interest of my LO. It’s not easy, but it is necessary (at least it is for me). As mom progresses, less detail is needed and she asks fewer questions. It’s sad, but also a relief to not have to constantly be answering the same questions over and over again.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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