No lying necessary - Blair McPherson

When I first became a specialist social worker for people with dementia I took a very purest view to lying to clients. All to often staff who cared for some one with dementia would collude with the the individuals confusion and memory loss as away of placating them when they were anxious or agitated. The individual insists on leaving the care home  to pick up her children from school, children who are now grown up with children of their own. As a result of her dementia an elderly women refuses all offers of help saying her daughter lives near by and calls in daily, her daughter moved to the other end of the country years ago and sees her elderly mother only two or three times a year. An elderly women refuses to get into the day care transport saying she can't leave her disabled husband as he can't cope on his own, the husband has been dead for for ten years. To get her on the transport and not keep the others waiting the care assistant says the husband is at the day centre waiting for her. Is this acceptable? If the transport left without her she would be   at home alone and at risk and yet if the care assistant reminds her that her husband died almost ten years ago she will treat the news as if it is the first time she has heard it and go through the trauma of grieving  all over again. Should you further distress an already confused and anxious dementia sufferer by correcting them even if you have to do this reputedly or is it kinder to collude? Will this just add to their confusion? How about when they try to leave and staff say this is your home now ? 

According to a new report by the Mental Heath Foundation (http://www.mentalhealth.org.uk/publications/what-truth-inquiry-about-truth-and-lying-dementia-care)
not telling the truth to dementia suffers may be justified in some cases where it supports the wellbeing of the individual but it should " not be undertaken lightly."
Which is stating the obvious by saying you should not lie to clients/residents /patients but in some circumstances it may be justified. This is not as  helpful as it could be because it is to open to interpretation. I think a simple guiding principle is if you are going to lie to a dementia sufferer is it to avoid causing them unnecessary distress or to make your life easier? 

In most circumstances like those described above the accepted response is to use distraction and diversion to calm the situation. Is it really necessary to mention that her husband is dead?

Blair McPherson ex specialist social worker and former director