Therapeutic fibs: What they are and why they are OK

February 6, 2018

“Don’t tell lies.” It’s a lesson your parents likely taught you at a young age. And yet, compassionate communication when interacting with someone with memory loss sometimes necessitates the need for “therapeutic fibbing.” Though controversial, therapeutic fibbing can help reduce anxiety or distress in a loved one.

What is therapeutic fibbing?

Therapeutic fibbing is lying, or bending the truth, in order to avoid increased agitation from a person with dementia. Here’s an example from the Alzheimer’s Association:
Family member: “What doctor’s appointment? There’s nothing wrong with me.”
Don’t respond by saying: “You’ve been seeing the doctor every three months for the last two years. It’s written on the calendar and I told you about it yesterday and this morning.”
Do say: “It’s just a regular check-up. I’m sorry if I forgot to tell you.”

Therapeutic fibbing is not about deceiving your relative. You are simply helping them to feel safe, secure, and comfortable. Remember, individuals with memory loss are often scared and acting out of fear. Imagine how frightening it would be to no longer recognize your surroundings or to believe your family members are strangers. As a caregiver, you can address and eliminate some of these fears.

In this context, a fib is an act of kindness, not deception.

Example of therapeutic fibbing:

Family member: “Where are my parents?”
Therapeutic Fib: “They’re not here right now, but I’ll let you know when they arrive. Let’s eat lunch before they arrive.”
In this example you are sparing your relative from grief (over the loss of their parents who died a number of years ago) and anxiety. You have also offered them comfort in its place.

Alternatives to Therapeutic Fibbing:

If telling a therapeutic lie induces feelings of guilt or stress, you may consider using distraction or choose not to respond at all.

Example of distraction:

Family member: “I haven’t heard from my parents in a long time.”
Distract: “I’m sorry you haven’t heard from them. It’s a beautiful day. I know, let’s go for a walk!”

What to do if you struggle with fibs:

The idea of telling a relative diagnosed with Alzheimer’s disease or related dementia “fibs” is understandably uncomfortable for many family caregivers. As a society, we’re taught that lying is wrong—so not being truthful can feel awkward or even upsetting.

Ultimately, as a caregiver your role is to love and reassure your family member. If these techniques make you feel guilty or uncomfortable, remind yourself that you’re using them with compassion and respect. Additionally, you might consider using other tactics first, or setting guidelines for when therapeutic fibbing is appropriate (for instance, only if your relative’s safety or well-being is at risk). Trust your intuition!

And, finally, remember to be kind to yourself too. You are doing the very best that you can.

For more information on Therapeutic Fibbing, take a look at this excellent Alzheimer’s Association PDF on Creative Communication Techniques.