My grandpa has dementia. In his world, he believes he is not invalid and is independant. He will not bathe because he believes he has done it already, he refuses help from me; for awhile he wouldn't eat my cooking because he can prepare his own food; he forgets to brush his teeth use mouthwash (his dentist bill was $812 most of them were fillings and palliative care); when I try to help him he gets mad and pushes me away. he calls me names and verbally abuses me. i am his full time weekday caregiver and it is the most challenging and difficult "job" i've ever had. i often walk around his house in trepeditation fearing that he may snap at me. he has threatened to hit me. he won't get out of the house unless he has a doctor's appointment or has church. i have to lie to him just to take him to the park to get some fresh air and to look/feed the ducks and he often asks why he needs to be there and I just say it's for physical therapy. i often to have to lie to him to get him to function and for him to get out of the house. am I a bad person for lying to a person with dementia? sometimes I question my faith and if I'm going to get punished in the afterlife for "lying". of course, I won't know until I get there. thanks for the vent.

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There is actually a term for what we do, it's called "therapeutic lying". As caregivers, we want to be completely honest with our patients. However, when someone has dementia, honesty can lead to distress both for us and the one we are caring for. It is best to use therapeutic lying when the truth would incite mental anguish, anxiety, agitation, and confusion in the demented patient. Also use therapeutic lying when the demented patient is obviously not grounded in reality and is living in a different time than everyone else around him or her. People with dementia do not need to be grounded in reality. In most cases, telling the truth is the reasonable, moral, and ethical thing to do for all parties involved. The problem is that patients who are in the middle and late stages of dementia cannot be reasoned with. When someone is acting in ways that don't make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the demented patient has lost this sense of logic. Therapeutic lying works in these situations, whereas reasoning and logic fail miserably.

It took me some time to convince my father that he didn't have to correct my Grandma all the time. When I told him about therapeutic lying, I think it actually helped him understand things better and now he goes along with things more when it comes to talking to her about things.

@jeannegibbs thank you so much for your support. i think the lying part got to my conscience for awhile and it seemed to hinder me giving my grandpa the best quality care because I felt guilty whenever I have to lie to get him to do things. sometimes the fibbing works, sometimes it doesn't. my family, even my sister who lives with him, doesn't offer much support. they just complain if I ask for help regarding my grandpa or think that I'm a nuisance. my mom (grandpa's oldest daughter) criticizes me if my grandpa is cranky. we don't get along much because she is very negative person and likes to point fingers at me and use me as a target of her own unhappiness. my aunt (grandpa's youngest daughter) also criticizes me if I give grandpa some canned food to eat because of sodium (which I seldom do unless I absolutely have no energy to cook) and of course my sister lives with him and can also contribute but she doesn't. she just prepares his meds before she leaves for work in the morning and she comes home at night after grandpa ate and is ready to go to bed. she doesn't contribute financially, doesn't offer support from me regarding grandpa if I need her (she will just pass on her responsibility to other people); doesn't answer the phone when I call her, nothing. i feel so disconnected from my family. if i ask for help, it is because of grandpa and it has nothing to do with my needs. i don't understand what's wrong with my family.
I vented to my "God" or higher power or whatever one wants to call it, why I'm faced with so many challenges in my life - divorce, being a single parent, being a caregiver to a difficult and challenging grandpa; dysfunctional unsupportive critical family members; etc. I guess it is a test for my soul.

I agree 100%. Some of your lies serve to protect his dignity. How would it work if you were always saying, "No, Grandpa, you didn't eat. You don't remember because you have gotten senile, and have lost your short term memory." Now that would be a sin to say that to him! Kindness and compassion are the virtues you will need for this very hard job. Do what you can to stay sane yourself and to help him be happy. My father responded well to kidding and a teasing kind of disrespect. Calling him a doodoo head made him less uncomfortable than being lectured to. He also responded well to my (pretend) temper tantrums. He sometimes would calm down to humor me.
How old are you? I'm wondering how my 22 year old daughter is going to handle her father's decline.

If you are going to be punished in the afterlife for lying to someone with dementia believe me, you are going to have some of the best company in the world!

If you are lying to Grandpa in order to cheat him out of his money, well, I think we all know that is wrong no matter if you have "faith" or not. But if your goal in lying is to get him to eat or get some fresh air, or to have him take a medicine the doctor has prescribed, surely that is not even in the same universe as a lie-to-cheat.

When you are dealing with dementia, the whole concept of "lying" has to be reconsidered. Grandpa isn't lying to you when he says he already bathed or he can cook his own meals. He is living in his his own world, where those things are true. He did not ask to live in that world. He never prayed, "Please, God, give me dementia." And being verbally abusive to his wonderful caregiver isn't something he would probably approve of if he didn't live in this strange world.

As caregivers we can serve our loved ones best, I believe, by entering into their world and speaking an emotional truth that will comfort them. Telling the literal truth of our world is often not helpful and sometimes cruel. Do you believe in a god that rewards cruelty?

As an example, my mother came to visit me for a weekend. She was having a bad day, she was very confused about where she was, she didn't remember my house at all, and she was very anxious. She asked me why Dad didn't stay when she was dropped off. I could have told her the "truth" -- that he died 15 years ago, but instead I got into her world as much as I could. She wanted assurance that she had not been abandoned and that her husband was not in any trouble. So I told her this was a boys weekend for him, and he was going to play a lot of poker with friends. She and I would have a fun girls weekend. That "lie" helped calm her down. I had to embellish on it a little as the day went on -- I couldn't call him because I didn't know his friends' phone numbers but he had my number and he would call if he needed anything.

It would have been cruel to tell Mom the "truth" that did not fit into her world just then. I am proud of telling her something that fit where she was at. And, by the way, the next day she was back in my world and she knew that she was a widow.

I doubt there are many caregivers of loved ones with dementia who would disagree with you that this is the hardest job we've ever done. It think it is hard enough in the here-and-now without worrying about the afterlife. Do your best, in love.

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