When is the Truth a Lie? – Coping and Caring when Seniors are Cognitively Impaired, by Andrea Leavitt
A few life lessons come early for many people: We have been taught to be respectful to our elders. We have been taught to tell the truth. We have been taught the Golden Rule: Treat others as you would want to be treated. When it comes to helping seniors in cognitive decline living out these maxims may look a little different than we expected.
When an individual has some degree of cognitive impairment and has lost the capacity to make decisions or provide input on important matters in their life, others are required to make decisions on their behalf. Families often struggle with this change in role and involve their loved one in decisions that are too difficult for them.
When does the truth become a lie?
A loving son is concerned because Dad’s driving has become dangerous. “Dad – you can’t drive anymore.” (This statement is not perceived as truth by his father. And if it’s not perceived as true – it is received as if it was a lie. This “lie” erodes trust.) Impaired Dad responds: “Sure I can. I can and I will.”
Telling partial truths or reframing a circumstance so that it is not threatening or overwhelming is a good thing. In fact, being completely honest can be disruptive and disturbing to an aging person with cognitive decline.
Why? Because the truths being told don’t match the senior’s reality and are either: experienced as a lie (which disrupts trust) or cause grief over and over again.
When to consider shifting your language?
When providing: information about care, choosing a retirement community or driving. In these circumstances, for someone with cognitive impairment, it’s completely appropriate to do what I think of as providing constructive manipulation.
Consider seeking ideas from others who have walked the same path by sharing your story with a friends or attending a support group.
This conversation is so prevalent the Aging Life Care Association took a survey of its professionals on this matter and you can find their feedback here: Is it Okay to Lie to Your Parents?