In the world of dementia and Alzheimer's, there is a term called therapeutic lying, which is intended to be calming instead of creating more confusion and/or agitation. As in all lying, there is a matter of degree of importance, in the grand moral scheme of things. Caregivers new to this concept are often firmly convinced it is better to be honest, even at the expense of calm in an already confused mind. An example of this would be if every night your loved one asks to call a long-dead parent and you tell them, no, your mother has been dead for over forty years and she's buried behind the church in (whatever) town. The person with dementia or Alzheimer's proceeds to burst into uncontrollable tears and anger, because they are mostly living in their long term memories. Imagine now, repeating this every night when instead you could both be lying in bed with a small degree of intimacy and when asked to call the long-dead parent, you, the caregiver choose therapeutic lying and say, "Oh, it's too late at night. Your mother is fast asleep, with her favorite cat curled at her feet. Let's call in the morning after breakfast." The part of the dying brain that wants reassurance from somewhere reacts well to this. And there is calm, which may or may not have to be repeated every night for awhile.

This need for reassurance in a person with Alzheimer's is much like leaving night lights on for a small child who has a fear of the dark at bedtime. Or, deliberately making a grand charade out of looking inside the closet or under the bed for monsters, which you, as a rational adult or parent know do not exist, but it takes some time for children to get over this fear. One of my own children, who slept on the bottom half of a bunk bed, with convenient drawers for toys underneath the sleeping area, was convinced deer somehow got into our house, past locked doors front and back, up two flights of stairs, while we all slept. I tried explaining the impossibility of that happening, to no avail, and ended up rigging a sheet across the bunk, so the deer couldn't see. I let the child keep it up as long as was needed. Unfortunately, a person with Alzheimer's does not outgrow the fears or need for reassurance. Just when you think, okay, we can get through this...another matter becomes distressing to them.

The first example I gave was from a person who came to one Spousal Caregiver Support Group, took copious notes, asked numerous questions regarding dietary changes, supplements, ANYTHING to stop what was happening in her husband's brain. Those who have been attending these groups far longer than I, as well as the facilitator, who is an RN, gently tried to tell her there is nothing that can stop the biological process of a degenerative brain disease. I'm only guessing why she never returned, not quite ready to hear what others who are farther along the path were saying. I remember all too well the way I felt after the first spousal group, even though I had read the stages. Hearing the voices of those who live minute-by-minute, hour-by-hour, year-after-year doing the best they can is the most brutal honesty I've ever experienced.

So, as a person who prefers the truth at all costs, on lying in bed with my husband, if he wakes up confused and asks whether it's night or morning; I tell him the truth. If he asks, even if it's for the 30th time, what day it is; I tell him the truth. If he seems worried or overly concerned to the point of agitation regarding something he no longer is capable of doing or understanding, I will make use of therapeutic lying, to calm him down, even if it is at my own expense. That is something I am learning to be more realistic and forgiving of, in myself, although on many days I feel our world is moving far too fast, and I am barely keeping pace.