When your mom is convinced your husband is hers or your dad believes your son’s 25th birthday party is really for him, it can feel cruel to remind them that no, your husband died 10 years ago or no, you’re not 25, you’re 85.
Although you might be tempted to tell a little white lie to spare them unnecessary upset and distress, memory care experts say “going with the flow” not only makes caregiving easier but also provides comfort and reassurance to people who are living with memory loss.
When someone is struggling with memory loss, their world gets turned upside down and inside out. Your 92-year-old dad thinks he needs to go to work. Your 85-year-old mom believes her mom is going to come pick her up from school.
Sitting them down and telling them the truth is not helpful, says Teepa Snow, a leading Alzheimer’s and dementia expert in the senior living industry. But neither is lying.
“It may be there is an old story that runs deeply and painfully in the person’s past,” Snow writes on her website. “It may be that the current story is really about an important need that should be addressed. I believe curiosity and empathy go much further than a quick Band-Aid approach.”
So although agreeing or saying things that are not true might avoid causing your loved one distress, you won’t learn about which unmet need is being expressed or is present — which means that need will continue to go unmet.
“It is easy to think you can offer a quick fix,” Snow continues. “It is also easy to misunderstand or underestimate the value of the words and message they are sending if you are committed to believing that what they are saying is nonsense or simply illogical or has no basis in fact.”
So if your mom or dad has memory loss and you don’t always want to tell them the truth but you don’t want to fib or tell little white lies either, what options do you have left?
Instead of making stuff up that is not true or forcing your reality on someone whose concept of time, place, and circumstance is constantly changing, Snow suggests offering “supportive truths.” Also known as validation therapy, this approach places more emphasis on the emotional aspect of a conversation and less on the factual content.
For example, say your dad thinks that his 25th birthday party is today when really he’s 85 and living in a memory care community. Rather than telling the truth and saying, “No, it’s not your 25th birthday party” or lying and saying, “Yep, it’s your 25th birthday today and your friends will be here later to pick you up” — when really you and your daughter will be stopping by to take him to a doctor appointment — validation therapy focuses on things like asking your dad about his favorite birthday memories.
The point of validation therapy is to try to determine what emotions are behind your loved one’s feelings and help them feel listened to and supported. Sometimes that could mean reminiscing about an event. Other times, it means joining them in their reality rather than trying to bring them back to yours.
Another example: You walk into the house and say, “Hi, Mom, it’s me, your daughter.” Your mom responds with, “But you’re not my daughter.” Instead of correcting her, ask your mom about her daughter, what she misses about her, what she looked like.
By entering your parent’s world, you’re able to reduce their anxiety, and they begin to feel a sense of security as empathy is established and trust is built.
Validation therapy requires patience, and when you’re caring for someone with memory loss, you might already feel like you’re at your wits’ end. Here are some tips for the next time your loved one struggles with memory loss.
Your initial reaction will be to use logic. Before you react, take a deep breath. Set aside your own emotions for the moment, and try to be present with your loved one.
Listen to what your parent is saying, and try to pick up the emotions behind it. Join with your loved one in their feelings, and ask questions that allow them to express these feelings: What was your mother like? How did you and Dad meet? What do you miss most about your daughter?
Reflexive listening — rephrasing what your loved one says and matching their emotions with empathic statements — can decrease anxiety because it provides reassurance that you understand what they’re feeling. For example: “You must really miss your mother,” “You were close,” or “You want to be back in your house.”
Although fibbing or telling little white lies might allow you to quickly move onto the next task on your caregiver to-do list, validating your loved one’s sense of self is more beneficial in the long run. It increases their sense of happiness because they aren’t continually being told that they are wrong or confused by truths that they cannot understand. Rather, validation therapy, supportive truths, and going with the flow helps reduce stress, improve communication, and reinforces dignity and self-esteem.
For more tips for caring for someone with memory loss, download our Guide to Caring for Someone with Dementia for Family Caregivers.