Difficult questions and telling the truth to a person with dementia

Is it okay to lie to someone with dementia?

Not telling the truth can make the person with dementia more suspicious, if they realise that those around them aren’t being truthful. It may also make you feel uncomfortable to lie to them.

There is no right or wrong way to respond to difficult questions. Try to decide what is in the person’s best interests and be consistent in whatever you decide.

Time-shifting and difficult questions

A person may ask you questions as a result of time-shifting, such as ‘When am I going to go home?’ when they are at home, or ‘When is my mum coming to see me?’, when their mum hasn’t been alive for a long time.

Certain times of the day might be worse than others. There may be triggers. For example, if the question happens near meal times, a snack might help. You may notice that they ask when the environment is noisier than usual, or perhaps later in the day. If you see a pattern, you can take steps to lessen or avoid some of the triggers.

An ideal solution is one that you feel comfortable with, and which considers the best interests of the person you care for.

This includes not causing them distress. However, it is often not easy to manage these questions on a regular basis and it is important you have as much support around you as you need. It can be helpful to hear from other carers about approaches they have tried, and what worked for them.

Difficult questions a person with dementia might ask and how to respond

Asking for a partner, friend or relative who has died

If they are asking for a partner, relative or friend who has died, telling the person the truth may shock and upset them, as it will feel like the first time they have heard the news.

As they may well have short-term memory problems, they could experience the shock of grief repeatedly if they continue to be told every time they ask. Some carers choose to tell the person initially, but do not repeat if it becomes a recurring question.

You may feel that reducing the person’s distress is more important than telling them the truth. If you choose to tell the truth in this scenario, try to give them the news in a sensitive and compassionate way, offering warmth and support.

Think about whether it is in their best interests to continue to be told this news every time they ask. Try not to give details of how and when it happened if it was long ago, as this can add to the confusion caused by their time-shifting.

Try not to ignore the question. The person may continue to feel distressed if their concern for their loved one is being dismissed. You may need to acknowledge their question first, perhaps by saying ‘I don’t know the answer to that at the moment. Is there a reason that you need them?’ Or, instead of answering the question directly, you could say ‘Do you miss your Mum?’ and encourage them to talk about their mother, possibly using photos to reminisce.

They may be asking about a particular person as they have an unmet need, which this person may have provided earlier in their life. This could be a sense of security a partner gave them, or the love their mother gave them. Try and explore this and allow them to talk about the person they miss.

You might use phrases to show you understand how they are feeling, such as ‘It sounds like you’re missing your mum at the moment?’, or ‘You must be lonely without your husband?’. Try to meet the need, for example for security or affection, as best you can.

Asking to go home

If someone asks to go home, describing a place they have lived in the past:

• Try not to argue about whether where they are is ‘home’. If they don’t recognise it as ‘home’ at that moment, then for that moment it isn’t home.
• Ask if there is anything you can do to make them happier where they are now. Often when a person with dementia asks to go home it refers to the sense of home rather than home itself. Find out where ‘home’ is for them – and what they like about it.
• Reassure the person that they are safe and cared for. Check that they are comfortable, not too hot or cold, hungry or thirsty, or needing to use the toilet.
• Keep a photograph album to hand, to gently distract them. Sometimes looking at pictures from their past and being given the chance to reminisce will ease feelings of anxiety. It might be best to avoid asking questions about the picture or the past, instead trying to make comments: ‘That looks like Uncle Vijay. Granny told me about the time he....’
• Distracting them with food or other activities, such as a walk. Ask them as many details as possible about their home and consider completing a ‘Herbert Protocol’ with previous addresses in case they try and return there. A Herbert Protocol is designed to help the police if a vulnerable person goes missing. Visit the website for your local police for more information.