Telling the truth is not always a measure of love and respect for the patient with Alzheimer's disease. It may be necessary to lie to the Alzheimer's victim. A caring spouse and other family members may agonize over how much to tell a patient and are torn between the desire to protect the patient from the horrible knowledge of the future course of the disease and the feeling that it is unfair of them to be deceptive. ....Forcing an understanding of the reality of Alzheimer's disease on the victim may indeed be a needless cruelty, or an impossible task....

Families can be helped to learn that a lie is sometimes a useful tool when it works in the patients best interest. For example, a patient who insists on visiting a Mother who dies 25 years previously may respond with anger and disbelief to a spouse who recites a lengthy history of the Mother's death and patiently repeats it with each request, but he or she may turn away satisfied when the response is, "We'll go after dinner." This kind of simple lie is helpful at times to protect the patient from emotional confrontations and the family from repetitious exercises in futility.

Although no one can determine exactly how much information the patient can process, it is a kindness not to overburden him or her with stimuli. If the caregiver is helped to observe what best keeps the patient calm and relaxed, the burden of truth may be lightened.

--Clinical management of Alzheimer's Disease, edited by Ladislav Volicer, MD, PhD, Kathy J. Fabiszewski, RN, MS, Yvette L. Rheaume, RN, BSN, and Kathryn E. Lasch, MSW, PhD. Aspen Publishers, Inc. 1988


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