Is it okay to lie to someone with dementia?

A person with dementia might ask questions that are difficult to answer truthfully without causing distress. Read our advice on why the person might be asking these questions and how to respond in situations where it might be better to lie or to not tell the whole truth.

I try not to lie, honestly, but some things push the boundaries: “Socks! You shouldn’t have”; “Oh, I thought you meant I should eat the entire cake” and – often to my subsequent regret – “No, I'd love to have your mother visit”.

Being a bit flexible with the truth is just part of the social contract, it seems - the price we pay for jogging along in relative peace. But what if one of us has dementia? What price comes with telling the truth then?

Types of questions a person with dementia might ask

The questions people living with dementia ask can challenge us. You may recognise some of these from your own experience:

  • When is dad coming to visit? (When the person’s father is sadly long dead)
  • Will I be going home soon? (Person living in a nursing home)
  • Shall I set the table for the guests? (From a former B&B owner, now in residential care)
  • You seem nice... but who are you? (Person to their partner)
  • Who are those little people by the window? (Person could be living anywhere)

For those close to people with dementia, how to respond to their questions can be a daily challenge. Is it acceptable to lie – ever? Or should we just tell the brutal truth - always?

How we respond will affect how the person and us feel and behave, now and in the future. We feel that if we get things ‘wrong’ we might damage a relationship that may well be already strained. 

Why might a person with dementia ask difficult questions?

Difficult questions often arise when the person is living in a different reality and/or has different beliefs from those around them.

These differences may become more apparent as dementia progresses but they are not limited to the condition’s later stages. They include:

  • behaving as a younger version of themselves (time-shifted)
  • beliefs – sometimes strongly held – that are false to others (delusions)
  • unfounded suspicions or allegations about others (infidelity, malice, deceit)
  • experiencing things that aren’t there (visual hallucinations).

We need to understand that these realities and beliefs often have meaning for the person with dementia, and we should not belittle or dismiss them.

Rather, as with changes in behaviour, the challenge when supporting someone is to get behind the words, rather than attribute them as simply dementia ‘symptoms’.  (Hallucinations in dementia with Lewy bodies may be an exception because they can be a symptom.)

For example, if someone with dementia asks for their dad, they may be expressing a need for comfort which is not being met.

If someone says they are setting the table for 'guests', maybe it's because they are looking for something to do, or are using older, more familiar memories to make sense of the present. When someone with dementia invents a story, it may be a coping strategy to support self-esteem.

When someone with dementia unknowingly invents a story – which is called confabulation – it may be a coping strategy to make sense of the world around them.

Should you always tell the truth to a person with dementia?

Is it important to recognise that 'truth' and 'lies' are not always simple or clear cut.

A spectrum runs from ‘whole-truth telling’ through ‘looking for alternative meaning’, to ‘distracting’, ‘going along with’ and finally ‘lying’.

As we move through this sequence the level of deception rises and we feel less at ease; who likes lying to a loved one?

It feels uncontroversial that we would all want our default response setting to be telling the whole truth. But it is equally obvious that the whole truth can sometimes be brutal or cause pain or discomfort. Who would support telling the whole truth when a person repeatedly asks after a long-dead parent as if the parent were still alive?

The whole truth here could mean repeatedly breaking the news of the parent’s death as if it has just happened, over and over again. What could be more cruel?

Selecting the correct response to reduce distress

We instinctively want to lean towards the ‘whole truth' end of the spectrum, but we also want to minimise any distress our response causes to the person with dementia.

But these aims often contradict, leaving us to seek a balancing act or a ‘least-bad’ trade-off. (We should not forget our own wellbeing either, as we don’t want to end up feeling bad about ourselves.)

One consequence of this approach is that we tell a direct lie only when doing anything else would cause the person significant physical or psychological harm. Professionals sometimes call this a ‘therapeutic lie’, but it needs to be seen a bit like antipsychotic drugs: used only under very select conditions and even then only with extreme care.

It’s also really important to recognise how hard this balancing act can be, and how impossible it can sometimes feel.  This is true particularly if the person’s realities/beliefs fluctuate – for example, if they are time-shifted only some of the time.

Carers can often find themselves being unfairly accused or argued with, find that their own reality is being suppressed, or feel unnecessarily guilty if they occasionally get their response ‘wrong’.

Responding to difficult questions from a person with dementia

Although every case needs taking individually, some guiding principles to start with include:

  • be compassionate 
  • try to understand and acknowledge the person’s feelings
  • seek to reduce distress and promote wellbeing or happiness.

When a person with dementia thinks you have stolen from them

Let’s take an example of a person who believes you stole their purse, on the assumption that the person’s suspicion is unfounded and they’ve simply mislaid it and forgotten where it is.

Perhaps this has happened before and when you found the lost purse you returned it with a whole truth: ‘I didn’t steal it; I found it in a drawer where you put it’. 

If this approach has caused an argument or distress, it may be better to try something less blunt next time: ‘It looks like it wasn’t stolen after all, it was just hiding upstairs’. If it’s a common accusation, trial-and-error can be useful in finding a suitable approach.

When a person with dementia asks about a deceased love one

If you think the person needs comfort or assurance, then ‘Is there something you wanted to speak with them about?’ might work.

The person with dementia may just want to reminisce about the person, and you could try saying something like, ‘I can tell you really cared for each other – tell me about them’, perhaps reinforced with personal photos, letters, or objects.

Or it may be that the person with dementia is still grieving, in which case gently acknowledging that their partner has died and supporting them to grieve might be best – for example by talking about their relationship and the person’s life.

As is so often the case for a person with dementia, feeling heard may be more important than being given advice.

But if the question here is frequent and the grief severe, then the kindest response is likely to be to acknowledge the person’s feelings and gently move them on to a topic or activity that you know they will enjoy. This is clearly ‘distraction’ but it should still not deny or ignore their feelings.

This article was first published in 2019 and most recently updated in February 2024.

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93 comments

It is so hard now to find out about pain or toilet needs as it becomes impossible to ask questions as the question is forgotten before my Darling can be respond. I can only hope she is pain free.

I have found this 'piece' wholly encouraging and quite beautiful. Some of we humans do have to cope with intense feelings. Just to love someone with Alzheimer's sometimes isn't quite adequate. I'm therefore grateful for some of the very practical remarks. I use 'loving' lies - because they often help my wife. Long may you work continue. And the government WAKE UP!

Thank you all - I have had problems telling lies to my wife, but the comments here have helped a lot. One has to lie to avoid distress, but it is not easy.

My wife who’ll be 93 in just over three weeks had additionally a stroke making her wholly dependent on the careers for everything except she can to some extent use a fork and knife. Her memory is gone but she still recognises relatives and friends when she sees them. I avoid telling lies and try to go along with her feelings. She used to be an active person always on the go. The demands she put on herself created stress of which she is free now and has become like a child delighting and responding positively to the careers - if they smile. But she tends to reject them if they don’t. So I make sure especially when she’s going to bed to tell her career to smile and joke. She then she gets involved with the career and forgets me and I can leave without distressing her. Little things like that can completely change things and bring back the joys of childhood back

This article would have been ideal when my now 94 years old mum first developed this cruel, insidious demeaning disease.

I live with my partner who has dementia.
We are very happy together but his daughters who have power of attorney want to take him off without me. They don't like me and the one has always wanted to split us up. They want to put him in care but I feel this will upset him to be taken away from me. We love each other but they don't seem to realise this.
I look after him really well and there are no complaints off social security. I cry and cry. What can I do? His daughters really hate me.

Hi Josephine, I'm very sorry to hear about that. If you call our Helpline one of our advisers would be glad to discuss things with you and offer advice.
Our Helpline is open Monday to Wednesday (9am-8pm), Thursday to Friday (9am–5pm) and Saturday to Sunday (10am-4pm), and can be reached on 0300 222 11 22.
Thank you

Bless you Josephine; hard enough as it is. I look after my husband with Alzheimers - his sons haven't offered to take him off me yet! Don' think they will. Thinking of you, it is very hard. Hang in there x

After 55 years married bliss my wife & I are ageing & obvious signs of dementia are occurring, with me becoming something of a carer. Numerous NHS referrals to specialists have produced no feedback & my only solace to date has been the literature provided by the Alzheimer's Society. Despite being a former H.R. manager, I find the ongoing situation very taxing indeed.

Mum had dementia and white lies were always helpful when she was distressed. "When am I going home" was answered by 'after the doctors see you in the morning'. It calmed her and helped for another day.
My husband has vascular dementia but he hasn't reached this stage but at least I'm aware of what is to come.

My mum asked me, 'Do you suppose I'll ever get better? She was quite late stage by that point but had previously broken her hip so I paused to think and then replied, 'Well you're already a lot better than you were when you were in hospital aren't you?' She was happy with that answer. Another time she said, 'I need to be honest (she was very close to tears) with you Carla, half the time I haven't got a bloody clue what I'm doing. Do you think I'm going mad?' I replied, 'I don't know what I'm doing half the time either so I wouldn't worry about it too much!' She really laughed at that and it seemed to make her happy. The harsh truth would have destroyed her. I used distraction when she got upset about things as eventually I couldn't lift her mood but if I suddenly said, 'Wow, look at that!' pointing to something in the garden, she'd snap back and ask me what I was looking at. There's usually a way around things when you know somebody well and it's far kinder to find what works for them, usually without telling outright lies

My mum has Alzheimer’s and my dad, her husband of 67 years died earlier this year, I think lying is a very negative term to use, my mum realises he has died but thinks it was a long time ago We don’t correct her nor do we insist on the whole truth a lot of the time, I think the right approach with mum is whatever causes the least distress.

My wife has rapid-progressing Alzheimer's Disease and by far the most frequent distress relates to wanting to go to see mum (deceased 2013) and dad (deceased 1987), or wondering why mum and dad haven't been to see her for ages. Apart from rare occasions when she is temporarily aware that they have deceased, I find myself having to tell her that they're fine and we'll go and visit them tomorrow. But that first lie, well meant as it is, often seems to lead to more lies to back up the first one and that leaves me feeling very uncomfortable. I could never lie to my wife before her diagnosis and it goes against the grain to do so now, even when it's done out of loving care.
If I could have two wishes granted (apart from the obvious wish for instant cure / reversal of the disease), they would be that my wife of 49 years would know who I am and who our daughters and grandson are and that she would be always aware that her mum and dad had passed on, but not be in distress about that.

Telling ' loving fibs' are always useful, no one would accept to
be reminded the person they are asking for has been dead for ages, keep a list of practical answers eg, Cutting the lawn , gardening, gone to the football match, Gone shopping, At the hair dressers etc, photographs are usefull.

A difficult question but there is always an answer. I have found that distraction seems to work, in other words either start talking about some one or something different. Always keep a kind attitude , and a smile on your face , mention a 'cup of tea'talking about a holiday, or a wedding that you saw coming out of Church, if it's a lovely day a stroll around the garden, seeing the flowers and the birds, take some bread crumbs and bird seed with you .

As a nurse in elder are, the sensible thing to do is to reaffirm the demented person’s reality in the most positive manner—depending on their grasp of reality, ask”why do you ask?” Or “I’m not sure—can I help you with something?” This allows the person to state where they are & possibly indicate what need they are expressing. Generally they are aware of the reciprocal aspect of the conversation. Use WWYD? (What would you do—want to hear?)

A more helpful way of talking about people is to say ‘person living with dementia’. Terminology such a ‘demented’ is rather outdated and can be seen as negative and labelling. The DEEP network, a group of people living with dementia have published useful guidance online about language that may be of interest to you.

My Husband has started to say
How much are the flights back to the Uk (we are in Spain)
I said I do not know darling, why. ?
He said our parents are knocking on a bit now, I think we should go and see them before it's to late.
(Our parents passed many years ago.)
I said ok I will look into it and see what we can do.
He was pleased with this and started chatting about something else. Bless him
I would not distress him by telling him his mum & dad are no longer with us.
I don't feel guilty telling a Love Lie
My husband is stage 4-5
Mary x

Beautiful Mary, reads like a poem. I care for my husband and have to manage our lives with what I don't tell him as it then cannot cause him stress - that's a form of "love lie" and I couldn't care for him and look after me without it. Bless you. Debbie x

Here here to you Mary & Debbie. I trained as a student nurse in mid 70s 1973 to 1976yrs. Thank fully new care attitudes are coming in . My mum had sclerotic dementia & it was tough. Her tears, tantrums all hours of day & night then put in a nursing home as I'd become disabled & step dad couldnt cope. During the day I'd send him down to his local. If night make him use spare bed anything to stop him arguing with her & frequently she was right . It's no use arguing with a dementia person & they are still your loved one . Life perspective has changed. Keep things as simple as possible .