Making decisions and managing difficult situations

4. Telling the truth

Situations may arise where a person with dementia asks questions that leave carers feeling unsure about whether to answer honestly. This could be because the answer would be distressing to the person – for example, reminding them that a relative or partner has died. In cases such as these, carers can look for different ways of handling the situation.

If the person says something that you know is not true or possible, try to see past what they are saying, and instead look at the emotions behind it. For example, if they are asking for their mother, who is no longer alive, it may be that they are feeling scared or need comforting. By meeting the needs behind what is being said, it can be possible to offer emotional support while avoiding a direct confrontation over the facts.

In some situations you may decide that not telling the truth is in the person’s best interests. If you do decide that the truth would be too distressing for the person, there are other options available.

  • Distraction – for example, to distract a person away from asking for their deceased mother, you could ask questions like ‘Your mother? Tell me about her’. This allows someone to talk about the person and can also help convey their emotions. Other distractions include a change in conversation, or an activity.
  • ‘Bending the truth’ – it may possible to convey a message without telling the truth or lying. For example, if someone asks where their mother is, instead of explaining that they have died, a carer could answer with ‘don’t worry, she is safe’.
  • Lying – this should only be done as a last resort when other options are not appropriate, and to do anything else would cause serious distress.

Each case should be judged individually and the course of action should be chosen to suit the specific time and situation. An ideal solution is one that you feel comfortable with and also considers the person’s interests.

Things for carers to think about

  • Is there a message behind the question that indicates an emotion or unmet need, eg fear, loneliness or disorientation?
  • Is the person likely to understand what they are being told? Are there ways of making it easier for them to understand?
  • Would knowing the truth cause the person significant distress? If so, would the consequences of telling the truth outweigh the need?
  • Are there ways of telling the person the truth that would be less upsetting?
  • Are there some things that are essential to be honest about?
  • Will not telling the truth make things more difficult in the long run?
  • From your knowledge of the person, what do you think they would want?