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Therapeutic Lying (via Larissa MacFarquhar at The New Yorker)

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An in-depth article in The New Yorker dealing with dementia care and the way its practictioners struggle with the lying and untruths that are part of the life of carers and patients.
Over the decades and even within among practitioners differing points of view and practices have been dominant and then given way to others.
Consider what it is to work day by day in a world where truth is often judged as being what the patient needs to hear.

In dementia care, everybody lies. Although some nursing homes have strict rules about being truthful, a recent survey found that close to a hundred per cent of care staff admitted to lying to patients, as did seventy per cent of doctors. In most places, as in Chagrin Valley, there is no firm policy one way or another, but the rule of thumb among the staff is that compassionate deception is often the wisest course. “I believe that deep down, they know that it is better to lie,” Barry B. Zeltzer, an elder-care administrator, wrote in the American Journal of Alzheimer’s Disease & Other Dementias. “Once the caregiver masters the art of being a good liar and understands that the act of being dishonest is an ethical way of being, he or she can control the patient’s behaviors in a way that promotes security and peace of mind.” Family members and care staff lie all the time, and can’t imagine getting through the day without doing so, but, at the same time, lying makes many of them uncomfortable. To ease this “deception guilt,” lying in dementia care has been given euphemistic names, such as “therapeutic fibbing,” or “brief reassurances,” or “stepping into their reality.”

Read The Comforting Fictions Of Dementia Care at The New Yorker.

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