Should people with Alzheimer’s always be told the truth?

If, for example, a person with Alzheimer’s asks the whereabouts of a loved one who has died, should one tell the truth? Bearing in mind that as they invariably will forget what had been said yesterday, one might have to repeat the explanation day after day – is it then fair to expose them to the agony of grieving anew every time they learn of the death?

Or in respect of a favourite pet, should one explain to them that it was run over by a bus the previous week? What would be achieved by such honesty?

Then on less clear cut issues, perhaps the adage, there is your truth, my truth and ‘the’ truth holds true. It is probable that in terms of their world, the truth differs markedly from that which you and I hold dear. In Alzheimer’s situations, especially those where telling the truth may unduly upset the person; the truth may even result in aggressive retaliatory behaviour.

Complete honesty should perhaps be tempered by the following principles: Tell the truth whenever possible! And where honesty will not be in the best interests of the AD sufferer – try to avoid answering the question, try to change the subject; seek to distract them – then, if necessary, when all else fails, you may have to resort to telling a white lie! And always remember – do what is best for them… not what is comfortable for you. You are merely a pawn on a multi-dimensional chess board. Get over yourself! Remember that when they developed dementia the game changed – so too did the rules! So if you wish to assist your loved one, play by their rules.

Tell the truth when possible, especially in their moments of lucidity, but be willing to sacrifice your principles on the altar of their happiness. You need to ease your own conscience in the awareness that sticking firmly to the truth isn’t going to help either of you! So, in order to be kind to both of you, when absolutely essential, be prepared to telling a few white lies.
“Better a lie that soothes than the truth that hurts”
Czech proverb

Henry Spencer