It’s Okay To Not Tell The Truth
Why You Shouldn’t Feel Guilty About “Lying” to Loved Ones with Dementia
When a loved one is living with dementia, every conversation can feel like a delicate balance between truth and compassion. One of the most emotionally complex decisions caregivers face is whether to “correct” a loved one’s false belief, or gently go along with it. Many people feel deep guilt about what may feel like lying. But here’s the truth: it’s okay not to tell the truth in every situation. In fact, in many cases, it’s the kindest and most helpful thing you can do.
What the Alzheimer’s Society Says
According to the Alzheimer’s Society, dementia often causes confusion, memory loss, and difficulty understanding the world around them. In some situations, correcting or confronting these beliefs can cause distress, anxiety, or even aggression. The charity states that “being honest is not always kind”, especially when the truth leads to unnecessary emotional pain.
They support a compassionate approach known as therapeutic lying, responding in ways that reduce distress, even if that means departing from the literal truth. For example, if a mother with dementia asks when her long-deceased husband is coming home, telling her “he passed away years ago” could be like forcing her to relive his death over and over. Instead, a comforting response like “he’ll be home soon” or redirecting to a happier topic can help her feel calm and safe.
Understanding the Contented Dementia Approach
Contented Dementia, developed by Penny Garner and Oliver James and detailed in the book Contented Dementia, takes this idea further with what it calls the SPECAL method. One of its guiding principles is that we should always put the emotional well-being of the person with dementia first, even if that means letting go of the idea that we must always tell the truth.
The SPECAL approach suggests that people with dementia are living in a different “reality” where their long-term memories may be vivid, while their short-term memory is impaired or non-existent. Forcing our version of reality onto theirs only leads to confusion and distress. Instead, we are encouraged to step into their world. This means validating their feelings and avoiding challenging their perceptions, which allows them to feel secure and dignified.
But Isn’t Lying Wrong?
It’s natural to feel uncomfortable at first. Most of us were raised to value honesty and integrity. But when caring for someone with dementia, honesty can sometimes become an act of cruelty rather than kindness. The key difference is intent. You are not lying to manipulate or deceive, you are choosing compassion over correction. You are helping your loved one feel safe and happy, rather than scared and disoriented.
This is not about dismissing your own emotions. Guilt is a very human reaction, but it’s important to reframe your thinking. When you tell a “lie” to soothe your loved one, you are showing empathy, love, and respect for their dignity.
Real-World Examples
Here are some examples where “lying” can be more helpful than the truth:
They ask to go home, but they already are home. Rather than saying, “You are home,” which might confuse or agitate them, you could say, “We’ll go later, let’s have some tea first,” gently distracting them to reduce distress.
They ask about a deceased spouse. Instead of reminding them of the loss, which could feel new and raw every time, you might say, “They’re at work,” or change the subject to a happy memory.
They’re anxious about missing work. Telling them they’re retired might upset them. Saying, “You’ve got the day off today!” allows them to feel at ease.
Be Kind to Yourself, Too
Caring for someone with dementia is one of the hardest and most emotionally complex roles anyone can take on. There are no perfect answers, and there is no one-size-fits-all approach. But you are allowed to let go of the guilt. You are doing your best in impossible circumstances, and choosing peace and comfort over painful truth is a form of deep, compassionate love.
As the Alzheimer’s Society reminds us: “Dementia is a disease of the brain, not a test of character.” Responding with kindness—even when it means bending the truth—is not only okay; it’s often the best thing you can do.
Sources:
Lying In Dementia Care Science Journal: https://pubmed.ncbi.nlm.nih.gov/29573386/
Therapeutic Lying as a Non-Pharmacological and Person-Centered Approach in Dementia for Behavioral and Psychological Symptoms of Dementia Science Journal: https://pubmed.ncbi.nlm.nih.gov/36373316/
Therepeutic Lying Science Journal: https://pubmed.ncbi.nlm.nih.gov/24003817/
Is Lying Contradictory Science Journal: https://pubmed.ncbi.nlm.nih.gov/37139937/
Alzheimer’s Society, Lying Is Okay Science Journal: https://www.alzheimers.org.uk/blog/lying-dementia-is-it-ever-okay
SPECAL Method, Contented Dementia: https://contenteddementiatrust.org/what-is-the-specal-method/
SPECAL Method In Action: https://contenteddementiatrust.org/specal-method/specal-method-in-action/
About Contented Dementia: https://contenteddementiatrust.org/about-us/contented-dementia-trust/
The Search For Contented Dementia: https://contenteddementiatrust.org/2018/10/08/the-search-for-contentment-in-dementia-care/
How Penny Improved Wellbeing Of People With Dementia: https://www.elder.org/the-elder/dementia-care-how-penny-garners-specal-method-promotes-wellbeing/
