A topic that comes up often in Support Group is that of confabulation—when a loved one with dementia addresses an incident with their care partner that never actually happened. Like hallucination, confabulation is an occurrence when our loved one believes something happened when it didn’t. “Why did you yell at me in the car?” “My brother showed up drunk last night.” The caregiver knows he never yelled; she knows there are only sisters in the family, no brothers. What to do when a loved is convinced they are seeing something that isn’t there or experiencing something that hasn’t happened? Such occurrences require skill and fast thinking that can develop over time—it isn’t hopeless. Validation is the key.
I often tell the story of my mother and I sitting at her table one evening after supper. She is staring out the kitchen window that’s behind her chair, and she begins to describe a very large bird in her yard. It is green, has a great beak, and stands about three feet tall, according to my mother. It’s quite vivid. She wants to know if I see it. The skill here is not to contradict her, but also not to “lie” in a way that my mother will pick up on. I tell her I can’t see it, yet. I am sitting opposite her, not near the window. I lean side to side, looking from my chair, peering out to see if I might see this fantastic bird. Mom says it’s about 80 pounds. “Don’t you see it, Leigh?” I tell her I’d love to see it, but the side of window is blocking my view. Mom’s dementia doesn’t allow for logic. She doesn’t ask me to come to the window for her view, but if she had, I know I would have seen her bird. As it was, she was satisfied that I validated her experience, rather than trying to convince her no such bird exists.
A good lie prevents agitation and actually allows the care partner to engage with their loved one at a different level. It allows us to be closer to our loved one by entering into their world with them. Redirection would be needed only if our loved one were in danger. I had to follow my mother out the house once as she ran to a neighbor with a twenty dollar bill in her hand, convinced she had to pay her for cutting my mother’s lawn. Luckily, the neighbor simply told her they were good, and Mom didn’t owe her anything. Again, this satisfied my mother, and she returned with me to the house.
A good lie can be very helpful! Don’t be afraid to use it. It reduces stress and increases trust. And, in the long-term, the need for lying often decreases as the dementia condition progresses and a loved one starts medications that reduce agitation and hallucination. It is not a static condition. For my part, I love the story of my mother’s giant bird. Whenever I recall it, it reminds me of that moment when my mom and I were sharing something that was, overall, quite special.