Is It Okay to Be Untruthful with Someone Who Has Dementia?

Question from a reader:

A friend’s wife has dementia and is constantly forgetting how many sodas she has had (she has a rule that she will not drink more than two a day). Her husband (the primary care-giver) is constantly letting her have more than two sodas a day, because it is simply easier to let her have more than fight against her memory by letting her know she has had her daily limit. She thinks she has had none, when she has had several. He feels guilty about lying to her and is struggling with the moral ethic of his actions. Is it okay to be untruthful with someone who has dementia?

Answer from Karen Coleman, EPM Ministry Assistant:

I applaud your friend’s desire to live morally and ethically, with honesty in his relationships. 

Randy has spoken clearly on the importance of truth, simply because the Bible places such a high value on it.  We know that to be the case since Jesus even calls Himself “the Truth.”  It doesn’t sound like your friend needs any convincing of that aspect of this.

The first question that comes to mind for me is this:

  • Since the rule is obviously causing strain, what is the purpose of the rule?  Is the two-drink limit her own rule or a medical necessity?  If the former, maybe she and her husband could discuss changing the rule, or even letting the rule go, for the sake of reducing stress in their relationship and interactions with one another.

If the rule is non-negotiable, then perhaps he needs to discover creative ways to be entirely truthful but still help his wife stick to the rule.

I’ve just tried to brainstorm some practical ideas to address the situation….

  • For example, he could keep all the extra soda in the basement or garage, and be able to say truthfully to his wife, I’m sorry, there are no more sodas here [in the house/kitchen].  Would you like something else to drink?
  • Perhaps the man could implement a new plan…Each evening at bedtime, he will put two drinks in the fridge to chill overnight for her to enjoy tomorrow whenever she wants.  Those are the two that will apply to her own set limit/rule.  She will know when they are gone that she has had her limit, and that no more will be added until the next night.
  • Or, alternately, her husband could have a designated place for the two empty cans each day, to show her that she has already met the limit for the day.
  • Or, are there other drinks that could be added that might be satisfying to her, like flavored water, that she could have more of when the two sodas are gone for the day?

Secular medical or caregiver websites with articles on dementia talk about “therapeutic lying.”  I found several articles on this topic very quickly, so obviously your friend is not the first person to face this difficult dilemma.  Here are three of them:

As believers, we obviously need to tread very carefully here, and that seems to be exactly what your friend is trying to do.  These sites would give your friend an idea of the secular “conventional wisdom” that people are applying to this dilemma.

One of those same secular sites spoke of other communication strategies which did not include lying.  Perhaps you friend would find helpful ideas there:

As in so many things in our lives, James 1:2-8 is so apt:

"Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance. Let perseverance finish its work so that you may be mature and complete, not lacking anything.  If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you. But when you ask, you must believe and not doubt, because the one who doubts is like a wave of the sea, blown and tossed by the wind. That person should not expect to receive anything from the Lord. Such a person is double-minded and unstable in all they do."

Karen Coleman served as a ministry assistant at Eternal Perspective Ministries for three and a half years. She spent 23 years in Cameroon, West Africa involved in Bible translation and missionary care. Before going to Africa and before EPM began, she served as Randy’s assistant when he was a pastor. In June 2018, Karen went to be with Jesus.