The experience of lying in dementia care

Abstract

This analysis examines the practice of care providers in residential aged care lying to residents with dementia. Qualitative data were collected through multiple methods. Data here represents perceptions from registered and enrolled nurses, personal care assistants, and allied health professionals from five residential aged care facilities located in Queensland, Australia. Care providers in residential aged care facilities (RACFs) lie to residents with dementia. Lying is conceptualized as therapeutic whereby the care provider's intent is to eliminate harm and also control behaviour. Care providers of residents with dementia in RACFs need guidance around lying. An ethical framework cognisant of an ethical theory of good and ethical theory of right supplemented by a theory of virtue is proposed. A complimentary four stage communication strategy that promotes truth telling as a first option while also recommending the lie as a suitable strategy is also promoted.

The use of the truth and deception in dementia care amongst general hospital staff

“…No matter what ethical framework participants used, all suggested that their responses were given in the best interests of the patient. This corroborates a number of previous studies suggesting that lies are used only in the best interests of the person with dementia (Cunningham et al, 2005;Day et al, 2011;Elvish et al, 2010;James et al, 2006;Tuckett, 2012).…”

Why is dementia different? Medical students' views about deceiving people with dementia

“…Some authors contend that lying is morally distinct from deception (Benn, 2001;Jackson, 2001), whereas others argue that both acts in clinical practice are ethically akin, because they are both a deliberate abuse of power and an "affront" to patient dignity (Bakhurst, 1992). Whatever the terminology used, empirical studies demonstrate that decision-making about honest communication is a common issue faced by professionals caring for patients with dementia (Day, James, Meyer & Lee, 2011;Elvish, James & Milne, 2010;James, Wood-Mitchell, Waterworth, Mackenzie & Cunningham, 2006;Tuckett, 2012).…”

Meaning and practices of spiritual care for older people with dementia: experiences of nurses and care workers

“…Furthermore, the nurses and care workers perceived lies and deception to be acceptable in the context of certain interactions with older people with severe dementia. Although the acceptability and ethicality of deception in dementia care remains an area of heated debate, lying is viewed as therapeutic because the care provider's intent is to eliminate harm, control behaviour disorders, and reassure. Deceptive practice has been shown to be prevalent in long‐term care settings.…”