The Gentle Art of Therapeutic Fibbing
I lost my favorite, beloved aunt to Alzheimer’s Disease ten weeks ago. The truth is, I knew I had always been her favorite too.
When I was six, I covered her refrigerator door with bunny and Easter egg stickers. Those stickers stayed on her fridge long past my college years—a sweet (and tolerant) sign of how much she treasured the people and moments that mattered to her.
In the early days of her illness, when she was still living on her own, I remember my dad taking frequent calls from her when she was lost and didn’t know how to get back home. He would find her, and gently guide her home.
Eventually, she moved into a memory care community, where she spent the last six years of her life.
Our visits were always bittersweet, but there were also pockets of magic. She would occasionally call me by my childhood pet name, Cucharon. We’d sit in the garden together, watching the birds and the fruit trees, and she would tell me about recent, imagined conversations with her mother, her sisters, and her brother—my dad. I knew I was stepping into her universe, choosing to inhabit her reality. And in the last year or so, when the words no longer came, we simply sat together. In those quiet moments, that was enough.
In honor of my favorite aunt—and the boundless love she gave me—this blog is for her.
When memory fades, compassion becomes our language.
This past weekend, I had a meaningful conversation with Margaret, a lovely woman I met at a party. She told me about a friend who was struggling with his wife’s move into memory care. He visited her faithfully every day, yet over time, he began to notice that she had grown close to another resident. His wife and her new friend would sit together regularly, and on more than one occasion, he found the man sitting on his wife’s bed. He was heartbroken. The emotions were complicated, and he didn’t quite know what to do.
One of the most emotionally complex challenges in dementia care arises when the person you love no longer sees the world the way you do. The shared facts of your relationship—whether as a spouse, child, sibling, or lifelong friend—can begin to blur or vanish entirely. Names may be forgotten, roles confused, and deeply rooted connections reimagined. And in some of the most difficult moments, families may witness their loved one form new emotional attachments in their memory care community—bonds that can feel bewildering, even painful, to those who remember life before dementia. Whether you’re a husband, daughter, or dear friend, it can leave you uncertain of what to say, how to respond, or even how to make sense of your own feelings.
It’s a heartbreaking reality many spouses and families face. And yet, as difficult as it is, these new connections are often not about romance in the way we think of it—they are about comfort. About finding security in an unfamiliar world. As care partners, our most important job is to support what the person with dementia needs in the moment. That may mean holding space for their evolving reality, rather than insisting they return to ours.
This is the heart of therapeutic fibbing—a gentle communication strategy used by dementia professionals and caregivers when the truth may do more harm than good.
What Is Therapeutic Fibbing?
Therapeutic fibbing is a communication technique often used by caregivers and dementia professionals when interacting with individuals who have Alzheimer’s disease or other forms of cognitive impairment. It involves gently agreeing with or going along with a person’s version of reality, rather than correcting them—especially when the truth might cause distress, confusion, or agitation.
It’s not bending the truth to manipulate—it’s responding with empathy to reduce suffering. Many people are initially uncomfortable with this idea. One son recently told me, “I don’t want to lie to my dad. It feels wrong.” And I understand that. We’re raised to value truth. But in dementia care, the goal shifts from factual accuracy to emotional well-being. When reasoning is no longer effective, compassion becomes the more ethical path.
Key Principles of Therapeutic Fibbing
Preserve dignity and reduce anxiety
If someone believes they need to leave to “pick up the kids” or “get to work,” it’s often kinder to say, “They called and said they’re safe,” or “Today’s your day off—you’ve earned it,” than to tell them those days are long gone.Preserve dignity and reduce anxiety. If someone believes they need to leave to “pick up the kids” or “get to work,” it’s often kinder to say, “They called and said they’re safe,” or “Today’s your day off—you’ve earned it,” than to tell them those days are long gone.
Avoid unnecessary arguments
Correcting or confronting someone’s confusion can lead to agitation, frustration, or even despair. Therapeutic fibbing allows caregivers to maintain calm and connection.
Meet them where they are
Rather than pulling someone back into a reality they can no longer navigate, we step into theirs. This act of compassion often builds trust and reduces distress.
Therapeutic Fibbing in Action: 5 Real-Life Scenarios
“I need to go home to take care of my mother.”
Reality: Her mother passed away decades ago.
Response: “She called earlier and said she’s doing well. She wanted you to relax and enjoy your day.”
Why: Telling her the truth may re-trigger grief as if for the first time. This soothes and reassures.
“When is my husband coming to pick me up?”
Reality: Her husband died many years ago.
Response: “He called and said he’s running late—how about we have a cup of tea while we wait?”
Why: Redirecting to a comforting activity prevents panic or sadness and helps ease the moment.
“I have to get to work!”
Reality: They’ve been retired for years.
Response: “Today’s your day off. You’ve worked so hard—it’s time to relax.”
Why: This response respects their sense of purpose and avoids disorienting truth.
“I want to go see my children.”
Reality: Their children aren’t visiting today or live far away.
Response: “They sent their love this morning. Let’s look at their pictures together.”
Why: It reinforces connection without disappointment.
“Why am I here? I want to go home!”
Reality: They are already in their long-term care home.
Response: “We’ll go home soon. Right now, let’s take a walk and get some fresh air.”
Why: It avoids argument while redirecting toward a soothing activity.
Some caregivers feel torn—balancing honesty with kindness. But when dementia makes it impossible for someone to understand the truth, insisting on it can feel more like cruelty than clarity. Therapeutic fibbing, when used with compassion and intention, becomes not just acceptable, but essential.
Whether you’re supporting someone at home or visiting a family member in memory care, these gentle communication techniques can bring more ease, connection, and peace to your shared moments. Therapeutic fibbing reminds us that in dementia care, emotional truth is often the kindest truth we can offer. While it may feel unfamiliar at first, it’s rooted in deep empathy—an acknowledgment that what matters most isn’t the accuracy of a memory, but the comfort and security we can offer in the present moment. Choosing kindness over correction, and reassurance over reality, is not a betrayal of the person you love—it’s an act of devotion to who they are now. In the end, it’s not about fixing what’s been lost, but nurturing what still remains.