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Is telling the truth the right thing to do when mom has Alzheimer's?


Question: Last week, our mother, who is 84 and in early to mid stage of Alzheimer's Disease, lost our brother, 64 to kidney failure. He had lived in the home with her. Now we are trying to help her to adjust to being in the home by herself, which she wants to do, and help her to grieve. We find it very heart-wrenching to have to remind her of my brothers passing. Is there some way we can help her, or things we can do to be a better help in this regard? We love her dearly and hate to see her having to grieve afresh every day, while we struggle to make her existence more humane not only as a grieving mother but also someone who is in a contain of Alzheimer's as well.

 Dr. Amy: I am sorry for your loss and that you find yourself in this wrenching situation. Before I address your question, I want to mention the safety concerns I have about your Mom living alone now with early to mid stage Alzheimer's Disease. You mention that you Mom can't remember that your brother has passed. This is a reg flag to me that she may not be safe living in the home alone. You might want to talk to her doctor or to a geriatric care manager to get a professional opinion about whether or not there are safety concerns. If you mom is still ok now, you want to make sure you keep monitoring the situation carefully for changes.

You asked about how to handle your mom's inability to remember that your brother has passed. This is always a tricky situation. I am big fan of redirection and empathy. I encourage you to turn her questions into an exploration of more pleasurable memories, and avoid the subject of his death as much as possible. If she asks where he is you can say you were just thinking about him, and then tell a story about something he did that was funny, or touching, or outrageous. You can talk about things he did, his beliefs, his looks, his career, his hobbies. There are so many topics related to his life that you can explore together, while carefully avoiding the subject of his death.

Although we always start from a place of full truth and honesty with someone with Alzheimer's disease, there are times it is kinder to fib to protect someone from re-experiencing grief or other painful emotions unnecessarily. You have told your mom several times that your brother has passed. Now, as you say, repeating it over and over and having her grief anew each time seems like it is causing her unnecessary heartache. Sometimes it’s OK to fib, and say something like, “Yes, wouldn't it be nice if he were home! Why don’t we put the kettle on and make a nice cup of tea while we wait?” I recently wrote an article on the topic of therapeutic fibbing, which you might like to read.

I wish you and your family all the best on this journey.



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