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Therapeutic fibbing, also known as validation therapy or compassionate deception, is a caregiving technique used primarily with individuals who have dementia or other cognitive impairments. It involves intentionally deviating from the strict truth to redirect or soothe someone who is experiencing confusion, distress, or agitation.
Understanding Therapeutic Fibbing:
- Purpose:
- To prioritize the person’s emotional well-being and reduce distress.
- To validate their feelings and experiences, even if they’re based on inaccurate memories or perceptions.
- To prevent agitation or escalation of difficult behaviors.
- When It’s Used:
- When an individual is experiencing significant distress due to confusion or disorientation.
- When reality orientation is ineffective or causes further distress.
- When the “lie” poses no harm and serves to comfort or redirect.
- Examples:
- If someone with dementia is asking for their deceased mother, saying, “She’s at the store and will be back soon,” instead of stating the mother is deceased.
- If someone is insistent on going “home,” even though they are in their current residence, saying, “We’ll go after lunch,” to redirect their attention.
- If someone is looking for their keys, that have been lost for a long time, saying “They are in a safe place, and we will find them later.”
Ethical Considerations:
- Therapeutic fibbing raises ethical concerns, as it involves intentional deception.
- It’s crucial to balance the potential benefits with the ethical implications.
- The primary goal should always be to prioritize the person’s comfort and well-being.
- It should not be used for convenience or to avoid difficult conversations.
- It is very important that the fib, will cause no harm.
Relevance to Dementia Care:
- Dementia can cause significant confusion, disorientation, and memory loss.
- Individuals may experience distress due to their inability to reconcile their internal reality with external reality.
- Therapeutic fibbing can provide comfort and reassurance in these situations.
The Misconception: Therapeutic fibbing is simply lying, and therefore always wrong.
Key Considerations:
- Person-Centered Approach:
- Therapeutic fibbing should always be tailored to the individual’s needs and preferences.
- It’s essential to understand their life story and experiences to provide meaningful comfort.
- Context Matters:
- The appropriateness of therapeutic fibbing depends on the specific situation and the individual’s level of distress.
- It’s crucial to assess the potential benefits and risks before using this technique.
- Caregiver Training:
- Caregivers should receive training on how to use therapeutic fibbing ethically and effectively.
- They should understand the importance of validation and compassionate communication.
Resources:
- Alzheimer’s Association:
- Provides information on dementia care and communication strategies.
- Link: https://www.alz.org/
- National Institute on Aging (NIA):
- Offers resources on caregiving and dementia.
- Link: https://www.nia.nih.gov/
- Mayo Clinic:
- Provides medical information on dementia and related conditions.
- Link: https://www.mayoclinic.org/
- The Gerontological Society of America (GSA):
- Provides information related to aging, and caregiving.
- Information can be found by searching “Gerontological society of america therapeutic fibbing.”
- Your Local Area Agency on Aging (AAA):
- They can provide local resources.
- Use the Eldercare Locator to find your local AAA.
- Link: https://eldercare.acl.gov/