Hatherleigh Nursing Home Touches on Therapeutic Lying in Dementia Care

“Honesty is the best policy” is something many of us grow up hearing and it influences how we understand trust and respect. It can shape how we speak to the people we care about, and the belief that telling the truth is the right and responsible thing to do.

However, supporting a person living with a dementia asks something different of us. Memory can disappear, time can shift and perception can move in ways that feel very real to an individual on a dementia journey. In those moments, focusing only on factual accuracy may not ease distress or help someone feel calm again.

It is often in these difficult moments that what is known as a therapeutic lie becomes part of care – a thoughtful response grounded in compassion.

A therapeutic lie is never about convenience, and it’s not about dismissing the truth. It is a carefully considered response, sometimes described as a “white lie”, used to protect someone from emotional distress. When a person’s memory no longer anchors them to the present, repeatedly correcting them can mean asking them to experience the same shock, grief or loss again and again.

Walking alongside someone in their reality can spare them the pain of being reminded again that they cannot return to the home they remember, that someone they deeply love is no longer by their side, or that the routines they have always known are different now. In those moments, the priority becomes comfort, dignity and emotional safety, rather than factual accuracy.

An insight from a Dementia Care Home in Devon

In practice, this means recognising that a response is shaped not only by words, but by understanding. The ability to respond well in the moment comes from truly knowing the person. Their history, the roles that defined them, what steadies them, and what may unsettle them. It is that knowledge which guides whether reassurance, distraction, validation or gentle redirection is most kind.

This can perhaps be best understood through the experience of a lady currently living at Hatherleigh Nursing Home near Okehampton, who is on a dementia journey and will often ask where her car is. For many years, this car was closely tied to her role as a mother. She drove her children to school, to appointments and enjoyable days out. Being behind the wheel meant she was the one making sure everyone was safe and where they needed to be.

Although she has not driven for quite some time, the car feels real and important to her in that moment. Instead of questioning her understanding, the team will gently reassure her that her car is having its MOT and will be ready to collect the following day. This is a therapeutic lie in practice, used carefully to ease distress and help her feel safe.

Her attention then shifts away from the car, and the team are able to support her to settle into something else, perhaps a cup of tea, a chuckle and a conversation about the joys of motoring, or an activity she enjoys.

At other times she can be seen moving through the home, anxious and searching for her young children. To her, they are not adults with lives of their own, but little ones who need her. The team recognise what sits beneath this distress. It is not simply confusion, but a deep and enduring maternal instinct. Rather than correcting her or insisting on truths, they respond with understanding. A baby doll is gently placed into her arms, offered with reassurance. The searching gives way to something familiar, the instinctive act of holding and soothing.

Once the doll was placed in her arms, a sense of calm followed. The baby is carried throughout the day, bringing comfort and helping her feel more at ease within the home. Occasionally the car still feels important, with thoughts of the school run or plans that need attention. At those moments, the team gently reassure that the children are on half term and everything is taken care of, before guiding attention towards something familiar and comforting.

Telling her that the children are grown up or that driving is no longer possible would likely cause emotional upset, forcing a sudden confrontation with loss and change that can feel confusing and overwhelming. In her world, the role of a devoted mother remains present and purposeful. Honouring that identity helps maintain a sense of psychological safety, allowing her to feel secure, valued and understood.

Is Honesty the Best Policy in Dementia Care?

In the end, the question is not whether honesty matters, but to whom, and how it is expressed in moments of vulnerability. For some people, hearing the factual truth may offer reassurance. For others, it may reopen loss, heighten confusion or create unnecessary emotional pain that cannot be processed or resolved.

At times, gently entering someone’s reality can preserve dignity and calm in a way that correction cannot. A therapeutic lie is not a blanket approach, nor is it about avoiding difficult truths; it is shaped by compassion and a deep understanding of the individual.

In practice, this means truly knowing the person. When you understand who someone has been, you begin to recognise what they may be reaching for in moments of uncertainty.

The team at Hatherleigh Nursing Home take time to learn who each person is beyond a diagnosis, because when someone feels overwhelmed, they are often searching for something familiar, independence, connection, reassurance or meaning.

Care is not linear, and no two people walk the same path on a dementia journey, sometimes it simply comes down to us being open to walking that journey with them – “white lie” or not.

If you would like to learn more about Hatherleigh Nursing Home, please visit https://www.hatherleighnursinghome.com/lifes-journey-continued-2/