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Should nurses ever lie to patients?

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23 December, 2013

Relatives and nurses sometimes express concerns about colluding with patients who have dementia and the ethics of doing so. Others argue that correcting misunderstandings causes unnecessary distress.

This raised the question of when it is acceptable to lie to patients.

What do you think?

Readers' comments (6)

  • tinkerbell

    Especially when a widow/er repeatedly asks 'where's my wife/husband? The answer depends on how cognitively impaired your patient is, how much insight remains, how well you know their reactions to answering honestly. I do not think it is unethical to spare someone the recurring pain by repeatedly telling them that their loved one has passed away (husband, wife, mother, father etc.,) and I do not think it is collusion to act in their best interests if the honest answer repeatedly overwhelms them so try to spare them that particular continual reality orientation if it isn't therapeutic to their emotional well being.

    It really is about getting to know the person and there isn't one stock answer for all.

    As our consultant once said 'you've seen one dementia patient, you've seen one dementia patient'.





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  • Tinkerbell
    Merry Christmas and a happy Hogmanay.

    As for me, if a confused patient is being difficult at night I often use ' SHHHH! You'll wake the baby!', you'll be surprised how well it works!

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  • tinkerbell

    redpaddys12 | 24-Dec-2013 3:47 am

    Nice to hear from you. It's all been getting a bit tedious. Best laugh I had all year was your post about Eye fink from WillIAM Shakespeare.

    Merry Christmas & Happy New Year too.

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  • i've had patients, both demented and functional, complain that medication denies them the normal grieving process.

    as for knowing your patient, i once nursed a lady with dementia whose husband died shortly after admission. in conjunction with her family we care planned to reality orient for the first two weeks then re-assess. the initial shock of bereavement did not dissipate in any way, she was clearly unable to retain the news of her loss. so subsequently we employed distraction techniques, when she enquired about her husband we'd engage her in conversation about their past life together, and would soon be having a reminisce about the good old days.

    is that lying? i like to think not, having previously worked in a functional setting where the therapeutic relationship is built on honesty and trust.

    sometimes lying just seems easier, whilst maintaining integrity requires creativity, compassion and experience. however, that little fib can cause more confusion if the team presents conflicting information.

    stick to the care plan. if you don't agree with it, discuss with colleagues, it's a team decision. so far, in six and a half years working with both ward and community patients with dementia, i've never seen lying written in to the care plan.

    but as tink'll tell ya, each individual and their dementia is unique.

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  • tinkerbell

    Anonymous | 25-Dec-2013 1:26 am

    Totally agree. I don't actually 'lie' by not answering their question, I just ask them to tell me some more and get into a conversation with them in the hope that during our conversation they will find the answer themselves and then if they don't, as you say, we have distracted them with something else.

    Happy Christmas everyone.

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  • I understand the point about not wanting to distress the patient further, but part of who we are as nurses is built on integrity. If we accept lying as part of our approach, we can't be that person. Having said that, I think distraction and maybe omission of distressing information for someone with dementia are compassionate ways to handle those issues where lying looks appealing.

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