F   Fiblets

 

I remember how liberated I felt when I discovered the concept of “fiblets” and learned that they were not only acceptable but considered therapeutic with people with dementia. How freeing to have permission to lie!

For the past few years I had been struggling with my mother’s increasingly deteriorating sense of reality, constantly trying to reorient her to the “truth” when it eluded her. One problem was her lost memory of her family members who had died, and the most wrenching of these was my brother.

My brother passed away of a massive stroke at 2008 at the age of fifty-five. It was a devastating shock to all of us. I was afraid at the time that it would literally kill my mother, but she was surprisingly strong and held up through the ordeals of the vigil at the hospital and the funeral. In retrospect, I believe that this was when her deterioration really began. She soon forgot what had happened and from that point on her memory and cognition got worse and worse.

I felt at the time that it wasn’t right to lie to her by omission, by not correcting her delusion. When she would ask about David, I would gently remind her that he was gone, then have to watch her face collapse and hear her agonized question, “Why? Why him?”

So I was relieved and happy to learn about fiblets—little white lies told with compassion. The rationale was wonderfully simple: because people with dementia can’t hold onto new memories, they tend to forget what happened only a minute before. All those times I had told my mother the truth, it had never stuck: she would ask the same questions a few minutes later. So what good did it do to upset her in the moment? Fiblets take advantage of one of the blessings of memory loss. They  allow the kindness of going along with delusions. So when she talked about going home to make dinner for David, I would tell her that his wife would do that. If she asked how one of my aunts was, I’d tell her she was fine.

Fiblets are part of dementia care, and I’ve seen them used well in the AL. If a resident wants to use the phone to call a cab to take her home, she’s told that the phone is out of order or that someone else is using it right now. Then the staff distracts her, and she forgets.

I used to think I owed it to my mother to be honest with her. Now I know that compassion, more than honesty, is what she really needs—and that it’s just as valuable to the caregiver as to the patient.