Little white lie may be good therapy

Dear Dr. Gott: Regarding the doctor who wrote about “an elderly patient of mine in a nursing home,” does this man have an ounce of compassion, common sense or even a heart? What is the matter with him?

He states that every time he sees this patient, the man makes the same pronouncement. (“This is only temporary. I’m just here for a week or two.”) The man smiles and looks questioningly for reassurance. This cold, cold man then replies, “I’m sorry, sir, but this is where you’re living now.” And every time they have this discussion, “his disappointment is palpable, his hopelessness more pronounced.” And he has been doing this incredibly cruel thing to him for more than three years.

If this man doesn’t remember events from one minute to the next, what possible reason does the doctor have to destroy any peace this patient might have? Can he not understand that just by agreeing with him he will make the remainder of the patient’s time on earth easier and, yes, maybe even happier?

Dear Reader: Several readers have suggested that lying to a demented nursing-home patient is appropriate. And I endorse this strategy, provided other avenues have been explored, such as telling the truth.

Sometimes, professionals and family members have to make a real effort to prioritize their reactions to seriously ill or demented patients. Although I don’t endorse being consistently dishonest in my dealings with demented patients, sometimes I suspend the rules and tell a fib, such as “you’ll be going home soon.” Even though this is not a possibility, it might lead to a brief smile and some, also brief, relief of tension and sadness.

Therefore, I am printing your letter because I agree with your general position, and I hope your view will help stimulate more discussion about the topic of senility and how best to handle and support demented patients who live out their lives in a chronic gloom (to be differentiated from depression) for which family input and selected medications are often appropriate.

We owe this to our patients if, for no other reason, we can realize that those of us over 60 might be in the same category before too long. So, while we need others, we may unintentionally help ourselves.

As always, I welcome letters regarding the difficult subject of dementia.

To give you related information, I am sending you a copy of my Health Report “Alzheimer’s Disease.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.