Is it OK to lie to someone with dementia?

There was disagreement on social media recently after a story was published about an aged care provider creating “fake-away” burgers that mimicked those from a fast-food chain, to a resident living with dementia. The man had such strict food preferences he was refusing to eat anything at meals except a burger from the franchise. This dementia symptom risks malnutrition and social isolation.

But critics of the fake burger approach labelled it trickery and deception of a vulnerable person with cognitive impairment. Dementia is an illness that progressively robs us of memories . Although it has many forms, it is typical for short-term recall – the memory of something that happened in recent hours or days – to be lost first.

As the illness progresses, people may come to increasingly “live in the past”, as distant recall gradually becomes the only memories accessible to the person. So a person in the middle or later stages of the disease may relate to the world as it once was, not how it is today. This can make ethical care very challenging.

Is it wrong to lie? Ethical approaches classically hold that specific actions are moral certainties, regardless of the consequences. In line with this moral absolutism, it is always wrong to lie. But this ethical approach would require an elderly woman with dementia who continually approaches care staff looking for their long-deceased spouse to be informed their husband has passed – the objective truth.

Distress is the likely out.