Helping people with kindness is an important duty of any nurse, especially those who work with dementia patients.

What would you do if a new nurse was upset with one of the resident neighbors who had dementia because she was trying to leave the facility even when she wasn’t allowed?

That is what the experienced nurse in this story witnessed, so she stepped in to try to help, but the new nurse was upset. The new nurse said that she could not lie to the patient, but the one with experience showed how you can redirect the patient without lying.

Personally, I love the way this nurse handled a difficult situation. Read through the full story below and see what you think.

“Don’t lie to the residents!”

I was reminded of this little occurrence from a few years back today, thought I’d share it.

This is important and difficult work.

So, about three years ago I worked for a care home. I still do work for a care home, but I also did three years ago. It’s primarily nursing care with a little dementia care.

The residents can range from being totally independent and capable of going about their day with minimal assistance from staff, to end of life care with checks every half hour to make sure there’s always someone with them.

Every patient needs unique care, though.

The particular resident I’m going to be talking about here, we’ll call “Dot”, because she looked like the Eastenders character of the same name, only with a thick Liverpudlian accent.

Dot had a great sense of pride, and a low tolerance for anyone who she believed was talking down to her. She was largely independent, just had a few “funny turns” here and there.

I’m sure this situation is pretty normal.

I was working a night shift when this happened (7PM-7AM), and it was round about midnight. My colleague was setting up breakfast trays for the morning, I believe, whilst the nurse was doing a few clerical duties.

We had a nurse from an agency due to ours being ill. Agency workers can be a mixed bag here. Some are lovely, hard-working and understanding. Some are grumpy and uptight. Some, we politely ask if they don’t get sent again.

Not the best attitude for a nurse.

The nurse that night fell squarely into the middle category. She would be snippy with the care staff, opting to do her work without any communication to us unless it was absolutely necessary to hand anything over to us (fair enough, nobody says you have to make friends here).

And, she would treat the residents with a false smile and a semi-condescending tone, sort of like you’d expect one to use when talking to small children.

Dot seems determined.

Dot was going through one of her “funny turns”. She had put her coat on, and was trying to barge her way out of the front door. I came across the reception area to find the nurse trying to talk to Dot, with Dot trying to get to the front door saying “get out of the way, you miserable old trout!” to the nurse.

The nurse was saying things like “I’m sorry, Mrs Dot, but we need to look after you here! It would be irresponsible of us to allow you to wander about outside at this time! You could seriously hurt yourself! Look, it’s dark out!” All things that seemed to make Dot angrier and angrier.

This is an important question to understand what is happening.

After a while, Dot stormed off. I asked the nurse why Dot wanted to get out the home.

“Because she has dementia!”

“Yes, but why in her own mind, is she trying to leave? In her mind, it makes perfect sense for her to leave the home, what’s her reasoning?”

Being honest with a dementia patient is often very cruel.

“Oh, she wants to go to the pharmacy. What difference does that make? We can’t allow the residents out unsupervised for any reason, and especially not in the dead of night!”

“I’ll talk to her.”

“No, you will not! I know how people like you work! You’ll say anything to keep the residents happy, even if it means filling their heads with lies! Well, I was taught that we have to be honest with the residents!”

This makes perfect sense.

And this is true, you can’t tell a resident an outright lie. At least not where I work. If a resident with dementia is distraught because their mother hasn’t given them a phone call, you cannot say to them something like “Oh, but she did ring you about a couple of hours ago, remember?”.

However, it’s kind of frowned upon to say something like “your mother died twenty years ago. Dead people can’t use the telephone” instead, honest as it may be.

Good, hopefully she can handle this difficult situation properly.

You have to learn to use tact, omit details if they could cause distress, and treat the residents with some modicum of dignity.

Anyway, somehow I convinced the nurse to let me speak to Dot. The nurse said that if she sees me lie to Dot, she will file a report, and see that the home manager knows I am “institutionalising” the residents (which is a very, very, serious accusation here).

Let’s see how this is handled.

We made our way to Dot’s room. She is angrily stuffing things into her handbag at the time. The nurse folded her arms and stood in the doorway as I spoke to Dot.

“Dot?”

“What do you want, (my name)?”

She is getting the information she needs.

“What are you getting all dressed up for? Is something special happening?”

“I NEED TO GET TO THE PHARMACY! THEY HAVE MY MEDICINE!”

What a great way to handle this.

“But, Dot…it’s Sunday! The pharmacy isn’t open on Sunday!”

Dot stopped in her tracks. For the first time, she looked confused, rather than angry.

“…is it?”

And just like that, the problem is solved.

“Yes, Dot. Look… Here’s your clock. It says today’s date on it, and it says Sunday, see?”

Dot made a sheepish face to this.

“Oh. Oops. I suppose I’d better get settled. I do actually feel rather sleepy.”

What lies were told?

I left Dot to it. When I walk out the door, the nurse is stunned that I handled it so easily. She tried to sputter out that it was still filling the resident’s head with lies for the sake of a quiet life.

I just asked her, “what day is it right now?”, and she didn’t have an answer.

This contract nurse should never be invited back.

The nurse tried to speak to my colleague about my “behaviour” later that night. My colleague basically told her that what I did was the same thing she would have done.

When Dot had her funny turns, she would argue with you about the time of day, how safe it was outside, etc. But as you got to know the residents, you got to know what kind of advice they’d be willing to listen to.

It was a great story, though.

Anyway, there’s the time an angry resident calmed down and a grouchy nurse got egg on her face. Hope you enjoyed!

What a great story, and a wonderful example of how you can deal with a frustrating situation with kindness.

Read on to see what the people in the comments have to say about it.

Here is someone who thinks she did the right thing, though.

This commenter’s mother was a dementia care professional.

You do have to ‘live in their world,’ though.

She was lying, but it was the right thing to do.

If you enjoyed this post, check out this story about a contractor who flew along way and spent 3 days on a fix only to find a breaker that needed to be flipped.

This commenter has worked in mental hospitals, but he doesn’t think he could offer regular care.

Sometimes, lying (or stretching the truth) is the compassionate thing to do. Why anyone would want to engage in ‘care’ that clearly upsets the dementia patient is beyond me.

It is much better to help them to remain calm and happy, even if that is not perfectly in line with reality, but some people don’t like that.