Is it okay not to tell her the truth?

The spectrum

Nobody picks a single approach and keeps it forever. As your mother changes, most families drift along something like this, often without naming it:

• The whole truth. You tell her plainly, every time, even when it distresses her afresh each time she asks.
• Leaving things out. What you say is true, but you do not volunteer the harder part unless she asks for it directly.
• Answering the feeling. You reply to the worry underneath the question rather than the literal question itself.
• Going along with it. You accept her sense of the day, the year, or who is in the next room, without correcting it.
• Therapeutic fibbing. You add one specific, false detail, meant only to settle her, such as saying someone is at work rather than explaining a loss she has grieved before and cannot hold today.

Where you sit on this changes call to call, and that is not inconsistency. It is you reading what she can hold in that moment.

What bioethicists say

Truthfulness is the default. The Nuffield Council on Bioethics, in its 2009 report Dementia: ethical issues, kept a strong presumption in favour of the truth, then asked what to do when the truth causes real distress to someone who cannot reason her way through it. In our own words, not the Council's: her wellbeing comes first, and not being fully truthful can sometimes be justified, but only for her sake, never for the convenience of the people around her.

What validation therapy taught us

Naomi Feil's validation therapy is the approach behind Compassionate Validation: meeting her in her own reality, rather than pulling her into ours. If she says her mother is coming for lunch, the reply meets the feeling behind it, comfort, anticipation, love, without arguing the fact and without inventing one either.

This is not the same as a fib. A fib adds something false to settle her: "she just called to say she is running late." Answering the feeling adds nothing false at all; it simply declines to correct her, and stays with what she is actually feeling. Both sit further along the spectrum than most people expect kindness to require, and both are different from a lie told for your own ease.

A way to decide, tonight

Before you answer her tonight, two questions do most of the work. First: is this for her comfort, or for mine? A small mercy that spares her a fresh grief she cannot hold sits differently than an answer chosen because the truth is awkward for you to say. Second: could I explain this choice to my sister, or to her doctor, without wincing? If the answer is yes to comfort and yes to explaining it plainly, you are probably in the range bioethicists would recognise as reasonable. If either answer troubles you, that is worth sitting with rather than deciding alone at ten at night.

Where Voice Companion fits

We hold ourselves to the same test. On the call, she is not told it is a recording; she hears your voice, and that is the point of comfort, not something hidden from you. You submit consent to how your voice is used, what she hears, and how calls are recorded and transcribed. You can withdraw it at any time. It never argues if she asks whether it is really you, and it never invents a promise to visit or a call it cannot keep. Read the full position on ethics and consent.

Questions people ask about this