Alzheimer's White Lies
How to Use "Geriatric Fiblets" to Help With Alzheimer's Care
The term “geriatric fiblet” was coined at the 2000 World Alzheimer’s Congress as “necessary white lies to redirect loved ones or discourage them from detrimental behavior.” I have found the concept useful in analyzing my own actions as a professional senior move manager working with older adults.
The senior move management industry is guided by a code of ethics that defines the values and principles of behavior for the profession. Developed in 2002 by the National Association of Senior Move Managers (NASMM), the code includes honoring the client’s right to determine their own future, keeping confidentiality, respecting the client and his or her belongings, acting with integrity, and more. (View the entire code of ethics on the NASMM Web site.) But the concept of “beneficial” white lies, particularly when working with individuals who do not have dementia, would seem to contradict these values. Or does it?
Take, for example, a client of mine who had 100 National Geographic magazines. He didn’t want to keep them, but also didn’t want them to be simply thrown away. “Can’t you find someone who wants them?” he asked. So acting on his behalf as a move manager, I contacted a friend who teaches third grade and she agreed to take half the magazines for an art project. I gave her half, and told my client, “I found a third grade teacher who is using the magazines in an art project.” I told the truth, sort of, except that by omitting that half the magazines were discarded, I told what I call a geriatric fiblet.
When faced with a question about appropriate conduct, I often look to the NASMM code of ethics for guidance. In this case, the geriatric fiblet was one I can live with. I think it showed respect for my client’s wishes and for his budget.
Next, take the case of an adult daughter who is sorting sort through her parents’ belongings , much of which will not fit in their new home . “Throw this away and don’t tell my parents,” she asks. The daughter may tell this “geriatric fiblet,” but I will not. According to the NASMM code of ethics, my senior clients determine what goes with them to their new home . I provide guidance but respect their decisions, even if I don’t agree with them.
More complex, perhaps, is when the daughter throws something out without asking her parents and then asks me not to tell them. Do I blow the whistle on the daughter? On face value, it would appear that I should. However, I consider the code of ethics requirement to ensure cooperation among all individuals involved in my client’s move. I see this as the daughter’s ethical issue, not mine. I would likely opt to remain silent, or I would explain to the daughter why we involve clients in all decisions.
Now comes an even more complex issue: the adult children who ask me to misrepresent my costs as lower than they are to their parents, telling me that they, the adult children, will pay the balance. I recognize that they are trying to respect their parents’ desire for independence. I think back to thirty years ago, when I did the same thing for my grandmother. She was determined not to pay more than $200 per month for an apartment; but the place she wanted to live in was $260 a month. We asked the leasing agent if we could pay the difference. “No problem,” she replied, and prepared a dummy lease for my grandmother. My geriatric fiblet honored my grandmother by enabling her to preserve her sense of independence. I have no qualms about my behavior.
However, in that situation I was acting as a granddaughter, not a senior move manager. I would not misrepresent my costs to a client at the request of their children. I may have colleagues who disagree with this position, and for me, that is okay. Codes of ethics are not absolute. Often it is the thought process that is most important, and for many issues, cogent arguments could be made on both sides. Are geriatric fiblets appropriate? Yes, but it depends on the circumstances and on the person telling the fiblet. Appropriate behavior for family members may not be appropriate for professionals.
Margit Novack is the Founding President of the National Association of Senior Move Managers (NASMM). She can be reached via email at firstname.lastname@example.org or by phone at (610) 853-4300. See www.movingsolutions.com for more information.