Therapeutic lying: Brazilian speech and language therapists' point of view about a controversial communication strategy employed in the care for people with dementia.
Isabella Amaral Lopes, Emily Viega Alves, Bárbara Costa Beber
PMID 36287422WHAT IT FOUND
Most Brazilian speech therapists use therapeutic lying with dementia patients, viewing it as relatively ethical and valid for safety and care.
However, few had formal training or literature access, and many expressed interest in learning more. Current ethical codes may conflict with this widespread practice.
Key findings
0165.3% of participants reported having used therapeutic lying to benefit a patient with dementia, yet only 23.6% had heard of the term before this survey and 5.6% had found literature on it.
02The majority considered therapeutic lying relatively ethical (77.8%), valid (65.3%), and appropriate (68.1%), often citing patient safety and cooperation as primary motivations.
03Participants identified specific clinical scenarios where therapeutic lying was deemed useful, including convincing patients to take medication (82.8%), eat (79.7%), and perform hygiene (71.9%).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a convenience sample distributed via social media, which introduces selection bias. The sample was overwhelmingly from the Southern region of Brazil (45.8%) and entirely female, limiting generalisability to other regions or genders. There is no data on the total number of SLTs working in dementia care in Brazil, so the representativeness of the 72 participants is unknown. The study reports opinions and self-reported practices, not actual patient outcomes or safety data. The questionnaire was created by the researchers and not validated, which may affect the reliability of the responses.
Declared interests
The authors declared no conflicts of interest. The study was approved by a local ethics committee.
The easy way to misread this
Do not interpret the high percentage of therapists using therapeutic lying as evidence that it is safe or effective for patient outcomes. This study reports on therapist opinions and self-reported behaviours, not on clinical trials measuring patient well-being or adverse events. The widespread use may reflect a lack of better strategies rather than proven efficacy, and it exists in tension with professional ethical codes.