Therapeutic Truth-Telling: A Better Way to Respond to Delusions in Dementia
“She said I’m stealing from her. I’m her daughter. I’m her caregiver. And now, she’s telling neighbors she can’t trust me.”
If you’ve ever faced this moment, you’re not alone. In Episode 252, we meet Paulette—a caregiver navigating the painful reality of caring for her mom, who is experiencing paranoia and delusions due to dementia.
This episode is more than advice—it’s a heart-level conversation that validates the pain, confusion, and guilt many Christian caregivers feel when dementia gets tangled with accusation and mistrust.
Why Accusations Hurt So Deeply
Dementia doesn’t just steal memory—it can distort perception. Paulette’s mom forgets short-term details, grows paranoid, and even plans to have neighbors take her to the bank to “check” if she’s being stolen from—all while Paulette is the one managing her finances, her care, and her household.
The hardest part?
She’s doing everything out of love… and still being doubted.
But this episode reminds us: not every moment is about dementia behavior. There’s always something deeper going on—and that’s why we need a biblical lens to see it clearly.
Therapeutic Truth-Telling: A Biblical Alternative to Lying
The world tells caregivers to “just lie.” It’s called therapeutic lying—say what they want to hear, even if it isn’t true.
But as Christians, that doesn’t sit right.
That’s why Lizette introduces a grace-filled model called therapeutic truth-telling. It helps you validate feelings without compromising truth.
🗣️ Instead of correcting or arguing, try:
“That must be really hard, Mom. Tell me more.”
“What makes you feel that way?”
“Where do you think that’s coming from?”
This approach builds trust, calms fear, and honors both your loved one and your faith.
Facing Legal and Financial Concerns
Paulette’s case brings up a practical challenge: her mother has no official diagnosis, no neurologist evaluation, and no active power of attorney—yet Paulette is managing all finances and care.
If you’re in a similar situation, the episode recommends:
✅ Reviewing the trust and confirming your authority
✅ Consulting with an elder law attorney in your state
✅ Avoiding facility placement out of pressure and making decisions with clarity, not panic
Even when the paperwork is messy and the medical system is uncooperative, you don’t have to go it alone.
You’re Not Failing—You’re Facing a Spiritual Battle
When accusations arise and trust breaks down, it’s easy to feel like you’ve failed. But caregiving with dementia isn’t just practical—it’s spiritual. You’re navigating heartbreak, identity loss, and deep relational wounds all at once.
🎧 Tune in to Episode 252 to hear Paulette’s story and discover the tools, grace, and truth that will carry you through the hardest parts of dementia caregiving—with God’s help.
Join our monthly free workshop!
“How To Immediately Reduce Dementia Caregiver Overwhelm and Stress In 3 Easy Steps”
Transcript
Introduction to Caregiving Challenges
[0:00] The world says your job as a caregiver is to keep the peace, even if it means lying. They call it therapeutic lying. Just smile and nod and pretend. Tell the person whatever they want to hear, even if it isn’t true. But when you’re a Christian, you’ve likely felt the weight of that advice, because even when it sounds kind, it doesn’t sit right with you. Today, we’re going to talk about what to do when your loved one starts saying things that aren’t true and even accuses you of something you didn’t do. This is more than miscommunication.
[0:43] This is where paranoia and delusions live, where trust starts to unravel and where many caregivers start telling themselves a story that leads to guilt and isolation.
Real Conversations with Caregivers
[0:57] But it doesn’t have to stay that way. In this live Dementia Caregiver Support episode, you’ll hear a real conversation with Paulette, a daughter who is caring for her mother while being accused of stealing. And I’ll walk you through a biblical alternative to therapeutic lying,
Embracing Therapeutic Truth-Telling
[1:20] a model I call therapeutic truth-telling. It’s not about arguing. It’s not about pretending. It’s about giving yourself grace and truth when reality is broken.
[1:33] If you are a Christian and you are struggling with God’s sovereignty or God’s providence, reach out to me. I will have a conversation happily with you about God’s providence and God’s sovereignty and help you along in your journey. If you are struggling as a family caregiver and you’re ready for a little bit more support, hop on a Care Companion success call with me. It will take 20 minutes where you will be able to talk to me, gain some clarity about your very next step that you need to take in this journey, as well as have a conversation about whether or not, it makes sense for both you and for me for us to work together to help you through your dementia caregiving journey.
[2:21] Hey, Christian Care Companion. Welcome to Dementia Caregiver Support for Christians, the podcast where I teach Bible-believing Christians how to approach dementia care differently. Because caregiving isn’t random, and God is not a God of confusion. This isn’t a medical model, and it’s not just about managing their symptoms or preventing your burnout. It is a relationship-centered care that helps you with clarity and conviction and gives you hope. If you are a Christian spouse, the adult child, or a family member walking this road, you are in the right place. The next of our Ask the Dementia Coach monthly question and answer sessions registration is now open. These are small group, numbers are limited, opportunities for you to come in and have a live coaching experience receiving dementia caregiver support in action. And I invite you to register for the next session, which is May 29th at 6 p.m.
[3:31] Eastern time. The link to register is thinkdifferentdementia.com forward slash ask, or just go to our website, thinkdifferentdementia.com, where you can register for May 29th’s Ask the Dementia Coach monthly question and answer session and
Paulette’s Caregiving Journey
[3:51] get real live dementia caregiver support in action. Ms. Paulette, thank you so much for being here. So let’s say it’s about six months from today and caregiving is easier.
[4:05] What does that look like for you? Well, my daughter and her children will no longer be in the house, so I can just concentrate on my mom, and my mom is more calm and less paranoid on a daily basis. So more calm and less paranoid. How long are your daughter and grandchildren going to be there still? Right now, the plan is that they will be out by mid-June. She’s going to try and get out sooner if she can. Okay. But mid-June. Okay. Well, that gives us a timeline to work with. And what would it take Other than your daughter moving out with that timeline But related to your mom being more calm and less paranoid.
[4:50] What would it take in your mind to actually achieve that goal? I probably have to figure out better ways to interact with my mom to where we don’t end up getting in the fights that we’ve been getting in. Okay. It’s something that I need to change on my part because I don’t think she’s going to change at all. Okay. Well, that’s a very, very important insight, recognizing that that is one of the things that happens through dementia is the person really is not able to adjust or change. That is a very important insight. So to summarize, you said figure out better ways to communicate with your mom, right? Yes. So you guys don’t end up in fights.
Navigating Paranoia and Accusations
[5:37] Right. So the other word for that, like the fancy word, is managing those responsive behaviors? Yeah. Okay. All right. So go ahead and give me your specific question or situation that I can help you with today. My specific issue with my mother is she has become, I mean, her memory is completely shot for short-term stuff, anything time-bound or whatever. She doesn’t remember something she said or did a minute ago it seems like but as a result she’s become a lot more combative and she’s very paranoid she’s paranoid that people are trying to rip her off or, you know, just different things. She has a lot of paranoia. And I’m just not sure how to deal with this because at this point it’s becoming a problem because she’s talking to other people. Like she was talking to my daughter the other day saying that she’s going to have the neighbor Leonard take her to the bank to check her accounts because she’s positive she’s being ripped off.
[6:43] I’m the only person who has access to her accounts. So that’s basically accusing me of ripping her off and I’m her caregiver. Sure. And that must be super, super frustrating. It is. I absolutely understand that. And I’m also worried if she’s talking this way to my daughter, is she talking this way to Leonard? Is she talking this way to any of my neighbors? Is somebody going to think that something may be going on and report it and have it investigated? You know, I worry about that because if that sort of thing happens, I mean, all bets are off at that point because.
[7:18] And I’m thinking at this point, I need to get my mom to give me power of attorney right now while she’s still lucid rather than waiting until I have to go through a court to do it. You know, I mean, she has it in her paperwork for her living trust that I’m supposed to get power of attorney if she becomes incapacitated. But I’m thinking that it’s going to be a real shit show. Sorry.
[7:40] If I’m trying that I have to take that power of attorney, I have to go to court to invoke it or something. I’m thinking it’s, you know, get her to do it while she’s still lucid. Just tell her it’s better to get it in place now so that it’s an easy transition. But she’s also not trusting me, though she says she does, but then when she’s
Understanding Power of Attorney
[7:59] talking the way she’s talking, it’s like she doesn’t. So I don’t know. The whole thing’s just, and I know I don’t want to go down the conservatorship way. I don’t want to do that. Absolutely. You bring up so many valid points. So would you like to hear, based on what you’ve just told me, my best recommendations for you in your particular situation? Yes. Okay. So I’m going to kind of paraphrase what you just told me because there was a lot. And I want to make sure that I actually picked up all of the pieces.
[8:30] So what you expressed in my words is, you know, your mom has no memory. She’s struggling with time specific things, not recalling things within a couple of minutes. She’s pretty combative or argumentative, maybe would be a better word, and paranoid. And she’s very worried that she is being ripped off and she’s talking to other people about it, including neighbors, and wanting to go to the bank to check out all of those kinds of things. And it concerns you that she’s talking to other people because that can open up the door for people to come look and see whether anything has been done incorrectly, which I don’t believe, you know, there’s nothing you’ve said has me concerned about that. But it’s a natural concern that, you know, when somebody’s accusing you of stealing to be worried about other people coming in and trying to determine that. You did express about a power of attorney and you mentioned a trust. And so we’re going to go, we’re actually going to start there because it’ll help me understand how to guide you. So I don’t need specifics about the trust, but your mom has a trust. How long has it been in force?
[9:45] This trust has been in place for probably about 20 to 25 years. So a long time. Yes. And she has me set up as the executor if something happens to her and all that sort of stuff. So within a trust, usually there are.
[10:01] Two documents. There’s a healthcare power of attorney and a durable power of attorney for financial decisions.
[10:10] Do you know if you are the decision maker for both? I believe I am. I’m going to have to get her to pull that paperwork out again so I can look at it. But I looked at it a few years ago and I believe she already had it in place that I’m the person that’s supposed to be the one. Okay. You need to know definitively. That is the very, very first thing you need to know. Do you know who the attorney is who set up the trust? Oh, gosh, it was so long ago. I don’t even know if he’s around anymore, but she is a part of my prepaid legal
The Importance of a Diagnosis
[10:46] plan. So if there’s anything that we need to get adjusted, maybe they can help us by that. Now, here’s a very important question. The trust, was it enacted in the state that your mom now is living in? Yes. Okay. The reason I ask that is a friend of mine recently passed away and her original will, she didn’t have a will for the state that we live in. And that can open up all sorts of, you know, in 20 years is a long period of time, people could have moved away. So the trust is in the state that you guys live in and you’re pretty sure that you are the durable power of attorney for financial as well as health care decisions.
[11:27] Right, because that’s the way the trust is set up. It’s me first and if I don’t want to or can’t do it, then my brother’s supposed to do it. Okay, now does your mom have a definitive diagnosis of dementia? No. Okay, so tell me a little bit more about that. Well, I mean, she’s been having symptoms as far back as 2016. As far as her memory, it’s gotten considerably worse. I’ve taken her to her Kaiser doctor twice now, and she’s had blood work and CAT scans. And he says it’s just normal, age-related symptoms. Memory loss, whatever. He says she doesn’t have the markers for Alzheimer’s. However, he also will not allow her to go to a neurologist to get further testing unless we preemptively agree that if they say she should take medication, that she’s going to take it. And my mom’s like, absolutely not. I’m not going to agree to that. And I don’t want to agree to that either. But other people telling me, well, you should just say yes, get the diagnosis done, and when they give you the medicine, just don’t take it. But I feel that that’s dishonest. Correct. I wouldn’t recommend that you do that. Now, do you have the capacity or the ability to choose another primary care physician? I don’t think it would matter if I did choose another primary care physician. She is with Kaiser Permanente.
[12:55] Kaiser Permanente has a policy that if you’re going to be referred to neurology to get further diagnosis about dementia, that you have to preemptively sign off, that you’re going to take whatever recommendations and go with it. That’s the way they operate. That really concerns me in a lot of, I can’t tell you how many different ways that concerns me because one of the challenges that we have is a durable power of attorney is only really an enforceable if a person’s not competent to make their decisions.
[13:28] Right. And so you are in a sticky wicket place because on paper you don’t have a diagnosis, but you have all the signs and symptoms of something going on, right? And so are you on her checking account that you can sign for checks and things like that? I don’t think that I can sign for checks. I mean, I’m on her checking account that if something happens to her, I’m able to walk into the bank and get the money out, that type of thing. But I’m not actually on the account as a signer. But you’re managing her finances? I am 100% managing her finances. I’ve been doing it for about two years now because she got to where she couldn’t even balance her checkbook anymore, and she was sometimes paying some bills late, so I took it over, and that’s part of where the distrust is coming from at this point, I think. Sure. So I would actually recommend you go to an attorney.
[14:26] And the reason I say that is because.
Addressing Financial Concerns
[14:30] Everything that you have described tells me your mom has something going on. Yeah. Unless she has a longstanding history of other mental health issues that would cause paranoia or any of those kinds of things. The fact that she doesn’t remember the fact that she’s having time issues and the paranoia, plus what you said, you know, the errors that she’s been making in her finances over the last several years. Yeah. Does lead me to believe that she has cognitive loss or cognitive impairment, but you don’t have a diagnosis.
[15:06] And it sounds like in your medical system, they’re getting a diagnosis is going to be a challenge. So we have, there’s competency and capacity, right? And you mentioned earlier on about, you know, not wanting to go to court and take her, you know, get custodial care over her. That is competency. In order, you know, for a person to be, for those rights to be taken away, you are declared incompetent to make your decisions. And that is a legal determination. And the courts take that extremely seriously because you’re taking somebody’s right to vote away, to open a bank account, to do all of the stuff that we, the rights we get as an adult. There’s another one, and that’s called capacity to make their decisions. And that is a medical determination. You’re already in the problem that the medical system is failing you in the sense that it’s not helping you get a diagnosis.
[16:09] What in essence happens over time is that you and your mom kind of limp along with no diagnosis until something happens. And she ends up in the hospital and then when, you know, a urinary tract infection or she falls and she breaks a hip and has anesthesia and all these things and it makes everything worse. Right. And then all of a sudden we get a diagnosis slapped on us of dementia unspecified.
[16:39] Right. That doesn’t solve your problem. Right. In the here and now. Because your problem in the here and now is you have a valid concern about the finances.
[16:50] And technically on paper, if somebody were to go look, it could look not great. Not saying you’re doing anything wrong, but you don’t have the paperwork backing you right this moment. Exactly. Right. So you need to talk to an attorney and ensure that you don’t get yourself in a sticky wicket. Now, one possible solution is a money manager, which is a fiduciary outside of you and your brother that actually manages her money for her on her behalf and doesn’t flow through you. Yeah, the problem there is that was something that you’d have to pay for. There’s not much money there, so there would be no money to pay for something like that. Okay, so even though she has the trust, there’s not a lot of assets in the trust. No, and she’s on a reverse mortgage. The fact is, when she dies, the house has to be sold because there’s so much owed on it. Sure. Now, do you guys live in the house that you’re- My mom, I am living in the house with my mother because I am there. I moved in in 2019 when my brother and his wife moved away. I moved in with her. I’m not even living with my husband. I should be, but I’m living with my mom because she needs the care.
[18:04] Sure. I understand. So what I would love to recommend for you, you know, in a manner that can maybe help you plan through this is I have, I just started it this past week on Tuesday.
The Confident Caregiver Blueprint
[18:18] I started a, I call it the Confident Caregiver Blueprint. It is a six week, seven weeks, there’s a bonus week intensive that I’m taking people through how to actually plan through this, how to plan through what to do next. We look at a whole bunch of different things like, who’s responsible and what are the options and how do we put together this plan? And so that would be something that might make sense for you if you’re interested. It’s $97 and it’s live. It’s on a Tuesday at four. There’s no pressure. Until my daughter and her children are out of my house, I don’t see that it’s possible because I have three children in the house. I hear you. Running around. Now, to encourage you, the next cohort is going to be at the end of May. Okay. So I’m going to do it three times live. Okay. Because I want to get feedback from real people with real specific issues.
[19:21] Yeah. Now, right before I end with you, I do want to talk about the paranoia and the communication barrier that you said. When somebody is typically paranoid, they’re having delusions. And delusions are when a person is believing something that is not true. That is a delusion. It’s believing something that isn’t true. A hallucination is hearing, seeing, feeling, tasting, touching, you know, something that other people can’t see. Right. So that’s when a person is experiencing those kinds of things, it’s a hallucination. So what you’re describing sounds to me like paranoid delusions. Yes. When somebody is delusional, arguing with them, not arguing like fighting, trying to reason through with them is very counterintuitive. And it does not work and all that it will result in.
[20:28] Is making it worse. So here’s a strategy, a very practical strategy I want you
Strategies for Paranoid Delusions
[20:33] to try, and that is meet her emotionally wherever she’s at at that moment. So she says, I think somebody’s stealing my stuff. Then you validate that, oh mom, that must be super hard. Tell me more about it. Get her to tell you what’s going on in that pretty head of hers so you can hear what it is that she’s believing. Now, you’re not going to flat out lie to her, right? But we’re also not going to try to reason through, oh, it’s not true.
[21:05] This, this, this, because all that will do is continue to escalate it. So your biggest job is to try to de-escalate it by validating her emotions. And then the last piece of advice that I have for you is, and this is the hardest thing, and I’m not saying you particularly are doing this, but you in general, us, when we are helping somebody living with brain changes, with cognitive changes, they are super, super, super sensitive to your emotional energy. So if you are starting to get frustrated, she’s going to sense it and it’s going to continue to make it worse. Well, and I think it’s hard for her too, because she’s wanting everything to be flowers and roses and balloons and happy. And I am physically disabled. I’m living with daily pain. I was fired from my job. I’m financially struggling and I’m doing my best to stay positive, but I’m in pain on a daily basis. And so I think that that feeds into her, Like, she wants me to tell her everything’s great, but it’s not. But my husband thinks I should just lie to her. Lie to her. I love what she wants to hear just so that she’ll be okay, you know. I don’t believe in the technique called therapeutic lying.
[22:34] I developed a technique. I call it therapeutic truth-telling. There is truth in what you can say to one another. And so that’s why you need to get her to tell you what’s going on. And then you validate what she is saying. A good example is mom’s trying to leave. You know, I want to go home. I want to go home, right? That’s something we hear a lot. I want to go home. Well, tell me more about that, mom, or tell me where’s home. Tell me about home, right? Because home can be where I grew up when I was five years old or home can be where I was living with my husband when I was 20 or home can be where I’m living now, but I don’t recognize it as where I’m, it doesn’t look familiar. So get the person to tell you more about it and then, you know, or where’s my mom? Well, where do you think mom is, right? And then whatever they say, well, mom’s gone to work or mom’s at the, at the park or she’s taking care of the kids. Then you just validate and say, well, you must be right.
[23:38] So you’re not lying to her and you’re just working within the parameters. Find the truth. So if your mom, you know, if she’s wanting all roses and sunshine, then just try to get her to talk more about it. And I know and I understand it is hard when you’re not feeling well yourself. The reality is that as best we can we have to put a hedge around you a bubble around you so that you can have the bandwidth in order to be able to navigate this without making it worse yeah and it’s hard too when you have people around you telling you you just need to put her in a home and it’s like no that’s not going to happen she needs to
Preparing for Tomorrow’s Interactions
[24:21] hopefully be able to live in her own home until she dies. How old is she? She’s 83. 83. Okay. All right. So what’s one step that you can take today that will move you closer to making this easier? Well, I’m going to mentally prepare myself to try the techniques you were just talking about when I go back in the morning. She’s actually home alone right now. She’s okay. Three nights a week, I stay with my husband, but I go home in the morning.
[24:50] So I didn’t used to go home in the morning. I have to now because she needs to see me every single day. So I’m just going to work on mentally preparing myself to interact a little bit differently with her starting tomorrow. Good. That’s a good story. My daughter is not going to be there so she can’t talk crap about me today but she gets my daughter’s ear and starts talking crap about me. And my daughter tells me about it. So my daughter’s not going to be there. So I think that that’s actually a good thing. But my mom does get sundowners a little bit. She gets used at nighttime.
[25:27] So what I’d recommend, Paulette, I do this once a month. And like I said, you are welcome to come every single month and sign up again. And then let’s continue this so we can help educate you. Yeah. And I joined about three or four groups on Facebook, but I think I’m going to drop all of the other ones. I think I liked yours the best because it’s for Christians, and I kind of can tell the difference. There’s a massive difference, isn’t there? Yeah, so I think I’m actually going to just leave the other groups and just stick with this one for now. Yeah. One more recommendation for you. If you listen to podcasts, I have a free podcast. There are almost 200 episodes. There’s a lot of different types of episodes. There’s some interviews. There’s some of these type of coaching episodes. There are 10, 15 minutes of other people asking questions, and there’s a lot of good information on there.
Community and Continued Support
[26:26] So, you know, go check out the podcast. It’s called Dementia Caregivers Support for Christians. You can’t go wrong. Okay. Sounds good. All right, sweet lady. Thank you for joining us. I’m super excited you’re here.
[26:38] People who are really benefiting from the community are the people who joined earlier on before they need it and that have been active and are participating in the community because then they already know what questions to ask and they have a place to come and they’re not constantly wondering, what do I need to do? How do I need to do it? So people listening are interested in tapping into or learning about the community. I’d invite you to just go to the website, thinkdifferentdementia.com. There’s a link for you to schedule a 20-minute call there’s no pressure i’ll serve you regardless of whether you join the community or not but it is a way for you to take this relationship a little deeper a little bit more hands-on support because really the research also shows it’s longitudinal support over time absolutely yeah for sure i would highly recommend lizette she’s awesome i see i appreciate that endorsement you are well thank you everybody for listening today. And as I try to remember, I try to remember, I don’t always remember. May the Lord bless you and keep you and come back and listen some more. I’m hoping to do more of these coaching style episodes on a Friday. So come back in and check us out. And thank you for being here today.
