The Art of Utilizing a Fiblet

Republished from: https://www.alternativesinalzheimerscare.com/the-art-of-utilizing-a-fiblet/?utm_source=newsletter&utm_medium=email&utm_campaign=October2019&utm_content=blog

Based on an article called “Telling a ‘good or white lie’: The views of people living with dementia and their carers” by Dympna Casey, Una Lynch, Kathleen Murphy, Adeline Cooney, Mary Gannon, Catherine Houghton, Andrew Hunter, Fionnuala Jordan, Siobhan Smyth, Heike Felzman, and Pauline Meskell

What is a fiblet?

In the world of dementia, you may understand the term fiblet as a “lie” or “white lie.”  In order to increase the quality of day for the person living with dementia, the caregiver must create moments of peace and reassurance.  I would like you to reframe the term fiblet as a “therapeutic non-truth.”  In general, caregivers prefer to tell the truth.  In the world of dementia, it is referred to as reality orientation.  This choice may not be in the best interest of the person with dementia.

If we think of a fiblet as a therapeutic intervention rather than a lie, we can create moments of decreased anxiety and stress for the person living with dementia.  This published article explains it very well

Why use a fiblet?

In these moments of unfamiliarity and fear, if we choose to use truth or our reality about the current situation, it will only escalate the person’s feelings of discomfort and pain.  Here is an example of how using a fiblet worked.  Mary, 85 years old, living with Alzheimer’s was attending my day program.  Towards the end of the day, she is beginning to feel anxious and is pacing by the door and looking out the window.  Mary asks, “When is my father coming to pick me up and bring me home?”  If we choose to reality orient, or tell the truth, our response to Mary would be, “Mary, your father is dead; you are 85 years old; your ride is coming soon; you should sit down while you wait.”  Mary’s dementia disease has robbed her of remembering she is 85 years old and that her father is deceased.  Mary is now crushed, and her feelings of fear and anxiety are now escalating.  We, as caregivers, can create either negative moments, or positive moments in that person’s day.   The dementia disease is already responsible for creating negative feelings such as sadness, grief, despair, apathy, and poor self-esteem.  Trained caregivers commonly use fiblets in order to change those negatives into positives.

How do you use a fiblet?

In order to succeed when using a fiblet, your fiblet must be believable.  The only way to create a believable fiblet is to know the person.  Even in the delusional reality of the person living with dementia, if the fiblet is not believable, the person will call you out on your dishonesty.  If you know Mary well enough, you would know that Mary’s father worked in a shoe factory.  Mary will most likely believe you if you use that piece of history in your fiblet.  Here are a couple of steps could use to make Mary feel better.  “Mary, I hear you are asking when your father will be here to pick you up.”  She now knows you heard her.  “Mary, I can imagine how you are feeling. It is the end of the day, and I would like to go home too.”  She now feels that you are empathizing with her. “Mary, your father is finishing up his work at the shoe factory, then he’ll be here to pick you up.”  Even though this is not true, Mary feels reassured.  After that reassuring statement, you then will have higher potential of success by asking “Mary, would you please help me fold the towels, laundry, dry dishes, set the table, etc.”   This is a fabulous re-direction technique.  You first validate, then empathize, use a believable fiblet, and creatively re-direct.

When do you use a fiblet?

You must know the person’s history to create a believable fiblet.  When a person living with dementia expresses anxiety, stress, and fear, the goal is to reduce those symptoms.  When we validate, empathize, fiblet, and re-direct, we have a better chance of succeeding.  My experience has taught me that you need a toolbox.  This toolbox has a variety of strategies, interventions, and fiblets. Some may work for Mary; others may not.  Therefore, building a toolbox helps to provide you with creative interventions based on Mary’s history, likes, dislikes, interests, abilities, and preferences.

A fiblet is an effective therapeutic intervention for people living with dementia.  If utilized properly, the person is relieved and reassured.  As a caregiver, your goal should be to produce moments of peace and calm resulting in positive feelings for the person living with dementia.