On the Moral Permissibility of Therapeutic Deception in a Dementia Village

Abstract

Background Scholars believe that, by allowing severe dementia patients to be fully immersed in an alternative reality via the use of all-day reminiscence therapy, their behavioral and psychological symptoms could be alleviated. Since the Millennium, dementia villages emerged as an innovative nursing home design to create such environment. Critics, however, also appeared to comment on the approach of dementia villages as depriving patients of access to the objective reality in a manner that is akin to Jim Carrey’s movie The Truman Show (1998). To this date, only a handful of studies have questioned the ethics of therapeutic deception in dementia village. Method Relevant journal articles are sought on three databases: ProQuest, Scopus and Medline. Authorsuse the following/ any combination of the following keywords: “Hogewey”, “De Hogeweyk”, “dementia village”, “dementia care”, “therapeutic lie”, “deception” and “ethics”. The identification process also includes references cited in the primary search result. Result Of the articles identified, only two (Graf-Wäspe, 2016; Lorey, 2019) directly comment on the moral legitimacy of therapeutic deception as deployed in dementia village setting. Both center on discussing an illusory bus stop. It is thought that the following influence our perception in regard to how permissible a dementia village’s therapeutic deception is: (1) whether falsehood is disseminated in the process, (2) how far might it add to the potential stigmatization that persons with dementia deserve to only live in fictional world, (3) whether a false belief might be formed in a demented resident’s mind. Discussion Instead of denouncing the dementia village, nuances have to be made when it comes to therapeutic deception. We discuss why measures need to be taken to operate a more morally justifiable intervention or care relevant to dementia village. Future research should be conducted on the possible consequences of a dementia village resident debunking a deception.