Therapeutic Lying in Dementia Care: Attitudes and Knowledge Among Social Workers in Spain

Abstract

Este estudio analiza el conocimiento, uso y aceptación de la mentira terapéutica entre trabajadores sociales en España que atienden a personas con demencia. A través de un diseño cuantitativo y transversal, se encuestó a 253 profesionales. Aunque el 83.8% había utilizado esta estrategia, el 58.1% desconocía el término. Los resultados muestran una aceptación moderada, con mayor uso en entornos gerontológicos y en instituciones privadas o del tercer sector. Se evidencia una brecha entre la práctica y el conocimiento formal, lo que plantea dilemas éticos. El estudio subraya la necesidad de formación específica, protocolos institucionales y espacios de reflexión ética para garantizar una atención centrada en la persona y coherente con los principios del trabajo social.

Purpose: This study explores the use, knowledge, and acceptance of therapeutic lying among social workers in Spain. Materials and methods: A quantitative, cross-sectional, descriptive design was used. Participants were 253 practicing social workers, recruited via purposive sampling through professional associations and institutional networks. Data were collected through an online questionnaire covering sociodemographic and professional character- istics, acceptance and use of therapeutic lying, and prior knowledge/ training. Acceptance was measured with the validated16-item Acceptance of Lying to People with Dementia, supplemented by four ad hocitems on previous experience, frequency of use, perceived acceptability, and prior knowledge. Data were analyzed using descrip- tive statistics, Shapiro – Wilk tests for normality, Student’st-tests for group comparisons, and chi-square tests for categorical associations (p < .05). Results: While 83.8% reported having used therapeutic lying at least once,58.1% were unfamiliar with the term. The Acceptance of Lying to People with Dementia scale showed moderate overall acceptance (M = 50.67), with differences based on sector and prior experience. Socialworkers in gerontological settings and in private or third-sector institutions reported higher usage and acceptance levels. Discussion: The findings reveal a gap between practice and formal knowledge,raising concerns about ethical consistency. The study high- lights the need for training, institutional protocols, and ethical gui- dance to support decision-making in dementia care. Conclusion: Promoting structured reflection on this issue is essential to ensureperson-centered, ethically grounded, and professionally coherent social work practice.