Therapeutic lying in dementia care: social workers’ decision-making and attitudinal dimensions

Purpose This study aims to examine the differential roles of the person-focused and lie-focused dimensions of the Attitudes toward Lying to People with Dementia scale (ALPD) in relation to therapeutic lying among social workers. Design/methodology/approach A cross-sectional online survey was conducted with 253 Spanish social workers working with older adults. Correlations, t-tests, logistic regression and linear regression models were performed. Findings Both ALPD dimensions were strongly correlated but showed different associations. Person-focused attitudes were associated with use and frequency of therapeutic lying, whereas lie-focused attitudes were more strongly associated with acceptability. Research limitations/implications The cross-sectional design and self-report measures limit causal inference and may introduce social desirability bias. The findings support analyzing ALPD dimensions separately in future research. Practical implications The findings highlight the importance of reflective and context-sensitive approaches to ethical decision-making and professional training in dementia care. Social implications Understanding how professionals justify therapeutic lying may contribute to more informed and person-centered dementia-care practices. Originality/value Unlike previous studies using global ALPD scores, this study demonstrates that person-focused and lie-focused attitudes play distinct roles in professional decision-making and moral evaluation.