Patients lie for a variety of reasons. Most of the time, they are just too embarrassed to tell the truth. In some cases, they fear getting judged or they want to avoid being scolded and lectured for not complying with their treatment plan. Others, meanwhile, lie in fear of the severity of their illnesses. No matter what their reasons are, it’s a nurse’s job to know how to detect a lie to ensure a patients’ safety.
If you are always in doubt, here are some of the best ways to know if your patient is lying.
There’s no definite way to tell if a patient is telling the truth or not, but you can always look out for specific verbal and nonverbal cues. Take, for example, questioning.
If you ask a question and your patient takes quite a while before answering, there’s a good chance that he is lying. This commonly happens with patients who are showing non-compliance. Ask them how much time they spend exercising and how frequently. If they can’t give you a definite answer right away, your patient is probably not following his recommended exercise routine.
It can also help if you show a bit of skepticism, but make sure you won’t sound too cynical. There are uncontrollable factors that push people to lie. One of them is economic reasons. Disability payments that are about to run out can make a person skip filling his prescriptions. If your patient has just been fired from work, he might not be able to attend as much therapy sessions as he’d like.
Another factor to keep in mind is your geographic location. There are countries that are politically conservative and there are states that won’t have the same values as you. Women from conservative regions, for example, are not likely to disclose that they’ve terminated their pregnancies in fear of being socially ridiculed.
Look for Signs
There are patients who are so used to lying that they can come up with fabricated answers in an instant. This type of patient is trickier to deal with, especially if they see nothing wrong about their behaviors.
One of the best things you can do is to look for signs. Most of the time, patients like this are too anxious about the truth that no matter how comfortable they are with lying, they still show guilty body languages.
- Eye movements are the first things you’ll notice with lying patients. They’ll deliberately avoid direct eye contact. If their eyes tend to move to the left side often, they are constructing a lie orally. If they tend to move to the right, it means that they are trying to recall something.
- You also shouldn’t miss hand gestures. Patients who tend to hide their hands, either by clenching or placing them in their pockets, can mean that they are lying. Truth-telling patients feel comfortable letting their palms show.
- Tensed and pursed lips can also signal dishonesty. The same thing with patients who cover their mouths when speaking. It’s an unconscious effort to cover their lies.
- Listen to how your patients speak. There shouldn’t be any stuttering or stammering. Check for pitches and pace. Patients who lie speak with a higher pitch and may talk too fast and elaborate. They’ll give out more details than what is necessary to make their stories believable.
Apart from specific clues, you should also assess the overall body language of your patient. If he is lying, you’ll notice that he sweats and trembles more than usual. He’s also likely to take a protective stance, like keeping his arms crossed and distancing himself from you.
How To Deal With Patients Who Lie
Patients lie most of the time. Despite being common, nurses should never tolerate them. Indulging in their lies can make them believe that their lies aren’t going to impact their health and treatment tremendously.
To give you an idea, here are some of the ways you can deal with lying patients:
1. Direct confrontation is often regarded as the best way to deal with patients who lie. You can tell them the implications of their lies, especially if they are life-threatening. Explain to your patients that if their current treatment plans fail, the next approaches will be more aggressive and expensive.
Educate them about the importance of preventive care. Make them understand that compliance to their existing treatment plan can help prevent the development of more serious conditions and complications.
A lot of patients who have high blood pressure can’t see the importance of sticking with their medications, especially if they aren’t feeling anything wrong. They’ll tell you they’ve been religiously taking their medicines even if they aren’t. These patients are likely to be the same ones you’ll encounter a few months after with a stroke or heart attack.
2. It’s also a good idea to have your patients sign an agreement that they’ll not look for similar drugs from other health care professional, especially if your patients are showing drug abuse. Make them agree to see one physician only.
3. Cross-question your patient. If your patient is lying, he’ll have a hard time making the story’s ends meet. Ask high-risk and specific questions but make sure you won’t sound too judgmental. Patients tend to withdraw more if they feel ridiculed, cornered and humiliated.
4. If you encounter a patient who lies chronically, it’s a good idea to be more thorough with your assessment. While some patients lie for petty reasons, there are patients who lie due to serious mental conditions.
Patients with Munchausen Syndrome, for example, tend to lie because they want to be the center of attention. They fabricate stories and even induce some conditions to elicit a wrong diagnosis. They can take immuno-suppressants and insulin shots prior to testing to create other problems or prolong treatment.
Malingering patients lie intentionally because they seek to obtain external rewards, like not having to go to work or to get insurances and pensions. People with Somatization disorder, on the other hand, tend to show disproportionate reactions to their physical symptoms, like dizziness, shortness of breath and weakness. This disorder is closely linked to cases of sexual abuse and psychological illness. Nurses need to know how to detect a lie in order for them to prevent further harm to these patients.
How To Detect A Lie Infographic
Check out this very useful infographic on how to detect a lie. The illustrations should be useful in helping you learn this skill better.