Truth telling to persons living with dementia is a nuanced problem that demands negotiating between the hazards of principlism and the loving deceiver’s demand to lie as needed. To ban deception, as we do restraints, would be misguided and cruel. So too to demand we always tell the truth. We ought to adopt a practice called “creative care.” It begins with the premise that person’s living with dementia are capable of creativity. Creative care breaks down the mysterious fourth wall we build around persons living with dementia, especially persons with advanced dementia. It invites us to see a person living with dementia as a person who is capable of creating something beautiful. They need our time and words, not our lies and sedatives.

Purpose: The purpose of this case study is to discuss factors that have an influence on the process of role development in radiotherapy breast planning.

Key themes: This article describes the process of development as experienced by the author and discusses factors that hindered the process of role development. These factors include development of a career plan, professional issues, resources, organisational structures, support from consultants, managers, multi-disciplinary, and professional colleagues and peer resistance.

Conclusion: The author makes recommendations that may contribute to improving the role development strategy in the profession and aid successful implementation of advanced practitioner and consultant roles for those radiographers who aspire to the consultant radiographer role in future. The article concludes that there is a need to identify, standardise and coordinate role development for therapy radiographers nationally to increase the appointment of more consultant radiographers.