Confabulation in Dementia

A common question I hear is, "Why do people with dementia lie?" But, the truth is, they may not be intentionally lying. Let me introduce you to the term "confabulation." Confabulation is the unintentional creation of false, distorted, or fabricated memories or stories. It's a common symptom of dementia, and we may all be guilty of confabulating at some point in our lives.

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Think about it. Have you ever told a story and couldn't remember all the details, so you filled in the gaps to make it more coherent? Or, have you ever tried to recall a dream, but found yourself naturally filling in the blanks for parts that didn't make much sense to you? That's confabulation.

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So, let's dig into this a bit deeper.

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There are two types of confabulation: spontaneous and provoked. Spontaneous confabulation occurs when the person with dementia initiates a false memory or story without any prompting from others. This can happen when the person with dementia is trying to make sense of their environment or fill gaps in their memory. Provoked confabulation occurs when the person with dementia is prompted or questioned by a caregiver or others. If the person doesn't actually remember, they may come up with a false story that makes sense to them for the question that was asked.

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So, like I said, we are all guilty of confabulating from time to time, but why does it seem more prevalent in people with dementia? Well, it's due to damage of the brain. Though they aren't 100% sure, researchers believe that damage to the frontal lobe and temporal lobe of the brain is largely responsible for confabulation. The frontal lobe plays a big role in distinguishing between what is real and what is not, applying reasoning and logic, and controlling impulses. The temporal lobe of the brain plays a strong role in memory. So, if there is damage to the part of the brain that involves memory and you can't apply logic or reasoning well, or distinguish between what's real or not very well either, well then, what you get is confabulation. Does that make sense? So, it's usually not something that's done on purpose and it's not intentionally lying or deception either. Confabulating comes rather natural for many of us.

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My best advice is to not get too caught up in what's true and what's not, but rather find ways to connect with your partner through whatever story they may be telling. It's important to validate their feelings because it's not always about the story, but rather the feelings that are being evoked when telling the story. Please avoid challenging or correcting their memories or stories, this often leads to more confusion and distress. Okay? It is not necessary to orient them to reality unless they find it helpful.