Dementia affects everyone differently, and can often bring up challenging behaviours such as sundowning and wandering. One of the lesser-known symptoms of dementia is confabulation, which is a neuropsychiatric phenomenon where the individual creates unintentionally false memories.
While these memories aren’t meant to deceive loved ones, they can be upsetting and difficult to manage. Today, we’ll explore what confabulation is in dementia so you know what to expect.
What Is Confabulation in Dementia?
Confabulation is a specific behaviour change often seen in dementia, in which an individual unintentionally creates false memories without intending to deceive others. Dementia can cause gaps in memory, which the brain attempts to fill with fabricated memories.
There are two main types of confabulation in dementia:
- Provoked confabulation: This type occurs when a person fabricates information in response to questions about their past. It is common for dementia patients who are embarrassed or upset about not being able to remember their past memories.
- Spontaneous confabulation: This type involves the creation of unsolicited false memories without any apparent trigger. It can be distressing to family members who struggle to understand why their loved ones aren’t telling the truth.
It’s important to realise that individuals who confabulate as a result of dementia don’t understand that what they’re saying isn’t real. They’ll often believe the lies as a way of coping with their memory loss. Telling them that their memories aren’t real can cause anger, resentment and distress.
What Causes Confabulation in Dementia?
There are two main reasons why dementia patients confabulate, which are:
- A coping mechanism to deal with memory gaps: As dementia progresses, the memory is significantly impacted. The brain may compensate by filling in the gaps to avoid negative feelings such as embarrassment, distress and agitation.
- A result of neurological impairments: Dementia causes extensive damage to the brain, including the frontotemporal and medial temporal lobes. This disrupts memory processing and retrieval, increasing the risk of false memories.
Is Confabulation the Same as Lying?
Many people, who aren’t aware of why confabulation occurs in dementia, may think that their loved one is lying. However, lying is a conscious act to obscure the truth; confabulation is a memory error that leads to the unintentional creation of inaccurate memories.
Some psychologists call confabulation ‘honest lying’ because the individuals telling the stories genuinely believe that what they’re saying is true past experiences. However, it’s important to remember that the creation of false memories is not done to hurt or mislead you.
Practical Tips for Handling Confabulation in Dementia
Supporting a loved one with dementia can be difficult, especially as symptoms progress and new challenging behaviours present themselves. The best way to deal with many of these changes, including confabulation, is to remain patient, empathetic and communicative.
Tips for handling confabulation in dementia include:
- Avoid confrontation – It may be difficult, but avoiding challenging your loved one as much as possible is vital when dealing with confabulation. Directly saying ‘no’ or ‘that didn’t happen’ about a false memory can make them agitated and distressed, as they genuinely believe what they’re saying. Consider whether your loved one’s false beliefs are causing harm or putting them in danger in any way. If the answer is no, consider allowing them to believe the fabricated past. It may make them feel better and keep their memories positive instead of confusing.
- Consider their perspective – Instead of jumping to correct your loved one or prove them wrong, consider how they must be feeling. Their false past has been created to reduce feelings of anxiety and fear over losing their memories, which can be incredibly difficult to deal with – especially if they can’t properly communicate their feelings to you. Engage with their perceived reality and honour their memories. For example, if they keep talking about how they need to pick their kids up from school (who are now adults), ask them questions about their family and children. This acknowledges their feelings without reinforcing the false memory.
- Redirect their attention – If you notice your loved one getting agitated by their false memories, such as wanting to see a dead relative or thinking they’re late for work, gently shift the conversation to another, positive topic. Talking may not be enough to divert their focus from confabulated subjects, so keep a range of fun and engaging hobbies available that you know they enjoy. Reading, painting, or gardening can help bring their mind back to the present and help them forget their false memories.
- Adopt a consistent routine – An unstructured routine can exacerbate symptoms for individuals with dementia, making memory loss and confusion worse. In turn, this can increase the risk of confabulation and anxiety. Make a note of your loved one’s current routine and whether anything needs to change. For example, many dementia patients experience worsened symptoms in the afternoon and evening, so scheduling important tasks in the morning can make day-to-day life easier. A dependable routine can provide your loved one with a sense of security and comfort, minimising confusion and potentially reducing confabulation.
- Create a supportive environment – A safe home environment is essential for individuals with dementia, as home often serves as an anchor, providing a sense of security and familiarity. Display lots of images of their memories and loved ones around the home, and make sure personal items are easily accessible. A supportive home environment might trigger true memories, reducing the need for confabulation.
- Know when to ask for help – Dealing with a dementia patient can be difficult and overwhelming, especially if the majority of the care duties fall on you. Knowing when to ask for help from other close relatives or professional carers can help you deliver the best possible standard of care and reduce the risk of carer fatigue and strained relationships. Support groups for families of dementia patients can be an excellent place to meet others going through similar challenges, to connect with others and realise you’re not alone.
How Trinity Homecare Can Help
At Trinity Homecare, we’re proud of our commitment to our clients and their families, helping them navigate the challenges of dementia. Our fully trained, compassionate carers have years of experience helping individuals live life the way they want, despite evolving dementia symptoms.
Whether you require regular respite from a visiting carer or comprehensive dementia support from a live-in carer, we’ll work with you and your loved one to create a personalised care plan that honours independence, dignity and respect.
Talk To Us Today
At Trinity Homecare, our ultimate goal is to enrich your lifestyle in the comfort and familiarity of your own home. This allows you to live the independent lifestyle that you love without the daunting thought of moving into a care home. We are here to support you with various forms of live-in care.
Call us now on 0207 183 4884 in confidence for a free, no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.
