Confabulation may not be a term you are familiar with, but one whose symptoms you will recognize. If your parent is confabulating, it can be very challenging to deal with and even harder to know how to respond. You may wonder- is my parent lying to me? How do I know if the information they are giving me is reliable?
In many situations, you may know for a fact that something your parent is telling you isn’t true- that the recollection of events didn’t happen. However, in other cases, you may be relying on your parent to say to you whether they saw a healthcare provider or complied with medical directives. Most confabulation occurs as a symptom of Alzheimer’s disease or other dementia, but other causes exist. We will guide you through this emotionally draining condition and offer some coping and communication techniques.
What Causes Confabulation?
There are two main situations under which confabulation occurs. The first type is in response to a question that the person feels pressured to answer and may make up something incorrect rather than say that they don’t know. The other situation occurs spontaneously, and these confabulations can be quite bizarre or fantastic. Other times your parent’s stories may be benign, like making up a story about what they did on the weekend even though it never occurred.
The leading causes of confabulation are Alzheimer’s disease, Wernicke-Korsakoff Syndrome, or traumatic head injury. Wernicke-Korsakoff Syndrome results from an alcohol use problem, and Alzheimer’s disease is the most common form of dementia. Regardless of the cause, most people who have symptoms of confabulation usually have damage in two areas of the brain: the frontal lobes and the corpus callosum. The frontal lobe is crucial for memory.
Consequences of Confabulation Associated with Dementia
If you recognize confabulation in a parent, it is essential to realize that they are not lying and completely believe what they are telling you. Your parent is subconsciously creating stories as a way to conceal their memory loss. They don’t know that they aren’t telling the truth and have no doubt what they are saying is true. Confabulation can affect your relationship with your parent and complicate the caregiving situation due to other dementia behaviors.
Confabulation and Caregiving
One of the more disturbing aspects of confabulation is when your parent accuses you or another caregiver of stealing or mistreating them. Dementia is often characterized by paranoia and delusions, which can be heartbreaking and stressful. Your parent is someone you had mutual trust with, and it is almost as if they are a different person now.
Confabulation and Safety
If a person acts on the thoughts they have, it can be catastrophic. For example, if your parent believes that someone will pick them up to go “home,” and they go out into the cold and wander. Or, they think that they can cook or drive safely when they can’t.
Confabulation and Relationships
Even though you may understand and accept that your parent’s confabulation is unavoidable, others may not feel that way. Family and friends may be shocked and confused by confabulation, which only further alienates your parent from others.
Techniques to Coping with Confabulation
There are ways to cope with a parent who confabulates, and by following these suggestions, things may improve. Anything that creates more stability and calm will help.
- Use Validation Therapy Techniques
Validation therapy is a way to approach adults who have Alzheimer’s or dementia with empathy, comfort, and reassurance. Rather than correcting or getting angry with the person who confabulates, validation therapy recommends the following:
- Stay calm and focused. Breathe deeply.
- Reminisce and talk about the past.
- Acknowledge the emotion behind the false memory.
- Reassure and don’t correct
- Create a Memory Book
Memory books are a great way to create a photo album or scrapbook of important events in your parent’s life. When someone confabulates, they are losing track of the past. Memory books can provide comfort and stability by reminding people of the positive people and events in their life.
- Understanding the Purpose of Confabulation
If you understand the purpose of confabulation, it will help you learn how to respond in a caring and compassionate way.
- People with dementia are confused and overwhelmed by memory loss and confusion. Confabulation is a way of making sense of their situation.
- When a person is asked a question and doesn’t know the answer, it can be disempowering. Confabulation is a way of gaining relevance in the world and providing a sense of control over surroundings.
- Filling in memory gaps is a way of creating an alternate reality that is reassuring.
- Emotional Regulation of Responses
How you respond to your parent who confabulates has a significant impact on their stress and comfort level. We have some suggestions for anyone who is caring for a parent with dementia who confabulates.
- Using clear and simple language
- Reduce stress in the environment such as loud noises and lots of people
- Minimize distractions
- Stay calm and don’t get angry
- Allow your parent time for processing information.
How Home Care Assistance Can Help
Home Care Assistance can help with a parent who confabulates by providing support and facilitating coping techniques.
- In-home care can offer relief from caregiving duties and give your parent someone new to interact with.
- Caregivers provide patient-focused activities on reducing stress and keeping people stimulated by using memory books and other dementia-specific diversions.
- In-home caregivers use validation and distraction techniques to calm agitation.
- Caregivers keep your parent safe by monitoring wandering and other dangerous activities.
Resources for Families on Confabulation and Dementia
We have put together a few resources to help you and your family care for a parent who has dementia.
- Creating Moments of Joy Jolene Brackey uses humor and helpful tips for caring for a parent with Alzheimer’s disease.
- Understanding the Dementia Experience is a free ebook by author Jennifer Ghent-Fuller a nurse and educator working with people who have dementia.
- The Alzheimer’s Association has a wealth of information about the symptoms, causes, and research on Alzheimer’s disease.
- There have been movies about the dementia experience, but none may be as accurate and heartbreaking as The Father. If you want a clear picture of confabulation and how it affects families, this is the movie to see.
Confabulation and Caregiving
Confabulation is challenging but can be managed with compassion and empathy.
At Home Care Assistance, we understand the challenges of dealing with a parent who not only confabulates but is suffering from other symptoms of dementia. Our caregiving staff can help you in your efforts to manage difficult behaviors and keep your loved one happy and calm.