Confabulation

[Unusual1]

"Confabulation happens when your brain creates scenarios that did not occur to make up for gaps in your memory. It can happen as a result of various memory disorders or an injury to the brain". Healthline.co.uk (2017).

The elderly gentleman I care for full time confabulates in almost every conversation.

This started after he experienced a fall from a ladder around 7 years ago resulting in a permanent brain injury.

In the beginning of my caring journey I used to feel very frustrated and tried to correct him. This just confused him more. Over the years I have learned to just agree with him.

Does anyone have experience of caring for a person who confabulates?

Examples would be great to make people more aware of this memory disorder in people with an acquired brain injury.

[cat3]

My partner's 90 year old mum has dementia and he's learned over the past few years to never contradict her delusions. It still upsets him to hear "I don't know you do I ?" when he visits, but by encouraging her to expand on her tall stories (she manages the care home & goes swimming on her days off) she can talk freely, laugh and relax in his company.

With limited quality of life for dementia sufferers, time spent feeling worthy and interesting must surely provide much needed self worth, if only in the moment. And, despite visits immediately being forgotten, perhaps regular 'feelgood' periods can provide overall benefit for mental health ?

According to my family I was highly delusional after a brain haemorrhage. I didn't recognise my daughter, I swore like a trooper and talked gobbledegook. It pained me later to hear how they thought I was lost for good. Fortunately it was only a matter of time before my brain rebooted and we could laugh about my bizarre behaviour.

But caring full time for someone permanently affected, whether by a degenerative condition or brain injury, is a massive commitment and I've only admiration for those sharing the world of another's alternative reality.

Cat x

[Suziewong15]

my husband does, he suffered a large haemorrhagic bleed last year and fell down the stairs resulting in multiple fractures. His confabulation is mostly aimed at me as he believes all sorts of things about me which arent true of course by makes sense to him! I try and correct him but he doesn’t accept or can’t understand my views or that of his sons. He thinks I’m having an affair and have moved house because I can’t bring him home from the nursing home he’s now in🥲

[Unusual1 in reply to Suziewong15]

Thanks for the reply. It must be very hard what you are going through. I can understand how you must feel. The gentleman I care for did show mild improvement with memory over the years. When he came home and I slowly got him into a routine there was even more improvement. He was seeing a speech and language therapist for a while. (Maybe you should try to see if he can have speech and language therapy). Although, he still lacks capacity. I am lucky as he is well behaved and does whatever I tell him to. His confabulation revolves around his dog, the long walks he used to take and other hobbies he loved such as shooting/hunting. Since his accident he has become obsessed with his dog and I think he cares more about his dog than his wife!

[Suziewong15]

Thank you for your reply, he sounds a lovely gentleman. My husbands speech is nearly back to normal and he’s very able! He wants to go back to his fishing and getting fitter. If only he could. He thinks there’s nothing wrong with him most of the time and has tried on numerous occasions to try and leave😔his confabulation is just aimed at me!

[Leaf100]

Hi Unusual1

Another thing to be aware of, if you aren't, is that everybody does it. Just most of the time people aren't aware.

This is why eye witness reports vary so much, and even two people may swear a past event unfolded differently.

It's just a matter of degree.

Leaf

[Unusual1 in reply to Leaf100]

yes I know this. Thanks for pointing it out.

[lcd8]

This is an interesting conversation, thanks. Sometimes I have a 'memory' which feels really real to me. But others have no knowledge of the event. Its just little things, like something someone said or something I said, and happens most often with my short-term memory.

[Shreds]

Just to add that when in the ICU, I was convinced I went to the pub across the road from the hospital and watched a band on stage. It was so real. I even thought I asked the neuro if it was ok to have a pint. Yes. As long as its in moderation!

But of course none of this happened.

After being discharged I rationalised some years later that the party at the pub must actually have been the staff or a discussion in the operating theatre about staff Christmas Parties and what they were going to see.

Even in a coma or under anethetic you do hear things (hence why music therapy is good).

So dont despair, these situations are real to those experiencing them. Most of it though is the brain trying to rationalise limited information and fill in the blanks where there are gaps.

[Unusual1 in reply to Shreds]

yes my client did similar to this. Although he had been in intensive care unconscious for the previous three months he was telling stories of walking up pen pen y van with his dog the day before. Also when he was in neuro-rehab he was convinced that a fisherman was bringing in 6 fresh salmon every night and feeding them out the window to the seagulls. I think he was confusing his dreams with reality. I think that dream-reality confusion might result in confabulation.

[Shreds in reply to Unusual1]

Once more I speak from experience as I was convinced I was in a Manchester hospital near where I used to live, rather than the hospital I was actually in.

Again it would appear to have a rational explanation as I had endured a long ambulance journey (so travelling was relevant) plus some old friends came over from Manchester to visit me in hospital whilst I was either in a coma or out of it and dont recall meeting them, but the Manchester connection obviously played out in my head upon hearing them and rationalised thats where I must be.

After that and what I do recall, is telling other people that “of course I know where I am, I lived in Manchester for years”. I was convinced of that myself.

The mind/brain is bizarre but very logical and we think we are in control all the time, but it makes you wonder who is really in control? I shall not progress into deep physiological and philosophical discussion and debate here though or we could be talking for a very long long time.