Ask Nurse Lynn: Confabulation


Male, 38, Deletion

I have a question about what I think is confabulation. My son occasionally says things that are just not true, and I don’t really know how to respond. I don’t want to argue with him, but I do want him to know that what he said is wrong. The first time I really noticed this was about 10 years ago near the end of a long ICU stay. A nurse would come into his room, and he was convinced they had gone to school together. Or he would see someone on a TV show and insist he knew them. The doctors talked about “ICU Psychosis”, but this behavior still shows up periodically, many years after that episode. More recently he told a new caregiver that he has a step-father, which he doesn’t – and a twin, again, which he doesn’t. Is this confabulation? How should I respond?

Nurse Lynn’s Response:

Confabulation is a common cognitive characteristic for our loved ones with PWS. They believe what they are saying and believe that you should as well. I think that the bigger question should be, is this confabulation interfering with daily routines? Is this pervasive or does it come and go? If it isn’t interfering with completion of daily routines and cares, I would pick my battles.

You could try to ask something like, “Did I get married and not know it?” regarding the stepfather. You could also try to change the subject or remove the audience who is listening. Sometimes a bit of humor works but, I wouldn’t press the issue if it is not creating problems. Sometimes, the individual can become very upset when challenged about these false beliefs. I have linked a few articles about confabulation in PWS.


PWS Lying and Confabulation PDF

Confabulation – IPSWO

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