Why Do People With Dementia Make Things Up? Understanding Confabulation

When someone with dementia tells a story that isn't true, they usually aren't lying. Here's what confabulation is, why it happens, and how to respond without arguing.

By Jim Pavlish, Editor · Last updated: November 1, 2026 · Editorial policy

Short answer: when a person with dementia tells a story that isn't true, they usually aren't lying. The Alzheimer's Society describes confabulation as unknowingly inventing a story, which may be a way to make sense of the world. Research suggests it happens when weak new memories get mixed up with old, familiar ones. Arguing rarely helps. Listen for the feeling behind the words, respond calmly, and tell the doctor about sudden changes.

Your father tells a neighbor he drove to the hardware store this morning. He hasn't driven in two years. Your mother says her sister visited yesterday, though her sister died long ago. It's natural to feel alarmed, or even hurt, as if you're being lied to.

In most cases, that's not what's happening. This page explains confabulation and how families can respond.

This page is general information, not medical advice. Talk to the person's doctor about new or worsening confusion, especially if it comes on suddenly.

What is confabulation?

Confabulation means saying something untrue without meaning to deceive. The person believes what they're saying. The Alzheimer's Society describes it as when someone with dementia "unknowingly invents a story," and says it may be a coping strategy to make sense of the world around them.

That's the key difference from lying. A lie is deliberate. A confabulated story feels like a real memory to the person telling it.

Confabulation is different from some related symptoms:

• Delusions are firmly held false beliefs, such as being certain someone is stealing from them. The Alzheimer's Association notes these can occur in middle- to late-stage Alzheimer's. See Hallucinations and Delusions.
• Hallucinations are seeing, hearing or feeling things that aren't there.
• Lack of awareness (anosognosia) means the person doesn't realize their memory has changed. See Anosognosia (Lack of Awareness).

These can overlap. A person who doesn't know their memory is failing may fill the gaps without noticing.

Why does it happen?

Researchers are still working this out, but a few ideas are well supported:

• Gaps get filled with familiar material. A 2009 study in the journal Brain found that people with Alzheimer's often mixed up new information with "over-learned" information, such as habits, repeated events or well-known stories. Confabulations were more common when new information hadn't been stored well in the first place. So a man who drove to the hardware store every Saturday for 40 years may "remember" doing it today.
• Reduced self-monitoring. A 2020 review of awareness in Alzheimer's describes confabulation as a quick, unplanned response built from misinterpreted memories about oneself, linked to the brain's reduced ability to check its own output.
• Protecting dignity. The Alzheimer's Society suggests invented stories may help support self-esteem. Saying "I went shopping" can feel better than admitting "I don't know what I did today."

Confabulation can also happen with other conditions that affect memory, such as alcohol-related brain damage. See Alcohol-Related Brain Damage.

What it can look like

• Describing an outing, visit or phone call that didn't happen
• Telling an old story as if it happened recently
• Giving a confident but wrong answer when they can't remember ("Oh, the doctor said I'm fine")
• Mixing details from TV, dreams or other people's stories into their own life
• Insisting on a version of events that changes each time

How to respond

There's no perfect script, but these principles from the Alzheimer's Society and the Alzheimer's Association can help.

1. Don't argue or try to prove them wrong. The Alzheimer's Association advises not arguing or trying to convince someone of a different reality. Correcting them usually doesn't fix the memory and can lead to embarrassment, anger or withdrawal. See What Not to Say to Someone with Dementia (and What to Say Instead).

2. Look for the feeling behind the story. The Alzheimer's Society encourages families to "get behind the words." A story about a visiting sister might mean the person feels lonely, or misses her. You could say, "You two were close. Tell me about her."

3. Go with harmless stories. If the story causes no harm, it's often kindest to listen and move gently on.

4. Use a gentle redirect. Switch to a pleasant activity, a snack or a walk. The Alzheimer's Association suggests switching focus to another activity.

5. Think about where you sit on the "truth spectrum." The Alzheimer's Society describes a range from telling the whole truth, through looking for the meaning behind the words, distracting, and going along with something, to outright lying. It recommends a direct lie only when anything else would cause significant harm or distress, and even then with great care.

6. Check facts quietly when it matters. If the person says they've taken their pills, already eaten, or that a doctor changed their treatment, don't rely on the story. Check the pill organizer, the fridge, or call the doctor's office. See Managing Medications for Someone with Dementia.

When confabulation is a safety issue

Some stories need follow-up, even if you don't challenge the person directly:

• Claims about money, such as having paid a bill or given money to someone. These can also be a sign of scams. See Protecting Against Scams.
• Claims of being mistreated or harmed. Most will turn out to be confusion, but take them seriously and check calmly.
• Reports to doctors that don't match reality. Go to appointments if you can, or send the doctor a short note beforehand. See Preparing for a Memory Appointment.

When to talk to the doctor

Tell the person's doctor if confabulation is new, getting worse quickly, or comes with other changes. Sudden confusion can be caused by infection, medicines or other treatable problems, so call the doctor promptly. See Delirium vs. Dementia. If someone is in danger, call 911.

Common questions

Why does my mother with dementia lie?

She probably isn't lying in the usual sense. The Alzheimer's Society calls it confabulation: unknowingly inventing a story, perhaps to make sense of things or protect self-esteem. Research suggests memory gaps get filled with old, familiar memories.

Should I correct someone with dementia when they make things up?

Usually not, if the story is harmless. The Alzheimer's Association advises not arguing or trying to convince. Listen for the feeling behind it and gently redirect. Do quietly check facts that affect safety, money or medicines.

Is confabulation a sign that dementia is getting worse?

It can appear at different stages and varies from person to person. If it's new or increasing quickly, talk to the doctor, because sudden changes can have other causes, such as infection or medicine side effects.

Is it OK to lie to a person with dementia?

The Alzheimer's Society suggests looking for the meaning behind the words, distracting or going along with things first. It describes a direct "therapeutic lie" as something to use only when anything else would cause significant harm, and with great care.

The bottom line

Confabulation is a symptom, not a character flaw. The person believes what they're saying. Arguing rarely helps. Listening for the feeling behind the story, responding kindly and quietly checking anything that affects safety usually works better for everyone.

Sources

1. Alzheimer's Society: Is it okay to lie to someone with dementia?
2. Alzheimer's Association: Suspicion and delusions
3. Brain (2009): Attali E et al., Confabulation in Alzheimer's disease: poor encoding and retrieval of over-learned information (PubMed 18829697)
4. Psychogeriatrics (2020): Tagai K et al., Anosognosia in patients with Alzheimer's disease: current perspectives (PubMed 31930617)

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

Related articles

• Anosognosia (Lack of Awareness)
• What Not to Say to Someone with Dementia (and What to Say Instead)
• Hallucinations and Delusions
• Communicating with Someone with Dementia
• Repetitive Questions and Behaviors
• "I Want to Go Home": Why People With Dementia Say It and How to Respond