A 75-year-old patient has dementia of the Alzheimer's type and confabulates. A nurse should understand that this patient?

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

The correct option accurately defines confabulation as the act of filling in memory gaps with fabricated, false, or distorted information.
This is an unconscious process; the patient is not trying to deceive but genuinely believes their invented stories are real memories.
Confabulation is a common symptom in various neurological conditions that affect memory, including Alzheimer's disease and Korsakoff syndrome.
It serves as the brain's attempt to create a coherent narrative despite missing information due to memory impairment.

Option A: This describes a delusion or role-playing, not confabulation. Confabulation is about creating false memories to fill gaps, not assuming a different identity.
Option B: This describes denial, a common defense mechanism. The patient uses humor or joviality to avoid confronting the reality of their cognitive decline. It is a different psychological process from confabulation.
Option D: This describes rationalization, which is the act of creating logical excuses to justify one's behavior. Confabulation is about memory, not about justifying actions.

Clinical Relevance

Nursing practice connection: Use the key finding related to Understanding of confabulation in Alzheimer's disease to guide bedside assessment, documentation, and the next nursing action.
Nurses should not confront or correct a patient's confabulations, as this can lead to agitation, anxiety, and a breakdown in trust. The patient believes their stories are real.
The best nursing approach is to use therapeutic communication, respond to the feelings expressed in the story, and gently redirect the patient to a reality-based topic or activity.
Assessing for confabulation helps differentiate dementia from other conditions like depression, where 'I don't know' answers are more common, versus the near-miss or fabricated answers in dementia.

How to Approach the Question

First, identify the key clinical term in the question stem, which is 'confabulates'.
Recall or determine the definition of this term in the context of a patient with dementia of the Alzheimer's type.
Evaluate each option to see which one best matches the definition of confabulation.
Option A describes delusion or impersonation.
Option B describes denial.
Option D describes rationalization.

Concept Tested & Keywords

Q18KifMnFtJDdQiBXULG1J

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 80-82

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 770-772

Practise the full JODHPUR AIIMS SNO-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.