Confabulation:: sense-making, self-making and world-making in dementia

This study is concerned with the productive aspects of confabulation as it occurs spontaneously in dementia care, in its context, and in interaction with other care recipients. Confabulation is approached as a social and discursive event with distinct narrative features; plots and formerly established genres of plots, storylines, are used by confabulators in order to understand, manage and interact socially in the present situation. Three main functions of confabulation are discerned: 1) making sense of the current situation (sense-making); 2) maintaining a personal identity in interaction with others (self-making); and 3) organizing and legitimizing joint action in the world (world-making). The resources used by confabulating subjects are sparse and not well adjusted to changing conditions, as the number of accessible storylines is limited. This makes it difficult to apply storylines that explain the current situation satisfactorily, provide useful guidelines for how to act, as well as preserve a positive self-identity. Helping with this constitutes a major challenge in dementia care.