The motivation for sharing this case report is twofold. First, there is little available information on effective methods for managing confabulation. Second, it illustrates a method for managing cognitive impairments that has wide applicability and fits well within the current service delivery climate characterized by restricted therapy time.

Confabulation refers to a person’s tendency to give false accounts of past events, seemingly without any intent to deceive. It usually is observed in patients displaying some form of amnesia (Johnson, 1991). Confabulation has been described in connection with Alzheimer’s disease, Korsakoff’s syndrome, anterior cingulectomy, acquired brain injury (ABI), and cerebrovascular accidents (CVA) (Johnson, 1991; Kopelman, Guinan, & Lewis, 1995). It is commonly observed in patients during the acute confusional phase following ABI and CVA. Frequently in these cases, the confabulation is transient in nature and disappears following the recovery of orientation. In cases in which the basal forebrain and frontal cortex are involved, confabulation may persist for many months (Deluca & Locker, 1996). The type and extent of confabulation disorders are usually correlated with the severity of executive dysfunction, which in turn is related to the site of frontal lobe damage (Fischer, Alexander, Esposito & Otto, 1995). Although the literature offers very little treatment direction for confabulation, suggested interventions include attempting to increase insight and awareness of the problem and minimize executive dysfunction (Deluca, 1991; Deluca & Locker, 1996). A regional survey of 20 medical speech-language pathologists suggested that in clinical practice, it is common to introduce compensatory memory books to record information and increase the likelihood of accurate recall of events (unpublished survey by authors). Confabulation can be extremely frustrating for caregivers; hence, clinicians need guidance in how to manage this complicated disorder.