Trump’s mental decline is undeniable — so what now? 

"Confabulation." It's a word you are going to be hearing a lot in the coming months.  

President Trump has always been willing to mislead people when it was to his advantage. Even his supporters recognize this. Hence the famous admonition to "take Trump seriously, not literally."

But what Trump is doing now is something different. Confabulation is sometimes called "honest lying," because the person doing it genuinely believes what he's saying, even if it is obviously and patently false. A person confabulates when they are telling completely invented stories that don't provide them any particular tangible benefit. In other words, it's not like lying to try and get out of a speeding ticket. 
 
Confabulation isn't misremembering a date or forgetting something. The mistakes of memory we are all subject to become confabulation when people remember false information in vivid detail — detail so vivid and complete that people who don't know otherwise often believe what they are hearing is true. 
 
In older people, confabulation is one of the clearest early signs of dementia. The day you witness someone confabulate is often the day you are forced to admit to yourself that a beloved parent needs help, and that all the little slips and oddities you've been seeing can no longer be rationalized away. 

For Trump, the day we could no longer pretend everything is fine came on July 15, when he told a lengthy story about his uncle, John Trump, who he claimed taught at MIT and held three degrees in "nuclear, chemical, and math." His uncle, according to Trump, once told him how he had taught Ted Kaczynski, the Unabomber, and how very smart Kaczynski was.

Trump's uncle was indeed a professor at MIT, but everything else in this story is pure confabulation. Trump's uncle didn't have degrees in "nuclear, chemical, and math" — he had degrees in electrical engineering and physics. And Kaczynski did not go to MIT at all — he went to Harvard.

But most telling of all, it is categorically impossible for Trump's uncle to have told him any such story. Kaczynski became publicly known as the Unabomber when he was arrested in 1996. Trump's uncle, the MIT professor, died in 1985. In other words, Trump's uncle could not have told him the story because there was, literally, no story to tell during his lifetime.  

Once you have seen that Donald Trump is confabulating, it cannot be unseen — and all sorts of other mildly disturbing incidents suddenly fall into place.

Difficulty with mathematical concepts is another early warning sign of dementia. Now watch Trump attempting to explain how he is going to make drug prices go down by "1,000 percent, 600 percent, 500 percent, 1,500 percent." That's complete nonsense, unless drug companies will be paying patients to accept prescriptions, since reducing drug prices by 100 percent would mean they were free. Certainly, someone who got a business degree from Wharton and has spent his life running a company would know how percentages work.

Or take his insistence that former President Obama and his FBI director, James Comey, made up the Epstein files, even though they were long out of office by the time Epstein was most recently arrested in 2019. Again, that's very troubling, because being unable to correctly process when past events took place is a common feature in confabulation. The same goes for being unable to remember that he himself appointed Jerome Powell as the chair of the federal reserve. And then, of course, there are all the little lapses in judgment that Trump has been displaying recently. 

I have opposed Trump since he came down that famous escalator in 2015. But I want to step away from partisan sniping for a moment. I know a lot of people genuinely love the man, even if I don't. I recognize how hard this must be for them. After the death of a child, watching someone you love and respect struggle with dementia may be one of the worst experiences a person can have, whether it's a parent or a president. 

But when the time comes, it's something that must be faced squarely. That goes double when we are talking about the president.

If you aren't comfortable with labeling this as dementia, that's fine. But there is no question that the president — the man tasked with making critical life and death decisions for both the country and the world — is struggling with mathematical concepts, has vivid "memories" that are not rooted in reality and has an increasingly foggy grasp of past events that did happen. That's not a medical diagnosis. These are facts we can see for ourselves and we all know, even those of us who voted for Trump three times, that this can't be allowed to continue. 

Whatever dementia issues Joe Biden may have, there is no denying that his staff was superb at managing them and protecting both Biden and the country. Trump, however, doesn't have those guardrails. That's one of the reasons we are seeing what we are seeing. Can you imagine Pete Hegseth or Kristi Noem managing Trump's dementia or even simply telling him "no" and threatening to resign? 

Given this lack of independence in Trump's Cabinet, I'm not sure what the ultimate solution is. But I know that the first step is for Trump's most loyal supporters to admit, even if only to themselves, that there is a problem, just as Biden’s supporters did for him. 

Donald Trump is showing all the signs of suffering from dementia. If this were a neighbor, a parent, or a family friend, you would have no trouble seeing it. We should not turn our heads just because it is the president. 

Chris Truax is an appellate attorney who served as Southern California chair for John McCain’s primary campaign in 2008.