What does “Showtime” mean?

This is probably a term that you are not familiar with but have seen it happen, especially in the early stages of Alzheimer’s or dementia, there is a surprising phenomenon that we caregivers have seen many times, and it is referred to as “Show Time.” When people with dementia are still cognitive enough to realize there is a problem, they often have the ability to put on a convincing façade of normalcy for a short period of time, say ten or 15 minutes. It is an ability that can be quite exasperating for the caregiver.

For example, you’ve been struggling with behaviors all day, especially with trying to get your loved one with dementia to get ready to see the doctor. It is always like this. He won’t acknowledge your requests or instructions. He can’t dress himself. He fiddles around while you are trying to get him to focus. It is almost as if he is deliberately trying to be late. Maybe so.

Then, you finally get in to see the doctor. You are absolutely frazzled, and you are sure that this time the doctor is finally going to understand how much your loved one has declined. But what does your loved one do? He’s smiling, bright, chatty, utterly convincing that everything is just fine. You leave the doctor’s office feeling angry and defeated. The doctor surely thinks you are the one with a problem. You’ve just experienced “Show Time!”

As long as people with dementia have the ability to “pull it together,” this behavior is understandable. They know something is wrong, and the last thing they want is for people outside the family to realize it. They are embarrassed or ashamed of their condition, so they put on a happy face. As long as it does not require logic or complex thinking, it is possible to carry on small talk and answer the doctor’s simple questions. “How do you feel?” “Fine.” “Have you been sleeping?” “Yes.” And they keep smiling.

“Show Time” can cause serious problems in families. Usually, based on living circumstances, one sibling will be in proximity to the parent with dementia and take on the task of providing care. Other siblings may be more than willing to help, but they live miles away. They may check in with you by phone, and they hear you describe all of the problems you are having.

Then the parent gets on the phone for a few minutes, and it is show time again. Your brothers and sisters can’t fathom what you are complaining about. Everything sounds fine to them. This can lead to serious disagreements about money, care practices, and family responsibilities. It’s a serious problem.

Eventually — and sadly — your loved one will no longer be capable of this “show time” behavior. But in the meantime, what can you do? I suggest you maintain a journal. I can see your jaw drop now. It is worth much more than the time you will put into it.

There are two types of journals. One is a log of the facts that lists behaviors and connects them to the time of day or the circumstances at the moment. Another is just jotting down your feelings. Don’t try to psychoanalyze yourself. Just state how you feel. This one is for therapy. It will help you get the frustrations out of your mind and onto the paper. It will help you not relive them that night as you try to sleep after a difficult day.

The “factual” journal will come in handy when you are talking with your doctor or counselor. In fact, your loved one probably would not have gotten away with “show time” with your doctor if you had such a journal to describe and document the time and place of your loved one’s behavior. It will definitely convince a doctor to look beyond the superficial behavior.

I recommend doing both types of journaling. Write the log of events on the left-hand page, and later, on the right-hand page jot down how those events made you feel.
Trust me, such a journal will help you get through difficult times. Then, this too shall pass, and one day you will pick up your journal and realize what a really innovative, intelligent, person you are.

I also suggest that you attend local caregiver support groups. Many of your peers will have experienced the same things you have, and they can share ideas for how they dealt with it. You’ll find on my web site (www.coping.today) an Events page that lists all the dementia support groups in the area.

Until next time remember: “We all deserve the best”

Send your comments and stories to deb@coping.today

© Debbie Selsavage, 2016


Comments

What does “Showtime” mean? — 8 Comments

  1. this explains my life with my mother i actually thought i had the problem and its soul destroying!!

    • Catherine,
      This is a real issue for caregivers because when doctors appointments are limited to 15 minutes a person living with dementia can pull it all together in this amount time, they can do this if there if family out of town and make phone calls to the person with dementia and this again is very frustrating to the primary caregiver. All professionals need to spend more than 15 minutes with your person and they will see the issues.
      I recommend that caregivers journal their days, short statements, not a lot of words and this may track patterns and this can be reported to the doctor to read before the visit. The person living with dementia has to cover up as much as possible to fit into our world and to be noticed as normal.
      Hope this helps. Where are you from and do you have any support groups in your area?
      Debbie Selsavage

      • im in dublin ireland my mother fooled doctors even after long stays in hospitals i now know her physio and meal times were show times and she spent her days sleeping??still at this late stage she is doing it with family but doctors have finally listened to me and her body let her down severe dementia now after years of stress because i didnt know!!!

        • This is all true. They will do as long as possible until the disease advances enough so that it becomes more and more difficult to fake it. It is not a disease that many people, caregivers, doctors know what is going on with their loved ones, doctors are not well versed/trained in the disease and it is becoming an epidemic and they cannot keep up with it. When a person with dementia is sleeping a lot it is not unusual in the later stages of the disease but in other stages it could be generated by depression, anxiety, other reasons could be medication changes/adjustments, it is taking too much energy to be in the normal world and to fit in the normal world, this is where we see more frustration and behavior issues in the afternoon time called sun downing. Do not be so hard on yourself many people do the same thing not because they want to because they do not know what is happening inside the person, we almost think they are faking it. I hope that mom is adjusting now and that you are doing better, is mom at home with you or is she in a care facility?

  2. I gave an inside laugh when I read this , I do this when I read something that meets my need and I am desperately seeking to find support for my experiences. MY loved one is so good at putting on a show to others. Half the time I question myself and what I am observing. I don’t think she intends to fool anyone it is just her being real.

    • Hello Dave, You are right they are not trying to fool anyone this is a survival characteristic that they have. They can do this for only a short time and then get out of there because they will start to repeat. They can very easily maintain the idle chit chat. I am glad that you found this article helpful to understand what your loved one is doing. Keep learning and educating yourself of what the disease will do and how your loved one will has to maintain. If you live in Citrus County we present an annual conference in January 2020. If you want more information let me know.

  3. I just knew my lovely husband had problems with his memory and behaviour a few years ago,( but due to his ‘showtime’ which I’d never heard of) even a Memory Assessment Nurse thought he was just fine and in no need of further investigation. Finally, I begged our doctor to take me seriously, and he was referred and diagnosed with late onset Alzheimer’s Disease.

    • Hello Dorothy, This is not unusual for people living with dementia to be able to hold it together for a short period of time, like 15-20 minutes. They can do this so that the doctors will not notice that there is a problem. They will also do this in crowds, children etc. But there will come a time that they will not be able to fool people for that amount of time, it will get shorter and then they will start to repeat themselves. A person is normally about 4-5 years into the disease process before you get a diagnosis, because so many of use blame it on old age and forgetfulness, it is much more than memory. Once you get an MRI there may be shrinkage in the brain and that is a sign, not being able to do well on the mini mental testing, ruling out that it is not a medical condition like thyroid, dehydration, urinary track infections, vitamins and nutrition issues then it must be a form of dementia. Alzheimer’s is the number 1 most common of the dementias. Most caregivers g=have to really push for a diagnosis, because there is many more things going on that the professionals may not see in a short visit. Thank you for visiting my website. Let me know if there is anything else that you need. Where are you from?

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