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 [email protected]

© Debbie Selsavage, 2016

30 Replies to “What does “Showtime” mean?”

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

    1. 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

      1. 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!!!

        1. 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.

    1. 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.

    1. 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?

    2. Dorothy, Most doctors do not spend more than 15 minutes with us and this is a big issues with people living with dementia, if they can just get through the 10 minutes they probably will not se any issues. Most caregivers come out of the office more angry because the doctor did not see what they have been seeing. They can front really well for a short period of time.

  4. Hi Debbie
    I was told this was called hosting and when I spoke to my husbands nurse she knew nothing about it.
    My husband was diagnosed 6 yrs ago with F/T Alzheimers and is still able to do this . To say its frustrating would be an understatement people who have no knowledge of him are shocked when they are told. Your article has made me feel so much more reassured no I know its not me thats imagining it. Thank you n

    1. Hello Sue,
      You are not imagining this at all. We know that our loved ones that live with dementia can do really well to fool people for about 15 minutes, this is why so many doctors do not see what is really going on with the person, because they tend to spend less than 15 minutes with them. We hear this happening to out of state family when their only contact is on the phone, they believe they are doing just fine, when in actuality they are not showering, taking their medications, not eating. But they sound very normal on the phone for about that 15 minute time frame, if it goes longer they would probably hear the same story. If you need anything else please do not hesitate to contact me.

    1. Simon, Thank you for reading the article and I am glad that it did clarify somethings with your wife. A lot of caregivers believe their loved one is “faking it”, “Lying” when it is something that is really happening and they take a deep breathe and get through some interaction with others really well and then they are very different with you. MOst of this new face is happening within 15 minutes, after that timeframe they are repeating again. Thank you again for your comment.

  5. I did not realise this was an actual symptom – ‘Showtime ‘, l felt like it was me who was experiencing a strange situation . It has helped me greatly . My husband is 66 and was diagnosed at 64 with Lewy bodies dementia , also he has Capgras syndrome too

    1. Elizabeth, Thank you for your comments, I am glad that it helped. If you need a support group let men know I facilitate 2 online weekly through zoom. My email is [email protected].

  6. This was so helpful. I’m going through this showtime with my Mum. It describes so well with what is happening. I still have problems with the doctor to get him to diagnose her with dementia. I live with her, I do keep a journal, it’s titled, My Mum, Dementia and Me..

    1. Jayne, You can also take her to a research clinic to get a free memory screening and this can serve as a documentation to your primary. You can also do it with her to get a baseline for yourself. You can ask the primary for specific blood work and then an MRI. If you would like more information in your area, email me at [email protected].

  7. I would like to receive your emails. My husband was diagnosed 4 mo ago with Late onset, early stage Alzheimers.He is 83. I am 79, still working as a Realtor and feeling frozen in my tracks. Overwhelmed to say the least.

  8. The journaling idea is amazing. I have been having a hard time coping lately. My dad goes in and out of delusions and does showtime. My mom is the primary caregiver and I am so worried about her. I am going to start a journal of my own and am going to suggest that she do too. I think it will help us both.

    1. Cristi, I am glad that you found something from the article that could be a benefit to you and the support of your mom. Being the primary care partner can be very tough if they do not have support for this journey. You can find in home help, day programs and support of family and friends, this is the team. “Showtime” is very tough because in front of people they may look as though there is nothing wrong but behind the scenes there is so much struggle. Become more educated, support groups and this can help for the journey. If you have zoom I facilitate zoom groups weekly. If you would like to join email me and I will provide the links for you.

  9. This is exactly what I have been trying to understand and you have described it perfectly. “Showtime” is real and the stage my husband is in which causes more problems between us than I can begin to explain because others aren’t seeing it because he’s always been on the quiet side and had little interaction in conversations. But…. he’s smart enough to say just enough to fool people. This infuriates me!!! Please add me to your news ltr. Thank you.

    1. Martha,
      This is a very frustrating thing for the care partners when their loved one can fool or front very well and others do not see what you see, especially the doctors. Please remember the person living with dementia is trying to protect themselves the best way they can, this is not to hurt you, they may not even believe there is anything wrong. You just j=have to be with them the best that you can and let the professional know as much as you do by placing notes with the doctors before you they see your person, paint the picture of what is going on the best you can and that may put the doctor on alert to look at things differently. I will send you online links to our support groups if you would like to join us we meet weekly, this could help answer some of those questions, situation and connect with other dealing with the same.
      We meet every Tuesday afternoon and Wednesday evenings. I have provided you with the links, they will be the same each week. Thank you for reaching out to me. Keep in touch. Will also send the links via email.

      Topic: Care partner Support Group
      Every week on Tuesday at 1:00 pm
      Join Zoom Meeting using this link below:

      https://zoom.us/j/91376381906?pwd=R0xPZjV1K3QxajBHNzF6b2czL3dTQT09

      Meeting ID: 913 7638 1906

      Password: 521649

      Topic: Care Partner Support & Networking Group
      Every week on Wednesday at 7:30 pm

      Join Zoom Meeting using this link below:

      https://zoom.us/j/99144889608?pwd=SW55WkMxb28zb1p3RlYvN0FNR2RGUT09

      Meeting ID: 991 4488 9608

      Passcode: 888194

  10. Showtime can go on longer than u think. My Mum was diagnosed in 2009. Although bed bound, doubly incontinent, spoon fed pureed food, normally non verbal with us: last week she was still trying to make a noise for a carer. Only the men tho. This week she is end of end of life.

    1. Lisa, You are right about your comment, it is a way r=to keep them protected as long as possible. I am sorry to hear that your mum is at the end of her journey. Thank you for your comment.

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