When a person with dementia has the ability of acting and having a full on conversion, albeit for a short period of time, hiding the advancement of it. (this is a version of the explanation from alzheimers.org.uk)
Oh, the nasty surprises that dementia brings to the table.
I’ve only ever heard this from fellow caregivers of loved ones with dementia:
Dementia Hostess/Host mode.
Not surprisingly, medical professionals (in the UK, in my experience) often think you’re overreacting. After just five minutes of speaking to your loved one, they might even say, “they look fine.”
Here’s the thing—your loved one can display lucid and coherent behavior in front of others. Mama (and I'm sure my fellow caregivers can relate) had the ability to suppress the symptoms of dementia for long and then shorter periods, especially when social situations demanded it. She was good at it. I often saw it as her fighting dementia—a survival mechanism, of sorts.
She would usually be like this with medical staff, friends, and relatives they don’t see often, people they're trying to convince that they're still “fine.” It took a great deal of mental effort for her to maintain this act.
Hostess mode typically lasts for short periods, but my mother could keep it up for several long hours. Of course, as her dementia progressed, this ability became less frequent for her.
I think this mirrors what many of us do in life. How often are we truly ourselves? We tend to be on our best behaviour most of the time—that’s what we’ve been taught. And in our family, mama always said, never show weakness. She believed you should never let anyone know what you're going through; you just deal with it. I get that. And I relate to that to this day.
I remember during her morning church routine, she would leave right away because she knew she couldn’t hold a conversation. When she saw the neighbours, would stop for 5 minutes and then leave.
And when my brother visited... oh boy. She desperately wanted to appear fully coherent in front of him. She managed to do this for nearly a year. (Plus I don't think he wanted to see it.)
But after he left—when it was just me and her—her true self would emerge. He visited every three months for about two days, and I knew that after those two days, there would be a tornado to clean up. The exhaustion from keeping up hostess mode left her more confused, angrier, and more defiant. I had a list of tasks to tackle as soon as he left. The carer and I would be in full overdrive for at least the next week. To put her back on track.
Each time Mama slipped into hostess mode, I noticed a regression afterward, as though the efforts left her more drained and depleted.
People who haven’t cared for a loved one with dementia would always say, “It’s just old age…” or “She seems fine to me…” But those who've been through it can see the reality right away.
Some tips on how to deal with Hostess/Host mode:
Plan for the Aftermath: Try and anticipate the "crash" after social interactions. You'll know what or who can trigger it so plan quieter, low-drama days following events, visits or medical appointments to allow your loved one to rest and recover. You could go back to the same familiar routines as soon a possible or comforting activities to help ease any frustration or confusion.
Limit the time, if possible: Once you know the triggers that lead to hostess mode, such as social visits or doctor’s appointments, try and limit the length or intensity of these events. Shorter, more frequent interactions might help. No-one around me wanted to help or support this, so it never really happened. Hopefully it may work for you.
Communicate with Others: Helping family and friends understand. In my experience, I tried and tried but mama was so good at fooling everyone that everyone thought I was overreacting. You can only do so much. I also tried with medical professionals. As you can imagine, that never went across well.
Encourage Breaks: Sometimes I would say I needed a break and have mama join me. Either for a walk or a nap or just to step away from all the people around. I would notice her getting worn out and would ask her to "support" me and come with me. Sometime that worked. And she would rest and reset and it would prevent the exhaustion from maintaining the façade.
How have you managed to cope with Hostess/Host mode?
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