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He seems confused, angry and without much executive function when we are at home. When we go to his doctors appointment, he is more cognizant, appropriate and generally lucid. Is he just "acting" with me? It's hard for me to figure out what is real with him. Is his behavior just to get care and attention from me? He seems very confused with me but seems more clear with outsiders.

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I think you will find that interactions with brief time spans are more easily negotiated, and those with dementia often realize they cannot communicate well; they do learn to confabulate on a surface level. Someone will say "How are you" and get a "Oh, just fine. I'm doing just fine" with a big smile and lots of head nodding.
Of course we are always more our "real selves" with those we love, in a trusting situation where we don't have to try so hard. And our real selves don't get better with the onset of frustration that always comes with these losses.
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It's actually called 'show timing' what your husband is doing, and lots of people with dementia are VERY good at pulling the wool over others' eyes while they treat US like crapola!! Take my mother (please?)...........she is The Queen Of Show Timing! She's even had care givers at her Memory Care ALF ask her WHY she's living there!!!! She puts on SUCH a great act for others that in many instances, they think she's perfectly lucid with no dementia issues at all.

The key is.............they can show time when they're not asked REAL questions or have to give REAL information out, you know? They're great at small talk.......chit chat........the "Hi how are you today, how is the wife and family?" type of stuff. Ask them what day it is or what they had for breakfast, and it all falls apart.

The mean/nasty side and the frustration comes out with those they're closest to because they don't have to wear a mask for us. They don't have to put on a show to pretend all is well. We KNOW all is not well, so the jig is up. They let out all their angst with us, and it's unnerving, not to mention highly annoying. My mother has always been this way, though, it's only worsened with dementia. I remember my father saying "How can your mother be so nice to a stranger who comes to our door but treat me like a piece of garbage 2 seconds earlier?" It's called Being a Phoney.

Anyway, take it all for what it's worth. And know that the 'acting' is done for OTHERS, not you. You get the Real Deal with him while others get the Nice Him. Sucks, doesn't it?

Wishing you the best of luck dealing with a tough situation.
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No he is acting, show timing when you are out. It is exhausting and when he is home you are seeing the true impact of dementia.

Remember how when you children were small, they would behave in front of others, but when you got home they were tired and cranky?
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Its called "showdowning". They still have enough with it to sum up the energy to get thru an appt. What you see at home is how he really is. And I bet its worse in late afternoon and the evening. This is called "sundowning".

Keep a daily journal about how he is acting. Just before his next doctor visit put a short note together, just one page, one side. Give it to the receptionist and ask that the doctor look at it before he sees ur husband. This will give the doctor an idea of what questions to ask ur husband.
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DogsRgood Oct 2020
Your answer is so great and now I get it!!!! I thought he was just playing with me to get more....as if, he always wants more. Thank you for taking the time to help. xxx
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