Dementia & the Hostess Mode (or, Why We Sometimes Miss the Obvious)

“Are we going to the grocery store today?”

 “Yes, Mabel, after breakfast.”

“Oh good, I’m out of soup.”

“Are we going to the grocery store today?”

“Yes, after breakfast.”

“Oh good, I’m out of soup.”

I wrote this in “Rainie Daze,” and as I said then, no, it is not that I am trapped in a time loop like the intrepid cast of Star Trek or Bill Murray in “Groundhog Day.”

This is an actual conversation I would have several times a week with a client of mine, who I shall call “Jenny.”

Jenny was (yes, she passed, and oh! How I still miss her!) a warm, intelligent, hard working woman for most of her ninety-plus years. She ran a successful business and raised wonderful children and was actively involved in charity and community projects, many of which you folks local to the area probably still enjoy to this day. She lived alone for a couple of decades after her husband passed, still very social and very much a part of the world.

Then... dementia started creeping in.

Dementia is a tragic, frightening attack on the brain that can rob us of our loved ones long before their heart stops beating. In Jenny’s case, it first affected her short-term memory. She would do little things, like put money away and forget where she hid it, or put water on the stove to boil and then go take a nap.

Jenny’s family picked up on it early enough to prevent a tragedy, but often families aren’t aware of the problem until something drastic happens... like a person mistakes the gas pedal for the brake while driving, or takes a walk and gets lost miles from home.

Even in families where there is close contact every day these first signs can be missed. How?

One way is what I term “hostess mode.” Jenny was very good at it, even after the dementia was well advanced. Somehow, when confronted with “company,” her brain would switch to another track, and she would sound... normal, for lack of a better term.

One morning, before I arrived, the local newspaper called her for a comment on the closing of a wonderful community project she and her late husband had initiated. Now, Jenny knew nothing about it; no one had told her, for fear it would unnecessarily upset her. But the reporter gave her a brief rundown, and they apparently had quite a chat. Jenny’s quotes were in the paper the next day, coherent and intelligent as she had always been. Clearly, the reporter had no idea of Jenny’s condition. For that space of time when Jenny was speaking with a stranger on a social issue, her brain seemed to be functioning as it had a decade or more before.

She did not, however, remember the incident. She never told me about the reporter’s call, and none of us would ever have known if we hadn’t read the article.

I think we all have this ability to run our minds on alternate tracks. We use it in many social situations. It is the route our brain takes to prevent us from laughing out loud at something particularly stupid our boss says at the office party, and to keep us from slapping the annoying store clerk, thus getting ourselves thrown in jail.

What I’m saying is, that track seems to be an integral part of our survival set, for, like it or not, we are a social species, and we have to learn to get along.

What strikes me as odd is how that track can survive, even thrive, in the face of dementia. Oh, not always. Believe me, I have taken care of plenty of clients where the opposite is true, where they will literally bite the hand that feeds them!

It doesn’t seem to matter whether the victim was outgoing before dementia or not. Like so many things that affect our wonderfully complex and mysterious brains, it seems to be random. The one thing predictable about dementia, after all, is that it is not predictable.

Irascible people turn sickly sweet. Sweet-tempered people turn angry. “Neat freaks” suddenly won’t shower or change their clothes for weeks at a time, while modest folks might suddenly be found in the neighbor’s yard in their birthday suit.

But often, that social mode remains intact, concealing dementia just as a bright but fake smile hides a migraine from your coworkers.

So pay attention to your loved ones as they age. If their smile seems a little too bright, or their eyes seem to be focusing on the middle distance, they may be seeing you as an annoying boss or a cranky cashier, and be simply behaving nicely so you will go away.

So they can hide their money in the toe of a long forgotten shoe, put the kettle on the stove... and go take a nap.