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Some Changes

I was just about to write a post that would say that a number of things have happened over the past few days that make me think Kate is making a shift downward. The first sign is that she has seemed depressed and not as upbeat. The other is confusion which I have mentioned in an earlier post today.

Just before I started I heard her call me. She wanted me to come to her office. When I got there, she said she wanted me to see her closet. Her bed had no clothing on it, nor was there any on the floor. Her closet looked beautifully organized. She thanked me. When I asked why she was thanking me, that I hadn’t done a thing. She said, “You bought me the hangers.” For over a year she has periodically asked me for more wooden hangers. Each time we have gone by Bed, Bath, and Beyond. Each time I think this is the end. Then a while later she says she wants more. I am surprised she attributed her success to me. This is something she has done on her own. She said, “I feel so much better. I can’t tell you how much better I feel.” I reinforced how much better her room looked and that I know she must feel better. This is not the first time she has cleaned up, but it never lasts too long. I am wondering if in her depression of the past few days, she hasn’t directed her attention to cleaning up which made her feel better. Whatever it is, I am grateful. It makes her feel a lot better. It makes me feel better as well.

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Confusion

Quite a few times I have mentioned Kate’s Deja vu experiences that are almost a daily occurrence. I believe I have also mentioned that she sometimes imagines I have said or done things, for example, thinking that I had told her we were going somewhere when I had not. Just before going to lunch she said something that makes me wonder if this is a pattern that will continue to escalate. This is not the kind of thing I was expecting. Here is what happened.

Several days ago, I went to the backyard where she was working in the flower bed against our wall. I didn’t see a panel of grill work from her parents’ home that we had put in the flower bed. When I said something about it, she didn’t know what happened. Then she said she remembered that, Ronnie, a woman who has helped her with her landscaping had taken it to be painted. I thought that seemed strange since to the best of my knowledge, the Ronnie doesn’t have anything to do with painting. Then today when I went out to the yard to tell her it was time for lunch, she told me she knew where the grill work was and took me to the spot where it had been standing. Whatever had been holding it upright had broken, and it was lying on the ground mostly covered up by leaves. Apparently it was completely covered the other day when I missed it. After she came in to take a shower and get ready for lunch, I was in the bedroom watching a football game when she called to me and said something like, “Richard, I need to tell you something. I guess you will find out soon enough.” I asked her to tell me about it. She told me that Ronnie had brought the grill work back and would set it back up in the flower bed. She seemed especially concerned that I might be upset about her not telling me. While we were at lunch I asked why she seemed upset about it. She told me it was because she was supposed to have told me before and hadn’t done it. I also asked what Ronnie was to have done with the grill work. She said, “I guess paint it.” I told her I didn’t think she had painted it because I could see that it still needed painting. She accepted that and appeared not to recognize any inconsistency between what she had told me before and now.

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Taking Medications

I have the responsibility of putting Kate’s medications in her pill box every week. I also assume responsibility for checking behind her to see that she actually takes them. Yesterday I slipped, and she missed both her morning and evening medications. This is not critical except for Venlafaxine which she takes every morning. In the past I have found that if 48 hours pass since her last dose of Venlafaxine, she suffers from an unsettled stomach.

When I discovered that she had not had her Venlafaxine yesterday, I knew that she needed it right away and that if she didn’t get it by noon she might have the effects of an unsettled stomach. It turns out that this started shortly after I gave her the morning medications including Venlafaxine. I went to the Y and also to have coffee with a friend. When I got home to take her to the bank where she was to sign some papers, I discovered that the stomach problems had occurred even though she had had her Venlafaxine. We went ahead to the bank, but she did not feel well and didn’t want to stop for lunch. We headed home. Once home, she still did not feel like eating; so I went to get a bite. When I returned home, she was feeling all right. I asked her if she wanted me to take her to get something to eat. She said that she didn’t, that she would just get something here. She is now up and dressed. She walked into the kitchen where I am typing this post and said she was ready to get something to eat. That means we are off. We’ll probably return home, before leaving for her eye doctor’s appointment at 3:00 p.m.

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The Role of Humor

After being so depressed last night, Kate was herself this morning at least until it was time for us to get a bite to eat before our haircuts at 11:00. Here’s what happened. About 9:45 I went back to her office where she was working on her laptop. I told her we would need to leave in 30 minutes if we wanted to get something to eat before our haircuts. She indicated that would not be a problem. In the meantime, I went back to my computer. After 15 minutes, I went back to let her know that we had 15 minutes. Before I could say anything, she said somewhat angrily, “What do you want? You can see I’m getting ready.” Seeing that she was well on her way to being ready, I let her alone and didn’t say anything more. At 10:15 she called to me and asked, “Where are you?” She was all ready to go. Knowing that she would wait for me while I was getting my haircut, I asked if she wanted to take her iPad. She said, “And my computer too.” I could see that she didn’t have her computer; so I assumed that I needed to get it for her. Since she had been using it in her office, I went there to get it. I didn’t find it. In the meantime, I discovered that she was looking for it as well. I told her I had seen her using it in the office but didn’t see it there. We both started looking in different rooms of the house. Then she asked where her iPad was. I told her it was probably in the bedroom, but I had no luck there. Then I asked her, “You wouldn’t have taken both of them and put them in the car, would you?” Before she could answer, I went to the car to check. They were in the front seat of the car. She acted quite relieved to know they were found; however, she had already gotten pretty worked up and couldn’t immediately calm down. This was not a full-blown panic attack but her heart appeared to be racing and she was breathing more heavily than normal.

We went to Panera. On the way over I asked, “Are you back to normal now?” (This is something that occurs somewhat frequently. I ask the question, and she tells me if she is or isn’t.) She told me, “Not yet.” I sense that this routine exchange seems to facilitate her calming down IF I don’t I appear to be pushing her but simply being sympathetic. I told her I thought she would be perfectly calm by the time I brought her food to her. That didn’t happen. She told me (in a nice way) that she still wasn’t back to normal. About half way through her sandwich, she said, “I’m all right now.” We both smiled and went on with our lunch.

I dropped her off to get her haircut while I went back home to take care of a few things and to stop by Walgreens to pick up a prescription. When she finished, I took my place to have my hair shampooed. In a few minutes she approached me and indicated she wanted to get a Dr. Pepper out of the car. I gave her my key with some hesitation and gave her instructions as to where I had parked. Kate left. I felt uneasy, and Dawn said she would follow her to the car. I told her what my car looked like and where it was parked. She came back in a few minutes and said that Kate had immediately turned left as she walked out of the shop instead of going straight as I had told her. Then she couldn’t find the car, but Dawn helped her.

When I had finished, we both went to the car. I asked her for the car key. She didn’t have it. I went back in the shop and found that she had put it on the bench beside the spot where she had been sitting. When I came back with the key, she was quite relieved. She was about to panic again. She joked abut my having to put up with so much from her that sometime I was going to lose my patience and just shoot her. I smiled at her and said, “It’s not going to happen.” We both laughed. I said, “At least we can keep our humor.”

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A Low Moment

Kate and I are in our bedroom right now. She had been working on her computer this afternoon and suffered some frustration as she tried to do some things. I know that one of them was trying to find her mother’s recipe for cheese grits. It appeared that she was blaming herself because she could not find it on the computer. I did a search and could not bring it up. To me that is an indication that it is not on the computer. It’s not Kate’s fault.

After this she ran into something else but didn’t want to talk about it. I asked if I could help in some way. She said no. She looked as though she were miserable which makes me want to do something to help. I offered several options. She wasn’t interested in anything. I suggested that we go back to the bedroom when she said she was sleepy. I told her we could turn on some episodes of Dick van Dyke. She agreed unenthusiastically to accept that offer. When I turned on the TV, CNN was reporting on a new shooting in San Bernardino, CA, in which 14 people were killed and another 14 injured. She wanted to leave the TV on the news which I did. It continues now, and Kate is under the covers resting with her eyes closed though not asleep (I assume).

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From Panera

I woke up early this morning (4:55). Kate got up around 6:30. I walked and came back to the house. Around 8:30, I noted that she was still in bed. I asked her if she would like me to take her to Panera. She jumped on that immediately. She wasn’t really sleepy, just bored. She had been working jigsaw puzzles and got tired of that. The weather isn’t conducive to working in the yard.

When she got in the car, I looked at her jacket. It was one that I didn’t recognize. Then I gathered that it must belong to Libby, our housekeeper. She had come just a few minutes before our leaving. Kate quickly returned the jacket to the house. When she returned, she thanked me for noticing. She said, “You rescued me again.”

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Anger or Jesting?

Yesterday afternoon before we were to leave for a movie, I walked into our bedroom where Kate was editing photos on her laptop. I said, “We’ll need to leave in about 5 minutes.” She yelled at me that she was ready. When that time had lapsed, I went to get her. She still seemed quite irritated. That continued in the car as we drove to the theater. I don’t recall exactly what she said, but she expressed her displeasure at the way I rush her when we are going places. As we started walking toward the theater from the parking garage, she said, “You tease me enough. I should be able to tease you.” She held my hand. Then as we sat in the theater, she also held my hand. It is as though she really was angry but tried to cover by suggesting she was teasing. Then she began to express her apology not in words but by being loving.

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Memphis: Alone Time

This morning Kate and I were awake at 7:15. I brought her some orange juice and a breakfast bar around 7:45 and told her the family was just now coming to the kitchen. She thought I was asking her to come on downstairs and asked, “I’ll be able to see them later, won’t I?” I told her yes. She remained in bed using her laptop. She remained there until close to 11:00. She came downstairs and started editing photos on her laptop. Sometime around noon, she went back upstairs. I just checked in on her and found that she was resting in bed.

It is interesting how much she enjoys being with everyone (I think), but how often she removes herself to rest. I am not sure whether this occurs because she is simply tired or because she isn’t interacting with everyone and gets bored or feels left out. For the most part, each person has been on his/her own today. Jesse has been busy the entire day preparing food for our Thanksgiving dinner. I have remained in the kitchen most of that time working on my iPad and talking with Jesse and Greg. Ron has been playing games on the TV (football, basketball and hockey). Randy has been upstairs almost the entire morning. He is downstairs right now working on his computer. It could be that Kate has simply gotten tired of working on photos. It may be taxing on her. It could also be that she is having a very low-key experience with the family since no one is giving her any special attention. Of course, she hasn’t taken any time in the kitchen except when Jesse gave her a slice of banana nut bread and some fresh blueberries and raspberries.

Yesterday she was hurt when we were with the Robinsons in Nashville. We had had a good visit. Near the time to leave, she broke into the conversation and said, “Wait a minute, the three of you have done all the talking. Let me say something.” When we got in the car, she seemed depressed. We didn’t chat about it, but she offered several comments. She mentioned something that I have noticed before but did not notice yesterday. She said Angie and Tom looked at me and addressed all or most of their comments to me. She also said that everybody (even Ellen, her best friend) does this. She said, “I am not dumb.” meaning that she has things to say and contribute to our discussions as much as everyone else. I apologized to her because I had not been sensitive to that and that I would try to direct more conversation her way. I really do believe that my own personality is such that I quickly engage in conversation with other people and don’t think as much about whether or not she is being included. This is something I need to work on. I might think that the behavior of the Robinsons is a result of their knowing that Kate has Alzheimer’s, but the same pattern appears to be true with other people who have no idea of her illness. It may have something to do with the kinds of comments that she makes. Often they don’t tie into anything that we are discussing at the moment. It could also be that there is so little that she can offer to many of our conversations that she is more retiring and gets ignored. At any rate, it is a problem and one that I hope I can offset but fear that this will become a more common pattern.

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Sad Moment

Yesterday morning shortly after I told Kate it was time to get ready for church, she came to me with an outfit and asked, “Is this all right?” This seems a simple enough question, but viewed in context, it is another sign of her decline. She has been and continues to want to be very independent. She often shows signs of resentment when I make suggestions about what she should wear. She does, periodically, ask my opinion. In this particular instance there was something about the way she asked the question that hit me. It sounded very childlike as though she had no idea of what to wear. I think the fact that she was preparing to dress for church which is such a routine event adds to my sense that she is changing.

As a caregiver, I have to be very sensitive about what to say, when to intervene, when to let her make her own decisions even when I know it may be different from what I believe is appropriate. I am trying very hard to minimize her boredom now. I am spending less time at the office so that I can be with her more. That permits such things as simply coming over to Panera Bread where we are right now. Here is an example.

Today I have a foundation lunch meeting that starts at 11:30. That means I need to get her lunch somewhat earlier than I would do typically when my Rotary club meets at 12:30. For that reason I decided to come home directly from my workout at the Y and take her to Panera where we could both work on our iPads and then get her lunch. Knowing that she often goes outside to work in the yard and that if she did this, we wouldn’t have much time together before I have to leave, I called from the Y to remind her that we were going to Panera. She had forgotten. When I got home, she was waiting in the driveway near the street. When she got in the car, she said, “I didn’t keep you waiting.” This led to a few comments related to her saying that I didn’t give her credit for anything. She then gave me commands as to how to get to Panera’s. She was mimicking the way I do with her. My point in telling the story is that I had simply tried to do something nice for her, but she hadn’t recognized that and, in fact, seemed a little put out with me.

During our time here, she said, “The Olive Tree. That is the name of the restaurant where we ate on Saturday with the Harringtons. She had asked me several times but couldn’t remember the name. Then she said, “Katherine.” That is Mark’s wife. That led to her repeating our address, my cell phone number, as well as the names of several high school friends. She was demonstrating that she still remembers things. This is another sign of her own recognition that she is getting more forgetful and is working hard to compensate (remember). That makes me sad too.

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Imagining Things

Last night as I was turning into Ruby Tuesday for dinner, I said to Kate, “Oh, I forgot to bring my $5 off coupon again.” She said with a bit of irritation, “Why don’t you keep it in the car.” Then she went on to say, “I’ve told you at least 3 times to do that. You don’t listen to me.” This led to a further exchange in which I said, “You don’t think I listen to you.” She said, “No, you don’t.” My point in bringing up this episode is that she has never suggested that I keep the coupon in the car. In fact, we have not really discussed this. The only prior mention occurred the last time we were here about 2 weeks ago when I also had forgotten the coupon.

Kate did not sleep well last night. At 2:30 this morning she mentioned that she couldn’t sleep. I know she was awake around 4:00 when I woke up again before falling asleep until 5:00. I think she was awake then. I got up at 6:00. She has rested a little since that time, but I really believe she lost a lot of sleep. I asked her a few minutes ago if she had been worried about something. She said she hadn’t and couldn’t figure out why she couldnt sleep.