Pleasant New Year’s Eve

About an hour ago, Kate and I returned from lunch at Bluefish. For the past several months we have had our Saturday lunch there. It is several cuts above our routine places. Beyond the quality of the food (Kate always gets scallops with sautéed vegetables and sweet potato fries, and I get various things. I had my favorite today, Andouille sausage and shrimp stew and a special house salad that I love.), I find that it makes for a relaxing ride to and from the restaurant. It is a full 25 minutes each way. That seemed especially appropriate today. Kate got to bed a little later last night (shortly after 9:00). Consequently, she slept later than usual. She wasn’t ready to go to Panera until 10:45. I had to help her find some clothes. She was quite groggy.

We stayed at Panera for an hour before she was ready to go. (Over the past few weeks she has not wanted to continue in one place for long. The exception would be that she can stay outside a good while when the weather cooperates.) I asked if she were ready for lunch, and she nodded. Then we headed to Bluefish.

She was quiet at the restaurant, something that is not unusual. After the meal, however, we chatted a bit in a real conversation which is rare. The funny thing is that the conversation began with a strange comment from Kate. Out of the blue she said, “Now, let’s see what else you can blame on Dr. Pepper.” I said, “You think I blame Dr. Pepper for things?” She gave me a look that meant, “Are you kidding?” Then she went on to say that I don’t blame anything else; it’s always Dr. Pepper. I didn’t push her to explain as I knew that she was simply imagining that I discourage her from drinking her favorite beverage. I suspect this is something that has been on her mind for a while. The only other thing I had noticed is that occasionally she asks, “Is it all right if I have a Dr. Pepper?” I always say yes. From this point, however, we started to talk about how different we are but how well things have worked out for us. We talked about the fact that we had been able to overlook the things on which we differ because of the important things we share.

We also had a nice conversation with our server. I had asked her how she compared the quality of Bluefish with other restaurants around town. She gave me a good answer. I mean by that she was able to tell me how it stacks up in her mind compared to a number of other restaurants with which we are familiar. It confirmed what I hoped; she thinks it is a cut above most restaurants but not quite as good as several others. Kate and I believe it is unusually good. What had started as a slow day had now turned into one of those special moments that makes a day successful. We left the restaurant feeling good. I think that experience will set the tone for the balance of the day. I feel especially confident because she stayed outside pruning for an hour after we returned from lunch. That is one of the most therapeutic things she does.

I neglected to say something else that is becoming a pattern Kate is establishing. She came into the family room where I am listening to music and have the TV on to one of the many bowl games. When she sat down on the sofa with her iPad, she also had her charging cable in her hand. I think I had mentioned previously that she sometimes disconnects it to take when we are going out, usually to Panera. In some cases, like now, we aren’t going anywhere. When she sat down, she put the cable on the coffee table and said, “I want to take this with us.” I said, “You’re prepared.”

Something else that is becoming commonplace is closing doors to the bedrooms and bathrooms before we leave the house. I’ve never said a word to her about doing this, but I suspect that is something else that she believes I have told her she should do. This is just another reminder of the many things that a person with Alzheimer’s will do apart from the more typical memory issues.

More Asking Permission

Two or three times this afternoon and evening Kate has asked my permission to do something. One of those occurred when we returned from dinner. As she got out of the car, she noticed her Yeti coffee cup on top of our garbage bin. She looked at me and said with the inflection of a question mark, “I’m going to take this inside.” I said, “That is fine.” Before getting in bed, she asked, “Can I take off my shoes?” The other occurred this afternoon when she asked me if she could work on her album after getting home from lunch. Again I told her that was fine.

I realize that telling her something is fine is itself reinforcing her behavior. I really don’t want to do that. On the other hand, I haven’t wanted to question her as to why she would ask me because she seems so sensitive about my asking her why she does things. She doesn’t know herself.

Asking Permission

Despite her objections that I am trying to control too much of her life, it is interesting that Kate is increasingly asking if it is all right for her to do things. Two examples occurred at dinner this evening. After ordering, she asked me if she could start “my album tomorrow.” I told her that would be good. Then I asked if she were talking about her Chautauqua album. She said yes. After dinner, she pointed to the parsley that she had taken from her plate and placed on a paper napkin on the table. Without using words, she was asking if she should take the parsley home for her compost. That is what she always does. Why she happened to ask about doing that tonight I can’t imagine. I told her that she could take it if she wanted to. She said something like, “I don’t have to.” She brought it with her when we left.

When we got home, we both sat in the family room where I watched the news on PBS while she worked puzzles on her iPad. When it was almost 8:00, I told her I was going to take my shower. She decided to go into the bedroom. She sat down on the bed and pointed to the charging cable for her iPad. She didn’t say anything. I didn’t understand what she meant but said, “Yes.” When I said that, she reached down to disconnect the cable from the surge protector. Then I asked what she was going to do. She asked me what I wanted her to do. I told her she could leave it plugged in, that we were “not going anywhere now.” Then she said, “What am I going to do now?” I told her that it was getting near the time she would go to bed and that she might put on her night clothes. She indicated she would do that. Then she picked up her iPad and started to work on it in bed. After my shower, she was still in her clothes. I walked over to her side of the bed. She pointed to the sweater she was wearing. Then she said, “This or my night clothes?” I said, “Your night clothes.” In a few minutes, she got up and changed. Just another illustration of using minimal words and asking for my guidance even though she still wants to be very independent.

Yesterday afternoon, Kate and I were talking about some of our memories when I suggested that we start a project of writing down our memories from our life together. She liked the idea. This afternoon she had reached a point when she was ready for a change. We had been to Panera this morning. Then we had lunch. When we got home, she pruned in the yard. Then she had worked on her iPad for a while. I could tell she was getting bored. Instead of asking if she would like me to take her to Panera, I asked if she would like to work on our memory project. She liked the idea and suggested we do it at Panera. We did it. She told me from the start that she would have to depend on my memory. I suggested we try to write down how we met and something about our first date. Then we started a second section on places we have lived. We only addressed the first place in Fort Worth. I could see she was getting tired and suggested we stop. I told her that I didn’t want us to think of this as work, that we would not have to work on it every day, just as we felt we wanted to. This first effort was better than I might have predicted.

More Signs of Sundowning?

Since returning from dinner, Kate and I have been sitting in the family room. She has been working puzzles on her iPad. I have been watching the news. She has had a little problem taking her pills at night. It seems to cause a little reflux. I decided to divide her pills so that she takes half now and the other half a little later.

After she took them she got up and went to her room. She came out in a few minutes with another top over the one she had been wearing. She indicated she was ready. I asked her, “For what?” She told me, “Anything.” I told her I thought she was going to get ready for bed. She said it was too early. Then she went to our bedroom and said, “I’m just going to lie down in bedroom with my iPad for a while.”

I walked back to take my medicine. As I was leaving the room, she called my name and pointed to her iPad. I didn’t know what she was communicating and walked over to her bedside. She asked, “Should I take it with me?” I told her we weren’t going anywhere now. Then she asked me what she should do with her iPad. She asked if she could just put it down beside the bed as she usually does. I told her that would be fine

This is another occurrence of her acting as though we are going someplace and/or that we have spoken about doing something when nothing of the sort has happened.

Back Home

We arrived home again at 8:15 last night. All-in-all the Christmas visit had gone well. Kate seems to have enjoyed herself.

I spent about an hour checking email, unpacking and taking a shower before settling in to watch a Cowboys game on TV. I hadn’t seen Kate seen we got back and went to look for her. I found her in bed in the middle guest room working puzzles on her iPad. I asked if she were planning to come to bed. She said, “I thought you wanted me in here.” I may not have mentioned it before, but this is not the first time this has happened. This was the first time in a long time though.

On the trip home after a stop for lunch, Kate said, “I know I’ve said this before, but I am really excited about moving to Texas.” I said, “Yes, you have mentioned that before, and I know you are excited even though it will be a long time.” Neither of us said anything more. Jesse told me that she had mentioned moving to Texas in addition to the time she said something on a previous trip to Memphis. I moved behind Kate and shook my head to indicate this wasn’t so. They didn’t dispute or feed this conversation.

This morning was our monthly Y breakfast. I didn’t wake up until 7:06. I got up right away and reminded Kate. She initially said she wanted to go and got up to go to the bathroom. She came back into the bedroom and got in the bed. Then she told me to go on ahead without her which I did.

Sometime after getting home from the breakfast, I checked to see if she were up. She was. I noticed two pair of her black slacks thrown on my side of the bed. Then I found another pair on the floor beside the toilet in the middle bathroom. When I found her, she was wearing a pair of black slacks. I just hung up the slacks I found.

Christmas Eve in Memphis

Yesterday Kate and I drove up to Memphis to spend Christmas with our daughter and her family. We came in late in the afternoon and just about an hour before going out to dinner. Following that we returned home where we watched The Grinch that Stole Christmas and a portion of Disney’s version of A Christmas Carol. It was a nice evening

Today has been leisurely for Kate and me. Although we both woke up around 5:00, we went back to sleep, and I didn’t get up until almost 7:30. Kate remained in bed an hour or so longer

Jesse worked on the preparation of a cheesecake for our dessert tomorrow and a shrimp salad she was preparing for a drop-in at her neighbor’s across the street. We all went to lunch at the old train station there. It was a delightful ride over and back with a lunch that was quite good.

Another nice day

We’ve had another nice day. There isn’t much to report. We spent an hour or so at Panera this morning. Then Kate wanted to go to Lowe’s to see what plants they might have at this time of year. They were almost completely depleted. She did buy $50 worth of pansies that she plans to plant tomorrow

On the way to Lowe’s she asked me if I had said something to Sylvia about our moving to Texas. I didn’t know who she was talking about and asked if she meant Sylvia Bailey, our daughter’s mother-in-law. It turns out Kate was talking about our decorator whom we had seen at Panera while we were there. Kate noticed how puzzled I was and said, “Never mind.” I didn’t say anything more. It was as if she suddenly realized that she may have imagined this conversation. As I have noted in earlier posts, this is something that occurs periodically.

We had a couple of nice social encounters yesterday and today. The first was at Panera’s where we had lunch yesterday. A Rotary friend came in for lunch just as we were finishing up. He sat down beside us. That led to a conversation that lasted a little more than an hour. He is a funny guy and as a native Tennessean and former news broadcaster, he knows a lot of things that are happening around the state. Kate did not participate much, but she really enjoyed listening to the two of us.

The second experience was tonight at dinner at our favorite Mexican restaurant where I always speak Spanish with the servers. I engaged in conversation with one of them about how it seems like such a short time since we were there just before Christmas a year ago. After we finished the conversation, Kate said something like, “I would have married you just to hear a conversation like that.” She went on to explain that it was such a natural conversation between two people from such different worlds with no sense of any distance between us at all. I try to tell my friends that we don’t eat out just for food. It is an opportunity for significant social encounters. This is often the case.

I just remembered something else that occurred yesterday. We were driving to dinner when I said, “I haven’t seen Mark in a while. I think I will call him for coffee tomorrow afternoon.” She replied in a soft voice, “What am I going to do?” I felt so sad for her. She has such a strong need for activity other than what I am providing. It is so difficult to accomplish. I have mentioned to virtually everybody who asks about her that she is socially isolated. Several people have indicated a desire to help and would enjoy getting together. Only three people have actually responded. Two of them got together with Kate and me for lunch with no follow up. The third got together with the two of us twice. I believe she is likely to follow up again, but she is a school teacher and has obligations during the school year. I really do understand. All of us seem to be so busy that we can’t work in many extras like visiting someone who may be in need.

Last night on the way back from dinner, she looked at the clock in the car to see that it was only 6:00 p.m. Then she said, “What am I going to do?” She went on to say she can’t just work puzzles all the time which is what she is doing. This is so painful to me as I am working so hard to keep her active, but my efforts are never enough.

Last week I also mentioned Kate’s isolation to our associate pastor for congregational care. I asked her about others in the congregation who might want to establish a connection. I also left a phone message for Don Crawford whose wife has AD. I saw him at church on Sunday, and he asked me to call back. I would love for Kate and his wife, Cynthia, to get together. I am going to be hopeful.

Acid Reflux?

I don’t know how I could have failed to say something about what may be a recurrence of acid reflux. This is an old problem for which we found a resolution two or three years ago. Since that time she has taken a prescription for Prilosec that had solved the problem. About six months ago, she experienced a couple of instances of the problem. I thought the problem had gone away on its own. Kate said she was eating more slowly which she believed helped to prevent a recurrence

I can’t recall exactly when, but she started using extra paper napkins at restaurants. This typically occurs before she has even eaten anything. As I reflect, it is something that occurs at various time during the day. She goes through lots of toilet paper which I now believe may be associated with this problem. Let me describe the problem as well as I can

Unlike her previous experience with acid reflux, what she is experiencing now does not involve exactly the same symptoms. When she has had the more serious experiences, she has to stop eating. She usually lowers her head slightly and appears to be trying to calm herself. With the current problem, she can continue to eat. As I have already mentioned, she will be having the experience before food arrives at our table

To me it appears that she is simply spitting up saliva. I do not see any visible signs that she is experiencing acid creeping up her esophagus. It is more like the normal salivation collects in her mouth, and she spits it out. I think one reason I haven’t mentioned it before was that it never seemed like something serious. In the past month or so, the problem has become more serious and seems to bother her. In fact, last night she had some difficulty getting to sleep because of it. I suspect it was more than an hour before she got to sleep after going to bed. She got up at one point. I heard her burping in the bathroom next to our bedroom. That led me to give her some Gaviscon. Before she was taking Prilosec, I gave her Gaviscon when she had a problem. It always seemed to work. I have tried it several times recently without the same success. I am not certain that it helps at all. I do know that she finally settled down and slept well during the night

About three weeks ago, I sent a message online to Dr. Reasoner, Kate’s doctor. She suggested that we try several things. She said we could take a second Prilosec in the evening. She also said if that didn’t work, we could try her taking an antihistamine. Finally, we recommended staying away from acidic foods and beverages. I tried doubling Prilosec and could not tell any difference at all. I dropped that. I then tried adding a Claritin with her morning medications. I have not been able to detect a change though I plan to continue to give it a fair chance of success. My reason is that I think her symptoms seem more like a post-nasal drip which sounds like an allergic reaction
One other symptom has made me think of the situation as more serious than I originally did. Within the past 4-6 weeks, I have noticed that she sometimes starts burping when she takes her pills. That made me think there might actually be a gastro-intestinal source of the problem. On the whole, however, I find it very confusing. What I know is that it has become a chronic condition that annoys her. It also concerns me that it might possibly be a symptom of something more serious. Unfortunately, Kate is unable to provide any kind of description. I am hoping that we might have a conversation with her doctor. I think her next appointment is in January or February

Kate does drink a lot of tea and Dr. Pepper. That would be the next step to try. That will be a hard one as these are long-standing habits.