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Another Example of Kate’s Insecurity

Over the past couple of months I have felt much better when leaving Kate with a sitter. There have been one or two occasions when she asked if I couldn’t stay with them, but it didn’t sound like she was doing so as a result of any insecurity. It was more like she just wanted me to share in their time together.

This past Friday Kate was asleep on the sofa in the family room when I left. I started to wake her to say goodbye but didn’t. When I walked into the kitchen on returning home, I heard Mary say, “There he is.” I walked into the family room. Kate was sitting on the sofa. She stood up and said, “Thank God you’re here!” (That’s not something she would typically say.) I walked over to her, and she extended her arms to me, and we hugged. I told her I was sorry I hadn’t said goodbye. She said, “I was all right. I just didn’t know where you were.”

She was obviously relieved to see me. I’m not sure that Mary remembered where I was going. Even if she did, Kate’s memory doesn’t last more than a few seconds. She would never have remembered. On a few other occasions, Mary has mentioned Kate’s asking where I was, but this was the clearest indication of the intensity of her insecurity when she doesn’t where I am. I’m not ready to believe that this will become a pattern for the future, but I will be more alert to that possibility.

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More Confusion and Confusion

Shortly after midnight last night, Kate and I had what was almost a replay of a conversation we had yesterday morning. I had gotten up to go to the bathroom. When I got back in bed, I noticed that she was awake. She said, “Where are we?” That began another conversation that lasted until 1:35. She said she didn’t know anything. As I had done the night before, I said, “That must be scary.” She said, “Very.” From there I gave her my name and hers and our relationship. I followed that by lots of the same family information I had given the last time.

Several times she said, “I don’t understand why this is happening.” I told her I didn’t either but that it had happened other times and that she improved as we talked about our lives and family. This conversation was unusual in that she was able to grasp the change in her memory (or the way she felt) as I fed her information. At one point, I asked if I was overwhelming her. She said, “No, I can tell it’s helping.” She suggested that she was remembering a few things and that made her optimistic that her memory would come back. It’s been close to a year since she had her first experience like this.

At that time, it brought about a more intense emotional response. I described it as a “panic” or “anxiety” attack. This morning’s experience was not nearly as intense, but it had an element I had not heard since last summer. She made reference to her doctor’s telling her she might get better. She said the doctor also indicated that she might not. Nonetheless, she was encouraged last night. She also talked about the support she had received from friends. This time, however, she mentioned that her memory might not come back “all the way.” I told her no matter what I would be with her to help. We both said that whatever happens, we would deal with the situation, that we were good at adapting.

The conversation ended when she said, “I think I’ll go back to sleep now.” I asked if she felt relaxed. She said she did. The crisis was over. What is lingering in my mind now is that she seems to grasp that she has something that she won’t be able to conquer. She may improve, but the problem won’t go away. Once again, her intuitive thought processes are working. She doesn’t have a name for it or understand a way to beat it, but she knows something is wrong.

Just before 9:00 this morning, I saw on the video cam that she was starting to sit up in bed. I went to her. She smiled, and I walked over to the bed and sat down beside her. I was expecting that she would be back to normal again. She wasn’t. She was just as confused as she was earlier this morning. The difference was that she wasn’t in the mood to talk about what she was experiencing. She kept saying (not in rapid succession), “I don’t know what to do.” I asked if she would like to go to the bathroom. She asked why. I told her that she usually wanted to go to the bathroom when she woke up about this time. She repeated that she didn’t know what to do. I tried the same approach that had been successful in our two previous midnight conversations. She didn’t seem to pay attention. I think she was still tired and wanted to go back to sleep. I asked if she would like to see some pictures of her family. She didn’t, but I showed her a wedding photo of our daughter and brought in the “Big Sister” album to the the cover photo. She responded with a smile when she saw it, but she wasn’t ready to look at anything else. I asked if she wanted to rest a while longer. She nodded. I asked if she would like me to stay in the room with her. She did. That’s where I am right now. She opened her eyes a few minutes ago but is asleep again. We have a 12:30 reservation for lunch. I think I’ll let her sleep until 11:00 or 11:30 before waking her unless she gets up on her own.

I don’t like all the signs I have seen over the past week or two. This isn’t a change for the better.

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Midnight and Early Morning Conversations

I’m always trying to guess what is going on his Kate’s head. Sometimes I think I have a pretty good idea. Many times, I don’t. Between midnight and 7:00 this morning we had two very different conversations. I don’t know what prompted the first one. I think I understand the second.

Just after midnight, I felt Kate move and looked over. She looked at me. Then she said, “I want you to know how much I love you.” I said, “And I love you too.” Then she said, “If I were to die today, I would . . .” She couldn’t think of the words she wanted to say. I said, “You would be grateful for all the time we had together.”  She said, “Yes, I love you so much.”

That began what must have been a 15-minute conversation in which each of us expressed how thankful we are that we found each other. It’s been a while, but she used to say, “What were the chances that a South Florida boy would end up with a Texas girl?” We often talk about the choice that each of us made to attend TCU. That decision made it possible.

At least three times in our brief conversation she repeated what she had said at the start. “I want you to know how much I love you.” and “If I were to die today . . .” Each time I filled in the last part of her sentence.

We talk about death once and a while. She often says, “We’re all going to die. It’s just part of life.” In all the other times, I knew why she was prompted to comment on dying. This time it came out of the blue. The only thing I know is that she is aware that something is wrong with her. She is having more experiences in which she is concerned about not knowing who she is, where she is, or what is going on. Was she having one of those experiences? It didn’t sound like it. She was talking to me as though she knew exactly who we are and was grateful. It does make me wonder, however, if the experiences of confusion she is having are beginning to make her think she might be dying. I don’t know, but I will be more conscious of any other signs that might suggest that.

I woke up at 5:45 and was about to get up when I heard a whimpering sound from Kate. I told her I was about to get up but wondered if she was all right. She said, “I don’t know. I don’t know where I am or why I am here.” I told her I could help her. She said, “I’m glad you’re here. I’m confused.” I said, “That must be scary.” She said it was. Then I said, “You are Kate Creighton.” She said, “Who are you?” I told her, and she repeated, “I’m glad you’re here.” I told her we had some photo books I could show her and that they would probably help her. She said, “Just talk to me,” and I did.

I put my arm around her and for the next hour told her about her parents, where she was born, our courtship, our marriage, and our children and grandchildren. At one point, I must have started to dose off. She said, “Keep talking.” At 6:50, she seemed relaxed. I said, “Are you all right. I was thinking about getting up.” She said, “I’m fine.” I got up, and she went back to sleep.

I hate for her to have these experiences, but I am glad that it is possible to comfort her when they happen. I really didn’t do much at all. I simply talked to her slowly in a comforting voice and gave her information that stimulated her intuitive thought processes. I am sure she didn’t remember any of it after I told her, but she felt safe and secure.

This is another good example of the intersection of rational and intuitive thought processes. She began the conversation with little or no rational knowledge but an intuitive sense that she should. My providing the knowledge didn’t change what she knows. It did change how she feels.

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Morning, Noon, and Night

As a rule, Kate is happy, but there is clearly some variation that occurs from morning to night. Predicting how she feels in the morning is difficult. She has never been a morning person though she got up early for years without complaining when she was working professionally and playing her role as a mother. Over the course of her Alzheimer’s she has found it harder to get up. Not only that, but she is much less clear-headed now. That varies from one day to the next. Sometimes she seems quite alert. Other times she is quite groggy.

The good news is that she almost always becomes more alert and cheerful as the day progresses. There are exceptions. I reported on one of those two days ago when she didn’t talk much. She didn’t seem unhappy. She was just less energetic. Day before yesterday she was unusually upbeat. Yesterday she was somewhere in between, but happy, and more upbeat from lunch until bedtime.

I have tried to understand why her mood in the afternoon and the evening are the most predictable. I think the answer may lie in the weakness of her rational abilities and strength of her intuitive ones.

Her rational thought processes are weakest upon waking. That actually makes sense to me. I think that is true for many who don’t have dementia. We generally recover quickly as we look around us, especially if we have contact with a spouse or other family member. It doesn’t work as easily for people with dementia. During the day, Kate often doesn’t recognize that she is in our house or who I am, but she is groggiest in the morning. It’s hard for her to put things together.

She is usually able to reach a comfort level in a relatively short period of time. A few times it has taken as much as an hour or two. Here is what I think is going on. The longer she is up, the more contact she has with the things in her environment. That gives her a greater sense of familiarity with me and with our home. It’s not that she necessarily remembers her name and mine or our relationship, but she feels comfortable.

That contrasts with the way she feels upon waking. Then everything seems strange. Fortunately, there have only been one or two times when she didn’t seem comfortable with me. That enables me to help her find things in the environment (for example, looking out the window to our patio and back yard) or telling her things (like her mother and father’s names) that give her a sense of “place.” As we go about our normal routine, she encounters a variety of experiences. Throughout the day, she has more experiences that increase her comfort level.

For several years, I have thought the time after dinner is the best time of the day. A large part of that is because Kate is more at ease, but I think there is more to it than that. By that time of day, she is tired. She really wants to relax. The same is true for me. I have spent the entire day focusing on ways to make her day interesting as well as tending to the many other responsibilities of being her care partner. That includes taking care of the house and all that goes along with it.

When we return home from dinner, she likes to sit in her chair in the family room and work her jigsaw puzzles on her iPad. I like to relax by watching the news. About 8:00, we adjourn to our bedroom where I put on a DVD or YouTube videos of musical performances. We both enjoy the music while she continues with her puzzles, and I often take care of email correspondence, check in on Twitter, or work on my blog. At that time, we are both free of any great demands. Neither of us talks much during that time, but we are both happy doing “nothing” together.

Being alert and happy in in the afternoon and evening does not mean any improvement in Kate’s symptoms associated with her Alzheimer’s. She can be happy and confused at the same time. In fact, it is rare for her to be confused and unhappy. I have reported on each of the times this has occurred. It doesn’t seem like that has happened more than five or six times.

As I have said before, the way I feel is heavily influenced by her mood. I think that has always been the case, but it has become especially pronounced since her diagnosis. I think that relates to the loss of her rational abilities. I have learned to accept the fact that her memory is almost gone. As a result, our relationship is heavily dependent on sharing her intuitive abilities. When she enjoys music, children, social experiences, and nature, especially “all the green” of trees and shrubbery, I enjoy both the experiences she is having and, perhaps more importantly, seeing her enjoy herself. I understand those pleasures can continue close to the end of this journey. If that is so, many happy moments are in our future. If not, I’ll treasure the ones that came before.

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Mood and Conversation

In my previous post I commented on Kate’s less-than-cheerful mood and a change in her conversation. She just hasn’t been talkative lately. That changed yesterday. I wish I could remember exactly what she said, but I can’t. All I can tell you is a summary of what happened.

She was up about 7:30 and went to the bathroom. This was a day when she wanted to express her independence. She didn’t want my help. I walked her to the bathroom. Then I went back to the kitchen where I could watch on the video cam to see when she had finished. After a while, I hadn’t seen her and wondered if she had come out without my noticing. Then I heard the shower. I was happy about that since she was due for one. I also knew that she would want to return to bed afterwards. That would give me a little time to take care of a few things I needed to do. It wasn’t too long before she was in bed again.

From past experience, I knew that she could easily sleep another couple of hours, but I kept checking the video cam. (In case you wondered, my iPad with the video sits to the right of my computer.) At 10:45, she had shown no sign of getting up. I went back to wake her. When I approached the bed, I saw that she was awake and asked if she would like me to take her to lunch. She gave me a confused looked as though she wasn’t sure who I was.

When I sat down on the bed, I said, “I’d like to take you to lunch.” She said, “Where are my clothes?” I always put them on the chair about three feet from her side of the bed, but she can’t remember. I pointed and told her where they were. Then she said, “What do I do now?” I told her she should get dressed. As I helped her into a sitting position, I noticed that she looked frightened. She said, “I sure am glad to see you.” On one or two other occasions, she has been awake but didn’t get up because she didn’t know what to do or where she was. I quickly assumed (correctly) that was what happened this time. She was shaking as she talked. She said, “I didn’t know what to do.” Then I felt terrible for not checking on her earlier, something I will watch more carefully in the future. I apologized and told her how bad I felt. When I did that, she immediately tried to ease my guilt. She said, “Well, it’s going to be all right now? <pause> Isn’t it?” I nodded, but she wanted me to be more affirming and again said, “Isn’t it?” I assured her it was. She still appeared to be shaken by the experience.

Unlike her earlier desire to assert her independence, she wanted me to guide her through every step she needed to take to get ready. She was too emotional to think straight about everything she needed to do. On a normal day she has difficulty, but the emotional experience she had had exacerbated the problem. Several times she reiterated how scared she had been.

On the way to, during, and after lunch she was quite talkative. While we were eating, we had a conversation similar to one I reported on a couple of weeks ago. The first one involved Christopher Columbus. She asked who he was. I tried not to get into anything too overwhelming for her to understand. She asked questions about everything. That meant it did get too complicated for her, but she was still eager to know more. I had to repeat just about everything two or three times without her ever getting it, but she was interested anyway. Somehow the conversation drifted to food that was in the New World and introduced into the Old. I Googled a list of such items and read them to her. She was like a little child discovering something she had never thought about. She couldn’t believe they didn’t always have things like potatoes or corn in Europe before then.

The next topic was World War II. She started this one when she brought up the topic of discrimination. I mentioned the Holocaust and Hitler. We didn’t get too far on that one because she got too emotional. She was both interested and shocked. She is more emotional now and starts to cry at both happy and sad things she hears about.

We got home a short time before the sitter arrived. I didn’t tell Kate that Mary was coming. I just let her in. Kate welcomed her. I told her I was going out for while. She said, “We’ll be fine.” Once again, I left with a good feeling. When I returned, they were sitting in the family room talking happily.

After Mary left, we went to dinner. When we returned home, we sat down in the family room. Ordinarily, I would watch the news while she works on her iPad. She had been in such a good mood that I didn’t want to break it by watching the news. I turned on a Barbra Streisand album as Kate started to open her iPad. The first song I selected was “Send in the Clowns.” It has always been a favorite of hers. Instead of working a puzzle, she put the iPad down and just listened. Then I to selected a number of others that I knew or thought she would like. We sat there together for an hour just enjoying the music. She loved it. I did as well, but the real treat was sharing such a happy moment together. I feel fortunate that we can have moments like these, especially this late in her disease.

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Not a Cheerful Day

Yesterday was a nice day, but Kate was not in a cheerful mood. That was most obvious in her conversation. It began first thing in the morning. She didn’t give me a smile when I went in to get her up. Although she didn’t ask, I am pretty sure that she didn’t recognize me as her husband. On the other hand, she wasn’t alarmed. She was more independent. She didn’t want my help when I gave her my hand to help her from the bed. She told me she could do it herself. As I walked her to the bathroom, she changed her mind and wanted to hold my hand. Once in the bathroom, she responded to me as someone she recognizes and trusts.

We had lunch at Casa Bella with one of our associate pastors and his wife. She has always been drawn to him, but she no longer remembers him or his wife. I reminded her of how much she enjoyed his preaching and teaching. It didn’t seem to ring a bell. The lunch went well. We enjoyed being with them. Kate talked very little. I don’t believe it related to her not remembering them. I think she was just not in a talkative mood yesterday.

Her “Big Sister” photo album was the hit of the day for her. She took it with her when we went to lunch but left it in the car. We came back to the house where she spent some time looking at it before and after our appointments for haircuts and again after dinner before working on her jigsaw puzzles.

She didn’t talk much going to and from our hair appointments or lunch and dinner. Neither did she say much while we eating last night. She didn’t seem depressed at all. She enjoyed herself. There were times when I talked to her and expected a response but didn’t get it. As I think about it now, she hasn’t been very talkative over the past week or so. This comes after a few weeks when she has been. I don’t have an explanation or even a guess as to why. It’s one of those many mysteries. I do know that I like it much more when we have conversations even if they are repeats of the same ones we always have.

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Things Turned Out All Right Yesterday

After a rocky start yesterday, Kate awoke around 10:45 and was perfectly normal. I didn’t test her to see if she knew our names or our relationship, but she acted as though she did. Before I reminded her that I would be going to Rotary and that the sitter was coming to take her lunch, she was prepared for us to go out together. I thought my telling her I was leaving might change how well things were going. Fortunately, that wasn’t a problem. I suggested that she work on her iPad a few minutes until Cindy arrived. She arrived about ten minutes later. When Kate saw her, she said, “It’s good to see you.”

After Cindy left, Kate was ready to go. It was too early for dinner. We went to Panera for an hour and then to dinner. She was quite tired when we got home. She actually rested a while before going to bed. I think she had not had her afternoon nap. She was in bed by 8:00 although she was awake when I got to bed at 9:30.

Around 4:00 this morning, I felt her move in the bed. She seemed uneasy. I wasn’t sure she was awake, but I asked if she was all right. She said, “I don’t know.” She seemed like she may have been dreaming and that something had disturbed her. She moved closer to me and held my arm tightly. I thought she was frightened and asked if she was afraid. Again, she said, “I don’t know.” This reminded me of the way she was when she got up the first time yesterday morning. She didn’t say anything more. I said, “I am right here with you. You’re going to be all right. I’ll see to that.” She still didn’t say anything. I held her for the next forty-five minutes before she said, “Do we have a wedding?” I told her we didn’t. Then she asked if we have a daughter. I told her we do and that she was already married and had two children. She said, “So we don’t have a wedding?” I told her we didn’t and didn’t have anything she needed to be worried about. I was asleep shortly after 5:00. I’m not sure she was really awake at all during that hour.

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Not a Good Way to Start the Day

“It’s a New Day,” but I’m not “feeling good” this morning. About 7:15, the video cam alerted me that Kate was about to get up. I went to the bedroom to find her confused. I told her good morning and asked if I could help her. She said, “I don’t know. I don’t know what’s going on.” As in most of the other occurrences like this, she wasn’t having a panic or anxiety attack. She just looked puzzled about not knowing “what’s going on.” She was never able to say more than that. Based on past experience, I am sure it was waking up and not knowing where she is, why she is here, and who she is. She didn’t ask, but I gave her my name and hers and told her that she was in our house in Knoxville. I added that she was in her very own bed. She didn’t challenge any of that, but it didn’t seem to reduce her confusion.

She asked me what she should do. I told her that she usually liked to get up to go to the bathroom about this time. She asked where the bathroom was and asked if I would show her. I did and then took her back to bed. She was still puzzled. I told her I thought she just woke up and was groggy. I pointed out the window to our back yard. I reminded her of how often she looks out the window and comments on “all the green.” She seemed to recognize the yard. After getting in bed, she asked where I was going to be. I asked if she would like me to sit in my chair beside the bed. She said she would, and that is where I am right now. It sounds like she has gone back to sleep. There is a good chance that she will be fine when she wakes up again. I’ll just have to wait and see.

Moments like this always bring back memories of my mother. She used to say, “I don’t know what’s wrong with me.” That was when I first recognized how wrong people can be when they say things like “Well, at least she doesn’t know.” It was clear to me that my mother knew something was wrong with her. I can say the same thing about Kate. She understands and is disturbed by what is happening. I am grateful that this is not a constant pattern. Most of the time she simply asks where she is, who I am, and who she is without a hint of fear or anxiety. I think I handle the responsibilities of being her caregiver reasonably well. The part that is the biggest problem for me is seeing her when she is disturbed. I hope we are not in for much more of this.

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A Special Moment to Start the Day

Being Kate’s care partner brings with it the full range of emotional experiences from joy to sadness. As I have said so many times, we have been fortunate to share far more of those at the joyful end of the scale than the other end. Sometimes joy and sadness are intertwined. We had one of those moments a few minutes ago.

I was in the kitchen (my office) when I heard her say, “Hey.” I looked up at the display on my iPad. I didn’t see any sign of her. Then I heard a louder “Hey!” She wasn’t in the bedroom at all. She had gotten up without my seeing her on the video cam. I walked to the back and said, “Where are you?” She said, “I’m here. Where are you?” I walked down the hallway and heard her say, “Here” just before I saw her coming out of the guest room. I said, “I wondered where you were.” She said, “I didn’t know where you were.” I said, “I love you.” She said, “I love you too.” I gave her a hug and said, “Doesn’t it feel good to be with someone you love.” She agreed, and I said, “I hope I am your favorite husband.” She laughed and said, “Who are you?” I told her, and she said, “Who am I?” I said, “Kate Creighton, and you’re my wife.” She said, “I am?”

We started to walk back to the bedroom when I saw pictures of her maternal grandparents. I pointed them out and told her these were special people to her. She asked who they were, and I told her. She was quite interested and wanted to know more about them. I told her they were her mother’s parents. She asked her grandparents names one at a time, and I told her again. Across from those pictures is a photo of the home in which her father grew up. I told her this was an important place for her and explained the significance.

I walked her a little farther and showed her a picture of her father. I said, “This is a very special man in your life. Can you guess you that might be?” She couldn’t. I told her, and she said, “He looks like a good man.” I told her he was. Then showed her a photo of paternal grandfather and her uncle taken with managers of her grandfather’s lumber business. She didn’t recognize them or the photo but was keenly interested.

The next photo was of her mother when she was in her late teens, I believe. It is my favorite picture of her. I told her that she was also someone special in her life. She didn’t know who it was before I told her. It is a photo she likes as well. She said, “She’s pretty.” The last photo was of her father’s mother. Kate had no recollection of her at all. When I explained that she was her grandmother and that she was the first member of the family to attend TCU, she was excited.

It doesn’t seem that long ago that Kate could have walked along this hallway and told the same stories to accompany these pictures. It is sad that her memory is now virtually gone. She can’t remember them at all. At the same time, it was a moment of joy for me to tell her these stories and for her to hear them. It is moments like this that sustain both of as we move into the later stages of our journey.

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Insecurity at Casa Bella

Yesterday was not a typical day. Kate seemed to be in a cheerful mood, but she was also irritable off and on throughout the day. I observed that very early when I told her I thought she should shower before getting dressed. It had been four days since her last one on Sunday. Each of the previous mornings I had encouraged her but let it go when she resisted. I did the same yesterday.

We commonly hear about anger and violence as symptoms of people with dementia. There is another school of thought that suggests that such behavior is not a direct symptom itself but a bi-product of symptoms like confusion and misperception. According to this interpretation, anger and violence are or can be natural responses to the way the brains of people with dementia work (or don’t work).

If I employ this line of thinking to what happened between Kate and me yesterday, I would say that Kate wasn’t just in a bad mood, she may have been responding to the way I told her it would be good for her to take a shower. In fact, I don’t believe I was as gentle in my suggestion as I usually am. If I had thought of a gentler way to do it, she might have willingly agreed to shower. Instead, she dug in her heals. I didn’t push her.

I told her I had her clothes for her, and she thanked me. When I started to help her dress, she was resistant. She said, “I can do that myself.” Ultimately, she had to have my help with her bra and her pants, but she was determined to be as independent as possible. As I helped her, she snapped at me. Then she felt bad and said, “I’m sorry. I shouldn’t have said that.” She clearly understood that was not typical for her. I think her reaction related to my not being gentle enough in my attempt to get her to shower.

While she went to the bathroom to brush her teeth, I went to the kitchen to get her morning meds. Shortly, I heard her call, “Daddy!” I called back from the kitchen, but she didn’t hear me. She called again. “Daddy!” I walked toward the bedroom and said, “Here I am.” This was a time when I thought it was best not to tell her that I am her husband. When I reached her, she looked a little frightened and said, “I didn’t know where you were.”

As we drove to lunch, I played some music that she likes. She didn’t talk much. When she did, it was to comment on the music. She enjoyed it. We had a pleasant lunch. It was as if the problems getting up had never happened. The afternoon also went well. We spent a couple of hours at home. She worked on her iPad a while and then rested on the sofa. After her rest, she wanted something to eat. It was ninety minutes before time to leave for opera night at Casa Bella. I took her to Panera for a bagel. We got home in time to change clothes and leave for dinner. That’s when another problem occurred.

I made a complete change of clothes and had picked out a different top for her. She didn’t want to change and snapped at me. I tried not to push her. She consented, but she wasn’t happy.

As usual, she enjoyed the evening of music. The man with whom we share a table commented several times about her enthusiasm. He and his wife got to observe an example of Kate’s memory problems when she looked at me and said, “And what is your name?” I said, “Richard.” She frowned. I knew that meant she wanted my full name and said, “Richard Creighton.” She frowned again. I said, “Richard Lee Creighton.” That was the right answer.

The biggest problem of the day occurred just before we left. I was seated across the table from her. The seat to my left was empty. I was seated with my back to the singers and moved to the empty seat and turned halfway to the right so that I could see them. When the program ended, I looked at Kate who was disconcerted. She looked at me and said, “Is that you?” It turned out that she had lost sight of me even though I was only four feet diagonally across from her. She was quite relieved to see me.

The man in the seat to my right got up, and I started to follow him out. He stopped to help his wife with her walker. The two of them were standing between Kate and me. I chatted briefly with a man at the next table. When I finished, I went around the couple to see Kate. That’s when I saw that the couple and another man who had been at our table were trying to comfort her. She had been very disturbed because she didn’t know where I was. When she saw me, she said sternly, “Don’t ever do that to me again.” I am sure the three people who were trying to soothe her were shocked that these words expressed so strongly came out of the mouth of someone they had no doubt viewed as very soft spoken.

It amazed me that she had become so anxious in such a short span of time. It couldn’t have been more than a couple of minutes. Of course, with no perception of time, it could have seemed much longer to Kate. I was standing within six feet of her the whole time, but she couldn’t see me. I apologized and told her I would never leave her. As we walked through the restaurant to leave, she continued to be a little upset. My apology must have been too light-hearted because she said, “This is no laughing matter.” By the time we got to the car, she was fine. I played several pieces of music she loved on the way home. That made her even happier. The crisis was over.

It is obvious that Kate’s insecurity is increasing and that I am her “security blanket.” I also think the events of the day illustrate how much her emotional reactions are tied directly to her perceptions of the events around her. Her rational abilities are not working well enough understand what is going on. That misunderstanding leads to insecurity that is sometimes expressed in behavior that is not typical of her.