When Kate had her psychological evaluation following her diagnosis, the psychologist told us that she was likely to retain her greatest strengths the longest. I would say that is her gift for conversation in everyday social encounters. I attribute her success in social situations since her diagnosis to that particular skill. It has meant she could get along well without saying anything that would make it obvious that she has Alzheimer’s. That is changing significantly now.
There are two aspects of her aphasia that coincide with fundamental symptoms of dementia. The first is difficulty organizing her thoughts to explain something she wants to tell you. This has been a problem for a long time. I quickly learned not to ask her to explain anything. She would simply say, “Let’s not talk about it now.” The second involves her memory for words. That is happening now.
I am sure this began earlier than I recognized and relates to the difference between all the words in one’s vocabulary and the words that are most frequently used. Now she doesn’t recognize some of the most common words that we all use. I mentioned in an earlier post that I have had to tell her what pizza is on several occasions. I’ve tried to describe a pizza, but the best way to tell her is to pull up a picture on my phone. Ironically, one of the first words to drop out of her vocabulary was iPad. She almost always calls it “my thingy.” That is also used for a number of other words that she can’t recall.
Sometime during the past week, I told her she was up early enough for me to get her a blueberry muffin. She had no idea what I was talking about. This week she looked at the salt and pepper shakers on the table at a restaurant and asked what they were. I explained, but she didn’t appear to understand. On another occasion, I used the word “restaurant.” She didn’t know what I was talking about.
Another type of speech problem is properly pronouncing words. This comes up most often when she asks me the name of something or somebody. I think this occurs because she doesn’t hear the name correctly, but I am not at all sure. It also occurs in other situations. For example, she often pronounces “shoes” as “shows.” The other night she said, “I still want to walk a little bit on my thingy.” (Translation: “I still want to work a little bit on my iPad.”) Similarly, she recently said something about my “bed.” She meant my “head.”
Even though I know this is a common characteristic of this stage of her Alzheimer’s, I find myself concerned about it. Perhaps, I am sensitized because of our experience with Kate’s friend, Ellen, in memory care. We continue to visit her every 4-5 weeks, but her aphasia has made our visits more challenging. I can’t help wondering how long it will be before Kate is in the same position. That would be a major change in our lives.