Living in Kate’s World of Delusions

Kate has experienced delusions for several years, but they occur more frequently now, especially since we have been homebound. Prior to my experience with Kate, I was prone to think delusions were all bad. I am discovering that is not so. Most of Kate’s are benign. They are harmless, some puzzling, but most quite interesting and reflective of her personal values. A few have been disturbing. These have involved a belief that no one likes her, that she has done something she believes was wrong, or that she has some obligation for which she is not prepared. The most frequent delusions involve projects designed to help those who are underprivileged in some way. Often, they involve programs to educate women in third-world countries but also in the United States.

During the past 36 hours, she has had two separate but related delusions that led to unusual conversations. They were very one-sided with Kate playing the dominant role. In fact, soliloquy might be a better word than conversation. The first occurred Wednesday night when I got out of the shower. She began a conversation that lasted almost a full hour and a half during which I said very little. I played the role of facilitator by simply listening, expressing agreement, or asking questions that would lead her to say more.

The second conversation occurred yesterday morning at breakfast. Yes, I said, “Breakfast.” It was another time she had gotten up early before I had fixed my own breakfast. I took the opportunity for us to eat together, never expecting another lengthy conversation. This one was an hour.

Both of them were interesting and involved a school. In each case, she did not know my name and had not recognized me as her husband. That was true all day Wednesday and a large portion of the day yesterday. It was clear Wednesday night that she was talking to me as though I were a potential candidate to join their program. Unlike other similar delusions, she didn’t say much, if anything, about the students. Her focus was entirely on the underlying values of school for those who worked (volunteered?) there. It was a diverse workplace where everyone respected the talents and personalities of the others.

Like another conversation we had several weeks ago, she responded to me just the way she would have if she had known my name and our relationship. Like the previous one, she repeatedly referred  to her husband and used my name each time. She kept saying, “I wish Richard were here. He could give you a better idea (tell you more, etc.).” While she didn’t say much about the students, it was another example of a program designed to provide education to people who might not otherwise have gotten it.

The length and complexity of her conversation was a striking contrast with most of her delusions. She talked non-stop, though in a relaxed style, for a full hour and a half that night. Several times I suggested that we continue the conversation the next morning. She agreed the last time when I mentioned wanting to think about it and talk in the morning.

I never imagined that she would start a similar conversation the next morning, but that’s what happened as we sat down for breakfast. I was never sure that it was an extension of the previous night’s conversation, but it was strangely similar in length and complexity. She also periodically mentioned her husband (me) by name. This time it wasn’t clear if I was a candidate for a position. It sounded more like I was someone who had expressed an interest in what she was doing.

Conversations like these are rooted in delusions brought about by Alzheimer’s; however, they also involve powerful expressions of Kate’s feelings and values. I find that comforting. It reminds me that the real Kate is still here.

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