An Anniversary I Won’t Forget

Ten years ago today, Kate was diagnosed with Alzheimer’s. That led to the most significant life change we’ve ever experienced. That night I made the first entry in the journal that became this blog . I have posted it below with a few of my present thoughts about “Living with Alzheimer’s.”

JANUARY 21, 2011 BY RICHARD CREIGHTON

Getting the Diagnosis

Today Kate and I met with Dr. Reasoner to get the results of Kate’s PET scan. She had gone in for the scan a couple of weeks earlier following a routine appointment with Dr. Reasoner. I went with her for that appointment to give my own impression of Kate’s lapses of memory and to hear what Dr. Reasoner had to say.

Dr. Reasoner suggested that she have a PET scan and a behavioral evaluation by a neurological psychologist. Kate had the scan about 2 weeks ago. On Wednesday of this week, January 19, she had an initial visit with the psychologist. Kate is scheduled to have her evaluation on Wednesday, February 16, at 12:30. She has been told this will take as long as 5-6 hours.

Kate and I have not talked much about the PET scan and the potential results. We both knew what was possible, and I think neither of us wanted to drag ourselves down in worry of the worst news. For the past few days I have had some trouble sleeping and have found myself thinking about how she and I would react if the test came back positive. I am sure that every cancer patient would understand this reaction.

As we went to the appointment, I kept telling myself that we might get good news that the test was negative. That was not the case. Dr. Reasoner presented the results matter-of-factly but not coldly. She said the test did show signs of “early onset Alzheimer’s.” She went on to explain what that meant (the tangles in the brain) and how it can be addressed (initially with Aricept and after a few weeks another drug that has, in the past, been used at later stages of the disease).

Dr. Reasoner told her the average life expectancy for someone who is diagnosed early (the starting part was not and, I suspect, cannot be known) is about 12 years but that she could live much longer. She also gave a few examples of people she had known whose quality of life was good even with the memory loss. She is especially interested in Kate’s behavioral evaluation. That evaluation will determine whether the disease has affected other things than simple memory.

Kate handled the news with a good bit of control and later in our meeting, she said that in some ways, she actually felt relieved to know what was causing her memory problems. Her greatest concern is having to depend on family or professional help to take care of her personal care, something that she feels could be required for a long time should she live as long as her parents.

I tried not to give in to the emotion I felt on receiving the news. At one point as we were discussing Kate’s care in the future, I reached for her hand and tried to assure her but choked up. Dr. Reasoner gave me Kleenex to wipe my eyes.

After leaving Dr. Reasoner’s office, we went to Casa Bella, a restaurant that holds a special place in our hearts. We were introduced to it in the early 70s by one of Kate’s best friends. In the last 10-15 years, however, we have eaten there more frequently. We came there after both of our dogs died. She got her veal piccata and amaretto cheesecake that she loves so much.

We talked briefly about having to decide when to tell our children and friends. We both agreed that now is not the time. We know that once other people know they can’t help but treat you differently, and she doesn’t want that. We are just going to take it a day at a time right now and trust that we will know when we should let it be known. This is going to be very hard for both of us as there are people we might look to for support, but there will be a time for that down the road, hopefully a long time down the road.

At that time, I had no idea of what the future held. We were just determined to make the most of whatever time remained to us. I’m grateful that we’ve been able to do just that. We’ve not only enjoyed life but each other as well. Kate can only live moment-to-moment now, and I mean that literally, but I continue to focus on that initial goal. It has served us well in the past, and I am optimistic that it will do so in the future.

I am mindful that we haven’t done it alone. I’m grateful to a host of people who have lightened our load in numerous ways. They include our healthcare professionals, especially her doctors and their associates, but they extend far beyond them. I’m thinking of family, friends and even strangers who have boosted our spirits so many times in so many ways. I am thankful to those of you who are readers of this blog. You, along with my Twitter friends and fellow AlzAuthors, have given me a focus beyond that of being a caregiver. You have played a key role in keeping me going. I consider all of you as members of my “Caregiver Support Team,” and I thank you.

I also recognize there are many others “Living with Alzheimer’s” who haven’t been as fortunate as we have. Some of you reading this post may be among them. My heart goes out to you. My wish is that you will find your own ways to experience moments of peace and joy in the midst of the inevitable challenges that face all of us who travel this road.

Update on Kate’s Recovery from COVID

It’s been nine weeks since Kate and I experienced the first signs of COVID and almost eight weeks since she returned home from the hospital. Kate’s recovery has been gradual, but steady. The biggest breakthrough was getting her out of bed. In my last post, I reported that we had been able to get her up three days in a row. We added another three days to make it a total of six straight days.

Things are going well. Kate’s transfer from her bed to the wheelchair to the toilet and back to the wheelchair is easier than before. With one exception, she has enjoyed spending the day in her recliner in the family room.

We haven’t, however, been able to fully conquer her fear as we make the transfers. She is also frightened when we push her in the wheelchair. We have to move very slowly and watch her hands and arms closely as we go through doorways or past anything that she can grab. She holds tightly to anything within her reach. She also attempts to stop the chair’s movement with her feet. I’ve found it easier if we slowly pull her backwards.

Despite our best efforts, the only rewarding aspect for Kate is relaxing in her recliner. It does avoid changing her in bed, but the transfers are almost as unpleasant for her. That has caused me to think seriously about the cost/benefit ratio of forcing her to get out of bed. It is better for her caregivers and me, but is it a sufficient benefit to her?

On her 80th birthday, I really wanted her up. She wasn’t as cheerful as on other mornings and not eager to get out of bed. With my permission, the physical therapist and the caregiver got her up anyway. As it turned out, she didn’t appear to enjoy the afternoon as much as she has on previous days.

The next day the physical therapist came again. Kate was tired. We put our heads together and decided to be satisfied with the success we had achieved in the preceding days. We let her rest.

Saturday and Sunday we got her up again. It went pretty well Saturday. Sunday was another thing. She really didn’t want to get up, but we went ahead. She was angry with both of us, not just the caregiver. I left for lunch shortly after we had put her in the recliner. She wasn’t speaking to either of us. It is not unusual for her to need as much as an hour or more to recover from changing or just getting her out of bed, but her bitterness seemed more severe this time. Fortunately, she had recovered by the time I returned home, and we had our usual good evening together.

I felt bad about pushing her too hard and would like to avoid creating the same result again. I discussed this with the caregiver who was here yesterday. We decided to give her a break and get her up only if she seemed willing. As she has done on a few other occasions, she expressed an interest at one point but changed her mind when it came down to doing it. We accepted that. She had a good day and was much easier to change in bed. I think it was good for her to have a break. She’s making progress. We’ll get her up another day.

More Victories

Numerous times during Kate’s recovery I have said that she is making progress “though gradually” or “slower than I would like.” That doesn’t mean that we don’t have moments or days with giant steps forward. I reported on one of those almost two weeks ago when I described the first time we were able to get her out of bed, to the bathroom, and to the table for dinner. That was a major victory, and it occurred as a result of her own desire to get up.

I think all of us (home health, the daily caregivers, and I) felt that was a confirmation that we were doing the right thing by not having forced her. We had been acting on the knowledge that her hospitalization had traumatized her so much that we didn’t want to add further trauma to her life. I believe we made the right decision.

A number of times since then, she has said she wanted to get up, but she got cold feet when we tried to help her. Three times she wanted to get out of bed after the caregivers had gone. I was relieved that she backed out because I wasn’t sure I would be able to get her back in bed by myself.

At the same time, she was beginning to adapt to our changing her. That was good because that is the most difficult issue we have faced, but it was still an unpleasant experience. Even the caregivers recognized it would be almost impossible for them to do it without my help. We began to believe her life and ours would be improved if we could just get her out of bed.

Late last week, I decided we should be more assertive with her. I may have been motivated by a couple of experiences with Kate’s physical therapist. I had talked with her about the importance of getting her up. She said she could get Kate up if I would give her permission to physically pull her up against her will. I told her I thought we should try. With the two of us pulling her, we helped her sit up on the side of the bed. She protested verbally and physically, but the process occurred quickly. She settled down almost as fast. We repeated this when she was here last week.

The caregiver who was on duty the first time we got her out of bed was on duty Saturday. Soon after she arrived, we talked about another attempt. This time I told her I wanted us to be more assertive, that I felt getting her out of bed wouldn’t be any more traumatic than changing her in bed.

Kate’s best time of the day is usually later in the day. She was asleep until noon, so we decided to give her time to have lunch and then see if we could get her into her wheelchair. For several days, I had talked with Kate about getting her up. She felt that would be all right.  Of course, that was easy to say because there was no immediate threat. We took that same approach Saturday, and she expressed interest. I can’t say it was easy or that she didn’t protest, but we were able to pull her to a sitting position on the side of the bed and then to the wheelchair. From there we went to the bathroom and helped her on to the toilet. She was frightened and fought when we lifted her from the wheelchair to the toilet and back, but overall it went well. She spent the rest of the day in her recliner in the family room. When it was time for dinner, we took her to the table where we ate dinner together for the first time in weeks. It was a very good day.

Yesterday, the same caregiver was here. Kate was awake at 11:00 and had her morning meds and some yogurt before the caregiver arrived. She was also in a very good mood that lasted the entire day. We got her up, to the bathroom, to her recliner, and later to the table for dinner. It was a day in which she was filled with delusions. She was very talkative but also very happy. The caregiver and I were also happy.

The icing on the cake occurred today when a different caregiver was here. I told her about the weekend. We decided to try again and had another success. Lunch was especially fun. It was the first time she had come to the table for lunch since before she contracted the virus. That’s six or seven weeks. Our Monday/Wednesday caregiver is from France and enjoys making French Toast and French Omelets. Kate had a little of both today. She fed herself and even told the caregiver the meal was “wonderful.” Later in the meal, I asked if she liked it. She gave me a very loud and enthusiastic “Yes!”

I will say that it was a bit more difficult getting her out of bed today. I don’t believe we gave her enough time to thoroughly wake up, but we succeeded anyway.

Looking back, I feel that we did the right thing earlier by not forcing her out of bed. She was too fragile from her hospital experience. Gradually she was improving. It was clear there were times she wanted to get up but was too frightened to do so. I feel she reached the point at which she needed to be pushed to save her from an experience that was more traumatizing. I am glad we decided to change our approach. She has enjoyed being up. As I close this post, I can hear her happily talking with her caregiver.

She has been up three days in a row. That makes me believe it should get easier in the future. I can’t tell you how good it is to see this leap forward.

Feeling Grateful in the New Year

Over the past year, I’ve experienced a number of different emotions, most of the them related directly or indirectly to the progression of Kate’s Alzheimer’s, but some, like COVID, have occurred for other reasons. The feeling I have right now is a sense of gratitude. Kate and I have been on the receiving end of the goodness of people throughout the past year. That has been especially so during our personal experience with the virus and its aftereffects.

It marked the first time I felt a critical and immediate need for help, and everyone responded in ways that exceeded my expectations. Much of that came from family and friends who have given me encouragement via phone calls, cards, and email. I’ve been particularly impressed with our healthcare professionals. They have played an enormous role since the middle of November when we tested positive.

I’ve always felt good about the geriatric practice with which Kate’s physician is associated. I kept her doctor, nurse, and social worker busy responding to my questions. They went out of their way to address the various issues we have faced, and I continue to rely heavily on them.

Although unable to be with Kate in the hospital, I had several phone conversations with her nurses and doctors each day. They were responsive to all my inquiries and gave me a sense that they were giving Kate the very best care. They were also sensitive to my own needs.

It was only after Kate’s return home that I had direct contact with anyone. They include the Home Health personnel (nurses, physical therapists, and a social worker). I’ve had confidence in each one. They are all experienced in their respective areas and possess the sensitivity one expects from someone who has chosen a career caring for others.

My closest contact, however, has been with the caregivers who have been here every day since Kate’s return home. Watching and working with them closely has confirmed what I thought when Kate entered the hospital; I was facing a caregiving task that I couldn’t handle by myself.

I like every person our two agencies have provided. We’ve had seven or eight new caregivers. Only one person was with us before. Their training and experience have enabled them to address all of Kate’s needs. I’ve learned a lot from them. When you add their compassionate care to their clinical strengths, they are an excellent team.

I should make a special point concerning how hard they work, not just for us but for the others they serve when they are not here. I believe all but one of them works at least one other job in addition to their work with the agency that provides them to us. It is not unusual for the Monday and Wednesday caregiver to come to us after working all night and/or leaving us for another all-nighter.

I was especially impressed with someone who was here last week. She has undergone open heart surgery, has MS, and has had a brain tumor. She has four different jobs. In addition, she has two children, one who is in college. Despite the difficulties she has faced, she is very upbeat and grateful. I’m sure she is an inspiration to everyone who knows her.