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“Happy Moments” Make for “Happy Days”

Almost all of our “Happy Moments” are unplanned. That’s part of what makes them special. One of those occurred the other morning when I was giving Kate her meds in a cup of strawberry and banana yogurt, a favorite of hers. After her last bite, she began to whistle. (She’s hasn’t been a whistler until the past 6-12 months when she began whistling to express her happiness.)

One of my many quirks is that I often hum, whistle, or sing softly without being quite aware of doing so. In this case, I began to whistle “Let Me Call You Sweetheart.” She expressed her pleasure with a smile. It doesn’t take much encouragement for me to break into song, and I sang the song to her. Spurred on by her pleasure, I whistled “Old Man River” and followed by singing it.

She was enjoying the music so much that I put on an album of children’s songs I downloaded 3-4 years ago when she was disturbed about something. Since that time, I have periodically used it for entertainment, not to solve a problem. We spent the next 20-30 minutes listening and sometimes singing songs like the “Alphabet Song,” “If You’re Happy,” and “The Bear Went Over the Mountain.”

When we finished, Kate was ready to rest, but it was another unanticipated “Happy Moment” that didn’t require any planning or great musical talent. Just two people connecting through music that added an extra measure of happiness to our day.

Some might say, “What’s so special about that?” John Zeisel answers that in his book, I’m Still Here: A Breakthrough Approach to Understanding Someone Living with Alzheimer’s. He points out that too often we treat people living with dementia like “patients” rather than as “people.” We need to accept and appreciate their capabilities that last long after the diagnosis. It’s possible to maintain positive relationships with our loved ones with dementia through many things like photos and music that have been very important to Kate and me. This particular “Happy Moment” illustrates how we are able to continue to enjoy life and each other. May it always be so.

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How is Kate?

Every day, people ask, “How is Kate?” That’s a question I’ve been asked since I became open about her diagnosis 4-5 years ago. Because I’m around people much more since our move, I hear it more often these days. For years, I said, “Remarkably well.” For the past couple of years, I’ve been more likely to say things like, “She’s having a good day.” “She’s happy.” “Our relationship is as strong as ever.” Sometimes I say, “She had a rough day yesterday.” Each of the things is true, but it never tells the full story.

Something similar is true about this blog. Over time, my posts convey a pretty good picture of how she is doing, but reading only a few posts can be misleading. For that reason, I would like to give you a better sense of how she is at this last stage of her Alzheimer’s.

I have focused heavily on Kate’s recovery from COVID since Thanksgiving. She had only one problem, but that was a significant one. She was frightened by everything that involved moving her. She has made slow, but steady progress. The fact that we are able to get her up every day and sometimes take her out of the apartment are the best indications of that.

That doesn’t come without any problems. She still protests a little when we change her. She is also bothered by minor bumps when she is in her wheelchair. For example, she feels even slight changes in elevation as we roll her from the floor to the carpet and back again and responds with an audible protest. Getting her into and out of bed with the lift is going much better as is getting into and out of a chair. Her responses also vary from day to day.

Our visits to the café where we get her a milk shake or ice cream have been especially good times. It’s not the ice cream that is the major benefit. She, the caregiver and I enjoy spending time in the seating area that looks onto a courtyard. It is relaxing for each of us. I also like the fact that it gives Kate the opportunity to see other residents. Not every interaction goes the way I would like, but I think it is good for her.

A couple of days ago, for the first time, she became belligerent when we were about to leave the café. She yelled and screamed when we tried to get her feet on the footrests of her wheelchair. I’m not sure why, but she doesn’t like using them. It is one of the things that frighten or bother her. Despite this, she is getting better. Two days this week, she didn’t protest at all and kept her feet on the footrests the entire time.

While she’s recovering from the trauma of COVID, she seems to be on a plateau with respect to her Alzheimer’s. She doesn’t seem very different than she was a year ago. In three ways, I believe she has declined. She seems to have fewer cheerful moments than in the past, although she periodically has very cheerful and talkative periods that can last several hours.

When these moments occur, they are usually rooted in a delusion in which she refers to people and situations that are not real. Her caregivers and I converse with her as though she is making perfectly good sense. We know that she is happy, and we are glad to see it. This experience is especially common around the dinner hour. She almost always enjoys her food and expresses it joyfully. In between these cheerful moments, she has longer periods in which she is more passive or withdrawn than she used to be. Thankfully, she is happy most of the time. Even when she is sleeping or resting, I often notice that she has a smile on her face.

Following a longtime pattern, she is generally “slow” in the morning and sometimes confused but improves throughout the day. She is at her best after 2:00 or 3:00 in the afternoon. This usually lasts until she goes to sleep.

Another change involves Kate’s interest in her photo books and her family. Her mother has always held a special place in her heart. Now, Kate expresses little interest in her mother’s pictures or even hearing about her. Similarly, she displays less interest in her children and grandchildren. The exception is when she talks with them by phone. Sometimes, she responds as warmly as ever.

She is also less comfortable with people who drop by to see us or those she meets when we take her out. She often fails to say anything at all. Sometimes she surprises me. She did that earlier this week when the caregiver and I took her to get a milkshake. A church friend stopped at our table and spoke with us a few minutes. Kate didn’t say a word even when the person spoke directly to her and asked a question. When our friend said goodbye, Kate responded to her as warmly as if the two of them had been talking for ten minutes.

There is one other change that is particularly significant to me. She has more moments when I am not familiar to her. It’s not that she doesn’t remember my name or that I am her husband. I feel sure that happens more than I know. The difference now is there are times when she responds to me like I am a stranger. Sometimes she doesn’t seem bothered by that and asks in a friendly voice, “Who are you?” That happened last night as we were enjoying a series of YouTube videos featuring Peter, Paul, and Mary. Several times in succession, she asked who I was. Each time I answered she repeated her question. Other times, she seems disturbed and doesn’t say anything or respond to my questions.

In either case, I tell her my name and that we have been together since college. I mention our falling in love, getting married, having children, and that we’ve been happily married fifty-eight years. This usually sparks a sense of recognition. Even when it doesn’t, she seems more comfortable.

We had an experience like that this morning. After telling her who I am, she was still uncomfortable talking with me. I reached for The Velveteen Rabbit on the end table and read it to her. She kept her eyes closed the entire time and didn’t respond in any way. At the end, I said, “I like that story. Thank you for letting me read it. I hope you liked it too.” She looked as though she might be asleep and didn’t say anything, but she nodded her head. She was going back to sleep, something not unexpected as she had been awake 2-3 hours earlier than usual. Did she “know” me then? I don’t know, but she was relaxed.

Except for this change in recognizing me, our relationship remains strong. She is glad to see me when I return after leaving her with the caregiver. Sometimes she is very expressive and says, “I’m so glad you’re here.” She still calls my name when she needs something or during times she when the caregiver is doing something she doesn’t like. Most of the time, she also responds rather quickly when I try to calm her as the caregiver changes her. In addition, she frequently grabs my hand in moments when she feels threatened (bothered?) by the caregiver’s efforts to change her or move her in any way.

Several other good things remain the same. Music is still an important part of our lives. At times when Kate is quiet, her caregivers and I often notice that she is moving her head or feet in rhythm with the music. I don’t read The Velveteen Rabbit to her as often as I used to, but I am pleased that she continues to enjoy it.

Most important of all, to me at least and I think to Kate, is that the best time of our day is after the caregivers leave each night. We both relax and enjoy being together. That is something I hope we can hold onto for some time to come.

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Tender Moments at Stage 7

Yesterday, I worked on a draft of a new post focusing on Kate at this stage of her Alzheimer’s. I haven’t finished, but we had an experience during the afternoon that I decided to tell you about first.

I often think of the fact that our relationship has changed so radically over the course of Kate’s Alzheimer’s. Many things that were a regular part of our lives are now gone, but love remains and makes itself known to each of us every day. One of the changes is that she no longer does things with the deliberate intent of making me feel happy.

When she does express her affection for me, and I don’t believe a day passes without her doing so, it is a simple, often non-verbal, expression of her love. That would not be enough for some people, but it is for me. The impact of simply reaching for my hand has great impact, something that would not have had the same value early in our relationship.

We had one of those experiences yesterday. The caregiver and I started to take her out for a stroll around the hallways and to get a milkshake when she became upset. She refused to put her feet on the footrests of the wheelchair. That not only makes it harder to push her, it runs the risk of twisting her feet and legs as she drags them on the floor. I suggested to the caregiver that we back off, give up the idea of going out, and just focus on calming her. She was sulking as we went out on the balcony.

I put on some music that I thought might calm her. Then I took her hand and spoke to her very gently. I expressed my love for her and talked about our falling in love in college, getting married and having children. I spent at least 30 minutes doing this without her displaying any change in mood. Then I said something she thought was funny. She smiled and laughed. I said, “I guess you think I’m a silly guy.” She responded quickly and firmly with a “No.” That opened the door for me to mention how much I like her smile.

We sat quietly for a few minutes while the music played. Then she looked at me while pulling her hands together and held them close to her chest as though she were trying to tell me something. She followed that by extending her hand to me. I reached out to take it, and she pulled it to her chest and held it tightly. We looked in each other’s eyes, and I said, “I love you. I always have. I always will.” It was a tender, yes, romantic moment, for both of us.

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Settling in Part 3: My Adjustment

Eleven weeks ago, Kate and I moved into our new home (apartment) in a local life plan retirement community often called a continuing care retirement community. In two previous posts, I described the changes in our in-home care and Kate’s adjustment to the move. Today’s post deals with how I am doing. With one exception, I can say that my report is just as positive as the others. Let’s deal with the positive first.

Shortly after moving in, I went through a period of disorientation. All of my routines were disrupted. It was a little like starting from scratch – new grocery store, new pharmacy, new part of town, new apartment and a bit of confusion over where various things had been put by the movers, as well as a temporary cessation in my daily exercise. Within 2-3 weeks, I was recovering from that and am now quite comfortable.

At the same time, I found our new environment very much to my liking. After months of preparation for the move, it was a relief to be settled into a new home. That likely would have happened no matter where we had moved, but there are several aspects of this community that I find especially appealing.

We’re in a new building that opened the end of February, and I like our particular apartment. I had had a little concern about living in a place one-third the size of our previous home; however, I had always liked the floor plan. Everything is very efficiently arranged. We have two bedrooms on either side of a large open area containing the kitchen, living area, and dining area. We also have a 16-foot balcony overlooking a courtyard below. It felt right the very afternoon we moved in. Now that we have been here a while, I find that it suits our life style quite well. I haven’t missed the space we left behind at all.

Apart from the apartment itself, there are other things that are more important to me. Some of them are things people generally expect from from life plan communities. They simplify life. I am relieved of almost all the personal responsibilities required in our previous homes. Not having to hire help with cleaning, repairs, or the wide arrange of maintenance issues was never a great chore, but it is nice to leave that behind.

Among the big benefits is availability of daily meals. I still fix my morning breakfast and like it that way. I value my morning routine that had been somewhat disrupted right after the move. For a short time, I continued to fix a simple lunch but gravitated to going downstairs to the salad, soup, and sandwich bar. I eat there every day but Wednesday and Sunday when I go to restaurants I have frequented for lunch for more than five years.

Kate and I do not eat lunch together. That’s because she doesn’t usually wake up before noon and isn’t ready to eat until 1:00 or shortly thereafter. At night, I bring in meals from the dining room. Kate and I eat together in the apartment. I like that.

Speaking of meals, living here has also been accompanied by a change in my eating habits. I eat more soup and vegetables than I ever have before. That relates directly to the way they are prepared. Most of the soups are quite good, and the vegetables are nicely-cooked. I’m especially fond of their broccoli and asparagus. For years, I have enjoyed salads, and the salad bar downstairs offers a wide variety of ingredients to make salads to suit my particular preferences.

Although our balcony doesn’t provide as beautiful a view as we had at our home, we have taken greater advantage of it than the patio we had. We spend some time there with the caregiver almost every day. Now that it is hotter, we are eating early. Then we go to the balcony until time for the caregiver to leave. It has provided more relaxing moments than I expected. By the way, I am writing this post on the balcony enjoying a gentle breeze (from our ceiling fan) and a light rain.

Our new routine also involves other relaxing moments as well. At the top of the list would be taking Kate around the interior of the buildings. It gives her a change as well as an opportunity to meet other residents and staff. Several times, we have gone to the ice cream shop. The ice cream is good, and we have spent as long as 45 minutes relaxing while encountering other residents.

That leads me to say what I believe is the most important benefit of living here. It provides significant opportunities for social activity and interaction. As my closest friends know, I’m a bit gregarious. Despite Kate’s Alzheimer’s and the pandemic’s lessening my social contact, I never felt isolated as do so many people in my situation. A lot of that was because we ate out for all lunches and dinners for at least eight years. I also remained in contact with people via email and telephone and continued to serve on committees at church and several community organizations.

The move, however, has substantially increased my daily social contacts, and I am thriving. It’s hard to walk out of the apartment at any time of day without bumping into someone and engaging in a brief conversation. One of our caregivers has joked with me about how long it takes me to run down to the dining room to pick up our dinner because I get into multiple conversations along the way.

So, what is the one exception to how positive my experience has been? Here it is, and it has nothing to do with the move itself. Several weeks before the move, I began to experience a rash on my back and other parts of my body. My dermatologist took a biopsy and found that I have eczema. She gave me a prescription for prednisone and a cream that helped but did not eliminate the problem. She recommended changing the detergent used to wash our clothes, the soap I used for bathing, and hand lotion. In addition, I started using an over-the-counter cream to replace the prescription that had expired.

The rash subsided somewhat but flared up in the past week. For the first time, it hit my face around my eyes as well as spots on the right and left sides of my neck. The itching isn’t pleasant, but I have been more annoyed by the places around my eyes. I feel awkward when I leave the apartment. I find myself explaining the problem everywhere I go. The good news is that the dermatologist gave me a new prescription that seems to be working. We have also scheduled an allergy test in an effort to determine what is causing the problem.

Other than that, life is good, and I am adjusting quite well.