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Our Lives After Kate’s Diagnosis, Part 6: Adapting to Isolation After COVID

In an earlier post, I talked about two ways that COVID changed our lives. One was isolating us after nine years of active lives that kept us enjoying life and each other. The other was Sarah’s hospitalization with COVID. Each of these required us to focus on new ways to enjoy life.

Some of the things we did prior to the pandemic were things that we could do afterward as well. That included our collection of family photobooks that contain a variety of historical family information and photos.

Of course, music played a major role in our lives but in different ways. We couldn’t attend concerts, so we added another way to enjoy music. We started watching music videos on YouTube. That gave us a wide variety of music we could tap into at any time of day.

Before the pandemic, Kate’s only self-initiated activity was working jigsaw puzzles on her iPad 6-8 hours a day. She lost that ability during the first week of the pandemic. That put more pressure on me to entertain her.

One of the ways I did that was to act as a docent in our home. There were stories that went along with many of the pieces of furniture as well as paintings and knick-knacks. At that stage of Alzheimer’s, she would quickly forget what I told her, so that made it easy to tell her the same stories over and over.

It was during the pandemic that Kate experienced what is common among people with dementia. She wanted to go home. The obvious answer to this is to say, “We are at home”. I knew it made no sense to contradict her; she didn’t realize she was at home. I would say, “Well, let’s do that.” Then we went to the car and drove around for 15-30 minutes and came back home. Some days, we did that as many as three times. It never failed. Each time we arrived home, she was pleased to be there, at least until the next time.

Activities like these kept us going until both of us got COVID in November, 2020. More about that in a later post.

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Our Lives After Kate’s Diagnosis

Part 5: Major Changes

Apart from the changes in our lives that I mentioned in my previous post, there have been two other changes that have had a greater impact on us. They both involved COVID. Before it came onto the scene around March 2020, our lives were already shrinking, but we had no idea how the Pandemic would affect our lives.

Prior to Pandemic, we spent an hour or hour and a half every morning at Panera and about the same amount of time at the café at Barnes and Noble every afternoon. Coupled with eating out for lunch and dinner, we were away from home a large part of every day.

COVID brought that to a halt. Suddenly, we were trapped in our home without the social contact we had enjoyed for so long, but that wasn’t all the damage COVID left for us. The biggest hit occurred when Kate and I had COVID almost eight months later when it seemed safer to get out. My case was mild and ended quickly, but she was hospitalized for eight days. That changed her life forever. It wasn’t COVID alone that hurt us. The whole experience was traumatizing for her.

She was frightened by the ambulance attendants who were naturally strangers to her. As they took her out the front door to the ambulance, she was screaming, “Help me! Help me! Somebody help me!. To her, it must have seemed as though she were being kidnapped. I was the only one she knew, but the hospital did not allow visitors at the time.

She was without me for eight days. She didn’t know anything about COVID or that she was sick. All she knew was that strangers had taken her out of comfort zone, and in the hospital they were doing things she didn’t understand and didn’t like. The impact on her was so great that she didn’t want to be touched when she got home, and we had to do the same kind of things they had done in the hospital to take care of her daily needs.

Before COVID and her hospitalization, Kate was beginning to lose her mobility and was in the early stage of aphasia. COVID made them a permanent part of her life. For five months, we began to adapt to a new world in our home. Then we moved to Still Hopes Episcopal Retirement Community where we live today. We have established a new routine that is significantly more restricted than before, but we are living joyfully despite the combination of Alzheimer’s, COVID, and a stroke Kate experienced a year after our move.

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“Little Things Mean A Lot”

In 1954, Kitty Kallen‘s “Little Things Mean a Lot” was number one on the charts, selling over 1 million copies. I was 14 at the time, and I don’t think I really understood the meaning and relevance of the song’s message. Now that I’m closing in on 86, it means much more to me.

Kate and I have lived well throughout our marriage. In fact, I’d say it’s been a joyful adventure. That was true even during the early stages of her Alzheimer’s. Early on, we decided to enjoy life and each other for as long as we were able. We did that by binging on all the things we had enjoyed before Alzheimer’s. That meant going to movies, theatrical and musical events, eating out, and traveling. During the first 10 years, we ate out for lunch and dinner more than 6000 times. We also attended many musical and theatrical events not only in Columbia, our hometown, but also in cities within a two-hour drive.

Travel also played an important role in our lives. We went on a safari in Tanzania, where we got a close look at lions, elephants, zebras, and other wild animals we had only seen in zoos. We swam with iguanas, turtles, and other marine life in the Galapagos Islands, and on our last international trip in 2015, we paraglided off a mountain in Switzerland where we turned a somersault on the way down.

Those days came to an end in 2020 after Kate had a traumatic experience during eight days in the hospital with COVID. She’s been in the last stage of Alzheimer’s ever since. Before that, our world was very large. Today, it is very small. Our biggest daily events are going downstairs for ice cream at 3:30 and having dinner at 4:30.

In addition, we have great times when we are alone. Sometimes that happens in the morning when she wakes up early and is in a talkative mood. More often, it happens at night. We talk while watching music videos on YouTube. Our biggest surprise is that while our world is much smaller now than in the early stages of the disease, we have found ways to live joyfully.

We’ve learned to enjoy the little things. Best of all is simply being together. Every morning when she wakes up, I remind her that our first date was to a performance of Handel’s “Messiah,” and that we enjoyed it, but being together was the highlight of the evening. That is still the case today. I often refer to those times as “Happy Moments”. We’ve had quite a few of those in the past week. One of those days, she woke up at 6:30 in the morning, cheerful and talkative. That continued until she went to sleep that night. The other days were not as spectacular, but they, too, were punctuated with Happy Moments. Kitty Kallen was right. “Little Things Mean A Lot”. My perspective has changed significantly since I first heard that song.

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Happy Moments with Family

In some ways, being Kate’s caregiver is like being a parent. That’s the case when we are around other people. She is often cheerful, and her paid caregivers and I get to see that every day. I want other people to see that as well.

That is especially true for our children. Both of them live out of state and visit us three or four times a year. I send them videos regularly. That gives them a pretty good idea of what I call “Happy Moments”, but they don’t always see the best of her when they are here.

Our son and his wife were with us for four days this week, and Kate rose to the occasion. Each day, she was at her best, smiling and talking. She made all of us smile, and she closed their visit with a surprise Wednesday morning just before they left.

Please permit me to digress a moment. People often ask me if Kate recognizes the children when they visit. I tell them it’s difficult to be sure. She is comfortable with them, but I haven’t seen many clear signs that make me sure that she remembers their names or that they are her children. I may think differently in the future. That’s because of a Happy Moment that occurred as they were about to leave.

It was shortly after 8:00am when our son, his wife, and I went into the bedroom to see if she might be awake. She usually sleeps later than that and even when she is awake, she doesn’t often begin the day with a smile. Thus, I was doubtful that she would give us any response. I was wrong.

Our son leaned down with his face close to hers and began talking to her. She immediately responded with her beautiful smile that continued as he spoke. She was still smiling as we left the room. It was a touching moment.

I know I can’t be sure that she knew she was smiling at her son, but it looked like that to me. That’s what I believe, and I know it was a “Happy Moment” for our son, his wife, and me.

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My Best Source of Stress Relief

Because there are greater demands placed on me during this late stage of Kate’s Alzheimer’s, I experience more stress now than at earlier stages. The good news is that Kate is my greatest source of stress relief. I cannot say enough good things about her.

She is happy. That isn’t obvious every moment of the day, but she displays her happiness numerous times daily with her smile. She often smiles in her sleep. Sometimes she talks when she is apparently dreaming. These conversations (at least her part) are usually cheerful, and she sometimes laughs during them.

Our conversations are most important to me. They occur mostly in the evening after the caregiver leaves, but we also have them at other times of the day. These two occurred after I returned home from lunch on Saturday afternoon.

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Living in the Moment

During most of my adult life, I’ve heard people talk about ‘Living in the Moment.” I always felt that Kate and I had done just that throughout our marriage. Then she was diagnosed with Alzheimer’s. Suddenly, living in the moment took on a new meaning. I felt an intense desire to make the most of the time we had left.

One of my first efforts to spend more time with her was to change my lunch routine. That was easy. I was already transitioning into retirement and coming home after lunch. I started leaving the office earlier, and we began eating lunch together every day. Little did I know that it was our first step toward binging on eating out for lunch and dinner every day until the pandemic in March 2020.

Eating out was not the only thing we binged on. We also attended many movies as well as musical and theatrical events. We were together a lot, but I did get out to go to the Y, run errands and meet friends for coffee.

With the progression of her disease, I began to feel uncomfortable leaving her alone. That led me to bring in caregivers four hours daily on Monday, Wednesday, and Friday.

This turned out to be harder for me than for Kate. I didn’t like being away from her that long, and I always came home before the caregiver was supposed to leave. We continued that schedule until she was hospitalized with Covid in 2020. That is when I arranged for care eight hours a day seven days a week.

To a degree, I have adapted to being away from her. Even with help, the stress of caregiving is much greater than before, and I enjoy going out to lunch three days a week; nevertheless, I still want to be with her as much as possible. As a result, I am away no more than three hours of every 8-hour shift. That means I am with her twenty-one hours a day.

I have often talked about our Happy Moments. During the past year, we have begun to have more of those.  That’s because Kate is now waking up earlier in the morning than she has in the past three or four years. That has cut into my time to take care of my daily tasks, but it also gives us more quality time together. I’ve welcomed that and make the most of it. I am with her as much as I can during those mornings.

When I’m doing my daily chores like folding and putting up laundry, I do that in the bedroom so that I can be with her. Other times, I get my laptop and sit up in bed with her while I check email, and work on other things like new blog posts. Every morning I do deep breathing exercises. When she is awake, I do them sitting up in bed beside her or in a chair beside the bed.

On mornings when she is especially alert, we sit up in bed close to each other and just enjoy being together. Since Kate has no memories of the past, I remind her of other special moments in our lives. They include our dating, falling in love, getting married, moving to new places, having children, making new friends, and traveling. We often watch music videos on YouTube. These are very special moments for both of us. We are indeed “Living in the Moment.”

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Another Valuable Tool in My Caregiver’s Toolbox

The first seven years after Kate’s diagnosis went very well. We enjoyed life just as we had decided to do, but I never stopped to think about why we were doing so well. It was just good fortune. Of course, that was, and still is true, but it wasn’t until 2018 that I read a book that gave me a deeper understanding. That was The Dementia Handbook by Judy Cornish.

The critical piece of information for me was her distinction between rational and intuitive thought and abilities. She makes the point that “All is not lost with dementia.” People with dementia lose their rational thought that deals with facts and reasoning. They lose their memory and ability to do many things they have done before; however, they retain their intuitive thought and abilities that deal with feeling and emotion experienced through our senses. People with dementia can still see, hear, taste, touch, and smell. That means they can still enjoy many of the pleasures in life. This knowledge became one of the most important tools in my “Caregiver’s Toolbox.”

When I looked back at the things Kate and I had done, it was clear to me that we had devoted ourselves to activities that tapped into our intuitive thought and abilities. We didn’t focus on the things she couldn’t do. We devoted our attention to what she was still able to do. Our decision to enjoy life and each other for as long as we could led to our binging on the activities we had enjoyed before her diagnosis. All of them were things that Kate could still appreciate. I’ll say more on that in my next post.

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Creating a Caregiver’s Toolbox

Although Kate and I have experienced “ups and downs” while “Living with Alzheimer’s,” we’ve been able to live joyfully from the time of her diagnosis. There are many reasons for our success, but I believe having a large “caregiver’s toolbox” has been one of them.

We began our journey with 22 years of caregiving experience. That included all four of our parents and my dad’s significant other after my mom’s death. Three of them had dementia. We learned a lot during that time, and it made it easier for us to approach our personal experience with Alzheimer’s. That gave us the first tools for our toolbox.

My professional experience also provided relevant knowledge about caregiving. For ten years I was a social psychology professor. As I transitioned to a career in market research, I directed a master’s degree program for alcohol and drug abuse counselors. That fit well with my social psychology background and greatly expanded my knowledge acquired in academia.

Several years later, I joined the Stephen Ministry program of our church. This program links individuals who are facing personal and/or family problems with church members who serve as understanding companions who meet with them regularly until the service is no longer needed.

Despite that background, I felt the need to know far more. Each of the people for whom we had caregiving responsibilities was unique.  I wanted to know how other people dealt with their situations.

My first step was to visit the Alzheimer’s Association website where I found an abundance of information and sources of help for caregivers as well as their loved ones. I read a fair amount of posts on various message boards but found it a little depressing. It was a comfortable place for people to express their problems and seek help, but I wanted to find a source with a more positive outlook.

That led me to check books on Amazon where I found Alzheimer’s Daughter by Jean Lee. Both of her parents had been diagnosed with Alzheimer’s on the same day. She carried a very heavy load as a caregiver. It was far more challenging than any of the experiences with our parents. Although facing significant struggles, she came away with an uplifting message for others facing similar situations.

I liked that. It led me to write her a letter. I was surprised and pleased when she replied. It turned out that she did much more for me than that.

When I created this blog, I communicated with her. It was she who introduced me to AlzAuthors, a not-for-profit organization of people who write about dementia. Becoming a member expanded my knowledge about dementia and caregiving. It also provided me with a much wider range of support. Most of them were caregivers or former caregivers. Others were people who were medical professionals who studied dementia. Still others had been diagnosed with the disease. As a result, I have been asked to serve on panels of workshops on various aspects of dementia and to be interviewed on several podcasts.

It wasn’t just the authors themselves, but many of them were also active on Twitter (now X). I, too, became active. That brought me in contact with a host of other people whose experiences have influenced me.

In addition to the impact that Alzheimer’s Daughter had on me, I was highly influenced by an article I read. It dealt with the importance of a team for a caregiver. The article’s focus was on a team of medical, legal, and financial professionals. I shared the author’s view and already had those in place, but I took that one step further.

I’ve always enjoyed being around other people. I decided to consider everyone with whom I came in contact to be a member, or potential member, of my team. That began with my family and friends but expanded to social media like Facebook and Twitter and the many strangers I encountered. This didn’t require anyone to do anything special. Even people who checked and bagged my groceries became part of my team. Servers in restaurants were especially important. As I look back, having a large team of supporters has played a big role in helping me as a caregiver.

Thus, I began life as a caregiver for Kate with a toolbox of useful tools. That toolbox has expanded considerably over the years. A carpenter always encounters situations that require new tools. That is certainly true for me as a caregiver, In future posts, I’ll talk about other tools that have been especially valuable to me. Stay tuned.

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More Good Things

Wednesday morning, the caregiver who is with us Monday, Wednesday, Thursday, and Friday brought me more good news. She is now free on Tuesday and asked the agency to assign her to us for that day. She still needs to leave a couple of hours early on Wednesdays, but this brings closure to the most challenging period of stress I have experienced during the entire six and a half years we have had care at home for Kate. I am very happy. Not only do I have one person to handle Kate’s care for our weekdays, but she is the caregiver I have liked most since we first started home care in 2017.

That’s not all. Kate has had an unusually good week, and Friday was her best day since before she was hospitalized with Covid in November 2020. She was awake early and talkative off and on throughout the day. She was also responsive to residents who stopped to speak to her at the café downstairs while she was having her ice cream that afternoon.

For me, the highlights of the day were our times together that morning and that evening. I spent a large portion of the morning with her before the caregiver arrived at 11:00. She was cheerful and talkative. We had a good time. Our evening was a repeat of the evening I reported on in my previous post so I won’t elaborate. Moments like these are precious. I know we are very fortunate to have such experiences this late in her Alzheimer’s and wish that were true for every family “Living with Alzheimer’s.”

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Good Things

Two thousand twenty-four is off to a good start. Our caregiver issue is almost solved. The first month after losing our regular Monday-Friday caregiver, we had 29 different caregivers. After ten weeks, the total is 40. That means we’ve had only 11 different caregivers in the past 6 weeks. Not only that, but the caregiver who had originally said she could work every Monday, Wednesday, and Friday had a change in her schedule that allows her to work every Thursday as well. Now, we only have to find a person to take care of Tuesday. Until then, we have different people filling in. Fortunately, most of them have been here in the past. This improvement reduces most of my stress.

More importantly, Kate has shown more improvement in recent weeks. As I have said in previous posts, this does not mean an improvement in her Alzheimer’s. It does, however, indicate that she is more at ease which is expressed in her smiles and her speech. It is still difficult to understand her, but her speech indicates that she is happy. From my perspective, that is what is most important.

I am especially pleased that our relationship remains strong. That isn’t reflected in every moment of every day. She is still very quiet on most mornings. On some mornings, she doesn’t express any recognition or interest in me. Other mornings, she does.

She expresses her feelings for me most often when I return home after being gone for a while. At other times, it is in the evening after she is in bed, and the caregiver has left. Last night was one of those.

She had already had a talkative afternoon. When we have occasions like that I generally expect that it won’t continue as we move to other activities. That was no problem last night, and we had a conversation that lasted at least an hour, perhaps a little longer. Sometimes she seems a little hyper when she is talking. This time was different. She spoke slowly and responded to what I had said. Sometimes she asked me a question, and I gave an answer that I hoped would be appropriate for the question she had asked.

During our conversation, she smiled a lot and laughed a good bit as well. It is hard for me to put our feelings into words. The best I can do is to say that we were both perfectly at ease and engaged in a conversation that meant a lot to each of us. I might say it was a beautiful bond of love that transcended her inability to say much that I could understand. I could almost imagine that it was one of those early days when we were dating. It was like each of us was enthralled by what the other was saying. She was still in late-stage Alzheimer’s that requires total care for all of her activities of daily living. For those moments, however, neither of us was mindful of that. We were, and still are, a couple in love, and Alzheimer’s has not been able to take that away from us.

Moments like this will not last forever. For now, we will enjoy every Happy Moment that comes our way.