Update on The Velveteen Rabbit

It’s been a while since I’ve commented on my use of The Velveteen Rabbit to distract Kate when she is disturbed or bored. Regular readers of this blog will probably recognize that as one of the most reliable tools in my “Caregiver’s Toolbox.” I’m sorry to report that at this stage of her Alzheimer’s, some of my tools aren’t as reliable as they once were. Unfortunately, these include her photo books, our “tours” around the house, and The Velveteen Rabbit.

The good news is that TVR hasn’t lost all its charm. It continues to help me out and has done so twice in the past two weeks. The first occurrence happened when I thought she might be headed toward another experience with sundowning. The preceding occasions began with restlessness accompanied by a desire to go home.

Several times this occurred after she had been in her recliner for a couple of hours. In every instance, it followed a period during which Kate and her caregiver were seated close to each other but not interacting. Although all of our caregivers do a good job with the basic tasks involved in caring for Kate, they are very much like the average person with respect to communicating with her. I am very understanding about this. It really is difficult for them to establish a close personal relationship with her. When asked questions, she doesn’t understand or simply doesn’t answer. Thus, caregivers receive little reinforcement for their minimal efforts.

Even though I am understanding, the contrast between the relationship between Kate and her caregivers is dramatically different than the one Kate and I have. While we also have moments of silence after the caregivers leave each evening, the silence is punctuated by brief conversations and often expressions of our feelings for each other. I don’t expect caregivers to relate in this way, but I would like them to find their own “tools” to handle the situation.

I want to help them and decided to intervene next time I noticed the first signs of sundowning. When that happened, my first step was to kneel down beside her recliner and seek to comfort her. I spoke to her slowly and softly and explained that I wanted to help her. She wanted to get out of the recliner and go home. I told her I would be happy to do that. She began to feel less agitated, but I didn’t solve the problem. I started to pick up one of her photo books. Instead, I thought about The Velveteen Rabbit. I went to the bedroom where I keep it to read to her as a bedtime story. I brought it back to her and read it. As often happens, she was not immediately engaged. The more I read the more she listened. I can’t be sure if TVR made the difference. I do know that she enjoyed the book and didn’t show any further signs of sundowning.

A few days later, we had a similar experience. She and the caregiver were seated in the family room just a few feet from each other. Kate looked bored. She and the caregiver hadn’t been talking at all. I felt like Kate needed a boost. Once again, I picked up TVR and read it to her. She perked up rather quickly and gave her customary audible emotional responses to various passages. It was just the tonic I was looking for. At the end, I noticed that the caregiver was wiping away a few tears. She told me later she wasn’t familiar with the book and thought her daughter might like it.

Will it work the next time she has a problem? I don’t know. I haven’t found anything that always works. One thing is sure. The Velveteen Rabbit still has value, and I don’t intend to give it up anytime soon.

Caregiver Guilt

I’ve often said that as Kate’s caregiver, I have two goals: to keep her happy and to keep her safe. On the whole, I believe I’ve done well on both of these. That doesn’t mean, however, that I haven’t made mistakes, but I do try to learn from them. I had a lesson on that the other day.

Kate was tired that morning. She had been awake early the previous day and didn’t rest much during the afternoon. I woke her about 11:30. I assisted the caregiver getting her ready for the day. She took her meds with some yogurt. Then we let her rest a while. We are getting her out of bed frequently now though not every day.

That day I thought it would be especially nice to have her up and give her breakfast at the table rather than in the bed. A couple in the neighborhood was dropping by to look at our house that we have listed with a realtor before our move to a continuing care retirement community in April. Getting her out of bed is not a pleasant experience for Kate, but recently she has accepted it more easily. It was different that day. She protested vigorously as we got her ready to hoist her in the lift from her bed to the wheelchair.

I started to suggest to the caregiver that we just leave her in bed, but she is usually all right once she gets up. Now I wish I had followed my initial instinct and let her rest. Instead, we got her into the wheelchair while she screamed. Although I thought the worst would be behind us, she had a panic attack and I felt guilty about forcing her to get up.

She didn’t calm down for at least thirty minutes, but then she was fine. I was relieved but still felt guilty. I do think it is important to get her up as much as we can. If we don’t, she may continue to be bedridden. She is quite strong physically, and I would like to see her walk again, but in the future, I am going to be more careful in assessing her willingness or lack of willingness to get up. I don’t want to exacerbate the fear that she already has. It was a bitter lesson for me.

Sundowning

Among the many ways in which Kate and I have been fortunate is avoiding sundowning (sundowners, sundown syndrome), and, at this last stage of her Alzheimer’s, I began to think it was something we might not face. Not everyone does. To the best of my knowledge, my mother never did. I know my dad never talked about it. Since I visited them regularly in the late afternoon, it seems I should have had some personal observation if she had the problem.

I am also mindful that life is always changing. That is especially true with dementia. Nevertheless, I was caught a little off guard this past Friday when Kate, who had been happily resting in her recliner, became more talkative. It was more than just talking. The pace was faster than usual. It seemed like she was a bit hyper. Although it was late in the day, the thought of sundowners didn’t cross my mind. After all, I had observed this kind of behavior before and at earlier times of the day.

It was only at dinner when she spoke very sternly to her caregiver who was feeding her that I thought she might be sundowning. That was repeated numerous times before she finished eating. Her mind appeared to be focused on her own thoughts, not food. When it was time for dessert, she had her usual ice cream in which I mix her evening medicine. The dessert became her focus of attention. After that, she was back to normal, and we had a good evening.

Before the caregiver left, I told her I suspected that had been Kate’s first occurrence of sundowners and asked her opinion. She thought that might be the case. The next two days, we had similar experiences late in the day and during dinner. Each time, it was over when dinner ended.

After the three previous days, I was more prepared for a similar experience the next day. When she has been agitated before, my approach has always been to comfort her by speaking softly and slowly and conveying my love and support for her. That has always seemed to help. Based on what I had read about sundowning, I was doubtful that it was likely to work, but I wanted to try it.

Close to 4:30 when Kate became agitated and talkative. She also felt uncomfortable in her recliner and complained about pain. She wanted to get out of the recliner and go home. I kneeled down beside her and told her I would help her with whatever she needed. That had no immediate effect, but I continued my effort to comfort her. She did cool down somewhat but not completely. She was still disturbed.

The caregiver asked me if I had medications to give her for things like this. I told her the doctor had given me a prescription for Seroquel but I hadn’t used it since two days after Kate returned from the hospital at Thanksgiving. I told her I wasn’t ready to use it again. I didn’t want to resort to medication if I might have success without it.

I felt the need for something to distract her. Of course, I thought of music. I pulled my phone out of my pocket and turned on one of Puccini’s best-known arias, “O Mio Babbino Caro.” It’s a favorite of Kate’s. I’m sure it still is, but it didn’t do the trick this time.

I decided to try the Seroquel. The doctor had prescribed 1/2 of a 25mg tablet.  After giving it to her, I told her how much I loved her. As I did, I thought of another song that she likes and that I have often played for her, “A Bushel and a Peck.” I sang it along with the Doris Day recording. As I did, she smiled and started mouthing some of the words. I played it two or three more times. Then I selected a group of very familiar children’s songs from an album of 100 songs. I started with “The Alphabet Song” and continued with others like “Row, Row, Row Your Boat,” “The Bear Went Over the Mountain,” “Old MacDonald,” and “He’s Got the Whole World in His Hands.” Sundowners was a thing of the past.

We had no trouble at dinner. She happily ate everything. Midway the Seroquel kicked in. She was sleepy. As always we took her directly to bed after dinner. The difference this time was that she fell asleep immediately and slept until 9:30 yesterday morning. Normally, she is awake until 10:00 and sleeps until at least 11:00 the next morning.

Yesterday, for the fifth day in a row, Kate had a similar experience just before coming to the table for dinner. The first signs were a desire to go home and discomfort in her recliner. Again at dinner, she protested the caregiver’s effort to feed her. She ate about half of her meal before I decided to go straight to her ice cream for dessert. That turned the tide, and she was fine the rest of the evening.

Although I am unable to pinpoint the cause of these changes, she is obviously disturbed which makes me believe offering her love and comfort along with pleasant distractions have some therapeutic benefit. How well this strategy will work over the long run remains to be seen, but I am going to continue my preferred approach. I will definitely try comforting, music, and anything else I can think of before trying medication. I don’t mean to suggest that medication can’t play an important role in controlling sundowning. I just think it should be used only after pursuing other solutions. I am also going to be more sensitive to keeping her entertained late in the afternoon before dinner. It might postpone or prevent similar episodes.

Coincidentally, we had a telehealth appointment with Kate’s doctor yesterday afternoon. We talked about this, and she reinforced my suspicion that something other than medication is a reasonable first step in addressing the problem.

Treats for the Caregiver

Those of you who are regular followers of this blog know well the role that eating out has played in our lives. When sheltering began in March, that became a thing of the past. In late May, restaurants reopened with capacity limited to 50% occupancy and often with reduced serving hours. Kate and I began to eat out again, two or three nights a week and lunch on Sunday. That was still a far cry from eating out for lunch and dinner seven days of the week, but it was a significant relief from being completely homebound.

For us, the primary benefit of this habit was keeping us socially active, something that is often a problem for people “Living with Alzheimer’s.” We had developed quite a social network that went beyond the friends and acquaintances we encountered. We also developed friendships with servers, owners, and managers. They have been priceless members of our “team” of supporters.

When Kate and I tested positive for COVID, our routine changed dramatically. Kate, of course, has been in bed most of the time since she returned from the hospital nine weeks ago. Although we have caregivers seven days a week from about noon until 7:00, I’ve only eaten out a few times since then. That was because the caregivers come around lunch and leave around dinner, and those are times when I have been helping with the meals for Kate.

This past Wednesday I did something different. I took a late lunch and went to one of our favorite restaurants. Until March, we had lunch there every Tuesday for more than six years. When I arrived, I asked if the young lady who had served us most often was on duty. She was, but her tables were already full. I told the hostess, who was new and didn’t know me, that would be all right.

After being seated at a table with another server, I discovered that the server I had asked about was taking care of the table next to me. When she saw me, she stopped at my table. We talked briefly, and I explained why we hadn’t been there the past couple of months. To me, that brief exchange was energizing.

Not long after that, the shift manager noticed me and came over to the table to say hello. It wasn’t long before he asked if he could take a seat. That began an almost hour-long conversation. He’s an interesting man who came to the US from Romania. By chance, Kate and I had met his wife and daughter at the restaurant several years ago. His wife is Puerto Rican and a major in the Air Force. I was fascinated with his story of how they met and how they juggle their lives around their different careers as well as the cultural differences between them.

It turned out to be an enriching break from my daily routine as a caregiver. I had recognized before we got the virus that experiences like this were becoming less  important for Kate than for me. The benefit I receive from social contacts is more valuable at this stage of her Alzheimer’s.

I will say, however, that I am not dependent on eating out to satisfy my need for social engagement. I keep up with several college friends and a former professor by phone and email. I have a list of others with whom I often have lengthy phone calls. I have continued my longstanding involvement with our local United Way as well as the foundation for our largest health system, our local symphony orchestra, and Rotary. I am also a member of a men’s coffee club that is a local support group meeting via Zoom twice a month.

I am not as socially involved as I used to be, but interpersonal relationships still play a significant role in keeping me going. Even little things make a difference. Yesterday, I took care of a small responsibility as a member of the only church committee on which I continue to serve. It’s the birthday committee. Each of us calls 8-10 people a month on their birthdays. I’ve done this for 5-6 years and occasionally think about passing it along to someone else, but it’s another pleasant social experience. I think I’ll stick with it.

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.

A Glass Half-Full or Half-Empty? Reflecting on Our Present Relationship

In a few days, it will have been six weeks since I watched Kate taken by ambulance to the hospital. The last words I heard her utter were, “Help! Someone, help!” That was a dark moment for me. I thought to myself, “I hope this is not the last image I have of her.”

Much (most?) of the time before getting the virus she didn’t remember my name or that I am her husband. With few exceptions, however, she has always recognized me as someone familiar and a person she likes and trusts. I couldn’t help wondering if she would recognize me at all when she came home. I feared she wouldn’t.

That fear ceased quickly when she immediately broke out in a big smile when she saw me. She was much better than I expected, and I was relieved. This shift in my emotions reminded me of the countless times I have responded positively or negatively to how Kate feels. As I have said before, when Kate is happy, I am happy.

It’s been over four weeks since she returned home, and she is still in bed, but she is making progress. Not everything is the way I would like it to be, but I tend to be a “glass is half-full” kind of person. As Kate has declined the past few years, I have tended to focus on our “Happy Moments.” That has been especially true since her return from the hospital.

One aspect of her recovery that I have enjoyed involves her feelings for me. She has been more psychologically dependent on me than ever before. She doesn’t express her feelings a lot in what she says, but she likes to hold my hand and squeeze it or rub it when we are in bed at night. She also depends on me for security each time the caregiver changes her.

She still retains some of her rational ability that I had thought was virtually gone. When I tell her the caregiver needs to change her, I immediately see the apprehension on her face. It is clear that she has an idea, though perhaps vague, of what is in store even though the caregivers and I attempt to make the process as non-threatening as possible. I get in bed beside her and very softly and slowly explain that the caregiver will be very gentle and that I will be “right here with you.” I also tell her that we will need to help the caregiver and tell her to hold my hands and that she can squeeze them as hard as she wants, and she does.

Gradually, she is becoming more relaxed. A few times, she has been totally passive except for the moments we have to turn her. She resists, but we turn her quickly. Then she is fine. If I put my arms around her and ask her to hug me, she seems to feel more secure and holds me tightly. I take this as another sign of the security she feels with me.

Kate isn’t the only one who dislikes this experience. The caregivers and I feel the same way. If she can learn to accept this more easily, we will have eliminated the only serious negatives that occur in a day. Of course, the best thing would be for her to agree to get up from the bed. Then we might be able to take her to the toilet. That would really simplify our lives, and we are working on that. One of her caregivers and I got her to sit up on the side of the bed once last week, something the physical therapist was also able to do that week. Slowly, but surely, we may succeed in getting her on her feet.

The worst part of her COVID experience occurred because she is in the last stage of her Alzheimer’s. She has never been able to grasp what has been going on since being taken by ambulance to the hospital. Even her return home has been quite different that it was when she left. Between the two agencies providing caregivers and the Home Health staff, I suspect it is impossible for her to recognize any of them. The result is reflected in her feelings toward me. I am her primary source of comfort and security.

Increasingly, the caregivers are getting to see her kind nature. I find it touching that she often thanks the caregiver after changing her even though she protests vigorously both physically and verbally. On a couple of occasions when we were embraced while the caregiver completed her work, she spoke tearfully in my ear and said, “I’m sorry. I’m sorry.” I find that heartbreaking.

On Saturday, the caregiver was ready to turn her from her side to her back. She stopped when she saw that Kate had nestled her head on my shoulder and stroked my arm. That same night after the caregiver had left, she did the same thing as we were watching The Wizard of Oz.

These are not only signs of her recovery, but they are also an indication of her affection for me. She has always been appreciative of my care, but the events of the past few weeks have elevated that feeling significantly. That strengthens my determination to do the best I can to make her secure and happy.

I am optimistic that she will continue to make progress. In the meantime, I am sustained by the strength of our relationship and more than grateful to have a glass that is half-full. I fully recognize that at this stage of her Alzheimer’s, my glass will never be completely full.

Our Own Christmas Story

Very early in the pandemic, I learned the following expression concerning our plight. “We may be in the same storm, but we are not in the same boat.” That struck a chord with me. I believe it holds for just about every obstacle we encounter in life. I definitely believe it applies to people’s experience with Alzheimer’s. Our situations are very diverse. Some people’s experience is like being in a “leaky canoe” while others may be like traveling on an “ocean liner. As regular readers know, Kate and I have been fortunate to face her Alzheimer’s as if we were in a battleship safe from the harsh storms that sink smaller boats.

With that in mind, you might ask what this year’s Christmas was like for us. Judging by the number of Christmas cards, phone calls as well as the flowers and goodies we received, quite a few people may have thought the most fitting piece of Christmas music for us would be “In the Bleak Midwinter.” (One of my all-time favorites, by the way.) Had I thought about it, I might have felt the same way. Kate is in the last stage of Alzheimer’s and bedridden for four weeks related to her recent experience with COVID. Not only that, but we were going to celebrate the day alone except for Kate’s caregiver. As it turned out, we had a joy-filled day.

As usual, I was up early, had breakfast and took a 60-minute walk. I had a relaxing morning before going to wake Kate about 11:15. Her eyes were open when I got to her bedside, and she greeted me with a big smile, just the kind of beginning I like. I took care of her morning meds. Then I served her breakfast in bed. Of course, that isn’t exactly special when you have been in bed for a month as she has, but she still loves her food. Now that I am crushing her pills, even that is a pleasant event for her. I always put it in yogurt or apple sauce. I don’t even tell her she is taking medicine. I just say, “I’ve got a treat for you.”

When the caregiver arrived, it was time to change her. Neither Kate nor the caregivers and I like to face this. She is no longer as combative as she was the first couple of weeks, but it is still something she dislikes and resists. Yesterday was also a day to change the sheet as well, so we did it all at the same time. That is something that is especially disturbing for Kate, but it went relatively smoothly.

The afternoon went very well. Kate was quite talkative even though that involved a lot of delusions. I sat up in bed with her almost the entire time while we watched several Christmas musical programs on YouTube. During one of them, I pointed out that all the musicians in the orchestra were wearing Santa caps. Kate didn’t know what I was talking about, so I put on my own that I wear each year when ringing the Salvation Army bells.

After the caregiver left, we had our Christmas dinner. The meal itself was quite good. I arranged for it through a caterer we have used since near the beginning of the pandemic, usually on a Friday night. Her menu for Christmas was a generous portion of beef tenderloin accompanied by sweet potatoes gratin, twice-baked potato, and green beans. The dessert was an assortment of goodies including fudge, baklava, chocolate mint brownies, and Christmas cookies. We indulged ourselves but still have some leftovers for another meal tonight.

We had a good meal, and both of us enjoyed every bite. The setting itself was nothing to write home about. Kate, of course, was in bed. I stood by the bed and fed her while eating my dinner between her bites. In some ways, one might compare the glamour of the situation to the Parker family’s Chinese dinner in A Christmas Story. The big difference was that Kate and I were having a good time.

After dinner, we watched a portion of It’s a Wonderful Life. Kate was engaged as I tried to explain what was going on; however, I decided to move on to something else and scrolled through the TV schedule. I saw that The Wizard of Oz had just started and turned to that. As I had done with the previous movie, I explained what was happening throughout. She was so engaged that she didn’t want to stop when I first said it was time for us to go to bed. We ended up watching over half of it before calling it a night.

What could have been a depressing way to spend our Christmas Day turned out to be one I will remember fondly. We were together and very happy.

Delusions, COVID, and Recovery

Like many others with dementia, Kate has experienced delusions. They became more frequent over the past year. With the arrival of the pandemic and sheltering, they increased significantly. I attribute this to the fact that her life was less stimulating. I tried to compensate by entertaining her more at home, but we were still more sedentary than before. As a result, she started taking breaks to rest. Upon waking, she often experienced delusions. By the time she and I had our personal experience with COVID, they occurred during a significant portion of each day.

Once she had the virus, however, they disappeared. Overall, she was simply weak and didn’t talk much. It’s been four weeks since she came home from the hospital. She was gradually recovering but still wasn’t having any delusions. That changed last week when she experienced her first one since contracting the virus. They have become more common since. Night before last, she spent about forty-five minutes talking to me about a delusion that involved a group of people who were with us. As happened so much in the past, she thought we were in a hotel or lodge and had plans to do something with the others the next day.

This has caused me to have an unusual feeling. I had always interpreted the delusions as a sign of her decline from Alzheimer’s. Suddenly, I found myself viewing them as a sign of her recovery, not to her pre-Alzheimer’s self but to the way she was before getting COVID. It might seem strange, but I am happy to see this change. It is far better than the way she had been under the influence of the emotional and and psychological impact of the disease.

Her delusions represent signs that the effects of COVID are diminishing. She is also talking more and expressing more signs of happiness. These are encouraging signs. I just wish her recovery were faster.