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Visits with Nashville Friends

The recognition that Kate is now entering the last stage of her Alzheimer’s motivates me to do what I can to maintain our longstanding friendships with out-of-town friends. With that in mind, Saturday we drove to Nashville to visit Ann and Jeff Davis. Our past visit had been a good one, and I was eager to see how this one would go. Although she didn’t remember them before our arrival, Kate accepted the fact that we were going to see them without any reluctance at all. A couple of times on the way (and after I had mentioned our visit again) she did ask me to remind her of who they were. She was never straight on that.

As on our previous trip, she was immediately taken with the flowers outside. Ann saw us and came out to greet us. Our greeting was as natural as ever. I think Kate felt completely at ease. We went to their sun room where we enjoyed catching up with them. Since our last visit, they had taken a Danube River cruise and also made a trip to Mexico for a Spanish immersion course. Our conversation was lively, and the two hours we spent with them went quickly.

Kate was less talkative this time. Some of that may have been because the rest of us talked so much. I know she could not have followed everything we said. Throughout our visit, I was concerned that she was uncomfortable. It was a surprise when we got in the car to hear her say she had enjoyed the visit. She didn’t say anything that would have given me the idea that she was ignored or bored.

My own reading of the situation is that she was confused by our conversation and may have been uncomfortable. She chose to remove herself from it, an easy way to adapt to a challenging situation. I suspect this is something that I am more likely to see in the future. It reminds me of my mom when she and dad were with us in any group. She was very quiet.

Our visit does make me think about ways that I could have brought Kate into the conversation. Much of our conversation related to our past experiences, something that is impossible for her to handle. She does, however, retain her feelings. She could talk about her feelings for her family, especially her family. She also retains a strong sense of social justice and the fact so many people live in underprivileged conditions. These are things that are easy for the two of us to discuss. It seems like it might be more contrived in a typical social get together like the one on Saturday. I am going to think about creative ways in which I might encourage at least some conversation on topics that we could all appreciate.

Staying overnight in Nashville has worked out well for us. We had a nice dinner the night before, and Kate was able to sleep late before our going to lunch and then visiting our friend Ellen at her memory care facility. Our visits with her continue to be challenging. We understood very little of what she said. In addition, her memory is also declining. Her daughter told me to ask about Ellen’s visit from her son’s family the previous weekend. They live out of state and don’t get to visit very often. When I asked, Ellen didn’t remember their coming at all.

A few weeks ago, we saw a woman from the church where Ellen directed the choir for forty years. She told us about several videos of her daughter singing solos with the choir. She had posted on YouTube. I played them for Ellen. That was a treat for her and for us.

For the third time in a row, we were there for the “music lady” who comes to the facility about twice a month. She plays the piano and sings and invites audience participation. The residents love her. I can see why. Kate and I enjoy her as well. Kate seemed a little more controlled in her expression of enthusiasm than the first time we were there, but she danced and sang a little as well as clapping her hands and swinging her arms with the music. She was enjoying herself so much that we stayed thirty minutes longer than I intended.

I feel good that we can still have weekends with visits like this at this point in our journey and plan to keep going as long as we can.

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Transitioning from Husband to Helper

Kate surprised me yesterday when she got up early again. I reached her as she sat on the side of the bed. I asked if she was getting up. She said, “I don’t know.” We chatted briefly, and then I asked if she would like to get up. Again, she didn’t know. She said, “What do you think I should do?” I told her I thought it would be good for her to get up and take a shower. She asked where the bathroom was. I told her I would show her.

On the way she asked, “Who are you?” I told her I was Richard and could help her with anything she needed. She said, “You really seem to know your way around.” I turned on the shower and showed her the soap. As she got in the shower, she asked who I was. I said, “I am Richard, and I am your helper.” She asked what I did before becoming her helper. I told her I was retired. She said, “From what?” I told her I had been in the market research business. She said, “What’s that?” I explained briefly. As I closed the shower door, she thanked me. It didn’t sound the way she would have said it if she realized I was her husband. It was more like what you would expect if she thought I was a friend or hired helper. After her shower, she walked a few steps to the bedroom. I told her I would get an extra towel and help dry her. She said, “You really know everything.”

It wasn’t long before she wanted to lie down again. I started to leave for the kitchen. She said, “Why don’t you stay right here?” I said, “Would you feel better if I stayed with you?” She said she would, and I brought my laptop back to the bedroom. About thirty minutes later, she wanted to get up.

Once she was dressed, she wanted her shoes and socks. I picked them up from the floor near her feet. She said, “You think of everything.” Then she asked where I live. I said, “I live right here with you.”

Gradually she is failing to recognize me as her husband. I haven’t reached the stage of never telling her, but I am gradually changing with her. My obvious role is that of helper. I don’t think that’s a bad way for her to think of me.

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Is our glass “half-full” or is it “half-empty”?

When I began this journal (now a blog), I wanted to create an account of our lives since Kate’s diagnosis. That is the reason for my providing so much information about our daily activities. In a way, I wanted my posts to paint an accurate picture of the struggles we have faced and how we have adapted. Looking back, I think I was expecting more problems to deal with and fewer moments of happiness. As it has turned out, it is the “Happy Moments” rather than struggles that have filled our lives.

I often worry that whatever I say will lead some to believe that our lives are either “good” or “bad.” The reality is that our lives are a complicated mixture of both. Even now, the good far outweighs the bad. I do understand, however, that the way I have adapted to Kate’s changes permits me to see it that way. If I were looking at our lives today through the lens of 2011, I would be depressed. I am not depressed today. I have learned to appreciate many little things that I previously would have thought either insignificant or sad.

Let me give you a few examples of happy moments we have shared in the past few days. As we walked out of the bedroom the other day, she noticed a picture of our daughter, Jesse, in her wedding dress. It sits on the dresser, and Kate frequently stops to look at it. During the past two or three years, I don’t ever recall her recognizing that it is Jesse, but that doesn’t stop her from appreciating it. When I told her it was her daughter, she was moved to tears. She commented on the smile and her eyes, something that draws her attention in all photos. She asked her name. After I told her, she wanted to know more.

We spent at least five minutes or more looking at the picture. Then I told her we had a picture of Jesse’s twin boys in the family room and motioned her to follow me. This is another of her favorite pictures. She was thrilled to see it. She wanted to know their names. She got the impression they were her children. I told her they were Jesse’s boys. Then she wanted to know about their father. It wasn’t long before I was giving her far more information than she could digest. We went away without her ever having the understanding she wanted, but she had enjoyed herself. And I loved showing her the pictures. We do this regularly now. It’s not something we did much before, but it means much more to her now. I get a special kick out of her interpretation of the personal qualities of Jesse and the boys.

As we walked through the family room, she was captivated by the beauty of the flowering plants on the patio and the trees behind our property. She said hello to the ceramic cat that sits on the floor before we enter the kitchen. She looked at the photos of our son and her father that are also part of her daily ritual. This is always a good way to start the day.

During dinner, she said she wanted to tell me something. She said, “I know how much you do for me, and I want to thank you.” This began a series of comments that continued when we got in the car after dinner. She conveyed that she couldn’t live without me. She said some nice things about me to our server. As we left the restaurant, she said, “I wanted to tell you something else. I don’t know where all this is going. I wonder if we should get married.” I said, “I would love to marry you.” She said, “You would? That makes me happy.” I walked around my side of the car. We didn’t say anything more about marriage, but we talked about our relationship all the way home.

These are just a few of the many experiences we have on a daily basis. I would been sad if they had occurred eight years ago, but I have always wanted her to be happy. That is especially true now, and she is almost always happy. What I didn’t know then that I know now is that happiness is possible even after memory disappears, and I don’t have to look far to find things that make her happy.

I wish Kate had all of her rational abilities back – her memory for people, places, events and how to accomplish the many daily tasks of living. That’s not going to happen. From that standpoint, life is not going well for us now. On the other hand, being happy is of primary importance for both of us, so Kate and I would say that our glasses are still quite full.

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Yesterday was a good day.

After the challenges of the past week, I’m glad to report that Kate didn’t have any signs of anxiety yesterday. She wanted to sleep longer when I got her up but was cooperative. She was happy to see the sitter and didn’t give any indication that she was sorry for me to leave. She also got along well without me while I was away.

The only problem of the day involved her iPad. That is one I don’t think I will solve. This is a direct result of the progression of her Alzheimer’s. I just hope she will be able to continue for a little longer.

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Unpredictability

Yesterday started out early – about 8:30. What was even better is that Kate was cheerful and showed no signs of anxiety. She was quite confused and was especially dependent on me to tell her exactly what to do when she went to the bathroom and then dressed.

Because she was ready so early, we went to Panera for her muffin rather than going directly to lunch. We were there shortly after 9:00 and stayed for an hour before returning home. She was quite tired and immediately lay down on the sofa. It wasn’t long before she was asleep. (I wasn’t surprised. The night before she woke up around 2:00. She was confused about where she was. We talked for almost an hour as I tried to tell her about us and our children. She was awake for a while around 4:00 as well. When I got up at 6:30, she wanted to go to the bathroom. Then she went back to bed until 8:30 when she got up for good.)

About 11:15, she opened her eyes. I thought that was a good sign that she might be ready for lunch. In some ways it was. She let me help her into a sitting position right after I mentioned lunch. Very quickly I realized that she didn’t seem fully awake. She was in more of a fog than she is most mornings. She said, “I don’t know what’s wrong with me.” After she was on her feet, she asked if she could stay at home. I told her I thought she just needed a little time to wake up and might feel better if we went ahead to lunch. She didn’t protest. After we were in the car, she asked again if she could stay home. I reassured her she would feel better when we got to the restaurant.

When we walked in the restaurant, the server had just put our drinks on the table. She walked to us and gave us a hug. As she and Kate broke their embrace, I said, “I think she really appreciates that hug today.” That led the server to give her another hug. This time when they released the hug, Kate started to cry. It was over quickly, but it was a good indication of her emotions for the next couple of hours. Near the end of lunch, she reached out her hand to me and asked me to hold it. I said, “Sometimes it’s just nice to touch someone you know who loves you.” She had tears in her eyes and nodded.

On the way home, she started to whimper and said, “I don’t know why I am crying. I don’t feel sad.” I suggested that sometimes either happy things or sad things can prompt cause us to be teary. I also told her that at our age we begin to recognize that we are much nearer the end of life, and we realize how . . . I hesitated a moment. She said, “How precious?” and I finished the sentence “our time is.”

I didn’t say what else I was thinking. She may feel happy, but I see signs of sadness. I try not to read too much into this, but I know she recognizes that she has problems that are well beyond what is normal. I experience sadness myself when I see her decline. I see my losing a little bit more of her each day. During her attacks of the past week, she has looked like someone in her last days on hospice.

She was very tired after we got home and wanted to rest. She rested the balance of the afternoon. She may have slept a little, but most of the time she was awake with her eyes closed. I suggested we leave for dinner. She asked where we were going. I told her, and she said, “I don’t have any money.” I told her that was no problem. I would pay for it. She said, “Well, I’ll pay you back.” At the time, I thought she must remember that I am her husband, but I didn’t say anything to be sure.

Before leaving the house, she mentioned another two or three times that she didn’t have any money. Each time I assured her that was no problem, but she wanted me to know that she would pay me back. I finally said, “You don’t have to pay me back. We are married. The money belongs to both of us.” She gave me a mildly defiant look and shook her that meant “We are not married.” I didn’t pursue it anymore.

After we arrived at the restaurant, she thanked me for helping her from the car and seating her. I told her I liked caring for her and mentioned that we had been together a long time. She asked how long. That led me into telling her the story of our meeting, our courtship, marriage, and having children. As I did this, she began to recognize me as her husband. She didn’t make any specific reference to things she could recall, but she asked me questions and reacted positively to my answers. She didn’t question anything I said.

I thought that would have cleared things up for the remainder of the day, but I was wrong. She was tired when we got home and wanted to rest again. We decided to go to the bedroom. She wanted to undress, so I took this as a good opportunity to get her ready for bed.

After brushing her teeth, she struggled for more than an hour over what she thought were bugs that get on her body and in-between her teeth. She worked to brush them off and to clean them from her teeth. She kept talking about how smart they are and that they know when you are looking at them. She asked me to look over her body and see if I could find them. I didn’t see anything. She had gotten wet while brushing her teeth and tried to dry herself off. She felt she wasn’t succeeding and was concerned that the bugs (she never referred to them as bugs) liked wet areas. She wanted me to help her get dry. I tried with a towel. Then I got the hair dryer. She felt dry, but she was still concerned about “them.”

All the time this was going on she periodically thanked me for being patient. She actually called me by name several times. At one point, I got the floss and tried to make sure there was nothing between her teeth. I never found anything. Finally, I think she must have gotten tired and quit. She said she wanted something to “read.” I gave her a photo book and her iPad. She chose the iPad, but she never opened it. She continued to pick at her teeth and her fingernails in an effort to get rid of the bugs. Once asleep, she slept until I was getting up at 5:45 this morning. She wanted to go to the bathroom.

She was very confused and frightened. She wanted to know where she was and who I was. I gave her my name and told her she was going to be all right, that I would help her with anything she needed. When I got her back to bed, she was still uneasy. I asked if she would like me to get back in bed with her. She did. I put on some soothing music. We talked a little while and I held her in my arms. Within thirty minutes she was calm. I asked if she was all right. She said she was. I told her I was going to get up unless she needed me. She said that would be fine. She is sleeping now, but I don’t know what lies ahead when she wakes up.

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Another, But Milder, Morning Experience

It was a week ago yesterday that Kate experienced an intense and long-lasting (an hour) attack of anxiety. She had milder experiences four other mornings during the week as well as Friday afternoon’s experience while the sitter was here. That brings us to yesterday.

I was just finishing up a blog post when I noticed that Kate might be getting up. I went to the bedroom and found that she was having another attack. This time it seems to have arisen from either a dream or delusion. She apparently thought someone was in the house. She asked if they were gone. Rather than correcting her, I decided to go along, and I told her they had left. The problem with these fibs is that they often lead to further creative responses. In this case, she asked what they had said as they left. I told her they just said goodbye. Then she asked who they were. I said, “I don’t know, but they are gone now. Nobody is here but the two of us.” She was relieved, but I was concerned that she might still be a bit uneasy. I asked if she wanted me to sit with her in the bedroom. She did.

I remained with her for another two hours. She slept well and got up cheerfully for lunch. We didn’t have any other problems the remainder of the day.

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Trying to Understand Kate’s Expressions of Her Feelings

Kate had another anxiety attack yesterday. This time it occurred in connection with a different kind of feeling. She wasn’t frightened by not having any memory. She was worried about being separated from me while the sitter was here. Here is the way the day unfolded.

We had a good morning. Unlike five other days in the past week, Kate showed no signs of anxiety at all. She wasn’t eager to get up for lunch, but she did so without any resistance. She was very comfortable with me. I like to think that she knew my name and relationship, but she didn’t say anything specific to confirm my suspicion. We had a nice lunch and were able to get back home in plenty of time to meet our sitter with ten minutes to spare. As I left, I told her I was going to the Y. She didn’t express any reservations about my leaving. She was tired and was resting on the sofa in the family room.

When I returned home almost four hours later, I encountered a very different situation. I heard Mary say, “There he is.” Kate said, “Where?” Then I walked into the room. Kate was seated on the sofa. She had a very worried look on her face. Mary said, “She’s been stressed.” When Kate saw me, she gave a big sigh of relief. I walked over to her. Even though she was relieved to see me, she remained upset. She said, “Are you my one?” She’s never referred to me that way, but I assumed that the word “husband” or “friend” wouldn’t come to her. I said, “I am your one.” She said, “I didn’t know where you were? I was worried.” She was more emotional than she had been when she experienced her attacks earlier in the week. I sat down beside her and tried to console her. She was appreciative, but it took her a long time to calm down. In fact, she repeatedly said, “I couldn’t imagine where you were. I knew you wouldn’t leave me.” It was thirty minutes later before she was calm again. I was surprised that she could retain a memory of her feelings for such a long time.

The rest of the evening was uneventful. As I have reflected on a number of recent experiences, I see a common thread. Her intuitive side is more “alive” now than in the past. Her feelings don’t seem to be different in kind than they were in the past, just more intense. I see that in her appreciation of music and beauty. It is very evident in her reaction to sudden noises, especially those that occur when we are in restaurants. The screams of babies and the noises of dishes as they are removed from tables by the wait staff cause her to make louder audible responses than ever before. She complains about the brightness of the sun when we walk from the parking lot into a restaurant and back again. She is bothered more than usual by the heat anytime she is outside. She is irritated by waiting. That happens at restaurants and also at the doctor’s office the other day. At several of our recent music nights at Casa Bella, she has been uneasy when seated at a table with more people than usual. She is also more easily irritated by things I say or do. She is very sensitive.

I am now connecting her anxiety attacks of this week as part of the same pattern. The loss of her rational abilities leaves her with only her feelings. While that is what provides her with a great deal of pleasure, it also brings with it a greater amount of pain than it would have in the past.

This is just one more thing that I didn’t fully anticipate. I have always tried to keep her safe and happy. This change is one that requires me to be more attentive to those things that are uncomfortable for her and minimize them as much as I can. I definitely need to work with her sitters to enlist their help when I am away from the house.

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Another Milestone in Our Journey

It was January 21, 2011, when Kate received her Alzheimer’s diagnosis. Late yesterday Kate had a routine appointment with her gerontologist. As I have done prior to other appointments, I posted an update to Kate’s chart via her doctor’s online portal. That way I am free to explain how Kate is doing without worrying about her feeling talked about or my taking over the visit. It worked especially well this time. The doctor took far less time exploring how she was getting along.

She began by asking questions of Kate. Because my report had mentioned a concern with her vision, she asked Kate to read a sign on the back of the door to the room. She was able to see the first word, “Our,” but not pronounce it. She never got to the rest of the words. The doctor asked about her daily routine. Kate hesitated and then mentioned something completely unrelated to the question and unintelligible to us. I had feared that they were going to go through the usual questions related to the President’s name, date, drawing a clock, etc. but was relieved that the doctor felt she had enough without going further. Kate also mentioned working in the yard, but, of course, that is something she hasn’t done in two or three years.

The doctor was accompanied by a man serving a residency with the practice. She asked Kate if it would be all right if she and I stepped out for a few minutes and let the resident collect some additional information. That was fine with Kate, and we left. While we were out of the room, the doctor gave me the prescription and application for a handicapped sticker for our car. That is something I had requested in my update. She also gave me a sheet with a detailed list of symptoms for the 7-Stage Model of the Progression of Alzheimer’s. She agreed with what I had already estimated, that Kate is at the end of Stage 6 and about to enter the final stage. I looked over the list when we got home. It seems rather clear that is correct. As I said in a previous post about two weeks ago, no one can provide a precise estimate of the length of any of the stages, but it was sobering to receive the information.

I thought back to the time of Kate’s diagnosis 8 ½ years ago. Kate and I both expected to hear that she had dementia. Hearing the doctor say it; however, had a great effect on both of us. That was also true for her current doctor’s confirmation of where she is now. I suspect most people who are around her would never guess that she is this far along. I am personally surprised that she is able to function as well as she does now that she is on the cusp of the final stage of the disease. I am able to see all the signs without any problem, but it seems to me that she couldn’t be at this stage just yet. I was also struck by the specific symptoms of each stage. There are quite a few for Stage 6, but very few for Stage 7. I am copying them below.

  • “Frequently lose the ability for recognizable speech although words or phrases may be uttered.” Just beginning for Kate.
  • “Need help with eating and toileting, and there is general urinary incontinence.” Just beginning for Kate.
  • “Lose the ability to walk without assistance, then the ability to sit without support, smile, and to hold up head; reflexes become abnormal, muscles grow rigid, and swallowing is impaired.”) Just beginning for Kate.

Like so many things, I find myself wishing I knew more precisely how much time we have, but it may be better that I don’t.

Looking back, I am satisfied with the way in which we have approached her diagnosis. Our goal was to make the most of whatever time we had. That goal has served us well. It is my intention to continue the same game plan. I realize that we will reach a point at which we are much more restricted in what we are able to do, but we won’t stop until I find that it is wise to do so. I remember that my dad took my mom with him wherever he went, except Kiwanis, until shortly before her death. I hope that Kate and I will be able to do the same.

This is one of those sad moments, but I want to emphasize that we are still experiencing happy moments and will do so for the foreseeable future. Apart from that, I have accumulated a treasure trove of memories before and since her diagnosis. I never imagined that we could enjoy life so much while living with Alzheimer’s. I am truly grateful.

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The Fading Allure of the iPad

I made the following entry seven years ago on August 18, 2012.

Thursday afternoon I bought Kate an iPad since her computer is in the shop again, and it seems that her computer is really a lifeline for her. When she is not working on a particular task like photo albums, she likes to play free cell. She also likes to get her email. I keep thinking that an iPad will be easier for her to use since she likes to use the computer in bed which can cause some problems with the connection to the power cord. 

Until I checked my old journal entries this morning, I hadn’t realized that Kate had been using her iPad for so long. At the time I got it, her primary “self-initiated” sources of pleasure were working in the yard (as much as six hours a day) and working on her computer. It’s been five or six years since she gave up the computer. It had become too difficult for her to operate. For a while the iPad was a mere adjunct to her yardwork. It’s been almost three years since she gave that up. That wasn’t because it was too hard. It related to the fact that she had pruned all the shrubs so severely that there was little for her to do. That was the major part of her yardwork although I have recently discovered that she must have been weeding as well. I say that because weeds had never been a big problem until the past two years. She obviously had been keeping them at bay.

When she stopped working in the yard, she was left with the iPad as her only source of amusement. The only thing she uses it for is to work jigsaw puzzles. She has used it morning, noon, and night. I haven’t kept track of the time, but I know that sometimes she must have spent as much as eight hours a day working puzzles.

I charge the iPad every day for her, but it is only in the past week or ten days that I have been especially attentive to the battery life left when I start the charge. My guess is that the average battery life has been somewhere between 25% and 45%. Sometimes it has been totally exhausted. Recently, the figures have been 89%, 88%, 45%, 91%, 75%, 45%, 92%, and 65%. That is a clear indication that she is using the iPad less now.

There are two primary reasons for the change. The first is that she is having increasing difficulty operating the program. The most common problem is that she gets into the store to buy more puzzles when she completes a puzzle. Just this morning, I taped a piece of paper over the upper right hand corner of the display. That is where the icon for the store appears. Like so many things, that could create another problem, but it should be one for me and not her. On other screens there is an “X” icon to exit that page and go back. I don’t believe she normally gets to one of those pages. If I can address that problem, it should make Kate’s life and mine a lot simpler.

There are other problems that I can’t prevent as easily. One of those is forgetting what to do with the scattered pieces. Thus far when this happens, I have been able take care of it by telling her just to put the pieces together to form a complete picture. Another involves her eyesight. She can’t see the lines of the frame against which the edge pieces should be placed. She seems to get there by getting near the line. When she is close enough, the piece will lock in place and can’t be moved. The other issue is that she is unable to associate similar colors or shapes to figure out where a given piece might go. She just seems to keep trying until she gets it right. Similarly, she can’t distinguish between the background color and design to identify places a puzzle should go. I have worked with her enough on this issue to conclude that is impossible for her to learn because of her poor vision.

Last night was particularly frustrating for both of us. I am surprised she persisted as long as she did. In fact, she only stopped working her puzzles because I suggested that she might be getting tired, and it was time to get ready for bed. Prior to that, she had worked on her iPad more than an hour. I was watching (trying to watch) the evening news. Throughout that time, I got up and down from my chair every few minutes to address a problem.

As you would expect, I am concerned about her giving up the iPad. That would create quite a void in her life. It would also add greater responsibility for me to keep her entertained. She does enjoy her family photo books, but they provide a different experience. They are not something that holds her attention as long as jigsaw puzzles. The puzzles also have the advantage of being more interactive. They require her to think more. While I can’t know for sure, I have an idea that she derives some sense of satisfaction from completing them. In addition, she likes the beauty of the puzzle pictures themselves.

One thing I know is that I won’t be able to control much of what happens. It will be helpful if my taping over the store icon works, but the other problems are more a function of the disease itself. I’ll just have to wait and see what happens.

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Morning Confusion Continues

I was just finishing up yesterday’s blog post when I heard Kate call my name. I started for the bedroom when I heard her call again. She didn’t smile when I entered the room, but she was relieved to see me. She was experiencing a milder anxiety attack than she had a couple of days ago. She didn’t appear to be as frightened, simply confused. It was another case of her memory’s being almost blank. She felt insecure and kept expressing that she felt better that I was with her. Despite her calling me by name, she didn’t remember either my name or our relationship. She clearly felt secure with me. She specifically commented that my tone of voice made her feel better and said she knew that I wouldn’t let anything happen to her.

I brought the “Big Sister” album to her. She recognized herself in the picture on the cover; however, I ran into a problem when I tried to go through the book with her. She was lying flat on the bed with her head on a pillow. It was awkward holding the book so that she could easily see the pictures. We decided to look at it later.

Then I started talking about her family. Although she was interested, it was too much information for her. As I had done the past two mornings, I played music for her. We turned our attention to it. The impact yesterday was greater than I have seen before. They were all choral pieces with beautiful harmony and soothing melodies. She was particularly moved by “Danny Boy,” “Deep River,” and “Swing Low Sweet Chariot.” Most of the time she held my hand or put her hand on my arm. A few times she asked me not to talk. She just wanted to listen to the music. At one point she shed a few tears. It was a very tender moment for both of us.

It was also a sad moment. She was still confused though uplifted by the music. She continues to have a sense that she is not all right. I think back to the times when I have heard people say, “At least she doesn’t know.” Kate may not know the name for it, but she knows she has a problem. How long will that last?

I stayed with her for over an hour. She was feeling better. I asked if she would like to go to the bathroom. She got up easily and took a shower. Most of the time, she didn’t know my name or our relationship, but she was quite comfortable with my helping her with toileting, showering, and dressing.

She was ready early enough for me to take her to Panera for a muffin before the sitter came at noon. Kate didn’t express any concern when Cindy arrived and I left for the Y. When I got home, they weren’t there. Kate hadn’t wanted any lunch until 3:00, so they had gone out for lunch. I am sure that had something to do with her having had a muffin not too long before Cindy arrived. I also believe Cindy is more passive with her than I would like. I think another sitter might have said, “I’m hungry. Let’s go get some lunch.” Kate might have responded more positively to that.

Kate may not have rested before they went to lunch because she was tired when they got back. I let her rest for an hour and a half before going to dinner. She didn’t sleep during that time. She just relaxed while listening to the music I played for her. She was ready for bed earlier than usual but was awake when I got in bed a couple of hours later.

During the night, she apparently had a dream. She was kicking her feet. I put my arm around her, and started to comfort her. She misinterpreted me and said, “No” in a very stern voice. Then she grabbed my hand and squeezed it very hard and held it for several minutes before she relaxed and dropped it. I don’t think she had been awake at all.

There is a lot going on in her brain right now. I just wish I could fully understand it.