Posted on

Kate changes. I change. Things don’t always work out.

As Kate has been sleeping later in the morning and also becoming more dependent, I have been making my own changes. I know that I have talked a lot about living in Kate’s world, and that it has worked. I’m not sure that I have also stressed that caregivers must also engage their rational abilities as well. That means shifting gears to solve or prevent problems. I’ll give you an example of what happened this morning.

It has become increasingly challenging for Kate to select her clothes in the morning. She has tried selecting them the night before, but she usually forgets some of the things she will need (e.g., her shoes, socks, a top, etc.). I decided to address this issue last week and have been selecting her clothes either the night before or in the morning before she is up. This has worked pretty well.

You may remember that she fell out of the shower last week. I decided it was safer for her to shower in our bathroom that has a walk-in shower. Some mornings, she chooses our bathroom anyway. This past week I caught her before she was about to use a shower in another bathroom and suggested that she use ours. That worked.

When she showers, she often uses several towels. That usually means at least two bath towels. In addition, she often uses one or more hand towels and, sometimes, the bathmat. When she finishes she drops or throws them on the floor or counter tops or whatever is nearby. That’s not a problem for me when she is using another bathroom; however, it conflicts with my OCD when she uses our bathroom. I try to keep all the towels, toothbrushes, and toothpaste in their “proper” places. That means a clean up after she showers. Since she doesn’t know which towels are hers, she often gets mine. To solve that I started keeping two on top of the counter directly across from the shower and pointed them out to her. Once or twice she has used at least one, but she still opens a drawer and pulls out one or two other hand and/or bath towels.

When I had the bathroom redone, I had two hooks installed inside the shower to hold towels. That way the person showering could dry off without opening the door. That gave me another idea. After my shower last night, I hung two bath towels for her on the hooks. In addition, I left the original two towels for her on the counter in case she wanted more. I thought I had it made. I had adequately addressed the problem, for me anyway. The shower issue was no problem for her. It was solely mine.

Now I can tell you the results I had with my little experiment. Kate went to bed earlier last night, so I thought about the possibility that she might wake up earlier this morning. I checked on her once or twice, and she was still sleeping. I got busy on my own things. When I checked on her again, I discovered that she had already showered and not in our bathroom, so I hung her towels back on the towel rack where they are normally kept. I can’t say that my plan for the shower didn’t work. I just slipped up and didn’t get to her quickly enough.

Next I noticed that she had left all the clothes I had put out for her right where I had put them last night. She had gotten out her own clothes except for a top. I went to her closet and brought one to her. I also got her a pair of shoes and socks. She suggested that I let her take care of the rest, and I did. When she was ready to go to Panera (yes, we were early enough for that), I noticed that she wasn’t wearing the top I had picked out. I didn’t say anything because the one she picked out was just fine. This often happens. I am never sure if she just didn’t want to wear the one I picked out or if she misplaced the one I had given her. I think both of those things happen from time to time. I don’t worry about this. The important thing is that she has a top to wear. However, it’s one more example of the things that I do to prevent a problem only to discover it didn’t work the way I intended. I’m just glad our problems are not bigger than this, except for her Alzheimer’s itself. That, of course, is the biggest issue we have faced in our entire marriage.

Posted on

Confusion, Growing Dependence, But Happy Times As Well

Kate’s confusion continues and along with that her dependence on me. Despite her confusion over our marriage, we had a nice lunch. We had two brief social encounters with friends we hadn’t seen in a while. One was a former neighbor, the other a member of our music club. After lunch yesterday, we came back to the house for a little over an hour before we went for our hair appointments. During that time, we relaxed in the family room where Kate worked on her iPad. The music was relaxing. It was a very pleasant moment in the day.

After our haircuts, we were off to Barnes & Noble where we also saw a couple of friends who stopped at our table to chat. From there we went to Bonefish Grill for dinner. Once again, we saw several people we know from our neighborhood and had a good meal.

When we got home, we spent a little time in the family room where I watched the news. Then we retired to the bedroom for more of Fiddler on the Roof. After saying yesterday that Kate only puts down her iPad for Les Miserables, I noticed that she quickly became engaged with Fiddler. We watched for an hour during which time she never opened the iPad. Watching an hour or so of a musical she enjoys is becoming a good way to end the day. She enjoys herself must direct her attention away from confusion and loss of memory.

I am noticing more confusion at bedtime now. It is something that has been happening for a good while. It’s just that now she seems to be especially confused about getting ready for bed. That has obviously happened in the past when she has gone to her room to get a night gown and not come back with one. During the past few days, I have taken the lead and said, “I’ll get your nightgown.” She says, “That would be nice” or “Thank you.” There is no sign of independence. I think by that time of the day she wants what is the easiest thing.

I woke her at 10:40 this morning. I think she was about half awake anyway, and I would like for us to get to lunch before Mary comes at 1:00. She got up easily, but it was obvious that she was confused. She asked me what I wanted her to do. I told her she could take a shower in our bathroom. She asked, “Where is that?” I point to it and told her I would show her. I got towels out for her. She seemed very unsure of herself. I definitely feel better about her showering in our bathroom because of the walk-in shower. She has showered there every day since her fall last week. I feel we were fortunate that she didn’t hurt herself. The next day I asked her if she felt any pain from the fall. She didn’t remember the fall and didn’t have any pain.

Life is quite a mix of things right now. I suspect this is only the beginning. I am just glad that we can still enjoy time together. I would not have believed it 7 ½ years ago.

Posted on

An Interesting Mix of Confusion and Lucidity

At lunch, Kate and I had an interesting conversation. I only wish I could remember precisely what she said. I’ll do my best to capture the essence of it. It began when she asked my name. I told her and said, “I am your husband.” She was surprised and said, “You’re my husband?” I said, “Yes, did you think we were friends.” She said, “Buddies.” I told her we are buddies, but I am also her husband. Then I added that we have been married 55 years. She said, “No way.” She usually finds that hard to believe but accepts the fact that I have told her. This time she wouldn’t accept it. I mentioned it later during the meal. She still didn’t believe it.

Several times she poked fun at me and said, “I’ve been around you too long.” I found it interesting that she hadn’t remembered that we are married, and yet she retained the awareness that I often joke with her. Of course, this fits well with what I do know. People with dementia retain their memory of feelings about people, places, and things long after they have forgotten names and other specifics about them. A little later in the conversation she said something similar. She said, “You can relate to people who are different from you.” At the risk of being wrong with my own self-analysis, I would say that she is right.

Having said this, I still find it surprising when these seemingly contradictory things occur in such close proximity. On other occasions, for example, she might fail to remember that she has children and then say something about them that is true. All of these things are just further examples of how the brain’s circuitry gets scrambled for a person with dementia. That is hard for the rest of us to understand.

Posted on

Very Confused

Kate rested for 1 ½ hours after Anita left. I woke her up for dinner. She woke easily and didn’t show any signs of confusion. That occurred in the car on the way to dinner. We only went a short distance to Chalupas, but she asked my name at least three times, perhaps more. As we pulled into the parking lot at the restaurant, I told her my name and said we had been married 55 years. That surprised her. She said, “We’re married? Are you sure?” I told her yes, that we had married in 1963. As I pulled into a parking space, she said, “Are we legal?” I told her we were. She asked, “Who did this? You’re gonna have to explain this to me.” I told her I would once we were inside, and I told her about our first date, the wedding and her preacher who conducted the ceremony.

I could see that she looked very puzzled. Nothing I had said seemed to make any difference except she had some familiarity with the church and the preacher. She asked what we had been doing all this time. I told her about the places we had lived, the birth of our children, and jobs. When I mentioned our time at the University of Wisconsin in Madison, nothing rang a bell until I mentioned the English professor for whom she worked. She always liked him. I should add that during all of this she didn’t express any of the anxiety I have witnessed on several other occasions. She was just puzzled and really couldn’t remember most of what I was telling her. Finally, she was getting far too much information. She asked me to stop. Then she asked, “Does anybody else know about this?” I asked, “This?” She said, “All this that you have been telling me.” I told her our children know. She asked how they would know. I told her she had raised them and learned about the things I had told her. She said, “I didn’t raise them.”

I decided to go in another direction. I said, “There’s only one thing that matters. That’s us. We know we love each other and that we’ve had many great experiences. She agreed.

As I pulled into our garage, she said, “I like all this.” I said, “You mean our house?” She said, “This is our house?” Once we were inside, she said she wanted to go to the bathroom and to brush her teeth. I could see that she was unsure of where to go. I told her I would show her the bathroom and took her there.

We are now sitting in the family room where she is going through the photo book that her brother Ken gave her. I had gotten it out to show her pictures of our wedding. She recognized the photos and the church parlor where the reception was held. That seemed to settle her, and she has been looking through it for about twenty minutes or so.

I don’t ever recall another instance in which she was so confused, but she seems all right now. I’ll see what happens as we get closer to bed time. I am going to play one of our musicals to see if we can end on a high note again.

My personal reaction to the situation has been less sadness than a resolve to help her in any way that I can. She really needs help, and she trusts me. After giving my explanation of our courtship and wedding, she said, “That’s what I like about you. You just say it straight out.” I’m not exactly sure what she means by that, but later she said, “When you tell me things, I can understand them.” I don’t think this is quite true, but I sense her trust in me and want to be a supportive as I am able.

Posted on

New “Firsts”

As you have probably noticed, I try to be alert to changes as they occur. Over the past few weeks, I haven’t had to work hard to find them. We’ve had several small, but notable (to me anyway) ones this afternoon. The first occurred as we drove into the garage at home after returning from Panera. I told her that I would be leaving for Rotary and the Y and that Anita would be with her while I was gone. She asked, “Is she the baby sitter?” I said, “Well, I wouldn’t call her that, but she is someone to stay with you while I am gone just in case you need something.”

Up until that moment, I had never referred to Anita or Mary as “sitters.” To me that sounded too much like “baby sitters,” and I didn’t want to offend Kate. Apart from using their names, I just said pretty much what I said above, that Anita (or Mary) is someone to stay with with you.” On a couple of occasions, she has indicated that she liked to have someone with her. I also thought she might be self-conscious about being with them at Panera, but that doesn’t seem to be a problem.

Before leaving for Rotary, Kate said she was tired and asked, “What if I want to rest?” I told her she should feel free to rest. She asked if she should rest on the sofa in the family room or on the bed in our bedroom. I told her should could rest wherever she felt most comfortable. She chose the bedroom. When Anita came in, I explained that she had lost some sleep last night and was resting.

Later, while I was at the Y, I received a call from Anita. She said that Kate had gotten up and seemed confused. Anita thought she might have had a dream because she said something about my mother and was a little teary. This seemed strange as my mother died in 2002. Kate asked about me. Anita thought she might want to speak with me. I asked her to put her on. She asked where I was. I told her I was on the treadmill at the Y. She seemed perfectly fine. I told her I would be home as soon as I finished. We said goodbye, and Anita got back on the phone. She said they were going to Panera.

On the way home, I stopped by Panera and told Anita that I would take her home. When we arrived, she said she wanted to rest. I told her I was going to be in the family room. She decided to rest on the sofa.

I wonder how much of her behavior is related to having lost a lot of sleep last night and how much, if any, is another sign of the changes that are coming our way. I guess I will find that out in the days ahead.

Posted on

A Schedule Gone Awry

If you read my previous post, you may remember that Kate rested for about two hours yesterday afternoon. That was after sleeping until 10:30 yesterday morning. Even though she had never had a problem before, I began to worry that she wouldn’t be able to go to sleep last night. We got to bed a little later. Kate was in bed at 10:00. I followed her at 10:35. Sometime after midnight, I heard her turn over and realized she was awake. I’m not sure that she had been asleep at all, but she was very wide awake and talkative. That led to a long conversation during which we both reminisced about our relationship, our children, her parents, our travels. These are all things that we talk about regularly. I don’t think there was a thing that was new including our agreement that we have been a very lucky couple.

Interlaced with the discussion were some of the usual questions about names. Early in the conversation, she mentioned how proud she was of our children. A little later, she asked if we have children. Then she wanted to know all about them. As she often does, she asked me to tell her where we first met.

Knowing that I was likely to be up early, I didn’t play as big a role in the conversation as I might normally do. I felt the need to get to sleep. Finally, at 2:35, I said something about going to sleep. She took the not-so-subtle hint and said she thought she would go to sleep as well. That’s the last thing I remember.

During our conversation, I had decided I would sleep late this morning. Habit got me. I was up at 5:35. I dressed for my walk, ate breakfast, and was out the door a few minutes after 6:30. I walked just over 4 miles and returned home at 8:00. To my surprise, I saw that Kate had gotten up. There are only a few times that she has gotten up that early in the past couple of years, and that was after a good night’s sleep. I was sure that she would sleep until I woke her for lunch. As it turned out, she was ready for Panera before 9:30. That is where we are right now.

The lack of sleep may be having an effect on her. She just asked, “What is your nome?” She knew that wasn’t right and repeated it. She still couldn’t say “name.” I gave her my name. Then she asked her name. Moments later she asked my name again. I just gave her my first name, but she wanted the whole thing. Then she said, “What’s my name again?” She asked where we lived. When I told her, she tried to say “Knoxville.” As she did with “name” earlier, she pronounced it in a funny way. All of this is not dramatically different from what goes on every day, but the look on her face and the way she is speaking makes me think she is more confused than usual.

Today is my Rotary day. That means the sitter comes at noon instead of 1:00. I like for Kate to get her lunch around 11:00 so that we can easily get back home in time to meet Anita. I have frequently had to call her and tell her to meet us here, but that won’t happen today. I suspect Kate is going to be tired. I’ll get her a sandwich in another twenty minutes. Then we’ll go back home. My guess is that she will take a nap.

After Rotary, I will go to the Y. That will keep me awake. I hope we will get our sleeping back to normal tonight.

Posted on

Kate’s iPad

For a while now I have noticed that when Kate is looking for her iPad, she doesn’t say “iPad.” She says something like, “Where is my?” and then makes a motion with her hand. I hadn’t thought much about it. I felt she was just momentarily slipping on the word. On several occasions recently, she has asked, “Is there something I could read?” That seemed strange to me because she never reads. On these occasions, I have asked if she would like her iPad. She quickly says she does. This happened yesterday. For the first time, it dawned on me that she is having the same experience remembering the “name” iPad for her tablet in the same way that she is forgetting the names of people. As for me, she still retains an attachment to the iPad, but she doesn’t know what to call it.

This is just one more example how many things are dropping out of her memory. She is beginning to forget the locations of her toothbrushes. They have been kept in three different bathrooms because she uses all three. Sometimes she accumulates more of them in one bathroom than another, but I come behind and try to see that she always has some in each bathroom as well as toothpaste, of course. Yesterday she asked, “Where can I brush my teeth?” I took her to our bathroom.

She is becoming less assured of where to go when we come in the house at night. On several occasions, she has said, “I’ll follow you.” Last night, I stopped in the kitchen to get something to drink. Instead of going to our bedroom, she lingered around until I was going. I am sure that was because she didn’t know where to go. Each of these things goes along with other things like forgetting where and how to get ice.

I think I mentioned yesterday that she is having more trouble with her iPad. She usually asks me to help her when she can’t do whatever she wants, but sometimes I can see her working hard to solve the problem herself. I suspect part of that is not wanting to bother me, but I think it is also not wanting to acknowledge encountering the same problems over and over. Sometimes she just closes the iPad and has a forlorn look on her face. I know then to help her. Once the problem is solved, she goes right back to work.

Posted on

A Follow-up to “The Light is Dimming”

I maintain a very active email correspondence with two college friends from TCU, Tom Robinson and Bruce Morton. Tom responded to one of yesterday’s blog posts that dealt with Kate’s recent changes. I am copying his message along with my reply as I believe it sheds a little more light on our present situation.

Email from Tom Robinson

Richard, I just read your blog, and the “Light Is Dimming” is, for me, the saddest one yet. I’m thinking it is for you, too. As you say about yourself, I’ll say, too: I did not realize that Kate would, being this far along, be saddened by her inability to remember. This is the first time I recall your writing about this, so it must be that it is the first time. Of course, maybe she was crying about something else. I don’t know. But I took it as you seemed to – that she was realizing she has a disease and that the loss of memory is not going to stop. It does no good for me to say so, but my heart so truly goes out to you and Kate. I was glad to see the later post where things were somewhat better. What would we do without music!!!

Tom

My Reply

Thank you, Tom. You are reading the situation correctly. The convergence of so many new symptoms as well as the increasing frequency of the old ones tells me Kate is declining more rapidly now. We may still have plateaus, but she is clearly reaching a new low. As I have conveyed and you understood, I had thought because she seemed to have gotten along so well up to this point that she would just drift away without realizing that she has a problem. That has been particularly true since she has been asking me about my name and her own name. She has done so without displaying any sign of being disturbed by it. Regardless of whether she sees her symptoms as a sign of Alzheimer’s or not, I can now see that she is indeed aware of her loss of memory and it disturbs her. 

 As I remind myself, let me remind you that we are on borrowed time. Because it has been 12 years since we saw the first signs of her Alzheimer’s, we could have faced the current situation several years ago. That doesn’t end the pain; it only helps me to put it in perspective. I remain satisfied that we have taken full advantage of the time we have had. I even believe that the way we have approached her diagnosis may have helped us get along for a longer period of time than would have otherwise been the case.

 This is not the end of our good times, but I expect to see more signs of change. It’s not going to stop. That is the nature of this disease. About 30 minutes ago, we arrived home after dinner. She left the kitchen for the back of the house. She came back to the kitchen rather quickly and pointed to the door to the dining room. I asked what she wanted to do. She said, “I don’t know.” I asked, “Do you want to brush your teeth?” It turned out she was asking if that (through the door to the dining room) was where she should go to brush her teeth. I walked her to the bathroom. On a couple of other occasions, she has been disoriented upon arriving at home, but that has been after dark. This time it was still daylight. It is difficult to watch this deterioration of someone you love who had been a fully-functioning adult with two master’s degrees.

Posted on

The Light is Dimming

Yesterday seemed like a short day to me. It was Monday and the day for the sitter. Kate got up a little earlier but went back to bed after her shower. It was just after 11:30 when she was ready to go to Panera. Knowing that Anita was to arrive at noon, I called her and asked her to meet us at Panera. I left the two of them for Rotary shortly after Anita arrived.

It was 4:00 when I returned. I had a few groceries to put up. Then Kate and I went to Barnes and Noble. She seemed to be fine. During the time we were there, she asked my names several times. At no time did she seem disturbed by asking. Almost 24 hours earlier, my friend Tom Robinson had asked in an email how long Kate could remember things. I told him that it was often just seconds. Her attempt to remember my name illustrated that. Two times in succession, I told her my name, and she couldn’t remember it.

We went to Chalupas for dinner. When we got out of the car, she said in a very serious, thoughtful way, “I want to thank you.” I asked what she was thanking me for. She said, “For everything you do for me.” I said, “That’s because I love you.” She answered, “I know.” At dinner, she again asked my name several times. As we walked out of the restaurant, she said, “You’re a good guy.”

When we got home, I played the last portion of the DVD I had played the previous night, the one with her father’s home movies. She watched them with interest but without saying a word. That’s unusual. She usually expresses her pleasure audibly when she watches them. When we finished, I told her I was going to take my shower. As I was getting ready, I noticed that she hadn’t moved from her chair and wasn’t working on her iPad. She was just sitting there with a sad look on her face. I walked over to her and knelt beside her chair. There were tears in her eyes. I said, “Tell me what’s wrong.” She said, “Nothing.” My immediate interpretation was, and is now, that she was thinking about how little she could remember. She didn’t ask why she couldn’t remember as she has done before. That made me wonder if she had recalled my telling her about her Alzheimer’s the day before.

After she said, “Nothing,” tears welled up in my eyes. I said, “I understand, and I am here to help you. Whatever happens, I will always be with you.” We hugged and gave each other assurances of our love. The light is dimming. I knew this day would be come, but I never envisioned the pain she might feel this late in her journey.

After a few minutes, I decided she needed something uplifting and put in the DVD of Les Miserables. That worked. She was immediately engaged. After my shower, we watched a while before going to bed.

At 10:30 this morning I have my labs before a routine doctor’s appointment on Thursday. Knowing that I wouldn’t get to eat until after that, I decided not to get up as early as usual. At 6:00, I decided to get up. As I did, Kate made a sound. I leaned over and kissed her on the cheek. She said, “Thank you.” I could tell that she was crying very softly. I decided not to get up. I moved closer to her and put my arm around her and gently stroked her shoulder. Neither of us said anything. In the darkness, I could see tears drop from her eyes. When she went back to sleep thirty minutes later, I got up.

It is now 8:08. A few minutes ago, I thought I heard the flushing of a toilet and went to see if she is up. She is. Since I need to be at the doctor’s office at 10:30, I was going to wake her about 8:45 so that she could go with me. It looks like I won’t have to do that now. I wonder what today will be like.

Posted on

A Second Chance Comes Sooner Than Expected

As I noted earlier, Kate seemed to be fine this morning. It was late, but we got to Panera at 11:00. That gave us hour for her to have her muffin and for both of us to relax. On the way to lunch, something happened that all of us can relate to. We worry about things that never happen or surprise us when least expect them.

As we were driving, Kate asked, “Where are we exactly right now?” I’m accustomed to the question and told her we were on the road in the northern part of Knoxville. She said, “Is Knoxville a city?” I told her it is. Then she asked my name. I told her and told her how long we had been married. As always, she was surprised how long that had been. I mentioned our children. She wanted to know their names. After I told her, she asked again. She seemed more confused than she normally does.

We drove a little further, and, for some reason, I brought up the fact that we had visited Ellen last Sunday. She looked very surprised and said, “We did? I don’t remember that.” I said, “Yes, we did.” Then she looked perplexed and said, “I should have remembered that. What’s wrong with me?” Since we had had a similar conversation just last night, it caught me off guard. I made a quick decision to tell her what was wrong.

I said, “You may remember that some time ago, we learned that you have Alzheimer’s. That affects your memory and is why you have trouble remembering things. The good news is that most of the things we enjoy in life don’t depend on memory. We enjoy listening to music, going to Casa Bella for their music nights, as well as our local theaters, and spending time with family and friends. Not only that, but you have me to help you with anything you need to remember. I will always be with you for that.” She still looked a little puzzled, but she did say how good she felt knowing she could depend on me to help with her memory. By that time, we were arriving at the restaurant where we had a good lunch and a delicious dessert.

When we arrived at home, she asked, “What now?” I told her that we could spend a little time at home and that we had several options. I mentioned that we could look at some of our pictures from our 50th anniversary trip with our family to Jackson Hole. I also said I could put on some music, and we could relax in the family room. She saw her iPad and said she would like to work on it. For a while we enjoyed Tchaikovsky’s Symphony No. 6 as she worked on her iPad. Then she said she was tired and wanted to lie down on the sofa. I put on some softer music to play while she rests. I am finishing up this post. After that I am going to bring in the clothes from the dryer to fold and put them up.

At the moment, all is well. I am glad I decided to remind her of her Alzheimer’s. This  time it seemed like the right thing to do. Maybe that is because I had thought it through. She seemed to accept it well. At least, she didn’t indicate any concerns about the long-term implications. Perhaps that will never come up. If it does, I will continue to emphasize the good things that we will continue to enjoy and that I will cover the memory issues.