Posted on

Update on Kate’s Talkative Days

After several posts between September 30 and October 5, Kate’s talkative days settled back into what had been our previous normal routine. That changed again this week.

On Monday, she was awake about 6:45. That changed my morning routine, but it was well worth it. I can’t recall her having a better day. She was far from wide awake, but her smile conveyed a cheerfulness that was to last until she went to sleep that night. I took care of her morning meds, something to drink, and her morning snack before the caregiver arrived, and I left for Rotary. I spent most of the morning beside her in bed and enjoyed every minute. We talked and enjoyed music videos on YouTube.

When I returned from Rotary and the grocery store, she, Adrienne, and I went out for ice cream. Since it’s not as hot as it was during the summer, we sat on a deck outside overlooking a beautifully landscaped area and remained there until going to the dining room for an early dinner.

It was a day when Kate seemed almost “unflappable.” The only things that seemed to trouble (bother? frighten?) her were a few bumps while in her wheelchair as we went out that afternoon. The only problem I encountered that day (and it’s a minor one) was that she stepped up her talkativeness at dinner and afterwards. At 9:30, I could see that she wasn’t ready to stop, and I resorted to Seroquel. I’m not sure how quickly it worked because she was still talking when I went to sleep. I awoke at 10:30, and she was out after having been up a long time.

I admit to having mixed emotions regarding my giving her a sedative to get her to sleep. Although she was quite talkative, she was relatively calm and certainly happy. Since she is quiet so much of the time, I really enjoy hearing her talk even though most of what she says makes little sense to me and is rooted in delusions and hallucinations. On the other hand, I don’t enjoy it as much when it encroaches on our normal bedtime. I’ve spoken with her doctor who says that the dose I am giving her is very mild, but I plan to speak with him again, probably at her next appointment in early November.

It was no surprise that she slept until noon on Tuesday and was tired the rest of the day. Her eyes were closed most of the time while she ate dinner. She perked up a little after dinner but went to sleep shortly after Adrienne left and slept through the night.

Yesterday, she was awake early and fully rested. Once again, she was cheerful, talkative, and unflappable. It was a day that easily matched the great day we had on Monday. Two highlights stand out. Both occurred on the deck outside the ice cream shop during the afternoon.

The first was quite a surprise. Adrienne feeds the ice cream to Kate but stepped inside to get a drink. Kate then picked up her spoon and scooped a bite of ice cream for herself. On several occasions, she has picked up food in her hands and eaten it (something we encourage), but this was the first time she had picked up a spoon or fork and fed herself. Ultimately, Adrienne took over. It was difficult for Kate to get more than a small bit of ice cream, but it was good to see her try.

A woman came out of her apartment onto her deck and down the stairs for an afternoon walk. We had spoken to her on one of our previous visits. This time I got up and introduced Kate, Adrienne, and myself. When she returned from her walk, I invited her to join us at our table.

We had a very pleasant conversation for the next twenty minutes or so. We were interested to know that, by chance, she had been given an apartment that was her mother’s forty years before. We discovered that she knows quite a few people at our church, and I knew her sister-in-law.

During our conversation, I was struck by the fact that Kate seemed to be picking up on some of the things we were saying. At one point, she stopped me and said, “You’re talking too fast.” When our neighbor told us goodbye, Kate told her goodbye. Like feeding herself the ice cream, this was a little thing, but it is not typical. Often, Kate doesn’t speak when someone speaks to her, so I am really pleased when she does.

Like so many other things, I can’t explain why she has such good days. It is as if she is simply in a good mood on some days and feels more secure than on other days. I only know that these days bring me a special sense of joy, something I didn’t expect at the time of her diagnosis 10 ½ years ago. That’s one more reason for me to be grateful.

Posted on

Back to a Typical Day

Kate’s first experience with incessant talkativeness occurred a week ago today. It was one of three days of extreme talking. Each day was followed by a day of rest. If the pattern had persisted, yesterday would have been a day of talking, but it wasn’t. Her caregiver and I were happy.

She awoke about 11:15 in line with what is normal for her. She was in a good mood although a little sleepy, again, something normal. I took care of her morning meds and gave her some juice and a snack before the caregiver arrived. Then, I left for Rotary.

When I returned, she had had lunch and was relaxed in her recliner. She was quite calm and not talking. When I approached her, she had a smile on her face. I told her I was glad to see her, and she said the same about seeing me.

They were giving flu shots that afternoon, and I decided to take advantage of the opportunity for both of us to be vaccinated. First, I went to see what it looked like and discovered there was about a 30-minute wait. I completed forms for both of us. Then I went back to tell the caregiver it might be better if they remained in the apartment until nearer the time for us to be called.

When I got back downstairs, they had moved more quickly than expected. I rushed back to the apartment and brought Kate and the caregiver with me. We were called in right away but had another 10-minute wait before someone came to give the shots. I didn’t think Kate would have any problems, but I wasn’t sure. I was relieved that it went smoothly.

We returned to the apartment for another thirty minutes before the dining room opened at 4:30. We have been going early and sitting in a corner of a room adjoining the main dining room. We’ve eaten in more public areas of the dining room in the past, but I prefer the more private area in case Kate should say or do something that might be disturbing to others. That hasn’t happened often, but her loud voice gets attention. As usual, she enjoyed every bite of her food and was in a pleasant mood the entire time.

After dinner, we spent almost an hour on the balcony. While we were there, Kate began talking. The caregiver and I both wondered if this might not be the start of something we couldn’t stop. Once in bed, however, she began to relax. That is not unusual. She has often rested an hour or more after getting into bed.

While she rested, I took a shower. Kate was awake when I finished, and I got in the bed beside her. For more than an hour, we lay there talking. We talked mostly about our relationship and how we felt about each other. It was another very special moment at the end of a day that had gone well and is more typical of our days than those of the past week.

Posted on

A Day of Rest

It’s too soon to say Kate has established a new pattern of behavior, but there was a bit of consistency the past few days. Tuesday, Thursday, and Saturday she was very talkative for significant portions of the day. Tuesday was the most extreme. She talked almost non-stop from 8:30 in the morning until about 9:00 when I gave her a tablet of melatonin. That worked, but I gave her a sedative (Seroquel) on Thursday and Saturday nights.

It was no surprise that each of the days that followed her talkativeness and agitation she was very tired. She slept late and rested most of the afternoon as well. Yesterday was a good day of recovery. She was tired most of the day until dinner time. By then, she was quite rested, and we went to the dining room for dinner.

After the caregiver left, we relaxed in bed. I watched part of the Buccaneers/Patriots game with the sound muted and music playing for Kate. It was a welcome moment for the two of us after the past few days. I hope we find our way back to something a bit more normal in the upcoming week.

Posted on

More on Kate’s Talkativeness

For the third time in the past five days, Kate was unusually talkative yesterday. I’ve welcomed some of that. That has been especially true during the morning when she has waked up much earlier than usual. I’ve enjoyed spending that time with her. The bulk of her conversation has involved delusions and hallucinations, but she has been happy and seemed at ease. That was true during the entire day. During the afternoon, we went to the café for ice cream. After Kate had finished eating, we went out on the deck beside the café. It is shady in the afternoon, and the temperature was so pleasant that we spent an hour there.

As on previous days this week, the pace of her talking began to pick up. She talked constantly while we were on the deck. We went straight to the dining room for dinner. I was somewhat uneasy because Kate was talking so much and can be loud at times, but the meal captured her attention. She ate well and seemed relaxed.

Upon our return to the apartment, we got her ready for bed. She was very cooperative, something that has become the norm in recent weeks. She began to talk a little more after the caregiver left, but she was relatively calm. Over the course of the next hour and a half, the pace of her talking picked up. At 9:00, it was obvious that she wasn’t going to be ready for bed anytime soon. I mentioned that I was getting tired and would soon get ready for bed. I don’t remember exactly what she said, but she conveyed that she wasn’t ready at all.

I prefer not to use Seroquel unless I have to, so I got her a melatonin. I muted the sound of the TV and turned on some soft music she likes. Forty minutes later, she showed no signs of sleepiness. At 10:00, I crushed a tablet of Seroquel and gave it to her in a spoonful of yogurt. I’ve only used Seroquel four or five times, and it usually takes effect within twenty minutes. An hour later, she was still going strong. I gave her another Seroquel and turned on a YouTube video of Andre Rieu and his orchestra accompanied by a very large contingent (at least 50) of brass instruments playing a very soft rendition of “Nearer My God to Thee.” I hummed along with the music. For a few moments, Kate eased up on her talking. She picked right up when the music ended. I switched to a recording of “Edelweiss” and hummed along with that. She started humming too. She also began to relax. I turned out the lights, and she was asleep by 11:30, almost two hours later than usual.

As I prepare to upload this post, it is close to 10:00 a.m. the next morning. She slept through the night and has shown no signs of waking. If she follows the pattern of the past few days, she will probably be tired and will catch up on her rest today. I’m still not ready to make any predictions. What will be will be.

Posted on

Follow-up on the Two Preceding Posts

We had no problem with Kate’s incessant talking yesterday. She was quite tired. In fact, I wanted to take her for ice cream during the afternoon, but she preferred resting. She perked up a little at dinner but never displayed any of the agitation we observed on Tuesday and Thursday.

We had a very peaceful evening together watching music videos on YouTube. It was like the mid-week agitation had never occurred. No melatonin or Seroquel was needed, and I hope we won’t need them again anytime soon. I vote for “Never.”

Posted on

Addendum to Previous Post: Time Did Tell

In yesterday’s post, I talked about my looking for patterns in Kate’s behavior. I was motivated to talk about that because she had an unusually talkative day on Tuesday. She was agitated, and I resorted to melatonin to get her to sleep that night. Predictably, she was very tired the next day. Yesterday started out like a somewhat typical day except for the fact that she was awake at 8:30, several hours earlier than normal. In my final sentence, I suggested that “time will tell” if Tuesday’s talkativeness/agitation was a unique happening or the beginning of another pattern.

As it turned out, yesterday was not quite like Tuesday; however, around 3:00 p.m. she became talkative but did not appear particularly agitated. At 3:30, I left for a residents’ meeting. When I returned at 4:30, Kate was talking with agitation similar to that on Tuesday. The caregiver and I decided not to go to the dining room. I brought our dinner back to our apartment. She began to calm down a bit while she was eating.

I thought we might be home free, but she started talking again as we got her ready for bed and continued talking after the caregiver left. Before 9:00, she seemed somewhat agitated. As I had done the other night, I gave her a melatonin. It had no effect. Just before 10:00, I gave her ½ of a 25mg tablet of Seroquel (not crushed) in a spoonful of yogurt. She swallowed the yogurt and spit out the pill. (These tablets are very small, so small that I was unsure I would be able to split them when her doctor first prescribed them. I thought she might swallow it uncrushed.) Then I crushed a whole tablet and mixed it in yogurt. She took it without a problem and was asleep within twenty minutes, and, as usual, she slept through the night and is still sleeping at 9:25.

What’s in store for today? I’m not predicting. I’m just going to wait and see. She should be rested after resting all day Wednesday and sleeping well that night and last night. The focus of my attention will not be on the time she wakes, but her incessant talking during the day and especially at bedtime. By itself, talking would not be an issue. What concerns me is the agitation that makes the talking so out of control.

During the past year, Kate’s behavior has seemed like she might be experiencing sundowning. I haven’t been ready to say that is it because her symptoms haven’t always appeared in the late afternoon or early evening. One of the two occasions this week began much earlier in the day. Nevertheless, I would say that her behavior appears to match what I have interpreted as symptoms of sundowning. If so, I will probably see this again. One thing I know. Tuesday’s talkativeness was not unique. Whether or not this becomes a pattern still remains to be seen. Once again, time will tell.

Posted on

Always Looking for Patterns

As a caregiver, I’m always looking for patterns in Kate’s behavior; however, I tend to talk more about variations. I suspect that is true for most of us. It’s the unusual things that stand out, not what is normal every day. There are exceptions, however. The first time something new occurs, I wonder if this is the beginning of a new “pattern.” Often, it is not, but that doesn’t keep me from wondering the next time I see something new.

Kate’s daily pattern has changed many times during the course of her Alzheimer’s. I remember the early days when she worked in the yard 6-8 hours a day. Later, she working jigsaw puzzles on her iPad became her primary activity. She did that, too, 6-8 hours a day. That ended with the pandemic. It was also the end of her self-initiated activity. I had to spend more time keeping her occupied. Despite that, she began to rest on and off during the day.

She’s gone through several changes in her sleep patterns. Most of the time since she was hospitalized for COVID, she has slept until 11:00 or noon almost every day. There were always exceptions, but I found I could pretty well count on her not being awake before 11:00. That gave me time to relax and take care of routine household or personal responsibilities.

More recently, perhaps the last couple of months, she’s been alternating in a somewhat unpredictable way between waking much earlier, sometimes before 7:00, and sleeping until 11:00 or 12:00. I haven’t tried to keep a record of the time she wakes and how she is behaving, but it appears that she has one or two days when she wakes early and then is worn out the next day. Sometimes when she wakes early she is talkative. On a number of those occasions, she’s been talkative a good bit of the day.

The past two days have been a good example. On Tuesday, she was awake around 8:30, just before I took my morning walk. I gave her some juice and her morning meds. She was somewhat talkative for that time of day and in a good humor. I expected that she would go back to sleep while I walked, but when I finished, she was wide awake and even more talkative. That doesn’t mean someone was actually there to talk with her, but she doesn’t talk as though she is talking to herself but somebody she imagines to be there.

I decided to join her in bed and talked with her. As usual, I couldn’t always understand what she was talking about. Some of her words were unrecognizable even to her. That is something new in the last few days and occurred a number of times that day. She would say something like “She’ll want to go to the ‘boober.’” Then she would say, “’Boober’? What’s that?” Each time it was always a different word.

I spent most of the morning with her but checked on her periodically when I was out of the room taking care of other things like finishing up a few details on our 2020 income tax for which I had taken an extension. She never stopped talking.

After the caregiver arrived around noon, I joined a couple for lunch in the café downstairs. When I returned almost two hours later, Kate was still talking. She was also fiddling with her clothes, running along creases in her pants as well as pulling her shirt up as if she planned to take it off, something she was unable to do. This was something I had noticed when I was with her that morning. She was somewhat agitated but not disturbed, just talkative and fidgety.

It was about the time that we normally go out for ice cream, but the caregiver and I agreed that it seemed better to remain at home. She gradually seemed less agitated but continued to talk. When it was time for dinner, we decided not to go to the main dining room. I brought our meals to the apartment.

After dinner, we sat on the balcony for a while before getting her ready for bed. Kate talked the whole time and continued to talk after we put her in bed. Shortly after 9:00, she was still talking. I gave her a 5mg tablet of melatonin and turned out the light. Twenty to twenty-five minutes later, she was asleep. It had been quite a day, certainly not her normal pattern.

I wasn’t surprised that she was very tired yesterday. She was still asleep when the caregiver arrived at noon. Adrienne let her sleep another hour or so, before getting her up for the day. She fixed Kate some lunch. Kate ate it all but was very quiet. She rested until it was time for dinner.

We ate in the main dining room. When we returned to the apartment, we spent a little time on the balcony before giving Kate a shower and putting her to bed. It wasn’t long before she was asleep.

She slept until 8:30 this morning. After my walk, I spent the morning with her. She was cheerful. We had a good time together. It looks like a more typical day, but after the events of the past couple of days, I can’t help wondering if we are in the early stage of a new pattern. Time will tell.

Posted on

What’s Going On?

Friends sometimes wonder about Kate and me when my posts are less frequent than usual. Most of the time it’s not because something is seriously wrong, but I often find myself occupied with other aspects of life that need my attention. Less frequent posts also reflect the changes that have accompanied Kate’s decline and the pandemic. Our world is smaller now than it was before, and we have settled into a routine lifestyle that leaves me with fewer new things to report. Here’s a quick update.

After being on a plateau most of the year with respect to her Alzheimer’s, Kate is exhibiting signs of another downward shift. I’ve mentioned some, perhaps most, of them in previous posts, but, in this one, I want to stress the point that she is falling deeper into a stage most people think of when they hear someone has Alzheimer’s or another form of dementia.

One symptom that carries a lot of weight for me is her increasing failure to recognize me, that is, in a cognitive or rational sense. It has been several years since she began to forget my name or that I am her husband. For a long time, that has come and gone from day to day or moment to moment. It is now a much more common occurrence.

The same is true for her own name or anything about herself and her family. In fact, the saddist moment I’ve had with her recently was when she was in a fog the other morning and asked, “Do I have a name?” I said, “Yes, you have a beautiful name, Kate, and your mother and daddy gave it to you.

On this occasion, I would say she was puzzled, not frightened, over her mind’s being blank. This now seems to be the best way to describe her morning “fog” whereas I used to say she was frightened, disturbed, or bothered.  

More often than not, she is still comfortable with me when these moments occur. She trusts me, likes me, and certainly feels dependent on me. When she wants me, she calls me by name or may ask the caregiver “Where’s my husband?” Sometimes it’s just a reflexive response. The other night, for example, we had an extended conversation in bed. She was very talkative, but delusional. Several times she referred to me by name.

On the other hand, there are more times when she doesn’t recognize me and asks, “Who are you?” She is often surprised when I tell her I am her husband. Sometimes she accepts the news without any emotion or receives it positively. As with other questions she asks, she sometimes says, “Who are you?” several times in not quite rapid-fire sequences.

I take these changes along with others like being less cheerful and her increasing aphasia to be critical markers of a new stage of her decline. More often than not, she doesn’t speak to people who speak to her. It saddens me to see this and recognize there is no way I can stop the progression of this disease that robs her of more and more aspects of her personality. Yet, we still enjoy life and each other, and I continue to see signs of the same Kate I met more than sixty years ago. It’s been more than 15 or 16 years since we noticed the first signs of her dementia. I feel sure she is getting along better at this stage than many, if not most, people “Living with Alzheimer’s,” and I am grateful.

Posted on

One of Those Days

Kate and I have many good days, but not always. Sunday was one of those exceptions. It began around 9:00 when I got a call from the agency that provides two of our three caregivers. The one who was to come was sick, and they were looking for a replacement. They had identified someone who might be able to take her place, but she would be on overtime, and they wanted to know if that would be all right. I gave my approval.

A little later, I received another call telling me that person couldn’t come. After we hung up, I called them back to say that if they couldn’t get someone for the whole day, I would be happy to have someone for a short time to help me get her up for the day and return later in the day to help me get her to bed.

They found someone who could come under those conditions and that she would not be on overtime. They let me know that she was inexperienced and would need my help if I were agreeable. Since I’ve been an active participant in Kate’s care, I agreed.

When she arrived, I learned that she had been in training as a medical technician. She had taken a temporary position with the in-home care agency to make a little money before continuing her previous educational plans. It didn’t take me long to find out that she was not skilled in the kind of care Kate requires. She wasn’t good at changing or dressing someone in bed, and she had never used a lift for a patient.

This was not an ideal situation, but I began optimistically with the thought that I might have learned enough to make things go smoothly. I think of myself as a pretty good assistant to our regular caregivers, I quickly learned how unskilled I am in direct patient care and training of other caregivers. Trained and experienced caregivers clearly handle situations like this without any great difficulty. I won’t go through any of the details, but it took us at least twice as long to get Kate up and in her wheelchair. Fortunately, using the lift went more smoothly.

In addition, Kate was more confused and not as cheerful as she is other times. I’m not sure that I have mentioned that for the past 4-6 weeks she has had more experiences when she doesn’t recognize me. That normally disappears after I give her my name and tell her some of our history (where we met, falling in love, having children, that we have been happily married more than 58 years, and that I love her dearly ). After that, she usually responds to me as though she knows me. It usually lasts for the rest of the day or at least a few hours. On Sunday, she asked, “Who are you?” off and on until we retired for the night.

I’ve frequently mentioned that I like routine. This was a day that was far from that and, therefore, somewhat uncomfortable for me. That was particularly true in connection with the difficulties with a substitute caregiver. I had become comfortable and dependent on our regulars. A new and unskilled caregiver was an abrupt change.

Despite that, there are good things to report. For the first time, I took Kate for ice cream without a caregiver. We went down the main hallway that is officially named “Main Street.” Our building is at one end, and the café with ice cream is almost at the other end. It was a nice stroll and a treat to enjoy time to ourselves.

After the caregiver left that night, Kate and I had another good evening. At first, she couldn’t remember who I am. I gave her my routine explanation a couple of times and ended by telling her how much I love her. That seemed to stick. We watched YouTube videos with music by The Kingston Trio and The Brothers Four. The day ended well as it always has.

Posted on

How is Kate?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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