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A Major Victory

Today was the 32nd consecutive day that Kate has not gotten out of bed. That streak ended around 4:00 this afternoon. This victory came after at least three weeks of encouragement by her physical therapist, her caregivers, and me.

It was only the past ten days when Kate herself expressed any interest at all. Two of those times she wanted to go to the bathroom after  the caregivers left for the day. I was hesitant to attempt it but consented. When I tried to help her, however, she backed out. Within the past 5-6 days while caregivers were here, she said she wanted to get up. Each time the caregiver and I offered to help and spent as long as thirty minutes encouraging her. Ultimately, she was too scared to try it.

Yesterday’s caregiver and I decided that we were going to try again tomorrow, and we will. Today, however, Kate told her caregiver that she would like to get up. I walked into the room right after and join the caregiver in offering to help her. As it was with our previous effort, it took Kate a little time, perhaps 15-20 minutes, to go through with it. Even when she first tried to sit up the process didn’t go quickly. At one point, she rested at least five minutes with her feet and calves extended over the edge of the bed. The caregiver and I were like a crowd at a sports event saying she could do it. We tried never to push her. Instead, we asked her to tell us when she was ready, and we would help. Finally, after 30 minutes, she was on her feet. We supported her. I know she would have fallen if we hadn’t. We helped her into a wheelchair. Then we asked if she would like to go to the bathroom. She said she did. We maneuvered her onto the toilet and were successful.

We were approaching time for dinner, and the caregiver and I decided to take her to the kitchen table to eat. It brought back memories of the past as she enjoyed looking out the kitchen window to the neighborhood. She ate a good dinner. Afterwards, we took her back to bed. It was just as difficult getting her into bed as it was getting her out, and she was tired. Since then she has been resting quietly.

Apart from my own excitement at seeing Kate sitting up for more than an hour, the caregiver was also excited. It was a mutual victory for the two of us, but I must add that it was a tremendous victory for Kate. It was her will along with our encouragement and assistance that did it. We couldn’t have done it without her determination .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Making Progress, But Not Out of the Woods

I am encouraged by the progress that Kate has made in the past week. One of the areas in which she has improved significantly is eating. She is now eating more “regular” meals and in greater quantities than she did the two weeks before. We went from one scrambled egg to two in addition to yogurt in the morning (actually close to noon). We had been relying heavily on soups for lunch and dinner. Now, we are getting her the same takeout meals that I get, and she is enjoying every bite.

Just as important to her caregivers and me is that she is protesting much less when changed. That doesn’t mean she likes it, far from it. She still tries to push us away from her, but her screaming and yelling has almost disappeared. It only comes at the moment we move her. For example, once moved to her side, she is quiet. It still helps that I am almost always with her. I continue to hold her hands to which she holds tightly. Two or three times I have put my arm around her and asked her to give me a hug while the caregiver pushes her over with one hand on her thigh and the other in the middle of her back. That way Kate turns very easily and we continue hugging each other until the caregiver finishes.

I must admit to a touch of sadness when I see her submit to us like this. She doesn’t like what is being done to her but has just given in. I wouldn’t like it either. It doesn’t take a long time, perhaps 10-15 minutes. Yesterday, however, the caregiver bathed her and also changed the sheets. The whole process took almost an hour. I think Kate and the caregiver may have handled it better than I did.

We are making the most of the Christmas season. As I did last year, I called on the woman who attends to our shrubbery to decorate the inside of the house using the decorations Kate has collected over the years. In addition, we have tuned in to YouTube much more than we have before. Yesterday, for example, we played Christmas music on the TV in our bedroom from noon until 8:00 last night. One of our caregivers also found a more beautiful fireplace video that shows a large portion of a nicely decorated seating area of a lodge with a large tree and a grand fireplace. I don’t know that Kate likes it any better than the one I had found before, but I do.

Our daughter, Jesse, was in town Saturday through Tuesday morning. It was a good visit for all of us. She felt Kate was much better than she had expected. She also had time to get acquainted with the caregivers who were here during that time. She was impressed with them and felt I was in good hands.

We had an especially touching moment on Sunday night when she joined us as I read The Velveteen Rabbit. I don’t believe I had known the book is a favorite of Jesse’s. As I read, Kate took Jesse’s hand in her right hand and mine in her left. She squeezed them periodically as I read. She still doesn’t talk a lot, but she is feeling and expressing her emotions.

Over the past week (until last night), we’ve had other wonderful evenings after the caregiver leaves. Kate has been relaxed and enjoyed the Christmas music and an almost nightly reading of The Velveteen Rabbit. Two nights I also read Love You Forever.

Not everything has gone the way I would like, but I think that is natural for someone who has experienced the kind of trauma she faced. The most significant thing is that she still has not gotten out of bed. We have talked about it, and last week, the physical therapist was able to get her sitting up for a few seconds. She came again on Tuesday, and Kate was too lethargic. That wasn’t too long after the caregiver had changed her. It sometimes takes her a while to recover. She is coming today, and we will try again.

As I mentioned above, our nights have gone very well until last night. She was a little upset when we changed her, but she seemed cheerful afterward. After the caregiver left, we watched a band concert in San Antonio in which our youngest grandson was playing. Her mood changed during that time, and she didn’t talk to me the rest of the evening. I even read The Velveteen Rabbit and didn’t get much response at all. When I reached the end, I thanked her for letting me read it and that I like the story. I was hoping to get her to say the same thing, something she almost always does. This time, she was silent.

This morning around 9:30, I noticed that she was running her fingers through her hair and went to see if she was awake. She was, but she didn’t speak to me at all. I went back to the kitchen and mixed her morning meds with yogurt and took it to her. She took it easily. Then I brought her some mandarin oranges. She ate a good serving of those. I took the dish back to the kitchen, and when I returned, she was asleep and still is at 11:30. I hope when we wake her shortly that she will greet us with a smile.

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Making a Recovery and Two Very “Happy Moments”

Kate is still a long way from a full recovery from COVID, but I’ve been encouraged by her progress over the past two days. Although she is still not out of bed, she is somewhat more accepting of the efforts of the caregivers to change her and move her in any way. Changing her is one thing with which I am still helping. We have found that my getting in bed with her and asking her to hold my hands seems to give her added security. Except for the actual move to her side and back again, she has been calm.

I will say, however, that changing her and the mattress pads (chucks) is no easy task even with my help. I continue to be struck by the little things that the caregivers know to get the job done. I would not have believed that they could change the bed sheets while Kate is lying on them if I hadn’t seen it for myself. Were it not for Kate’s strong resistance to being moved, it would be even easier.

She is eating more now, and her “plumbing” is working as it should. It took two attempts, but Senokot did the trick. In addition, crushing her meds has made pill time a breeze.

We are still dealing with a problem that occurred while she was in the hospital. I wasn’t with her during that time, but the reports of her behavior and what I have observed at home with all the new caregivers tell me that she has been traumatized by not having any idea of who these people are and why they are “pushing her around” so much.

That leads me to tell you about two very “Happy Moments” we had last night and the night before. For years now, our evenings together have been the most predictably good times of the entire day. I’ve always attributed that to the relaxed nature of our activities after dinner and ending when we go to sleep; however, the contrast between our days and nights has never been as great as it has been since she came home from the hospital. It was quite dramatic the past two nights.

During both afternoons, I played YouTube videos of Christmas music. Several of them were full concerts. Two nights ago we watched “Christmas in Vienna 2018”. That brought back a pleasant memory of December 2008 when Kate and I were in Vienna and attended a live performance of this annual Christmas program. I think Kate enjoyed the video as much as I did. She was happy, and so was I.

Last night, I watched the evening news after dinner while Kate rested. Then I got in bed with her and turned on YouTube again. Kate was exactly like her old self. She was fully at ease, and we were able to talk periodically, generally about our relationship and how good it was to be together. Last night, she introduced this conversation by saying, “I’m so glad you are here.” I interpreted that as a response to all the time she has spent with the caregivers during the day. I think it also makes a difference that she has had at least five or six new caregivers and only one who has cared for her in the past. She has been with us for over three years. Both nights, I ended our evening by reading (you guessed it) The Velveteen Rabbit. She was especially moved by it last night and expressed her pleasure throughout.

Before reading the book, I went back to YouTube and turned on a fireplace video. I’m not sure what motivated me to do that. I know that I had learned about them years ago, but it never seemed like something we might enjoy. It may have been the Christmas music we had enjoyed so much combined with Kate’s joyful mood. It was very much like a Christmas evening we might have had long before Alzheimer’s.

When I finished reading, I decided not to turn off the “fireplace,” and we watched the fire and listened to my favorite album of Christmas music sung by Chanticleer. Kate loved the fire. It actually created a slight glow in the room with the lights out. We talked another 15-20 minutes before calling it an evening, but they were special moments.

Moments like these are encouraging to me. They remind me of something that has been true over the entire course of Kate’s Alzheimer’s. She has gradually lost more and more of her abilities over time. That has been especially true in the past 6-8 months. With each loss, however, we’ve experienced moments like the past two nights. We don’t know, and have never known, exactly what lies ahead of us, but I am optimistic that we will continue to have moments like these. I might even try the YouTube Fireplace again. You can’t have too many tools in your toolbox.

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Current Thoughts on In-Home Care and Caregiving

Although I engaged the services of a home care agency over three years ago, Kate’s recent decline and then her bout with COVID have led to a radical change from the past. Previously, her caregivers had little responsibilities other than being with her. That is why I have always referred to them as sitters rather than caregivers or CNAs. They engaged Kate in conversation and helped her identify people in her photo books. I always had her meals arranged for her before they arrived. Frequently, they spent time with her as she ate, but they never had to fix a meal. Neither were they involved with toileting or getting Kate dressed or ready for bed. Much of the time they were here, Kate rested.

It’s a different story now. She has been bedridden since arriving home from the hospital. They need to change her underwear, try to keep her turned (which hasn’t been successful so far), bathe her, feed her, and, if we can, to get her out of bed and into a wheelchair and back again.

Since I have been home most of the time (8-hour shifts) they are here, I take note of the things they do for Kate and the skillfulness that training and experience provide. Although some people have encouraged me to bring in more help in the past, I had relatively few challenges that I felt I couldn’t handle. That is not so anymore. In the past, I never looked forward to having the caregivers. Now I am eager to see them. So far, I have been an assistant to them while they are learning more about Kate, but in the future, I envision their functioning pretty much on their own. When that happens, my role will be that of a manager/supervisor. That will be more comfortable for me.

It is too early in this new phase of in-home care for us to have anything like an established routine. Kate has been sleeping a lot. We monitor her via an iPad connected to the web cam that I’ve had a couple of years. We frequently go into the bedroom to check on her as well. When she seems to be awake, we make an effort to turn her, change her and/or get her up.

As for meals, I take responsibility for getting them. I’ve purchased a variety of soups, yogurt, fruit as well as bread and cheese for her cheese toast. I also bring in some of her favorite takeout meals. The caregivers generally put the meals together and feed her. So far, this is working although Kate is not eating as much as she did previously. The bigger issue is keeping her hydrated. We are depending heavily on apple juice and Dr. Pepper. She likes both of those.

From time to time, I have mentioned that as situations change, I am required to think about solutions to new problems. Usually they come one at a time. Since coming home from the hospital, the problems have multiplied. It’s not that they began at home. The hospital was having the same ones. That is why they never got her out of bed until her release after eight days.

This new world does lead to creativity. The caregivers and I have tried a variety of things without much success. One thing I thought of last night involves her lift chair that I bought this past spring. I am thinking about replacing her chair beside the bed with the lift chair. If we were able to get her from the bed to the lift chair, we would be able to get her up rather easily. Then it would be only a step or two back to the bed. Since the chair reclines as well, she would still be able to rest or sleep in it as she desires. It might be of more value to move her from the bed to the wheelchair. That is also under consideration. Of course, both options depend on our getting her out of bed in the first place.

I spoke with Kate’s nurse at her physician’s practice a few minutes ago. They ordered an Hoyer lift for us. That would also facilitate getting her out of bed. That might still require a fight, but her doctor has called in a prescription of Seroquel to ease her anxiety. I will pick it up as soon as the caregiver arrives.

I am obviously in a learning mode right now. As I suggested above, my personal skills and my “toolbox” have been up to all the earlier challenges, but it is time for some new tools. That is exactly what I am doing. It’s just that some tools can be difficult to access at a moment’s notice.

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Thanksgiving and the Day After

Because of the pandemic, I had expected our Thanksgiving would be different, but I had no idea that we would be so directly affected by COVID. As it turned out, however, it was a Thanksgiving for which I was truly grateful. Kate’s coming home from the hospital made all the difference in the world. The bonus was that she was much stronger than I expected and appeared quite rested.

I will say that her return didn’t go exactly the way I hoped. When I spoke with the doctor that morning (Wednesday), she said that Kate would probably leave around 3:00 or 3:30. I conveyed that to the agency. They said they would have someone at the house by 4:00. At first, I thought that might not give me as much time as I wanted to brief her before Kate’s arrival.

That turned out not to be a problem. At 4:30, I received a call from the hospital saying they were about to release her. It’s a 20-minute ride from the hospital to our house, so I was confident they would be here by 5:00 or shortly thereafter. She didn’t arrive until 7:30. The CNA was scheduled to leave at 7:00 but stayed until 8:00. My uneasiness about Kate’s getting home so much later than expected was immediately forgotten when I saw her.

Once she was in bed. I played YouTube videos that she enjoyed until after I had showered and was ready for bed. It was a lot like our lives before she left for the hospital.

Thanksgiving morning she was awake at 8:30 while I was in the middle of my morning walk. I went to the bedroom and found that she wanted to rest a little longer, so I finished my morning walk. Then I went to the bedroom where I spent the next two hours with her until 11:00 when the  CNA arrived.

Although Kate had met her the night before, I reintroduced her. Kate received her as she would a guest in the house. I told her that I thought we would need more help now and that Tisha was a nurse whom I had asked to be with us while she was recovering from her stay in the hospital. She accepted that without question and agreed that we would need the help. I don’t think, however, that she really had any concept of why Tisha was here.

I was especially pleased when we were able to get her out of bed about 1:30. By this time, she was tired and back in bed before 2:30. We put her back to bed where she remained the balance of the day.

She didn’t sleep much, however. She dosed a little but was awake in bed most of the afternoon. I thought she would go to sleep easily that night, but she was concerned about something she need to do and wanted me to help her. I could never understand what she was talking about, but her concern lasted a good thirty minutes or more. I took the approach of simply comforting her. I told her I would help her, and it might be better if we did that in the morning. I took her hand and told her I had missed her and was very happy to have her back with me. I talked about the fact we had been together so long that it didn’t feel right when we are apart, something with which she agreed. That conversation diverted her attention from whatever was disturbing her.

The next day (yesterday) she was wiped out. She rested the entire day except for those moments when Tisha changed her or tried to move her to a different position.

Two different nurses came by for intake interviews. One was from the new home care agency we are using. The other was from the Home Health agency. Apart from the information they gathered from me, they took Kate’s vitals. Neither was bothered by the fact that she was resting/sleeping so long and said we should let her rest through the day. Tisha and I did just that.

Kate was awake when Tisha left, and we spent a couple of hours watching opera videos on YouTube. It was a nice way to end the day. I was afraid that Kate would be awake all night, but that turned out not to be a problem. She went to sleep easily and slept through the night.

Today we have a new person who will be helping us. I hope she is as good as Tisha and that Kate will be awake a little more. As we’ve been doing, we’ll take it a step at a time and adjust accordingly.

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A Day of Anticipation That Ended in Disappointment

Yesterday began with a meeting with the owner of the new (to us) agency that is providing the help this week and in the future. This will be in addition to the three days a week now covered by our current agency. We had a good meeting. I feel very comfortable with them. That is especially true after my interaction with three of his staff last week. He was here about an hour. During that time, I gave him background on Kate and showed him the key areas of the house with which he and his staff should be familiar. He had a CNA prepared to be at our house at noon, but we decided I should call him as soon as I heard that Kate was being released. The nurse and the CNA were to head to our house for a brief orientation and to be present to greet Kate upon her arrival.

In the meantime, that gave me time to make a few preparations. When Kate’s mother lived with us, we had bought a steel ramp that we used to make it easy for her CNAs to get her down the two steps from our family room to our patio. Her mother passed away in 2005. It has been stored in our garage since then. Although it is very heavy, I was able to slide it across the floor of the garage and lift it in place on the top of two steps into the house.

Word about Kate’s hospitalization had gotten around, and I received a number of phone calls and emails offering support. This is the first time I have ever been in this position. I quickly learned something that I had only thought of before when it was someone else in our position. Some people hesitate to call because they may catch me at a bad time. My personal feeling as a recipient of such calls is that they are welcomed. I did have to cut short two or three when I received a call from the hospital or someone else with whom I was coordinating Kate’s return. I found the conversations themselves to be therapeutic. They also filled my day as I was somewhat nervously, but eagerly, waiting to see Kate for the first time in six days.

Shortly after 3:00, I received a call from Kate’s doctor at the hospital. She began by telling me it was her first time to see Kate and was trying to get a clearer picture of her “baseline” before COVID. I filled her in on the fact that she had been declining recently but had been able to stand and walk and was eating well. I explained that COVID had pushed her over the edge, and she had been very weak.

Then she told me that one of the things they had been monitoring involved a measure of muscle tone or strength. I wasn’t too clear on this, but it related to her ability to walk.  The measure had gone up to 700 from 200. The doctor thought it might have something to do with hydration. Kate has been on an IV to keep her hydrated, but she pulled it out the night before. They want to try again and see if they can improve the numbers before releasing her. She went on to convey that she didn’t want my expectations to be too high for her immediate recovery.

This was a gut-wrenching way to end a day of anticipation of Kate’s being back home with me. Perhaps, I will get better news today.

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Good News

I’ve made no secret of the fact that Kate and I have faced serious challenges during the past 10-12 days, but we are beginning to see rays of sunshine. My conversation with Kate on Sunday afternoon was one of those. Yesterday, I continued to see a few things falling in place that will ease our burden significantly.

Yesterday morning, I received a call from the new agency with which I have been arranging additional help for this week and in the future. They confirmed that they have someone who can be with us today through Friday and then again on Sunday while they continue to locate a person for Saturday. They will be here from noon until 8:00 p.m. each day. I chose that time period because those are the hours that Kate is usually awake. She rarely gets up before noon these days and is normally in bed by 7:30 or 8:00. As with so many other things we have faced, flexibility is essential. If this schedule doesn’t work out, I’ll change it. I also contacted our existing agency to increase from four hours each visit MWF to eight.

Of course, the best news is that Kate is coming home today. I suspect that will be this afternoon. They are supposed to call me regarding a time. She will be coming home by ambulance.

When I spoke with the hospital yesterday, they said they are recommending the full plate of services for Home Health Care paid by Medicare. I don’t know that Kate will need or qualify for all of them. We will learn about that after her assessment. I spoke with a representative yesterday. He is awaiting my call to tell him when Kate is coming home.

So, how am I feeling about all this? The truth is that I am hopeful and a little sad and apprehensive about what lies ahead. I want to think that Kate’s strength will eventually improve to her pre-COVID level, but I am not confident since she had been on a steep decline in the preceding weeks. The fact that she has been bedridden for nine days is of concern as well.

I am also uneasy about her overall mobility. Will this experience be the catalyst that makes her wheelchair bound? If so, that will be a dramatic adjustment for both of us. It would obviously make if more difficult for us to get out and about. That doesn’t mean we can’t do it. I see people in wheelchairs almost everywhere we go. If others can adapt to it, we will as well. I am confident of that.

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Our First Crisis

As noted in a post last week, I have been having greater difficulty getting Kate out of bed for the past few weeks. That became a more serious issue this week and represents our first real crisis. Here’s the story.

Wednesday or Thursday of last week, I noticed Kate was coughing periodically. Then I felt the first signs of a sore throat Friday night. The next morning my throat was worse. I recalled that a sore throat was one of a number of symptoms of COVID. I decided to be tested and went to a nearby pharmacy that afternoon.

Sunday.

I felt better and began to think that I simply had a traditional sore throat. This reinforced my belief that it might not be COVID. I hadn’t had any other symptoms like fever, congestion, or any breathing difficulties.

Monday,

I was beginning to believe I was out of the woods, but I wasn’t able to get Kate out of bed.  I had already cancelled my help for Monday afternoon because we were on quarantine after getting the test.  She was very weak and couldn’t help herself, and I was unable to do it alone. I called 911 to send someone to the house to get her up, to the bathroom and back to bed.

Tuesday.

Tuesday I felt like I was recovering from a cold. I was encouraged, but I had to call 911 again for help getting Kate to the bathroom. It was late in the day when I received the news that I tested positive. That was a low blow that began a crisis that hasn’t been solved; however, I had already contacted her doctor on Monday and continued be in contact with them several times a day.

Given Kate’s weakness and that my problem getting her out of bed might worsen rather improve, I also contacted the agency that provides the regular help I have on Monday, Wednesday, and Friday. I asked if they could find someone to help on Tuesday and Thursday. They said they would  try.

Wednesday

I made an effort to get Kate up between 11:00 and noon. Once again, I could not get her out of bed. She was very weak but was able to speak clearly to me, something she wasn’t able to do the day before. Based on her doctor’s instructions, I had been checking to see if her breathing was labored. She was all right, but at 1:15, I thought she was breathing a little more heavily. I talked with the doctor’s nurse who listened and said she would get an opinion from the doctor who said to take her to the ER.

I called 911 to take her to the hospital. It was difficult even for the two ambulance attendants to transfer her from the bed to a wheelchair and finally to the cot in which she rode to the hospital. This process was painful for Kate and for me as well. It was awful to see how frightened she was to be hauled away by two strangers and having no idea what was happening and where she might be going. As they put her in the ambulance, I couldn’t help wondering if that might be the last time I would see her even though there were no life-threatening signs at the time. She certainly didn’t show any lessening of strength as she tried to fight.

That afternoon I called our agency to inform them of Kate’s diagnosis. That meant they will not provide any help for us next week. It will be Monday of the following week before they can send the regulars back and any added help for the other days.

At 6:00, I spoke with the doctor who had replaced the one on duty when she arrived. She told me that Kate’s vital signs including her breathing were normal. They had drawn a sample of blood and sent it to the lab and would know later if they found any problem. She also said they were going to send her to a Step Down unit or floor where she would be put on a heart monitor.

At 10:00, I spoke with the nurse in the Step Down unit. She confirmed that Kate was there and that she was resting comfortably.

I ended the day with serious concerns about what I would do for help when she returns home.

Thursday

At 6:00 that morning, I called to check on her. Fortunately, her nurse answered the phone. She told me Kate had eaten breakfast and had a bath. She also mentioned that Kate was enjoying the music they were playing for her on the TV. I was pleased to hear that because I hadn’t mentioned the importance of music to her.

During the morning, I placed phone calls to our current agency and the new agency that I am talking with. I got encouragement from the new agency and hoped to hear back before the end of the day if they might be able to help us.

I received a call from her Step Down nurse at 5:00 telling me they were transferring her to a new floor that should be her last room change. She also gave me the new room number as well as the phone number for the nurse’s station. This was just the kind of nurse a family member wants. She seemed informed on Kate and very compassionate toward Kate and to me. She didn’t make me feel I was intruding on her time to ask how Kate was doing.

At 9:45, I called the nurses’ station to make sure Kate was in her new room and how she was getting along. Her nurse said Kate was already in her room when she arrived at 7:30. Kate was very confused – didn’t know her name, where she was, and was hard to understand. I told her that was not new with COVID. I see that frequently. In a sense, she is at least somewhat confused all the time but not always to the same degree. She knew that Kate has Alzheimer’s but didn’t seem to know any more than that. I gave her a brief background so that she would be able to put in context the behavior she was observing.

Friday

I spoke with her again this morning before she left at 7:30. They gave her a light does of Atavan to control her agitation, and Kate slept well during the night. Last night, I began to wonder if they had all her medications. I had assumed so because Kate’s full medical records are available to the hospital, but things don’t always go the way they are supposed to. I was especially concerned because we have made several recent changes. The nurse asked me to call back later when the new shift had had time to be briefed do some of their initial duties after check in. I plan to do just that.

I feel I should comment on how I am feeling. The best general answer is that these have been the most stressful days since we began “Living with Alzheimer’s.” Nothing else that has happened over the past ten years compares. It isn’t simply my reaction to Kate’s having the virus. It is what she has had to go through to get help. She is frightened by many little things like the noise of ice dropping the ice making into a glass. Being hauled out of bed and being transferred from bed to the ambulance to the hospital and three different rooms with different people must have been traumatic for her.

Beyond that, the biggest problem I now face is what to do for her when she is released. Our agency will not provide care for her until 10 days after her diagnosis. That means no help at home next week. I am talking with another agency that looks like it may be willing to fill in, but finding additional help is a challenge for all home care agencies in our area.

I had a conversation with our daughter, Jesse, last night. She has offered to come from Virginia although she and I want to make sure that Kate and I are definitely free of the virus before she would do that. In the meantime, I have also spoken with the care coordinator at the hospital about options for Kate. We will be talking again soon, I hope.

The good news is Kate’s vital signs and blood work show nothing abnormal. It seems that both of us have mild cases. Her symptoms have been a cough and weakness. For her, weakness is the major problem. She had started this before the virus, but I feel the virus exacerbated her decline. Once she is well, she may be somewhat stronger, but I suspect that she may continue to weaken. There are some things we cannot avoid.

Kate’s overall decline has been more dramatic this year and has taken a more significant drop in recent months and even weeks. January will mark the tenth year since her diagnosis in 2011, and we had observed the first signs at least five years before that. We have been very fortunate to have lived so well despite her Alzheimer’s; however, neither of us was ignorant of this part of the journey. I am not happy to be where we are right now but very grateful for the joy we have experienced in the past. I also believe we will have more “Happy Moments” together in the future even though the remaining time is likely to be punctuated by more troubling experiences like this one.

 

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Sunday Incidents That Are Hard to Predict

I’m not sure at all, but it looks like Kate might be moving toward a schedule to sleep later on a more regular basis. That may relate to the fact her doctor put her back on Trazadone to see if we might be able to stop her erratic sleep pattern and, possibly, the recent trouble I have had getting her ready for bed. It’s too early to tell, but she has slept later everyday since starting her Trazadone.

There are always other things that get my attention and deserve an appropriate response. Yesterday, I got her up about 12:45. She was in a good humor and got up rather easily though getting her out of bed is beginning to be a problem. It is hard for her to sit up on the side of the bed, so I hold her right hand with mine and put my arm around her back just below her shoulders. It isn’t as easy for both of as I would like. It’s tough to lift her with my arm under her back, and Kate doesn’t like my doing it. She screams as she reaches a sitting position. This may be a problem with arthritis, but she only complains of it in that moment.

Once she was ready, we were off to pick up a takeout lunch from Andriana’s where we usually eat on Sunday. Everything was going well until getting home. So well, I didn’t expect what would happen next. When I opened her door to get out of the car, she sat there as though I were going in the house by myself. I said, “Let’s get out of the car and eat our lunch.” She didn’t say anything. She just sat there looking straight ahead. I extended my hand and asked her to take it. She was silent. For a couple of minutes, I tried to interest her in going in the house with me. She told me she would just sit there. The look on her face told me she was bothered by something (likely “someone”) that she thought was inside. I asked if she could tell me what was wrong. She gave her typical reply, “I don’t know.”

As usual, I didn’t push her. I just told her I would go ahead with my lunch and to call me if she wanted to come in. I went in and set the table for us and got drinks ready. Then I went back to see if she would like to come in. She came with out a problem. She didn’t seem disturbed once inside, but she ignored the food on her plate. I always cut her meat, use her fork to pick up the first and gave it to her. She liked it. I got another piece and placed the fork on the table and told her she could enjoy the rest. For several minutes, she didn’t eat or drink anything. She just sat there. I asked her about it. She asked where it was. I told her it was on her plate right in front of her. She made no effort to eat. I made several more efforts, but she just sat there. She seemed all right except that she wasn’t talkative and made no attempt to eat.

I went ahead with my meal. I had a salad first. When I finished it, I got up to rinse out the container in which it came. I walked to her and fed her another bite. She ate it. When I asked if she liked it, she said she did. On the way back to the table, I stopped and fed her another couple of bites. She ate them willingly and seemed to enjoy them. She didn’t eat anything after that.

I finished my meal and cleaned up and returned to the table to sit with her. As I had done before, I gave her several more bites. Then I sat with her for the rest of the meal. It must have been 5-10 minutes before she took her first bite, but she continued to eat until there were only a few bites left.

When she was through, I asked her to come with me into the family room where I wanted to show her something. She didn’t respond. It was just like she was in the car. She just sat there without saying anything or making any effort to get up. I told her I was going to the family room and told her I would like her to join me when she would like.

She remained there for about thirty minutes when I went back to ask if she could join me, and she accepted. We looked at one of her photo books a short time before having Zoom call with our daughter and son. She said very little while on the call and closed her eyes for most of it.

She surprised me again when I ordered a takeout meal and asked her to come with me to pick it up. It was one of her passive-aggressive responses. She wasn’t rude or hostile. She just said she wasn’t going. She was right. I phoned and cancelled the order.

We weren’t that hungry anyway because we had eaten so late, so we skipped dinner and retired for the night. We got in bed and watched a series of YouTube videos of musical performances and enjoyed them together. It is unusual for us to watch TV in bed, but I just thought it would be nicer than sitting in our chairs. It was a great way to end the day.