I can’t prevent attacks of anxiety, but they don’t last.

When I went to the bedroom to wake Kate yesterday, I found that she was having another anxiety attack. She was frightened and looking around the room for something that seemed familiar. I recognized the problem without her saying anything. I said, “I’m sorry I didn’t know you were already awake. I’d like to help you if I can.” She said, “Where is my maybee?” I told her I didn’t understand. She realized she wasn’t using the right word and tried again. Then she said, “My mother.” I said, “I can tell you about your mother.” She said, “Do I have a mother? I want my mother.”

We talked a few minutes about her mother. Then she wanted to know where her clothes were. I brought her clothes to her and told her I would help her dress. I suggested that she first go to the bathroom. As we walked to the bathroom, she asked again about her clothes and said, “I see other people, and they all have clothes on. I want my clothes.” I said, “You are right. You’ll want your clothes when we go outside.” She said, “See. I’m smart.”

This was one of the many times I wish that I had recorded or could remember exactly what she said. I can only try to capture the sense of what happened. It is not unusual for her to tell me she is smart. Although sometimes she makes it clear that she wants me to understand that, I believe she is also telling herself that she is smart even though she recognizes her problems. In this particular conversation she commented on understanding a word I had used and also one that she had used herself. I don’t recall either one, but she said, “See, I remembered that.” She was also proud that she put her top on the right way.

When she was dressed, I told her I wanted to take her to lunch. She said, “I want to go home.” She says this occasionally when she wakes in the morning. I usually tell her she is at home, and she accepts that. Sometimes she doesn’t believe me, and I try to redirect her attention to something else. In this case, I told her I would take her home, but I wanted to show her something before we left.

Then I went through the same routine I had done the day before with photos of her family. Once again, she noticed Pepper, the ceramic cat, as well as the flowers on the patio. She asked if we could walk outside to get a better look. We took a few minutes to do that and then left for lunch. She no longer showed any signs of anxiety. She didn’t, however, know who I was. When she was dressing, she asked if I were her daddy. I told her I wasn’t and that I was her husband. She didn’t believe that. I said, “Let’s just say I’m a friend.” She liked that better.

On the way to lunch, I played an album of music by a group that had played the Four Seasons in Jersey Boys. She enjoyed the music and clapped her hands on her legs and also moved her hands around the way she might have done if she were dancing. She had a good time.

She was talkative at lunch. It wasn’t long before we began to talk about our relationship. She specifically said something about our being married. The rest of the lunch and the day went very well. She showed no anxiety or doubt about me and our relationship. I will say, however, she often slips back and forth between knowing our relationship and not. I don’t quiz her all the time to know when she knows and doesn’t know. I almost always make a judgment based on the way she relates to me. During the afternoon and evening, it seemed like she did know me as her husband. Once again, we had moved from a moment of anxiety to feeling at ease. This reinforces my belief that she just needs to be exposed to things with which she has been familiar. Then the anxiety disappears.

Yesterday was a good day.

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

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

Unpredictability

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

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

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

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

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

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

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

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

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

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

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

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

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

Another, But Milder, Morning Experience

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

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

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

Trying to Understand Kate’s Expressions of Her Feelings

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

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

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

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

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

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

Another Milestone in Our Journey

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

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

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

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

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

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

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

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

I spoke too soon.

Not long after uploading my previous post, I went back to the bedroom. I saw that Kate was awake and walked over to her. She was having a similar, but milder, attack like those she experienced the past four mornings. I said, “Are you all right?” She said, “I think so. I don’t know.” I told her I would like to help her if I could. I asked if she would like me to bring my laptop to the bedroom and stay with her. She nodded. I returned and put on some music.

She never went back to sleep. I doubt that she had been to sleep since getting up to go to the bathroom at 7:45. Around 9:30, she sat up on the side of the bed. She was still confused, but she didn’t seem to be troubled the way she was earlier. She said, “What now?” I told her I thought it might be good for her to get dressed and get her something to eat. I mentioned getting a muffin. She didn’t say anything, but she looked as though she had never heard of a muffin.

I helped her to her feet and told her I wanted to show her something. We walked hand-in-hand to the hallway outside our bedroom. We stopped at a picture of her grandmother. I told her this was somebody very important to her. Then I explained that she was the first member of Kate’s family to attend TCU. She was pleased about that. I was glad to see her response because a few days ago I mentioned TCU, and it didn’t mean anything to her. That was a first.

After talking with her about her grandmother, I focused her attention on the next photo. It was her mother when she was around 19 or 20. Kate didn’t recognize her but was taken with the picture. As she often does, she noted her mother’s eyes and smile. She commented more extensively than usual on this and other pictures that I showed her. I can’t remember exactly what she said, but she interpreted her mother’s personality based on what she saw in her mother’s face. By this time, she seemed just fine.

We went on to two other photos, one of her grandfather on her father’s side and then her father. From there we walked into the family room where I showed her a picture of our daughter’s twin boys when they were about 5 or 6. As we entered the room, she said, “You’re really helping me.” She always likes children whether in person or photos. Thus, she was enthralled at the twins’ picture. Again, she tried to interpret their personalities from what she saw.

I took her to the sofa and asked her to sit down so that I could show her something else. I picked up the “Big Sister” album and called her attention to the cover picture. This time she didn’t recognize either herself or her brother, but she was taken with the children, especially their eyes and smiles.

We talked about them for a few minutes. Then she said she was cold. She was still in her nightgown and bare feet. I suggested we get her dressed. I helped her stand up and, as we walked to the bedroom, she said, “I’m bouncing back thanks to you.” I was particularly struck by her recognition that she was “bouncing back.” It had been thirty minutes since she had gotten out of bed. I was surprised that she could remember how she felt that long ago. Once again, we had found our way out of what might have been a crisis. It’s a relief when this happens.

Another Morning of Anxiety

As I have described the past three mornings, yesterday Kate’s memory was almost completely blank again. In some ways this isn’t unusual. Over the past year she has often not known where she is or who she and I are when she wakes. The difference the past few days is the anxiety that accompanies it. In the past, I would tell her. Then she seemed to be all right even though she might ask the same questions again right away. During each of the past few days she has been more concerned, even frightened, about not knowing these things. The first experience on Saturday was the most intense. It also lasted an hour.

Her experience yesterday was different in that it was milder and shorter in duration. She was very sleepy. I didn’t attempt to show her any pictures of her family. I focused primarily on comforting her. I did play the same music I had played the previous days. I got in bed with her. She began to relax and fell asleep within fifteen minutes. I brought my laptop back to the bedroom and stayed with her until it was time for lunch. She was fine when I got her up.

We met one of our associate pastors and his wife for lunch at Casa Bella. Kate has always liked him and his wife. She wasn’t talkative, but she enjoyed being with them. They probably would never have imagined the state she was in a little earlier. Her ability to bounce back is another way in which we have been fortunate.

This morning at 7:45, she started to get up. I went to the bedroom. She was unusually alert and seemed like she didn’t need my help. I walked her to the bathroom and back to bed. She thanked me and said, “You’re really a nice guy.” She is asleep again. We’re off to a good start. I’m hopeful that she will be fine when I get her up for lunch.

Morning Confusion Continues

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

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

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

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

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

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

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

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

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

A Better Day, But Moments of Confusion

The way yesterday started was far better than the day before. I woke Kate just before 11:00. She smiled and was at ease. She was enjoying the music I had selected, but she wasn’t eager to get out of bed. Once she was up, everything went smoothly.

While we were eating, she said, “I don’t even know who my parents are?” She said this without any obvious sense of anxiety. It was said as though she were telling a friend about her having grown up without parents. As I told her about them, she was amazed and said, “I didn’t know any of this.” This conversation continued off and on throughout our meal.

We also had a slight rough spot during lunch as I was eating a bowl of tomato basil soup. When our server placed it on the table, she said the bread was better when dipped in the soup. Kate was eating bread at the time. I asked Kate if she would like to try it. She dipped her bread in the soup and then asked me to put some soup on her bread plate. I did, but she didn’t use it. Thinking she might not have noticed, I asked if she was going to dip her bread in it. She didn’t understand what I was talking about. I explained that she had asked me to put some soup on her plate for her bread, but she wasn’t using it as a dipping sauce. She felt as though I was scolding her, got a sad look on her face, and apologized. I told her she hadn’t done anything wrong; it was just a case of miscommunication. She was hurt, but it didn’t last long.

On the way home, she mentioned that she didn’t know her name. I told her and then mentioned her parents. She wanted to know their names. After telling her, she asked if I knew them. Then she asked if they knew her. I explained that they did and that they had loved her. Then she asked if she had ever known them. She showed none of the fright she had the previous day though she clearly conveyed a sense of regret about not remembering them.

She was tired when we got home and wanted to lie down as soon as we walked in the house. I got my laptop to jot down a few notes and sat in a chair across from her. In a few minutes, she began to cry. I walked over to her and asked what was wrong and if the tears were those of joy or sadness. The answer was joy. She said, “This is the first time I have ever really felt at home.” I didn’t push her to explain. I was just glad she was happy.

Before going to bed, she spent quite a while, at least twenty minutes flossing and brushing her teeth. She said she thought she needed to see a “doctor.” She feels something caught between her teeth and can’t get it out. I helped her floss but didn’t detect anything. I don’t know why, but I don’t see a dental appointment on my calendar. We always make one at the end of each visit. I’ll check on that this morning.

After she was in bed, she started pulling her hair as she does so often. It wasn’t long before she said, “Richard, (yes, she called me by name).” I said, “Yes.” She said, “I want to thank you for your patience.” I told her I was just happy to be able to help her. A few minutes later, she called my name again and said, “You know what makes it all worthwhile?” I said, “What?” She said, “You.” I said, “And you make my life complete. We made a good decision when we decided to get married.” In another few minutes, she said, “Hey!” I said, “What?” She said, “I’m glad to be here with you.” She repeated this five minutes later. This should give you a taste of one of the reasons I say that we have gotten along “remarkably well.” She is so appreciative, and I am working to be sure that she stays that way.

She was talkative when I joined her in bed. She continued to pull strands of hair for a long time. She said it was a lot of work to do this, but pays off in the end. She also talked about her teeth. She said it’s a small problem when compared with the big problems that so many other people face. She was very relaxed and happy. It was a great way to end the day.