Ken and Virginia’s Visit

Today is the last day we have with Kate’s brother and his wife. The visit has gone well. We have focused on being together. Except a short drive through the continuing care retirement community that we will be moving to next year, we haven’t done anything special apart from eating out. I was interested in learning more about Ken and Virginia’s move to a similar community this past November. They seem to have adapted well. In their case, it involved a change of cities. They are now closer to family. We have had time for conversation.

I was especially pleased when Kate and Ken had an hour or so to look through a book he had recently given her. It contains a large collection of photos of their hometown of Fort Worth. Virginia and I adjourned to the living room, so we couldn’t hear their conversation. The fact that they spent so much time was a good sign that Kate enjoyed it. This was right after returning home from lunch yesterday. That is a time she normally rests. They finally stopped because she was tired. Ken mentioned that she also began cry as he read and told her about several of the photos. One involved the deaths of a basketball team many years ago.

It helps that Virginia and Ken are sensitive to Kate’s need to rest and have gone back to their hotel an hour or two each day. They understand that she has to work hard to keep up with a group. We have followed our daily routine though she has gotten to bed later at night. I think it is good for her to have a little extra stimulation. I feel very strongly that she and Ken should make the most of this visit. The next one is likely to be very different.

The only concern I have had is maintaining Kate’s involvement in our conversation. Virginia and I are the talkers in the group, and we have dominated. There is a certain inevitability to this. The nature of the conversation has to be rather limited for Kate. I also recognize that she is approaching a time when it won’t be possible for her to join in a conversation no matter what the rest of us do; however, I don’t want her to feel excluded from the group.

What makes for a good day?

It is far from unusual for me to say that Kate and I have had a good day, but what are the elements that make it so? Number one on the list is Kate’s happiness. My contact with other caregivers suggests that I am not unique. Whether caring for someone or just living with someone who is perfectly healthy, one’s happiness is vitally linked to the feelings of the person you love. Fortunately, Kate is typically happy.

There are a number of other things lead me to say we’ve had a good day, and they all play a role in Kate’s happiness. They include my not having to wake her, getting up early enough to make a trip to Panera and return home for a rest before going to lunch, having a rest after lunch, and having time for other pleasures like looking at photo books, reading, social interaction with friends/family, and events like our music nights at Casa Bella.

That is exactly what happened yesterday. Kate woke up on her own before 8:30. She was in a cheerful mood, and we were at Panera about shortly before 9:30. She was tired from getting up early and ready to go home at 10:00. She rested for an hour. Then I told her I would like to take her to lunch. She thought that sounded like a good idea. We went to one of our favorite lunch places and came back for another rest for about an hour and a half.

When her rest was over, I suggested we look at her “Big Sister Album.” While we were going through it, Ken and Virginia arrived. The flew in from Texas for a long weekend visit. It was our first time to see them in a while. We enjoyed visiting with them and then went to Casa Bella for Broadway Night. It was an excellent program featuring music from the 1940s. We were familiar with every song. To top it off the singers and accompanist were quite good. We don’t normally pack in this much in a single day, but it was all done at a leisurely pace. It was a good day.

Reflecting on our Son’s Visit

Since I first informed our son, Kevin, and our daughter, Jesse, of Kate’s diagnosis five years ago, Kevin has made a point of visiting us for long weekends several times a year. I am sure that he has benefitted by making the most of his time with Kate. It has also given me a lift and provided Kate with much pleasure as well.

During his recent visits, her memory of him has faded. That means she hasn’t had the pleasure that accompanies the anticipation of his coming. She does, however, enjoy his presence and connects with him as though she recognizes him as her son in the same way that she relates to me when she doesn’t remember that I’m her husband. She is very at ease with him.

During each visit there are special moments. Their time together on the afternoon of his arrival was one of those. They spent about two hours looking through one of her family photo books. It was the kind of experience I had hoped might occur after I informed both children about Kate’s diagnosis five years ago. I went to the grocery store when they first started. When I returned home, I let them continue this personal time to themselves but joined them a little later.

Of course, life isn’t a constant stream of such moments. Our lives consist of many routine activities that, by themselves, don’t mean anything special. When they are shared with people you love, however,  they are special in their own way. Kevin’s visit was a good example of that. He was here for his high school class reunion, so that was a highlight for him. His time with us, however, was spent going through our activities of daily living.

As Kate’s care partner and Kevin’s father, I am glad that he was able to catch a glimpse of what our lives are like. Since he lives almost 1200 miles from us, it’s hard to know what is really going on. He actively reads this blog, but I felt even that might not fully convey what living with Alzheimer’s means for us.

You might ask why this matters to me. It goes back to the time when my father was caring for my mother who had dementia. The last eight years of my mom’s life, my parents lived right here in town. I was with them a lot, but I didn’t know as much as I should have. I have only realized that as I have cared for Kate. Dad never shared much about his life as a caregiver or Mom’s as a person with dementia. I want our children to have a better understanding of our lives. That was a major factor in my starting the journal that eventually became this blog.

In addition, our son is a care manager. His whole career has involved caregiving. It seems appropriate that he should be fully informed about his parents’ situation. Not surprisingly, he has taken a genuine interest in staying in touch as Kate’s Alzheimer’s has progressed.

Although not in a career that deals specifically with caregiving, our daughter, Jesse, works a lot with seniors and takes a great interest in their lives. I also want her to know about us.

That said, Kevin’s visit was an especially good one because he got to see a very representative snapshot of how Kate is doing and the way in which I care for her. During past visits, her symptoms were much less noticeable. She has changed significantly since he was last here in March. He saw how much her memory has faded. He also was here when she didn’t want to get up in the morning and her desire to rest in the afternoon. What is more important to me is that he could tell how much we still enjoy life and each other.

Because Kate slept late while he was here, he and I had an opportunity to talk about our mutual observations. I am often concerned that my blog posts don’t adequately express what our lives are like. I was pleased to hear him say that he thought there was a pretty good match between what he had read and what he observed for himself.

Since his career is in eldercare, I was eager to hear how he thought our own experience compares to that of other couples living with Alzheimer’s or another form of dementia. My personal impression is that we have been exceedingly fortunate compared to most others. He confirmed my impression.

We were also able to talk about the future. We discussed my plans for a move to a continuing care retirement community in another year and a half. I also told him my own desire to work closely with him as well as Jesse as I get older. My exposure to the caregiving memoirs of children caring for the parents has sensitized me to the problems that can arise. In particular, parents often share very little about things their children will need to know when the parents require help. I would like our relationship to be a smooth one with as few surprises as possible.

Considering all these things, Kevin’s visit was a very good one. His attentiveness both in phone calls and visits has strengthened our relationship and set the stage for a bright future.

Three Days in a Row with More Confusion Than Usual

After getting up early and taking a shower, Kate went back to bed yesterday morning. As she had done the day before, she got back in bed after her shower and didn’t want to get up. I was going to my Rotary meeting, and Kevin was taking Kate to lunch as he has done on other visits.

Although she seemed to recognize me when she got up the first time, she didn’t when I tried to get her up later. She asked who I was, and I told her my name and that I was her husband. She didn’t believe me. As I usually do, I backed away from trying to convince her. I decided to focus on getting her dressed. We immediately ran into a problem. She was still undressed following her shower and was uneasy about letting someone she didn’t know help her with her clothes. I didn’t push but continued to talk with her. She asked about her clothes several times. I told her I had them right there on the bed and would help her get dressed. She finally consented. As she was dressing, I told her that Kevin was here and would be taking her to lunch. She didn’t know who Kevin was. I explained, but I wasn’t successful. I told her she would recognize him when she saw him.

As it turned out, I was right. At least she acted as though she “knew” him. That didn’t mean she remembered his name or that he was her son. She did, however, greet him happily. Then for a few minutes she gave her attention to the flowers inside and outside. She followed that by asking his name. Then she commented on his voice. She said, “You sound like a nice guy. I don’t know why I say that. I just sense it.”

We went into the kitchen where I had put out her morning meds. While she was taking them, she asked again about Kevin. I told her that he was our son. She found that hard to believe and asked Kevin. He confirmed what I had said, but she was still skeptical.

When we got to my office where I was meeting a colleague, Marianne, I told Kate I would be going to Rotary and she would be going to lunch with Kevin. She said, “Why don’t you go along with us?” I told her I could have invited her to attend my Rotary meeting but thought she might not enjoy it. She agreed, but she still looked like I was deserting her.

After lunch, we met back at the office and then went home where she rested until it was time to take Kevin to the airport for his flight home. From there we went directly to dinner. Once we were home, she wanted to rest again. She rested until 8:00 when I suggested we get ready for bed. I got the impression that her memory of me as her husband was “on again” “off again” for the rest of the evening, but she wasn’t like she was during the morning. She clearly was quite comfortable with me and showed complete trust in me though she had been suspicious in the morning. I don’t think I observed anything that I hadn’t seen before; however, the depth of her confusion seemed greater than I have noticed before. I think she was quite confused much of the day but still functioning pretty well. She even surprised me on the way home from dinner when she made an observation about the two of us. She said, “When you say silly things, I don’t get mad at you. I know you are just trying to be funny.” She may not know my name or our relationship, but she has a keen insight into my personality. She “knows” me.

A Good Day But a Lot of Confusion

It’s hard to summarize in a heading what yesterday was like. Bare with me as I try to explain.

The day began differently than others over the past few weeks. She has been getting up rather easily when I woke her sometime between 10:30 and 11:00. There have been three or four days when I didn’t have to wake her at all. She waked up on her own at earlier times. In fact, it was earlier enough that we made it to Panera three or four times over the past week or ten days.

Yesterday was different. I was about to get up at 5:50 when she wanted to go to the bathroom. She didn’t display any of the confusion she has on some occasions, but she sounded relieved when she said, “I am glad you are here.” She repeated that a couple of times on the way back to bed. I quickly decided it was best if I got back in bed with her. It was the right thing to do. She was feeling insecure over not knowing who she was, who I was, or where she was. I stayed with her until 6:50. Then I got up to prepare for the day. She was still awake when I left the bedroom. I told her I would be in the kitchen. She was completely comfortable with that.

Before I ate breakfast, she started to get out of bed. I went to the bedroom and found that she wanted to get dressed. It was still early, and I asked if she would like to take a shower. She did. When she was finished, she went back to bed. The fact that she had gotten up and taken a shower so early led me to believe I would have no trouble getting her up for lunch. I was wrong.

We have not been to church in almost a year and had planned to take Kevin with us. To insure that we would be on time for the 11:15 service, I went in to wake her at 10:00. She didn’t want to get up. I decided not to push her. I went back around 10:20. She was firm in her intention to remain in bed. Kevin and I changed our plans for church. I made a noon reservation at Bonefish Grill. Finally, I went back to wake her at 11:00. She still didn’t want to get up, but she gave in with a little encouragement. She wasn’t happy about it, but her mood quickly changed when she saw Kevin as well as the flowers and pictures in the family room.

She surprised me at lunch when she expressed displeasure that I didn’t order a salad for her. I never order a salad for her because she doesn’t enjoy salads. She has never complained before. I offered to get her one or to share mine, but she didn’t want anything but two of my olives.

I wasn’t surprised that she wanted to rest when we got home, but, as usual, she got up rather easily when it was time for us to leave for a live performance of Hello Dolly at one of our local theaters. She did surprise me, however, during the intermission when she struck up a conversation with a man in the lobby. He was standing by the three of us and told us he had first been to this theater when he was a child. Kate asked him what he did. He told her he was a retired radiologist. Kate said, “What’s that?” He began to explain by giving her a tidbit of history including the early experiments of William Roentgen. Kate expressed interest and complimented him about the contributions that he (the man she was talking with, not Roentgen) had made. He tried to play down his own work, but she insisted she accept her compliment. I found it a most interesting conversation. Except for not knowing anything about radiology and x-rays, she seemed quite normal. She was a very active participant in a conversation with a total stranger.

After leaving the theater, we stopped by a pizza place that had been a favorite of our children’s when Kevin would have been as young as two or three. We finished the meal by sharing a piece of cheesecake. Kevin and I didn’t waste any time sampling it. Kate apparently didn’t notice it was sitting in front of us. I put some cheesecake on her fork and placed it on her plate. She still didn’t eat it or acknowledge that it was there. I pointed it out, but she couldn’t understand what I was trying to tell her. She put her plate aside and pulled the plate with the cheesecake toward her. I explained that I had already cut a piece for her. Again, I showed her the fork with the cheesecake on it. She was still confused. After several tries, she finally understood.

When we got home, she asked what she could do. I handed her the iPad and suggested she work on it. She said, “What’s this?” That was not an unusual response. She almost always takes interest in her iPad, but she often doesn’t know what it is. When I mention that she can work puzzles on it, she understands. That is what happened last night. On occasion, she is confused as to what she should do after the puzzle pieces are scattered. Last night was one of those times. I explained, and she went to work. She had a very difficult time. I don’t recall her every having more trouble before. In my effort to help, I may have exacerbated the situation. I was trying to be patient, but I realized the tone of my voice was stronger than usual as I pointed to specific pieces and then to places where they should go. That probably frustrated her even more. I decided it was best if she dropped the puzzles for the night.

Then she picked up a word puzzle book on the table beside her. I noticed that she was holding it upside down. She seemed confused. I turned it right side up. Then she put it aside and picked up the coloring book I had bought her months ago. She has never shown any interest, but I have kept it on the table beside her chair in the family room since then. Once in a while, she picks it up and looks at it. I picked out a crayon and gave it to her. She wasn’t sure what to do with it. I gave her what was an insufficient explanation. Then I decided it was better to demonstrate. I colored a small teardrop object on the page and gave her the crayon. From there she took over and colored for the next twenty minutes or so before it was time to get ready for bed. I was pleased that she was interested and hopeful that she may try it again. That could be a good replacement for the iPad as she loses her ability to work her puzzles. I was also discouraged when I watched her color. She didn’t appear to know what to do. What she colored looked like something that a young child might have done. The most important thing, however, was that she found something she liked.

There are two things I can say about yesterday. First, it was not a good day in terms of Kate’s Alzheimer’s. I don’t remember a day when she has been as confused for as long a period of time. Second, all-in-all it was an enjoyable day. She especially enjoyed the musical. The day was another good example of how mixed our days can be and that the Happy Moments still outweigh the sad ones.

A Very Good Day with our Son

Our son, Kevin, arrived Thursday morning from Texas. Weather wise, it was the best day we have had since last May. We took advantage of it by eating lunch outside on the patio of a sports bar a short distance from our house. It was a good start to his visit. Although Kate often has difficulty remembering that we have children, she responded to Kevin as though she knew exactly who he is. We had a relaxing conversation. The fact that it was just the three of us and that it wasn’t noisy added to the pleasure of the moment. There were times then and later in the day when she asked him his name as naturally as she asks mine.

She had a routine dental appointment at 2:00. Kevin went along with us. I thought it was good for him to be a part of the experience though he remained in the waiting room while she saw the hygienist and dentist. For the first time, I went in with her. I did so because of her experience on the previous visit six months ago. At that appointment, she was frightened when the hygienist cleaned her teeth, and they had to cut her visit short. This time I gave her a Xanax before going and went in the room with her. Everything went smoothly. I didn’t think that had anything to do with my being in the room with her, but the hygienist felt it was helpful and suggested we make this a habit in the future. Both the dentist and the hygienist commented that her teeth and gums were in excellent condition.

Once we were home, I picked up Kate’s “Big Sister” album and suggested that she show it to Kevin. They sat down on the sofa and started going through it while I went to the grocery to pick up a few things for Kevin’s breakfast. In just the few minutes before I left, I could see that they were having a good time.

When I returned, they were still enjoying going through the album. Kate continued to relate to Kevin very comfortably. He had a beautiful opportunity to see first hand the kinds of things I have noted in the blog. Since most of the pictures are of family, Kevin was able to tell her all or most of the names. I joined them in the room with the intention of just listening to their conversation. Kate asked me to sit with them, and I did. There were a few things I commented on, but I let the conversation between the two of them continue. At one point, Kevin pointed to a photo of Kate and me and himself. She asked his name. He told her, and she asked his last name. Then she said, “Who are your parents?” After two hours or longer, Kate said she was getting tired. It was also time for us to prepare to leave for dinner, but this conversation, like others she has had with her brother Ken, was a beautiful thing to watch. I love seeing her enjoy herself. That is especially true when she is engaged in conversation with someone with whom she is so comfortable.

We finished the day with a good evening at Casa Bella for Broadway Night. Kate enjoyed herself as usual although she was a little lost in the conversation. The other two couples were there ahead of us which left us with minimal choices about our seating arrangement. Kate and I sat across from each other. We could have sat side by side, but she would have been seated with her back to the singers. Everything worked out well until late in the program when I saw her looking around the room for me. She had forgotten where I was seated. I was able to catch her attention and reached across the table to take her hand. She was relieved and teary but recovered nicely. I doubt that anyone else noticed except the woman seated next to her.

Reflecting on Ken and Virginia’s Visit

Visits with friends and family have always been important to Kate and me. That’s true for most people; however, they have played a more significant role for us since Kate’s diagnosis. I’ve been especially mindful of that during Ken and Virginia’s visit with us the past few days. I hated to see them go. The fact that Ken was diagnosed with Alzheimer’s almost five and a half years ago has heavily influenced our relationship. It’s not that we talk a lot about dementia itself. We don’t do that at all in Kate’s presence since she no longer remembers that she has the disease. I don’t see any reason to tell her. We do, however, have such conversations before she gets up and when she rests.

What is more important is that they have such a clear understanding of what this journey is like. They may have picked up a few things from reading this blog, but most of that comes from their own personal experiences. That makes a difference in our interaction when we are together. When they are here, I have a feeling the three of us are partners as caregivers for Kate. They understand how to relate to her in a way that is difficult for just anyone else to do. I feel a load is taken from me. I still get her up and see that she is dressed and ready for the day, but when we are together, she interacts with the rest of us. The fact that we share a common set of experiences as part of the same family is also important. That expands the range of topics we can talk about in ways that couldn’t happen with even our closest friends.

Ken himself has taken steps to remain close to his sister. One of the best things he has done is to have given her the “Big Sister Album.” With 140 pages of photos covering their lives from Kate’s birth to January 2018, it has provided countless moments of pleasure for Kate since he gave it to her a year ago. We keep in on a coffee table in our family room. The cover photo of her and Ken when they were about four and two catches her eye almost every day.

Because it contains so many memories of their lives including their extended families, Virginia and I have enjoyed letting them take some time just to themselves to go through it. They looked at it for almost an hour yesterday afternoon. After dinner last night, they went through it again. This time Virginia sat across from them. When they had finished, Kate put it down. Then Ken said something about the cover picture. She didn’t know what he was talking about and showed her. She didn’t remember who the children were. Ken told her. She seemed confused about Ken in the photo and Ken sitting beside her. It didn’t appear that she remembered that they are the same person. As they moved to other photos, she did refer to Ken by name. I was never quite sure what she understood and didn’t.

As Kate continues to decline, there is another aspect to visits like this. Will this be their last visit together? None of us expects this to be the last, but we don’t know. Ken and Virginia are planning to return in the fall. How will Kate be getting along then? She won’t be the same . How will that affect our time together? Like so much of this journey, we just don’t know. All four of us are living in the moment. One step at a time. That has served us well thus far. I trust that it will in the future. In the meantime, I will savor the memories of a very pleasant visit. I wish Kate could do the same, but she enjoyed the moments.

A Great Day with Kate’s Brother and His Wife

I am glad to report that yesterday’s visit with Ken and Virginia went very well. I have no idea how much of the time Kate recognized the two of them by name and/or relationship. What I know is that she enjoyed herself.

After the previous night in which she was confused about them, yesterday’s experience was a welcome one. Ken and Virginia came over about an hour before I woke Kate. When I got her up, I told her they were here and that we were going to take them to lunch. She was resting comfortably. I know she could have stayed in bed much longer, but she got up easily. When I brought her into the family room, I said, “Guess who’s here? Your brother Ken and Virginia.” They greeted her warmly, and we were off to a good start.

I had talked with Virginia about our going to the zoo after lunch. She and I both had mentioned that to Kate who responded negatively. That isn’t unusual except that her response seemed to be stronger this time. In the past, I have found that once we are there, she enjoys herself. I think it’s a good place for her because we do it leisurely, and she always finds things that are interesting. That happened again yesterday.

When we arrived, I suggested that they get out while I parked the car. Kate said, “Can’t I go with you?” That was the only indication of any insecurity I noticed the entire day. Instead of trying to take an overall tour, we went directly to the aquarium and reptile center. Kate especially enjoyed the fish. Then we went to see the Koalas and feed the Lorikeets. The latter is always a hit. Kate said she was hungry. We suggested getting ice cream which we did after leaving the Lorikeet exhibit. It was a perfect day for the zoo. Although it was windy, it was sunny and in the 70s. It was pleasant walking around as well as breaking for ice cream. From the zoo, we came home. Ken and Virginia went back to their hotel. Kate rested as well.

About an hour later, we went to dinner and then had some additional time for conversation at home. That turned out to be especially good for Kate. As people our age are prone to do, we reflected on our lives and the way we felt about the way life had turned out for us. That led to a longer conversation about our families, especially our parents. That opened the floodgates for Kate who has a strong admiration for her mother.

I doubt that any of the “facts” she told us were things that actually happened, but they did convey the truth about her feelings for her mother and herself. What she said was very self-revealing. She felt a need to live up to her mother’s reputation and found that intimidating. She told us that her mother and some of her mother’s friends had encouraged her to be her own person. She also talked about her own school achievements, especially academic ones. (These were true.) She didn’t say anything about her Alzheimer’s, but I am sure she has felt a loss of self-esteem. She often says things like “I’m smart, you know.” Or “I’m not stupid.” Indeed, she is not, but Alzheimer’s has altered brain in a way that makes it appear that she is.

I felt that this was a conversation that she couldn’t have had with anyone else. I’ll never know if she remembered their names or their relationship to her, but she clearly felt a kinship with Ken and Virginia. They listened to her and facilitated her conversation. They understood about living in her world. At one point, Ken said something about their father. Kate said, “My father did (or said) that too.” Ken started to explain that they had the same father and realized that was unimportant and let it pass. This kind of facilitation worked. Kate talked more than in a long time. I was happy for her to have such a receptive, understanding audience.

Ken’s Arrival

Like so many things, especially when it comes to airline travel, Kate’s brother, Ken, and his wife, Virginia, experienced a delay in their arrival yesterday. We were to have had dinner with them last night, but their flight didn’t get here until close to 9:00. I regretted not having that time with them but invited them to drop by our house on the way to their hotel.

They arrived at the house just after 9:30. Kate and I were in the family room when I heard them at them at the door. I got up to greet them. Kate stayed in her chair where she was working a puzzle. Ken and Virginia entered the family room ahead of me and said hello to Kate. They hugged, and she greeted them warmly. Everything seemed perfectly normal. It was a beautiful reconnection with her brother.

We talked about the day’s travel experience and laughed. They were both able to take it in stride. We caught up with their children and grandchildren. We talked a little about our courtship and a letter that her mother had sent to my mother talking about our “friendship.” There were times when Kate was confused and asked for clarification and spoke very little. Otherwise, she was enjoying the conversation along with the rest of us.

After an hour, Ken and Virginia left for their hotel. As soon as they walked out, and I had closed the door, Kate whispered to me, “Who are they, and what are they doing here?” I told her their names. She didn’t recognize them. Then I explained that Ken is her brother, and Virginia is his wife. I was floored that Kate had not realized this. She must have spent the entire time without knowing who they are.

This experience is a good illustration of a couple of things. First, it shows that even someone (me) who knows her condition best makes mistakes in judgment. I know that her memory is gone, but in many ways she still seems very normal to me. That often leads me to expect more of her than I should.

Looking back, I see that I didn’t handle the situation the way I should have. We had been sitting in the family room for over an hour without my reminding her that they were on the way and would be here soon. Of course, she forgot about our earlier conversations about their upcoming visit. I can’t remember exactly what I said when I heard them at the back door. It was probably something like, “They’re here.” That would mean nothing to Kate. In my haste to welcome them, I didn’t even walk ahead and tell Kate, “Your brother Ken and Virginia are here.”

The experience is also an example of how poor Kate’s memory (rational ability) is and how well she is able to handle a social situation through her intuitive abilities. Ken and Virginia are well-informed about Kate’s current decline. I am sure they noticed some changes since their last visit. On the whole, however, my guess is that they didn’t sense just how poor her memory is. I will be eager to get a chance to find out today.

A Slow Start, But a Good Finish

Yesterday Kevin and Rachel celebrated their 25th anniversary. It was a special opportunity to be with them and the grandchildren. I only wish Kate could have understood and been able to enjoy it. She got off to a rocky start. It was one of those few days that she didn’t know who I was when went in to wake her. I told her we were going to have lunch with Kevin. Knowing she can’t remember who he is, I was careful to tell her that he is our son. I don’t believe that fully registered with her. As she sat on the side of the bed before standing up, she gave me a puzzled look and said, “Who are you?” I told her, but she still looked confused.

She asked me what she was supposed to “do now.” I told her it was time for a shower and walked her into bathroom. She showered and dressed more quickly than usual. I sent a text to Kevin letting him know she was up. His family was as well, and they came over for a short visit at the house before we all went to lunch.

Kate was not in a good mood when she woke up and wasn’t interested in being with company. That and the fact that she had had trouble the day before led me to take the lead in our conversation. TCU is very important to her. I drew attention to the number of us who had graduated from TCU or were current students. Of the remaining two grandchildren, our granddaughter will be a freshman in the fall. I also mentioned that it was a special day, Kevin and Rachel’s 25th anniversary. My efforts fell flat. Kate was not ready to engage in conversation. I believe it was a combination of her mood as well as some insecurity. We had lunch together at a nearby deli. Kate was mostly quiet. I felt she was uncomfortable. After lunch, Kate and I came back to the house while Kevin’s family did some sightseeing.

We were home about forty minutes before we left for Kate’s dental appointment. She frowned when I told her where we were going. I was surprised. She has always liked her dentist. She was quiet all the way. We waited a few minutes in the lobby before the hygienist came to take her to the back for her cleaning. Even though Kate has known her for years, she didn’t display any emotion of recognition or pleasure at seeing her.

In a little while, the hygienist returned to speak to me. She said Kate resisted the X-Ray procedure. When she got to the polishing part, Kate seemed frightened. The hygienist didn’t go any further. I explained that she had not been in a good mood since getting up. Ironically, I had been considering taking her back for a cleaning every month or two. That doesn’t seem like a good thing. Besides that, she said Kate seemed to be doing a good job brushing. I told her I was a little surprised but that she brushes her teeth a lot during the day as well as when she gets up at night. She left and brought Kate back to the reception area where I took care of the bill.

As we drove away from the dentist’s office, she said, “Are you hungry?” By this time it was less than three hours since we had eaten lunch, but it is not uncommon for her to think she is hungry even sooner than that after a meal. I understand from what I have learned from others that this is quite common for people with dementia (PWD). I told her I wasn’t hungry, but I thought it was a good time for a treat and mentioned going to Marble Slab. She liked the idea.

After tasting the first bite, she raved about how good it was. I agreed. She continued to express her pleasure until she had finished. She was a changed person. All signs of moodiness had vanished in an instant. She talked about having another serving, and I felt the same way but didn’t give in. I knew that we would soon be having a big dinner.

Coincidentally, I had read a relevant section of Dementia With Dignity by Judy Cornish earlier that morning. It is a companion piece to her Dementia Handbook in which she outlines the importance of focusing on the intuitive abilities of people with dementia (PWD). Her latest book gives more details on how to apply her theoretical framework presented in her earlier work.

The part I read emphasizes the importance of managing the moods of those with dementia. She notes that PWD regularly fail at tasks and conversation and are unable to “understand where they are, why they are there, and who they are with.”  She goes on to say that these experiences often lead to negative feelings. Her point is that caregivers can play a major role in redirecting their moods. I hadn’t been successful with that when we were with Kevin’s family earlier in the day, but taking her out for ice cream did the trick.

That was good preparation for dinner. We came back to the house where she wanted to rest. Not long after that, Kevin sent a text asking if we were home. He and the children came over for an hour or so. We played Mille Bornes while Kate continued to rest. They left around 5:00 to get ready for our 6:00 dinner.

The dinner went very well even though it was a challenge for Kate to keep up with the conversation. She had to ask us to repeat ourselves a number of times. After I offered a toast to Kevin and Rachel, she leaned over to me and whispered, “Whose anniversary is it?” Despite these things, I was encouraged she was trying to understand and didn’t appear to be withdrawn.

So the day ended on a high note. I am glad about that but also disappointed that Kate was unable to fully enjoy what was a very special visit with Kevin’s family.