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Update on Kate’s Talkative Days

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

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

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

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

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

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

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

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

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

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

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

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

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Music in the Morning

Regular readers of this blog know that music has been important in our lives. That was true before Kate’s diagnosis. Since then, it has played a more critical role both as entertainment and therapy. More than anything else I’ve talked about our nightly ritual of watching music videos on YouTube; however, it goes much further than that. Music plays throughout the day and night. It doesn’t usually start first thing in the morning, but when it does, its purpose is to solve a problem. That happened this morning.

I had just finished dressing and was about to go to the kitchen for breakfast. A few minutes before, I heard Kate say, “Hey” and then something else I didn’t understand. It isn’t unusual for her to talk while she is sleeping, so I hadn’t checked on her immediately. It was 6:53 when I entered the bedroom. Her eyes were open and she looked confused. It was one of those mornings when she awakes “without knowing anything.” She wanted to know what she should do. I explained that it was still early and that she could just relax and go back to sleep a while longer.

I should have learned from past experience that would not solve the problem. I think I was just eager to fix my breakfast and take my morning walk. I tried to calm her with words as I stood by her bedside but quickly decided to postpone my normal routine. I lay down beside her, put my head on her shoulder and my arm over her chest. I spoke softly to her and told her my name and hers and explained that we had met in college, fallen in love, married, and had children and grandchildren.

While this may have been useful information, she was still uneasy and wanted to know what she could do. That led me to go in another direction. Music can be comforting. Instead of trying to explain what she could or should do, I simply started singing “Edelweiss.” After just a few words, she seemed to relax. I sang it another time before pulling my phone out of my pocket and turning on the audio system to “Edelweiss.” I repeated it several times and hummed along with it. She was calm. Then I thought of several other songs that she likes (“Danny Boy,” “Shenandoah,” “Loch Lomond,” “Swing Low, Sweet Chariot,” and “Deep River”) and played them for the next thirty minutes. The crisis was over.

I don’t know what I would do without music. I’m hopeful I won’t ever face that.

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Back to a Typical Day

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

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

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

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

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

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

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

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

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Follow-up on the Two Preceding Posts

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

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

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A Rough Start, But a Nice Day

Yesterday, as I was preparing for my morning walk (inside our apartment), I noticed that Kate was awake. She looked disturbed. It was easy to tell that it was one of those moments when she didn’t know where she was, who she was, who I was, etc. Her mind was an apparent blank. Although she didn’t recognize me, she didn’t appear to be afraid of me, only frightened by not knowing anything. This is something that used to occur occasionally before the pandemic. It seems to be making a unfortunate comeback.

I asked if she could tell me what was wrong. She said, “I don’t know.” I told her she had been sick and that sometimes caused memory problems. She said, “What’s my name?” I told her and then gave her my name and relationship along my usual recitation of our lives from college to having children. Sometimes she comes out of this fog rather quickly, but she didn’t this time. I turned on some relaxing music. Then I got her morning meds and gave it to her with some yogurt. I also made her a smoothie with cranberry juice, blueberries, and prunes, my latest effort to prevent constipation. I followed that with mandarin oranges. Her anxiety lessened, but she was still not cheerful. She looked a little tired, so I let her rest while I took my walk.

When I finished, she was very cheerful and talking to “someone.” That was the beginning of a day of talking and delusions that was only interrupted by an appointment with a podiatrist just before at 1:45. Knowing that the caregiver would have less time than usual to get her ready, I decided to fix her lunch. That was a good thing because Adrienne didn’t have to rush her while getting her dressed.

She remained in a good mood, but Adrienne and I were both a bit apprehensive about how she would respond to having her toenails cut. It had been too long, and Kate had protested vehemently the last time we tried. For that reason, I gave her half a tablet of Seroquel 25 mg. Normally, it takes effect with 15-20 minutes, but we couldn’t tell that it worked at all.

When we told Kate we were going out, she didn’t want to go. With a little coaxing, she agreed; however, her protest about leaving and the fact that the sedative didn’t appear to have worked added to my anxiety. Fortunately, the podiatrist’s “office” is only a short walk down the hallway. This is another benefit of moving from our home. We won’t trim her toenails again.

The podiatrist works primarily with seniors and visits a lot of local senior facilities in our area. Thus, she is experienced with the challenges she can face. Kate was quite comfortable with her. Her only protests came when the doctor lifted her feet to put them on a foot stool. She also screamed a few times during the trimming process, but she didn’t put up a fight.

After this successful experience, it seemed natural to stop for ice cream at the café we passed on our way to see the doctor. While Kate was enjoying the treat, two different people we have known from our church stopped at our table. We talked for about 30 minutes. When they left, we asked Kate if she were ready to go “home.” She said she wasn’t. We stayed another 30 minutes. During that time we asked several times if she were ready. Finally, we decided it was time and left. She didn’t protest at all. I’m glad she finds the café a relaxing place to spend some time. Adrienne and I feel the same way. It’s just nice to get out of the apartment.

We had more than an hour before dinner, so we spent that time on the balcony of our apartment. It was especially nice out as the temperature was much lower than usual.

Kate’s talkativeness had subsided until we got home. She began to talk again and didn’t stop until Adrienne left about 7:45. She even talked between bites at dinner. Once in bed, however, she relaxed and slept for about an hour. We watched a Peter, Paul and Mary concert on YouTube and then retired for the night. She was tired after a full day and was asleep in no time.

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Caregiving: An Exercise in Problem Solving

As noted in my previous post, life is going well in our new home. That doesn’t mean we don’t have any problems. Caring for someone with Alzheimer’s requires continual problem solving, but we do have successes. Among them is being able to get Kate out of bed every day, something we hadn’t been able to do for months after her return from the hospital on Thanksgiving. We also take her out of the apartment though hallways that connect us to all the other buildings in our complex. That’s been helpful in terms of introducing Kate to other residents, and stopping along the way for ice cream hasn’t been bad either.

We have encountered one troublesome problem during these outings. Kate doesn’t like her feet to be on the footrests of her wheelchair. She is quite strong, and the caregivers and I found that she stiffens her legs when we attempt to place each foot on its rest. We almost always succeed, but she protests loudly, something that stands out in our quiet hallways. Several times we’ve had to return to the apartment before going very far. When we succeed, she often takes one foot (her left) off the rest and drags it along the floor. That creates a safety hazard for Kate and also makes it decidedly more difficult to push the wheelchair.

I explored ways to address the problem for several weeks and didn’t find just the right thing. My initial thinking focused on the fact that it was her left leg that was the bigger problem and that it gradually worked its way to the right until the foot fell to the floor between the two footrests.

I talked with someone at a local medical supply store who wasn’t encouraging. He told me there are boards that are designed to be installed across both footrests, but he indicated a number of problems with them. Then I began to consider why Kate had so much trouble getting her feet on the rests to start with.

For months I noticed that she keeps her legs crossed while she is in bed. Since she is in bed about 18 hours a day, I wondered if she had experienced
muscle deterioration. A number of times I thought about having a physical therapist come out for an evaluation. I mentioned this to Kate’s doctor during her appointment two weeks ago. He took action for me and requested both a physical and an occupational therapist.

Before the PT’s first visit with Kate, I decided to check on Amazon for footrests that might address our problem. I found what looked like a potential solution the day the PT came. It’s a solid footrest that sits on top of the existing footrests and has a raised padded portion against which her calves can rest. I showed it to the PT who thought it was worth a try. I ordered it immediately, and it came in the next day. It works beautifully. We’ve used it four days in a row without a problem. When we put Kate in the wheelchair, her feet rest naturally on the new footrest. More importantly, she must feel comfortable because she keeps them there. That has made life much easier for Kate, her caregivers, and for me.

But, wait, there’s more. It turns out the therapist himself is the best I can imagine. He seems quite young but combines several important qualities, his knowledge, bedside manner with Kate, and a desire to explain what he does and why. In addition, he is able to explain in non-technical terms what the caregivers and I should do to build on what he does.

As it turns out, we found a way to keep Kate’s feet on her footrest as well as a physical therapist who is helping us acquire a reasonable set of expectations for someone in her physical condition. She is quite strong, but she is not going to walk again, and we’re not likely to need much PT. Although I had held this assumption previously, it was good to hear it from an expert. He also offers good tips for everyday care. Now, we’re ready to face whatever new issues arise, and I know they will.

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Benefits of Living in a Life Plan Community

Kate and I continue to get along well in our new home in a local retirement community. My motivation for moving was to provide backup support for Kate should something unforeseen happen to me. Having made the down payment two years ago this past May, we were considered to be part of the community with access to virtually all the benefits available to those who were already living here. It wasn’t until a short time before our move that I felt the need to take advantage of anything. That’s when we became eligible for the COVID vaccination. I jumped on that but wasn’t able to get Kate out at the time.

When we moved in, they were no longer giving vaccinations, but I spoke with one of the staff who coordinates resident services about arranging for someone to come to our apartment. She said she would work on that, and shortly thereafter, a team from the county hospital came to us for Kate’s first and second doses.

The longer we are here the more benefits I discover and take advantage of. Many of them are little things that make life a little easier, but some are more significant. This past week involved the latter. The first was a switch in Kate’s primary care physician.

For about fifteen years, she has been patient at the geriatric practice where my mother and father as well as her mother were patients. We have always been pleased with all of the physicians who practiced there, but getting Kate to the doctor now requires our arranging for a wheelchair van or ambulance for her transportation. A year ago, however, the doctor who started the practice and was on the faculty of the medical school opened his own private practice at our retirement community. Kate’s doctor who has worked with him for years and is also with the medical school suggested that it might be best for her to become a patient at his practice.

I thought about that for several months. Two weeks ago, I made the arrangements for the transfer. She had her first appointment Tuesday. He and his nurse spent an hour with us at our apartment where we spent most of our time talking about Kate’s medical history, especially her Alzheimer’s and medications and made the appointment for a second visit, also at our apartment, a month from now. What a wonderful benefit. She has a physician I have known and respected for more than twenty years, and his office is in the building next door. We are connected by a hallway so that we don’t even have to go outside when we visit him, and he doesn’t mind coming to our apartment when that is more convenient.

Kate was the recipient of another health-related benefit this week. Last weekend. a resident in one of the cottages tested positive for COVID. The management responded with a number of changes that involve our wearing masks, cancelling social activities and asking us to minimize our social contact for the next couple of weeks. They also required everyone to be tested Tuesday and Thursday.

I was tested the first day along with 251 others. No one tested positive. I was concerned about Kate’s taking the test that requires a swab for the nose. Although it is not at all painful, I thought she might be frightened by it. I spoke with the person who had arranged her vaccination. She immediately said she would be happy to come to our apartment for the test. We set that up for late afternoon the day before yesterday.

When she and her assistant arrived, I introduced them to Kate and explained what we were going to do. I did so in the calmest non-threatening tone of voice possible. She was quite accepting until I tried to use the swab. The moment the swab touched her nose she pulled away and was adamant about not wanting us to do it. We tried several times over the next five minutes and finally agreed that we should approach it a different way.

I told her I had a prescription of Seroquel that I had used only a few times before and that it makes her sleepy. I added that I felt most comfortable giving it to her before she went to bed. We scheduled it for the following day. I had only used the Seroquel three other times. It knocks her out, so I don’t like to use it; however, it works well for something like this. I held her hands and let the nurse do the swabbing. Kate awoke immediately, but the nurse was able to finish quickly. We had the results (negative) before she left the apartment.

Living in a life plan community (often called a continuing care retirement community) may not be for everyone, but it has certainly made life easier for us. I’m glad we’re here.

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A Great Day for the Caregiver

Last week, I spoke to a group at our church about living with Alzheimer’s. During the Q&A, someone mentioned the stress experienced by caregivers and asked how I was dealing with that. As I said to him, “That’s a good question and one that I’ve tried to address since Kate’s diagnosis.” My thoughts about care for the caregiver is rooted in watching my father as he cared for my mother who had dementia. Except for the things I did to support him, the only help he sought out was a daycare center for my mother 4 hours every Wednesday so that he could go to Kiwanis and the grocery store. He was always in good spirits, but the stress took its toll on him. I vowed not to let that happen to me. I can’t say that I have found a way to eliminate stress, but I have been able to minimize it.

Since our move in April, life has become much easier for me. Supervising only three caregivers is much better than the 6-9 we had before the move. That has meant more routine in our lives. As expected, the convenience of meals on the premises has been a major benefit. Little things like being able to stroll down the hallway to a café where Kate can get an ice cream or a milk shake adds pleasant moments of relaxation. On top of that, I am enjoying the social interaction with other residents and staff that occurs throughout the day.

I also get away from the grounds several times a week. I attend Rotary every Monday and have lunch at two of my favorite restaurants on Wednesday and Sunday. Of course, there are also trips to the grocery store and pharmacy.

This past Wednesday was an especially nice day. I had lunch at Carla’s where I had an arugula and goat cheese salad with cherry tomatoes and pecans accompanied by a side of smoked brisket (the best I have had outside of Texas). The meals in our retirement community are quite good, but they don’t compare to the ones I get at Carla’s or Andriana’s.

Apart from the meal, I had conversations with two of the staff I have known for quite a while. One is a server who is moving to Nashville. Her boyfriend just graduated and is moving there to look for a job. She is going with him to further her education to become a physical therapist. She was excited about the move, and I was excited for her. It reminded me of the early days of our own marriage.

The conversation was with the shift manager. He is from Romania and has been in the US about five years. He is married to a Puerto Rican who is in the Air Force. Earlier this year, he became a US citizen, and was very excited about that. Now, he is excited by the news that his wife’s next assignment is in Naples, Italy. That will put them within an hour by plane to his family’s home. That will make it much easier and less expensive for his parents to visit him and his wife and daughter. When his wife finishes this assignment, she will have only three years until she can retire. Upon retirement, they plan to return to the US. I found both of these conversations to be uplifting and was happy for them.

Wednesday is also “Spa Day” for Kate. The caregiver bathes her, shampoos her hair, applies lotion to her body, and does her nails. When I got back to the apartment, I was pleased to see Kate with eyes closed relaxing in her recliner while the caregiver filed her nails. Until two years ago, I had been taking her to have her nails done once or twice a month. As her Alzheimer’s progressed, she became somewhat frightened, and I stopped. This particular caregiver has been doing her nails since she came to us in December or January. It does my heart good to see Kate enjoy herself so much.

To top it off, we made our trip down the hall for ice cream. I didn’t need anything more to keep my spirits up.

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“Happy Moments” Make for “Happy Days”

Almost all of our “Happy Moments” are unplanned. That’s part of what makes them special. One of those occurred the other morning when I was giving Kate her meds in a cup of strawberry and banana yogurt, a favorite of hers. After her last bite, she began to whistle. (She’s hasn’t been a whistler until the past 6-12 months when she began whistling to express her happiness.)

One of my many quirks is that I often hum, whistle, or sing softly without being quite aware of doing so. In this case, I began to whistle “Let Me Call You Sweetheart.” She expressed her pleasure with a smile. It doesn’t take much encouragement for me to break into song, and I sang the song to her. Spurred on by her pleasure, I whistled “Old Man River” and followed by singing it.

She was enjoying the music so much that I put on an album of children’s songs I downloaded 3-4 years ago when she was disturbed about something. Since that time, I have periodically used it for entertainment, not to solve a problem. We spent the next 20-30 minutes listening and sometimes singing songs like the “Alphabet Song,” “If You’re Happy,” and “The Bear Went Over the Mountain.”

When we finished, Kate was ready to rest, but it was another unanticipated “Happy Moment” that didn’t require any planning or great musical talent. Just two people connecting through music that added an extra measure of happiness to our day.

Some might say, “What’s so special about that?” John Zeisel answers that in his book, I’m Still Here: A Breakthrough Approach to Understanding Someone Living with Alzheimer’s. He points out that too often we treat people living with dementia like “patients” rather than as “people.” We need to accept and appreciate their capabilities that last long after the diagnosis. It’s possible to maintain positive relationships with our loved ones with dementia through many things like photos and music that have been very important to Kate and me. This particular “Happy Moment” illustrates how we are able to continue to enjoy life and each other. May it always be so.

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How is Kate?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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