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Settling In Part 2: Kate’s Adjustment

In “Settling In Part 1,” I outlined the positive changes we’ve experienced with in-home care since our move. During the same time, there have been similar improvements in Kate’s behavior. She is much less frightened than she was when she came home from the hospital at Thanksgiving. That makes the experience of tending to her needs less disruptive for her. As a result, it is easier for her caregivers and me.

The biggest problems we’ve faced involve some of the basic things we have to do to care for her. That is mostly the process of changing her as well as getting her in and out of bed, her wheelchair and her recliner. As she has become more familiar with the process she has become less frightened and more cooperative. It’s not something she likes at all, but she is more accepting.

From the beginning, I’ve played an active role in these activities because her first response is to fight back with her hands. As one might expect, she has been particularly bothered by being changed. My part is mostly to calm her. In the gentlest voice I can muster, I tell her what is about to happen and that we need to help the caregiver by relaxing. I ask her to hold my hands tightly. That was tough for her at first, but in the past couple of weeks she has gotten much better. She seems to find security in holding my hands.

There’s a tendency to think that someone in the last stage of Alzheimer’s can’t learn at all, but we have seen signs that she can. This does not occur through her rational, but her intuitive ability. It’s not because she understands and remembers what we have told her to do. It is simply through experience that she is beginning to learn. One example involves our use of a lift to get her in and out of her bed as well as her wheelchair and recliner. She is learning where she needs to put her hands. That’s not only beneficial from a safety standpoint, but it keeps her from grabbing and holding on to something (like the arms of her wheelchair or recliner) that makes lifting more difficult for us.

She surprised me over the weekend when I took her on a tour around the other buildings. She told me to “watch out” as we approached an area where the tile floor ended and a carpeted section began. She has learned from experience that changes like these mean “bumps,” and she doesn’t like even small ones.

We’ve also been able to make important changes in her daily routine. We get her up daily, if not for the entire afternoon, for dinner. We relax on the balcony almost every day. Recently, she has been out of the apartment five or six times. Each time I have introduced her to other residents. Over the weekend, I took her out twice without the caregiver. One of those days, we stopped by our coffee shop for ice cream. I don’t know the full benefit of these outings and encounters, but I believe it’s good for her. It gives her a better feeling for everyday life, and I plan to keep it up.

I’ve also been pleased with recent efforts to read to her and to look through her photo books. Both of these have been of less interest to her in the past few months. I’ve had success with The Velveteen Rabbit in the past two weeks as well as at least one look through the photo book I gave her for our recent anniversary.

She still wakes up between 11:00 and noon, but she is occasionally wide awake much earlier. That allows me to get her morning meds earlier as well as getting her something to drink and a snack before the caregiver arrives. This is not a frequent occurrence, but it happens more often than in the past. The bonus is that several times I have gotten in bed beside her and read to her, looked at a photo book with her, or just worked on my laptop while she rested. It has been good to have that extra time with her without the caregiver’s being around.

We have two other goals: to get her hair done in the salon downstairs and to give her a shower. We may try the shower this week.

I should add that I attribute much of Kate’s improvement to the consistency we have with out in-home care. I am especially grateful to Adrienne, the caregiver who is with us 10 out of every 14 days. She has played a major role in the establishment of a regular routine.

There are two things that I don’t expect to improve. One is her Alzheimer’s. The other is her mobility. I don’t believe she will walk again although her recent progress has encouraged me to think about attempting it. That’s something I won’t pursue without the help of a physical therapist.

All in all, Kate seems more relaxed and happy. Her quality of life has gotten much better, and that means it has for me as well. We’re making progress.

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On a 1-10 Scale, Wednesday was an 11.

Just over two weeks ago, Kate and I celebrated our 58th wedding anniversary. That morning I wrote a post saying the day before she gave me the perfect present. She was  in a cheerful mood all day. I commented that if she wasn’t the same way on our anniversary day, it was just fine. She had given me enough to keep me going for a while.

I bring this up because yesterday was my 81st birthday, and the day before that was even better than the day before our anniversary. My feelings were the same. Although I would have loved it, she didn’t need to be as upbeat as she was on Wednesday to make me happy. Experiencing the pleasure of her joyfulness will last a long time, and Adrienne, our caregiver, got as much pleasure out of it as I did.

She was just waking when Adrienne arrived at noon that day. I left soon after for my usual Wednesday lunch. When I returned, she was in her recliner. Adrienne said that she had been happy and cooperative when she got her dressed and out of bed.

An hour later, we took her for a stroll around the interior of the campus. We went to the wellness center and met three of the staff. Then we toured the chapel. Along the way we saw a number of people who hadn’t met Kate. I was glad for them to meet her and for Kate to have the experience of getting out and engaging in normal activities. She was enthusiastic about going out and continued to be expressive throughout out our tour.

When we returned, we went to the balcony where we relaxed about forty-five minutes before dinner. It was a very pleasant afternoon, and we went back to the balcony for almost an hour after eating.

She was very cooperative as we got her into and out of the lift as well as when we got her ready for bed. It was her best day in many months. Everything seemed to go right, and that is something to treasure.

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Settling In Part 1: In-Home Care

Eight weeks ago, Kate and I moved into our new home in a local retirement community. Over the weekend, I met a couple who moved in two months before we did. He told me what a big change it had been after living in their home over forty years in the same town in which they had grown up. I could relate to what he must have felt. All my established routines were disrupted, and I’ve been working to establish new ones.

I’m happy to report that we’re making progress.  Over the past two weeks, I’ve felt much more settled. That relates to three aspects of our lives that have improved significantly. In this post, I’ll tell you about Kate’s In-Home Care and follow that with posts about Kate herself and then me.

Prior to Kate’s hospitalization with COVID eight days before Thanksgiving, we had help from caregivers three afternoons a week, Monday, Wednesday, and Friday, four hours for each day. We maintained that schedule for three years. We were fortunate that the caregiver who came on two days a week was with us the entire time. We had 3 or 4 for the remaining day. During this time, the demands on the caregivers were minor. I just needed someone to be with Kate while I was gone. They didn’t have to be in charge of any of her personal needs.

We were approaching the time she would require more care when she and I tested positive for COVID. Before she entered the hospital, I arranged for 8-hour daily care for her. Our regular agency was unable to fill the schedule. That led to my adding a second agency that provided help the four days not already served by the first agency. I’m grateful for their coming to my aid on such short notice, and I thought all of the caregivers were able to perform the needed tasks. Unlike our original agency, however, they never provided the consistency that I wanted. During the 5 months prior to our move, they sent us 6-8 different caregivers. They were all competent, but it was impossible for Kate to develop a comfortable relationship with them.

Our move required some adjustment. Our retirement community has its own home-care agency (Caring Hearts), but they do allow caregivers from other agencies to work here. There were two catches. The first is outside caregivers have to complete the same requirements as their own employees. That involves background checks, an all-day orientation, and health requirements. In addition, there was a $320 charge to me for each caregiver. As it turned out, only two caregivers chose to go through the process, one from each of the other two agencies.

The best news is that one of our caregivers, Adrienne, was already employed by Caring Hearts as well as the agency we had worked with for three years. She is also our best caregiver. As a result, it worked for her to cover 10 out of every 14 days. She gets every other weekend off as well as every Friday. The caregiver who has been with us over 3 ½ years continues to come on Fridays, and Caring Hearts is providing a new person for the weekend Adrienne is not with us.

These changes have had two major effects. First, our daily routine is decidedly more consistent. Adrienne shares some of my OCD tendencies and has a steady routine. Second, It gives Kate a chance to develop a closer relationship with her.  She has 3 different caregivers rather than 6-8. Only one of them is new. She is young (19) and has limited experience, but she is a certified nursing assistant (CNA) and is in school to become a nurse and then a physicians assistant. I’m optimistic about her.

I am especially pleased with the daily routine. When Adrienne is here, I feel more comfortable about leaving and regularly leave for lunch on Wednesday and Sunday very shortly after she arrives. She is the only caregiver that gets Kate up and dressed without any help from me; however, I have been helping her when we take Kate to the balcony or outside the apartment. I also help her get Kate ready for bed.

Apart from her routine, I like other things that she initiates on her own. For example, she has designated Wednesdays as “Spa Day” for Kate. On that day, she does Kate’s nails. She also takes more time getting Kate up each day. She works very slowly bathing, changing, and dressing her. She’s very good about making sure Kate gets her fluids, something I have found most of our past caregivers haven’t made a priority. I almost forgot to say that Adrienne always fixes a nice breakfast/lunch for Kate every time she is here. She is French and make French toast, French omelets, and fruit. On top of these things, she doesn’t ask if there is anything she can do for me. She just does the things that need to be done. She regularly takes care of washing and drying clothes, taking out the trash and recycling, organizing, and letting me know when we need new supplies.

This change in care has had a noticeable impact on both Kate and me. I’ll say more about that in my following posts. At the moment, I’m just glad that our in-home care is working well, and that makes life better for both of us.

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Our Relationship

First, let me say that Kate had been in a good mood all day. Second, nothing in my caregiver’s toolbox works every time. On the other hand, Kate and I still work well together most of the time. Here’s an example from last night.

Kate was awake very early yesterday, just before 8:00. In fact, in the past few days, she has been awake as early as 7:00. It’s not unusual for her to do this occasionally, but she typically goes back to sleep. Not so, this time, and I took advantage of the opportunity of being together. I got the photo book I made for our recent anniversary and jumped into bed with her. We spent a good while going through it together. This was a time when she was interested. We enjoyed reminiscing about all the things we have done together. We only stopped when she began to tire. Then she rested until the caregiver arrived.

The afternoon also went well. Kate, the caregiver, and I spent over an hour relaxing on our balcony. That’s becoming a regular part of our daily routine at least until the summer heat makes it less appealing.

Although she is adjusting to our getting her out of and back into bed as well as changing her, Kate continues to protest, at least a little, most of the time.  That was true when we got her into bed after dinner. As the caregiver started to pull her slacks down, Kate responded forcefully both verbally and physically.

I responded by getting into the bed from my side. She was holding tightly to the caregiver’s arm with one hand and her pants with the other. I spoke slowly and softly and asked her to take my hands. She didn’t release her grip. As carefully as we could, the caregiver and I took her hands and put them in mine.

Then I said something like this. “Sweetheart, it’s about time for Lilly to go, and before she does, she needs to get you ready for bed. She needs our help. I know you would like to help her.” She said she did. I continued, “What we can do is just relax and let her do what she needs to do. She’ll be very gentle. She knows how to do this. I know this isn’t easy for you, but I am right here with you. You can hold my hands and squeeze them as tight as you want.”

She began to relax. Lilly did what she needed to do, Kate never protested. The two of us talked about how much we appreciated having someone to help us. When she was ready for bed, she said, “Thank you” (to Lilly). A potential problem had been averted.

This recovery wasn’t a singular event. It grows out of our longtime relationship and individual personalities. We are both conflict avoiders, and each of us likes to please the other. That has carried us a long way in our marriage, but I never imagined that it could pay such benefits in the last stage of her Alzheimer’s. Will it last forever? Obviously, I hope so, but I can’t even be sure it will happen the next time we encounter a similar situation. Still, I’m optimistic that the nature of our relationship will continue to help us face future challenges as they arise, and I know they will.

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Accepting Each Day As It Comes

“It’s a day to celebrate although I don’t know what lies ahead.” That’s a quote from my previous post in which I talked about our 58th anniversary and that Kate had given me the perfect gift the day before. As it turned out, the actual anniversary wasn’t exactly the way I would have liked although it ended well.

Unlike the day before, she slept late and wasn’t in a particularly good mood when she awoke. I decided not to wait until later to give her the anniversary card and photo book I had prepared. She is almost always more cheerful in the afternoon.

In my eagerness, I didn’t wait long enough. When I told her it was our anniversary and read her card, she didn’t show any emotion at all. It seemed like she knew I wanted her to be excited, and she was going to show me I couldn’t do it. I gave her the photo book with 95 pages of pictures of people and places that had been special to us the past 58 years. It was clear after showing her the cover and first couple of photos that I was facing a losing battle. I made a wise decision to try again later.

The opportunity came as we ate dinner. She enjoyed her food, and she became more cheerful. When she finished her ice cream, the caregiver went to the bedroom to get things ready for the night. I picked up the photo book and showed it to her. She took to it right away. It was too much to go through all of it, but she liked what she saw. She was cheerful and loving for the rest of the night.

Yesterday was a very good day. For the third time since we moved six weeks ago, the caregiver and I took her out of the apartment. For the second time, we walked through the park across from our building. We followed that by relaxing on our balcony until time for dinner. She enjoyed the day.

Of course, I would have liked the day of our anniversary to have been like the day before and the day after, but I had little or no control over that. By this time, however, I’ve learned the value of accepting each day as it comes. That doesn’t mean I simply give up and let it go. I always try to make things better. Sometimes I succeed; sometimes I don’t. I try not to push her. That only makes things worse. If I just back away for a little while, she often comes around naturally. One thing is sure. I know that the bumps in the road are going to occur, and I am encouraged with the knowledge that we’re also going to have more “Happy Moments.” I wonder what’s in store for today.

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An Important Breakthrough

Kate has not been outside since two weeks before Thanksgiving. There have been several exceptions. Four or five times we spent an hour or so on the patio before our move. Another was the ride in a wheelchair van when we moved, and since the move, four times on our balcony. That ended yesterday when her caregiver and I took her for a walk in her wheelchair around our building and the one adjacent to ours.

It started when I mentioned to the caregiver that I would like to arrange for Kate to have her hair done. I’ve talked with her hair dresser and the person who manages the salon on the grounds but have been concerned about how Kate might react. Yesterday, her caregiver suggested that we gradually take her outside the apartment and around the building. I agreed.

It wasn’t long before I saw that the caregiver was getting Kate out of bed and assumed that as usual she was either going to bring her to the living room or to our balcony overlooking a courtyard located between the two long arms of our U-shaped building. When I said something about going to the balcony, the caregiver said she wanted to take her outside our apartment. I was pleased with her desire and offered to go with them.

Kate was very quiet and didn’t protest as we walked into the hallway toward the elevator. We were encouraged but wondered how she would react to the elevator. As we approached, our next-door neighbor got off and walked toward us to her apartment. This was the first time any of the residents had seen Kate, and I took the opportunity to introduce her. I told Kate her name and explained that she lived next door. Kate didn’t say a word.

Then we proceeded to the elevator, backing her in because that seems to be less frightening for Kate. We entered without Kate’s protesting. The next step was the closing of the door and the motion of the elevator’s going down. Kate was very calm.

Once downstairs, we ran into the “Move-in coordinator.” She is the person we newcomers look to first when we have a question or problem. We walked over to her, and I introduced Kate to her. As with the previous introduction, Kate didn’t say a word, but she didn’t appear to be disturbed in any way.

From there, we went outside to the courtyard and walked around the outer walkway. Kate expressed neither concern nor pleasure. Her caregiver and I were encouraged that she seemed comfortable. I commented on the assisted living building that is located at the open end of our building. The caregiver offered to give us a tour.

As we entered, I took note of the fact that one of the first things I saw was the office of the geriatric physician whom I have known since the late 90s. A few months ago, Kate’s current doctor had mentioned that it might be good for Kate to transfer to this practice. I definitely plan to do this but also like her current doctor and haven’t been in a hurry to make the change. I knew it would be convenient, but seeing just how close it is to our apartment heightened my interest. I plan to bring up the subject of a change at our next appointment with the current doctor.

After walking through the assisted living facility, we walked back to our building and took a seat at an outdoor table at the soup, salad, and sandwich bar on the ground floor of our building. We relaxed about thirty minutes. Kate was quiet but did say that she liked being outside when I asked.

A few minutes later, she asked, “When are we going back up?” You might not think there is anything remarkable about this, but her caregiver and I did. She never seems to say anything that conveys awareness of where she is or the location’s relationship to some other place. The notable exception would be the many times she has said, “I want to go home.” (By the way, I’m not sure she has said that at all since we moved four weeks ago today.) The fact that she used the word “up” was striking to us. Was this just a random use of the word, or did she realize that we were downstairs? I’m inclined to believe the latter. If I am right, it shows a greater sense of awareness than I thought possible at this point in her Alzheimer’s.

It was just after 4:30, and I usually order dinner around 5:00, so we made our way back to the apartment and without any complications. Her caregiver and I hope that this is just a first of many such experiences in the days ahead. Kate may not have expressed any great enthusiasm, but her caregiver and I did. It was a refreshing outing for both of us.

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The Final (?) Update on Kate’s Reflux

Yesterday was a good day for Kate. I gave her omeprazole in the morning and three doses of Mylanta during the balance of the day. I am glad to say that she had no recurrence of the episodes that had bothered her (and me) over the past week. Mylanta did the trick.

Tomorrow I’ll report the news to her doctor. I’ll see if she wants us to continue the Mylanta or simply rely on her omeprazole once a day. I suspect it will be the latter now that the crisis is over.

I will also speak with her about a transition to the physician’s practice right here, in fact, next door to our building. She had suggested this would be a good option for us at one of Kate’s recent appointments. I really like her present doctor, but I believe having her doctor next door would be an asset in the future. He makes house calls, something that would be of great benefit to us. I should add that I have known the doctor since at least 1998 when my mother became a patient at the geriatric practice with which Kate’s doctor is associated. The doctor here is the one who started that practice and was a neighbor of ours. I feel sure Kate would be comfortable with him, and I know I would.

I’m glad the mini-crisis is over. We can get back to settling into our new home.

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Update on Our Move

My previous post was almost three weeks ago. That’s the longest time between posts since I started this journal more than ten years ago. There is a good reason for this pause. I have found myself incredibly busy with preparations for the move as well getting settled in our new home. Although I had been getting rid of things for six months or more, the job wasn’t finished until ten days after we moved. I can’t say that I can relax now, but the major work is finally behind me.

I’m happy to report that my immediate reaction to being here is quite positive. I feel at home. It appears that Kate does as well. During the past two years, quite a few people have asked how I thought she would adapt. I think that’s because people are aware that change can be difficult for those with dementia. One reason I hadn’t been concerned was the trajectory of Kate’s decline at the time I decided to move. I felt by this time she would handle it well.

Two weeks before leaving, I started telling her that we were going to move. She wasn’t bothered in the least, and even expressed some interest though she never remembered my telling her. I feel sure she knew something was going on during the packing and loading of our household goods. The morning after packing I heard her talking to “someone” (an hallucination) in our bedroom. I didn’t catch all that she said, but I did here her say, “We’re going to be moving.” And that day we did. After arriving in our new apartment, I told her we were in our new home. She liked it. She seems no different than she was in our house.

For me there are lots of differences, but they are good ones. I like the size of our apartment. Even though it is smaller than what we are used to, it is not cramped. We have everything we need. Having the availability of meals is also a plus. I feel sure that I won’t be eating out as often now that it is only a short walk down the hall to pick up dinner. The wellness center’s location next door via an enclosed hallway is a big plus. That will enable me to return to my gym activities that I stopped over a year ago.

I’m especially pleased with the contact I’ve had with staff and residents. It’s a very resident-oriented place. Each of the staff members I’ve met has been dedicated to making our home as comfortable and pleasant as it can be. In addition, I know quite a few of the residents, and the ones I hadn’t known are friendly. So far, I haven’t been able to engage in any of the activities. I expect that will change as life settles down.

None of this means that I don’t face some challenges. What would life be without those? People who know me well, know that I (try to) follow a routine from the time I get up until I go to bed. Moving has upset that routine in many ways. I haven’t taken my 60-minute-plus walks since two days before the move. I haven’t learned where things are and haven’t found a number of things that I know we brought with us. This can be bothersome, but it’s not a big issue. I know it’s just a matter of time before I develop a new routine. At this stage of our lives and Kate’s Alzheimer’s, it seems like the perfect place for us.

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A Touching Moment

Despite many challenges that accompany Kate’s Alzheimer’s, I attempt to communicate that we also experience Happy Moments. I believe I’ve been successful in that, but some experiences can also be described by other adjectives. One of those occurred two days ago. It was “touching” for me, her caregiver, and a friend who had dropped by to say hello. Let me explain.

Kate is a member (now inactive) of P.E.O., a women’s organization that supports educational needs of women. Kate is a former president of her chapter and has always liked and been impressed with another woman who preceded her as president. Several years ago, we bumped into her in the lobby of a local movie theater. We were leaving as they walked in. After chatting briefly, Kate said, “Who is that? I recognize her, but I don’t know who she is. I liked her.” I thought that was a beautiful example of the loss of her rational abilities and the strength of her intuitive ones. The feeling she had for the woman had clearly stuck with her.

Yesterday, she stopped by to say hello on her way to meet a neighborhood bridge group. I was pleased that Kate was awake early and in a cheerful mood. When the friend arrived, I took her into the living room to talk with her. It had been a long time since she had seen Kate, and I wanted to update her and let her know that she might not recognize her. In fact, shortly before I had told Kate she was coming, and she had no idea who I was talking about. Nothing I said rang a bell.

Kate was in bed. I entered ahead of her friend and explained that she had a surprise guest who had come to see her. The friend walked to her bedside, and Kate responded like the Kate I’ve always known as a welcoming host to her home, one of the things passed down from her mother. With a big smile (something else she got from her mother), Kate reached out her hand, and her friend took it. Then Kate took her other hand and stroked the top of her friend’s hand.

She asked the friend to sit down on the bed beside her. That began a ten-minute conversation between the two of them. Kate’s words didn’t come out the way she would have wanted, but she communicated a sense of recognition and love for her friend. While they talked, I wiped tears from my eyes just observing the poise and feeling that Kate conveyed to her friend. There have been many other occasions when I hoped she could respond in the same way to a friend or to our daughter and son, but she couldn’t. Had it not been for her being in bed and getting her words mixed up, she would have been just like always.

I’ve heard and read accounts of other caregivers who have observed surprising experiences like this with their own loved ones. This was not the first time she has surprised me with things she has said or done, but this was the most touching I have witnessed. It comes during a week when she has gotten along particularly well.

It was an opportune time for her friend to visit, but there was more to it than that. The friend was very calm in demeanor and tone of voice. She spoke slowly and in short sentences. Most importantly, her words also conveyed an interest in Kate. I believe one of the problems Kate has is feeling left out because so much of the conversation around her is among the other people who are present. I think that is because people don’t know what to say to someone with dementia.

We caregivers are always trying to understand why our loved ones say or do things, but what is most important is that we treasure moments like these. I will hold on to this one for a long time.

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Celebrating Happy Moments in Late-Stage Alzheimer’s

Although Kate’s recovery is much slower than I would like, I rejoice in the Happy Moments we continue to experience. As I’ve said in other posts, our evenings are very special. That’s not to say that they are the only special moments of the day, but they are the most consistent. It’s nice to have a day that ends well.

One of our caregivers was surprised when I told her about that. She wondered what we could be doing that would be so special. I’m sure she asked because Kate often seems so passive when they are here. In addition, when she is talkative, most of the caregivers don’t enter into the conversation. Much of what she says is rooted in delusions. That may be why they tend to ignore her. They don’t know her well, and it isn’t easy for them to live in her world by participating in her delusions. It’s much easier for me to do that.

I believe our good evenings occur because she senses that when it is just the two of us, she can relax. I won’t do anything to disturb her. She almost always recognizes me as someone familiar. That contrasts with her caregivers. She has 5-7 of them and all but one is new since Thanksgiving. She hasn’t developed a strong relationship with them. Apart from the length of time we have been together compared to her relationship with the caregivers, I am also more careful to give her my attention. My impression is that she may feel more alone when she is with her caregivers.

Night before last was an especially good night. We were both propped up in the bed watching a 1993 Barbra Streisand concert. She was in a good mood and enjoyed the concert more than most music videos. We talked about the concert and especially Streisand. It’s important to note that it wasn’t a time when her Alzheimer’s symptoms disappeared. Throughout the concert she repeatedly asked Streisand’s name, but she liked what she saw and heard. She was also very loving. She held my hand and ran her hand across my arm, and we expressed our love for each other. When the concert was over, it was time to call it a night. Before doing so, Kate asked if I could take a picture of us. I take that as another sign that she had a good time.

It’s not unusual for her to be both puzzled and fascinated about her top sheet and bed spread. She often asks me what they are. I explain that they are something to keep her warm during the night. She has another purpose for them. They’ve become a convenient “Fidget Pillow.” For those who are unfamiliar with fidget pillows, they are often pillows with a variety of buttons, ribbons, or other objects. Many people with dementia find them fun to fidget with. They come in a number of other forms than just pillows. I bought one for Kate a few months ago, but she’s never taken to it.

Her top sheet or bedspread has become her personal substitute. She uses two hands about 18 inches apart to pick up either the sheet or bedspread. While holding it, she pulls her hands together to make a “shape.” She continues to make different shapes and asks my help and approval of the work she is doing. We did this together for almost thirty minutes last night. She enjoyed it and admired her own “works of art” while I enjoyed being part of her fun. This is something else in which her caregivers are not likely to be a participant, and I understand how they might think this is just a silly game. For me, however, it’s rewarding to see her enjoy simple things like this. After all, it’s difficult or impossible for her to engage in many of the same things that appeal to us. As they say, “It’s important to live in her world.”