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An Experiment and Unintended Consequences

The word “experiment” means a trial of some kind. For those of us with a background in research, it usually suggests a rather formalized methodology to determine the relationship among a set of “variables.” Most experiments are not of this nature. They are much less formal (and, therefore, less controlled) experiments that all of use to solve problems we face in everyday life. Caregivers do a lot of this. I am no exception. Let me tell you about an experiment I conducted two nights ago.

As I mentioned in an earlier post, I’m concerned about Kate’s sedentary lifestyle. She doesn’t exercise, and over the past year we have become less active. Now it is getting harder for her to get out of a seat of almost any kind, especially a low one. She walks slowly as though she might be in pain. She tells me she is not feeling pain. I think she is just becoming stiff. We know that she has arthritis in her knees. I’ve been looking for ways to keep her more active physically in order to postpone the day when she needs a wheelchair.

I thought she would enjoy and benefit from some time in our spa. Over the past two years, she has shown no interest in getting in the pool or spa. It’s actually stronger than that. She has resisted the idea, and I haven’t pushed her. I decided I needed to try a different approach. Knowing that she can no longer fit in her old swimsuits, I ordered one online last week. It arrived on Friday. Now all I needed to do was find a way to get her to put it on and get in the spa.

As we arrived home from dinner Sunday night, I told her I wanted her to help me with something when we went in. She said she would. Once inside, I gave her the swimsuit. I told her I had bought it and wanted her to try it on to see if it fit. She agreed. I felt a small measure of success, but the bigger problem might be getting her in the water.

She put on the suit, and I told her I wanted to put on mine as well. I explained that I wanted to experiment with something in the spa and needed her help. She didn’t protest. Getting in the spa required care, but was not too difficult. At first, I tried to help her step down to a step about ten inches from the surface of the water. She was quite nervous. I gave up on that and suggested she sit on the edge of the spa. From there I was able to help her sit on the step and then slide over to the seated area.

Once she was in the spa she was relaxed and started talking. She loved looking around her backyard where she used to spend much of her time tending to her plants. The water was also a comfortable temperature. I showed her how she could move her legs as though she were riding a bicycle. I commented about its being an easy way to exercise her joints. She agreed but only moved her legs for a moment. We spent about an hour talking. Any number of times she said that we ought to do this more often. My experiment was working better than I hoped. I was thinking that next time I could get her to move a little more.

When we were ready to go in, I got out first with the intent of extending my hands to her and helping her get out. She was frightened again and unable to follow my instructions. I finally got her in a seated position on the step inside the spa and on top of the seating area. The problem then was her not having enough strength to get up on her own and my not having enough strength to pull her up without a little help from her. She was too frightened to do anything. I got her to roll over onto the deck of the pool. That is when I discovered how hard it is to get her up when she is flat on the floor and emotional as well. I had another idea. I thought it would be easier if I took it one step at a time. I got on my hands and knees and asked if she could do that. If so, I might be able to lift her. She couldn’t understand what I wanted her to do. I can’t remember exactly what worked, but I got her up after several tries. So much for my bright idea of the spa for exercise.

I haven’t given up totally on the idea. I think it might be easier and safer if we used the pool instead. We have four steps at the shallow end. It should be much easier for her to walk down the steps with my assistance. We could do the same on the way out. I’m going to think about it a little more. I’m not quite ready to try again.

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Dealing with Squamous Cell Carcinoma

Except for our regular appointments with our doctors and dentists, Kate and I have had little reason for medical treatment since her diagnosis. A year ago, Kate’s arthritis in her right knee led us to an orthopedic clinic for a shot of cortisone. She has gotten along well since then although she complained of a little pain a few months ago. More recently, I have asked her on several occasions if she felt any pain. She has always said she didn’t.

Four or five weeks ago, I noticed a small growth at the edge of her upper lip. It had been well over five years since she had seen her dermatologist. I made an appointment, and the doctor performed a biopsy. A week later, I received a call that the she has a squamous cell carcinoma. We arranged an appointment to have it removed. It was scheduled for noon yesterday.

I much preferred an afternoon appointment. That would have been much easier for Kate and for me as well. That’s because I would have to wake her earlier to have lunch before the surgery. Unfortunately, we would have had to postpone the appointment until much later. They didn’t recommend that.

Every time I face getting her up early, I do so with a bit of trepidation. This time there was no problem at all. Although I had to wake her, she got up easily. That enabled us to have a leisurely lunch and arrive at the doctor’s office twenty minutes before noon. I didn’t mention where we were going until lunch. Kate didn’t understand why we needed to see the doctor and quickly forgot. I explained again on the way over, but she never really grasped the problem.

The doctor who was to perform the surgery was not her regular dermatologist. This doctor is a specialist in squamous cell carcinoma. He immediately noticed that it was hard to see the spot where the biopsy had been taken. Her dermatologist had either removed a large portion of it or it had diminished since the biopsy. The specialist summarized five or six options for treatment. They included complete surgical removal, radiation, freezing, and a topical chemical treatment that we could give at home twice a day for three weeks. After a brief discussion, we settled on the chemical treatment. That requires a compounding pharmacist. I took the prescription to the pharmacy, but they said it would be 24 hours before they would have it ready. I’ll pick it up later today.

As you might expect, the whole process was confusing for Kate. I tried to translate the doctor’s explanations, but she never really understood why she was there and that she had almost had surgery. In this situation, I didn’t think that was a bad thing. She didn’t seem annoyed or frustrated by it all. She wanted to understand what the doctor was saying. She just couldn’t.

I had a United Way meeting at 1:30 and had arranged for our sitter to meet us at the dermatologist’s office at 1:00. She arrived a few minutes before that as we were checking out. Perfect timing. This was one of those times it was really nice to have a sitter. She was able to take Kate home while I went to my meeting. Kate mentioned that she was hungry, so they dropped by Panera on the way. That meant she had a second lunch, but it also helped Kate pass the time until I got home later.

The balance of the day went well. At dinner, we ran into three people we know and had nice conversations with them. At home, we watched an Andre Rieu concert from London on YouTube. Kate enjoyed it more than usual. I’m glad to report it was a good day.

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Another Good Day: Two Victories

It’s been a year and a half since I engaged the services of sitters for Kate. From the outset I was concerned about her accepting them. She surprised me by doing so immediately. She was never enthusiastic, however, just accepting. As she has become more dependent on me, she has seemed more reluctant for me to leave without her. Recently, she has enjoyed being with both sitters. That continued yesterday when Mary arrived.

When she came in, I was in the back of the house. I heard Kate greet her. A few minutes later, I walked in the family room. They were chatting. It looked just like Kate was talking with a neighbor who had dropped in to say hello. She did say, “Where are you going?” when I told her I was leaving, but she was perfectly at ease. There was no sign that she was bothered. As on several other occasions, I left feeling at ease myself.

When I walked in the house later, I heard Kate say, “Perfect timing.” It turned out that she and Mary had just returned from Panera. Kate told me they had had a good time.  I considered this another victory. It has been months since she has let the sitter take her to Panera in the afternoon. Prior to that it was a regular event. I hope this continues. Before Mary left, Kate said, “Have you ever seen her drive?” I told her I had only seen her drive in the driveway. Then she told me what a good driver Mary is. This is a consistent pattern for her. She regularly talks about well people do things. It’s one of the things I like about her.

Even after Mary was gone, she repeated they had a good time and how much she likes her. That was quite a victory. I couldn’t have had a better welcome home. I’ll feel much easier the next time I leave her. Even though I hadn’t spent much time with Kate earlier in the day, I was ready to say it was another good day. The rest of the day also went well.

Last night was pizza night. When we got home, she said, “What can I do now?” I suggested we go to the family room and that she could look at one of her family photo books, work jigsaw puzzles, or look at her “Memory Book,” the three-ring binder I had put together with information about our families and memories of our lives together. She started with the memory book while I watched the evening news. In a while, she picked up a history of her family’s church in Fort Worth. It was published in 2001 on the church’s 100th anniversary and had been a gift to her mother. It’s a book of over 200 pages with normal type (small for Kate).

As she went through it, she was thoroughly engaged although she had difficulty reading it. I was still impressed that she continued to work at it for about thirty minutes. She could not have done this before her cataract surgery. I should add that she also needed my help. I was seated on the sofa across from her. Every few minutes she would see a photo but couldn’t read the type indicating the person’s name. Sometimes she could read a heading but couldn’t read the text. She finally reached a section she wanted to read and asked me to read it for her. For another thirty minutes, I read to her. Her interest never waned, but I don’t believe it was because of the content per se. Some of the things I read were about people she didn’t know at all. There were also accounts of committees appointed to conduct a search for a new pastor or construct a new building, but it was her family’s church, the church in which she grew up. I was touched to see the pleasure she enjoyed looking through it.
That has to count as another good day.

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Post-Surgery Report

In my last post on Kate’s cataract surgery, I noted that she was having trouble keeping the patch over her eye. There was no improvement after that. She took the patch off just before we went to dinner. I kept it off until nearly time for bed when I saw her rubbing her eye. I woke up once during the night and saw that it was still on. When I got up at 6:25, it wasn’t. I decided then that I would not put it on again. I’ll just try to keep my eye on her and stop her if she starts to rub her eye. I think this may be just as effective as the patch and less troublesome for both of us.

Yesterday we had a late morning follow-up appointment with her ophthalmologist. Kate couldn’t understand why she had to see her. She has no memory of having surgery. That was true even as we walked away immediately after the surgery on Tuesday. The doctor asked her how her eye was doing and quickly recognized Kate hadn’t remember. Then she examined her eye. She was pleased with what saw as well as the eye test her technician gave her prior to her coming into the room. At her last appointment, Kate’s test showed that she was legally blind in that eye. One day after surgery, she scored 20/50 on the same test. The doctor said that was especially good since they had adjusted the lens for best vision to be at shorter distances. That’s because her major activity is working puzzles on her iPad. It’s still too early for me to know how well that is working. I’ll be watching closely in the next few days.

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Cataract Surgery

For almost a year I had seriously considered cataract surgery for Kate. I held back because I had a concern about potential effects of the anesthesia. In addition, she seemed to be getting along pretty well even though her vision was about 20/60. Two recent changes made me believe now was the time to act. The first was that I noticed that she was pretty shaky crossing streets and going up or down curbs or stairs. Even more striking was her inability to see where puzzle pieces should go even when there was only one remaining piece. The second was how poorly she did on her last ophthalmologist’s visit. She couldn’t even see the big “E” that covered the whole screen. The doctor said she was legally blind in that eye. As a result we made the appointment for surgery.

Among my concerns was that the surgery was scheduled for 11:00 this morning. That meant I would have to wake her earlier than usual. Fortunately, that turned out to be relatively easy. When I went into the bedroom, she was already awake and said hello. When I walked over to the bed, she gave me a big smile. To me that meant she recognized me. I told her I wanted to put some drops in her eyes. That startled her, and she wanted to know who I was. I gave her my name and told her I was her husband. This was one of those times she just wasn’t convinced. I decided to divert her and focused on getting ready. I told her we had to get ready for her eye doctor’s appointment, and I really needed her to get up. She was very cooperative.

We had a little time after she had dressed. I took her to the family room and asked her to sit down. I sat beside her and opened her “Big Sister Album.” She is always taken by the cover photo of her with her brother when she was five or six. I told her it was a picture of her and her brother. Then we opened the book and saw pictures of her with her mother and father. We went through several pages, and it seemed like her confusion was over. We didn’t, however get to pictures in which I was included, so I don’t know if she was beginning to recognize me or not. She was so engrossed with the album I suggested we take it with us. She liked the idea although I am sure she had no idea where we were going. I know she couldn’t remember we were going to see the eye doctor.

After checking in, we sat down in the waiting room and started looking at the album again. She loved seeing her baby pictures and commented on how cute she was. She asked me to identify her mother and father. Then we looked to the page on the right. I pointed to a woman and asked if she knew who that was. She said, “Nana.” She was right.

We didn’t get very far until we were called to the surgical area. It was very clear that she had no idea why she was there and what was going to happen, but she was very calm and cooperative with the various people who were assisting. Our appointment was at 11:00, and the surgery was over just after noon. They called me in about 12:20, and brought her to a recovery area five minutes later. We were on our way home before 1:00.

The only issue it looks like we are facing is keeping her from rubbing her eye. They put a rather substantial patch on her eye and told us to keep it on for six hours. I gave up after four hours. By that time she had taken the patch off twice, once when I left the room to brush my teeth and another when I was sitting in a chair ten feet across from her. She had frequently asked if she could take it off since leaving the doctor’s office. She simply can’t remember that she had surgery or that she has to wear the patch.

The doctor called around 4:00 to check on her. I told her the patch was off. She said that is all right but that I should do my best to see that she doesn’t rub her eye. We have an appointment with her at 11:20 tomorrow. I assume she will probably look at the eye to see how it is healing. I trust it will go well.

I took the patch off when we went to dinner assuming that I would be able to watch her closely from across the table. We had no problems. After we got back home, I saw her begin to rub her eye and had to put the patch back on. I hope we don’t have any problems while sleeping.

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Definite Progress

Yesterday was clearly a day of improvement for Kate. There has been no sign of wheezing since Friday evening. She is also coughing less. Those were the two most obvious signs of her being sick. She has had to clear her nose more than usual, but it has been less of a problem.

She has been so tired during the past eleven days, that I was surprised when she got up about 8:30. She wasn’t as groggy as she often is. For the first time in several weeks, we arrived at Panera about 10:15. That gave us plenty of time for a muffin and lunch before the sitter came at noon.

When Valorie arrived, she gave her a friendly greeting. I mentioned that I had put in a DVD of Fiddler on the Roof. At first, she said she wanted to rest. Then she changed her mind and wanted to watch. When I told her I was leaving for Rotary and the Y, she said, “You’re leaving? Why don’t you stay here with us and watch?” I explained that I needed to get my exercise and would be back later. She didn’t complain, and she didn’t look sad. It was clear by the look on her face, however, that she really wanted me to stay. As I left, Kate and Valorie were watching Fiddler. I wondered if Kate would make it through the entire movie without resting. When I returned, Valorie said she watched the whole thing without napping at all. I was happy to hear that.

The big disappointment of the day was learning a little later that Valorie will no longer be coming. She is the sitter I liked the most and would have loved having all the time. The agency didn’t give any explanation. Given the privacy laws, I can understand that, but I would really like to know if she left the agency or they shifted her to another client. I have her phone number and plan to call her tomorrow.

In the meantime, they are sending the new sitter that came last week while I attended a luncheon. I felt she was all right, but Kate slept the whole time I was gone. I did introduce the two of them before leaving, but I wish Kate had had more time to get somewhat accustomed to a new person. This is one of the challenges of our time. There is a lot of transition in positions like this. It makes me realize how fortunate we were with the team of caregivers we had with Kate’s mother. After the first month or two, we settled into a team seven or eight people who were with us until her death. That was almost five and a half years.

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Light at the End of the Tunnel (The Cold, That Is)

Yesterday Kate got up around 7:30, went to the bathroom and back to bed. I was pleased when I noticed in the video cam that she was about to get out of bed at 9:00. I went to her and asked if she wanted to get up. She said she did. As usual, the first thing she asked was, “Where are my clothes?” I asked if she wanted to take a shower. She looked unsure. I told her I thought it would be a good idea. She asked where she could find the bathroom. She rarely remembers. I know that she finds one if I am not with her. She must walk around until she finds one.

I went to the kitchen after seeing that she got in the shower. It wasn’t long before I saw that she was out and getting into bed. It was still early, and I know that she likes to stay in bed after her shower so I let her stay there an hour or more. While she was resting, she had a coughing spell about ten minutes. She seemed to be getting along pretty well as she was dressing and on the way to lunch. I didn’t hear any signs of wheezing then or the rest of the day.

She also got along well while we were at the restaurant. She had her usual memory problems, but they seemed worse yesterday. It started with one of the pictures of Frank Sinatra on the restaurant walls. Over and over she asked his name, sometimes within seconds. It is virtually impossible for her to retain information. We had chatted for about twenty minutes when she said, “What is my name?” She followed that with “What is your name?” After I told her, I asked, “Do you think we’re connected?” She said, “Are we married?” This time she didn’t seem skeptical the way she usually does and didn’t say anything.

When we got home, I decided to show her a TCU video on YouTube. Her brother Ken had let me know about it last week. She was fascinated to see the campus as well as some parts of Fort Worth. Like the music videos, the one we watched was followed by many others that were similar. She was well entertained and never worked on her iPad that was in the chair beside her.

After forty-five minutes to an hour, she took a break. While she was in the bathroom, I put in a DVD of her father’s family movies from the mid-1930s to the early-1940s. She was enthralled and whimpered as she watched. We were watching on the TV in our bedroom. Almost an hour later, she got up and walked over to me. She was very teary. She said, “Would you lie down with me?” When we got on the bed, she said, “I love my family. <pause>  My aunts and uncles. They’re all gone now.” I asked if she wished I hadn’t shown the video. She said, “Oh, no. I am glad you did. It just makes me sad. I said, “You must be glad to know that we have this video to remind us of them.” She said she was. I wasn’t surprised. The family movies have always been treasured memories. Of course, for Kate and for the other relatives her age or slightly older, they aren’t memories because they were taken either before they were born or when they were quite young.

While we were talking, we got a call from our daughter Jesse. We had a nice conversation catching up on her family. Kate greeted her when she called and said goodbye when we hung up. She was glad Jesse had called, but she did not participate in our conversation.

We took a break to get a bite to eat before the Super Bowl. When we got home, she waited for me to lead her to the back of the house. I said, “Would you like me to lead the way?” She said, “I could do it, but I would feel better if you did.”

She worked on her iPad for a while. Then she was tired and went to bed. I helped her get undressed and in her night clothes. She seemed especially confused. I had to tell her what to do every step of the way.

She went to bed around 8:30. I continued watching the Super Bowl until it was over around 10:00. When I got in bed, I thought she was sleeping soundly. Then I heard her whimpering. Periodically, she was shaking. I asked what was wrong. She said, “I don’t know.” I asked if she were afraid of something. She said she wasn’t. I asked her what I could do to help. She said, “Just stay with me.” That’s what I did. I gently stroked her back and talked softly about the good things we have experienced during our marriage. It wasn’t long before she was asleep, and so was I.

As I look back on the day, I don’t think there was anything she did that she hasn’t done before. Nonetheless, she seemed more like someone with dementia than she has in the past. During the afternoon, I received a phone call from a friend about our going with them to a concert in Asheville the last of May. I told him I appreciated the invitation, but I was very unsure because of Kate’s recent decline. At this point, I don’t know what to expect by then.

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Making Progress?

Kate was getting up on her own about 11:45 yesterday when I saw her on the video cam. I went to the bedroom and asked her how she was feeling. She looked puzzled and said, “Why do you ask?” I don’t think she thought she was sick. In fact, over the past nine days she has only recognized that she coughed and had to blow her nose and that, of course, only in the moment they happened. I had told her she had a cold, but she never remembered it. Day before yesterday, she definitely felt sick. That was when I heard her wheezing. I don’t believe she has had a conception of her being sick over a few days.

The good news is that I listened for her wheezing and didn’t hear anything. Then I asked her to take a deep breath and blow out through her mouth. She did that a couple of times. I still did not hear a wheeze. That made me feel a lot better. I didn’t want to see this advance to pneumonia. Of course, both of us have had the pneumonia shots, but we all know they don’t always work the way they are supposed to. Like many others, we had a light case of the flu last year even though we had the flu shot.

In addition to not wheezing, it was a good while before she coughed after getting up. Excluding her Alzheimer’s symptoms, she also seemed more normal. When I walked in she said, “Are you my daddy?” When I told her I was her husband, she couldn’t believe it. I decided it was best not to go into an explanation and suggested she take a shower. She asked where the bathroom was, and I took her. She took a long shower, dried off, and got back in bed.

After I got her up and helped her dress, she seemed fine. She wasn’t coughing. I decided to go out to lunch When I backed he car out of the garage, she coughed several times. Then I had doubts about going out. When she stopped, I decided to go ahead. Except for a couple of briefs coughs, she was fine at lunch.

Several times she asked where we were. Of course, she has been doing that for a long time. Now there is a new twist. When I tell her we are in Knoxville, Tennessee, she often asks, “What is Knoxville?” Then I explain that it is a city and that Tennessee is the state. It is only in the past few months that she has commonly asked this. It is another sign of the subtle changes that are constantly taking place. Mixed with her questions about our location, she also thought at times we were in Fort Worth. I suspected this on the way to lunch. She commented on remembering many things she saw along the way.

We came back home after lunch. When I got out of the car, she asked if she could help bring things in. I am sure she thought we were traveling and needed to unload the car. I told her I could get everything. Let me digress a moment.

(This is something new that I have mentioned before. Over the course of her Alzheimer’s, she has rarely asked if she could help me. In the past few weeks, she has asked if she could help me fold and put up the laundry, unload the dishwasher, and now unload the car. I also mentioned in a previous post that the other night she asked if there were anything she could do to help me. In that case, she was worried that I was carrying a heavy load and wanted to ease my burden. These may seem like very little things, but they are totally different from the norm the past ten years or so. She was letting me do things even before her diagnosis.)

She said she was tired and wanted to rest but brushed her teeth first. After brushing, she walked back to me in the kitchen. I could tell by the look on her face that she wanted to know what she could do next. That is a very common thing for her to do. I gave her the iPad and said she could sit in the family room and work puzzles, and I would be there in a minute. I went back to my computer. When I had finished what I was doing, she was walking out of the family room to the back of the house. I don’t believe she even sat down to work her puzzles. Shortly, I went back to one of the guest rooms where she was resting on the bed. She has definitely been more tired since catching her cold.

About two hours later, she came into the kitchen with her iPad under her arm and stood beside me. She didn’t say anything. This, too, is a very common experience. I knew that meant she wanted to get out of the house. We went to Barnes & Noble. We had been there fifteen minutes when Kate looked up at me and said, “I forgot they had this here.” I said, “What do you mean?” She pointed to her iPad and the puzzle she was working. By now I shouldn’t be surprised that she doesn’t recognize her own iPad, but I am. This was one of those times. I wonder what could have made her think it belonged to Barnes & Noble. This is similar to what frequently happens in restaurants. As we are about to leave, she often asks if the cup or glass is hers or belongs to the restaurant. It always makes me think about how she perceives the world. I simply can’t imagine how confusing for her it must be not to know where she is, what is hers, where we are going, and what she is supposed to do. There is so much I don’t understand. No wonder she gets confused.

We had another beautiful end to our day. I had chosen a YouTube video of choral music. In its cycle from one video to the next, we landed on a series of videos by a church choir. I didn’t see any identifiers as to what church or where it is located. I will have to check today. I do know that Kate was taken with everything they sang, and almost all their music was unfamiliar to either of us. She didn’t want me to stop the videos to go to bed. Finally, I turned them off and help her get ready to bed. I had to assure her that this was not a live concert we were watching, and we could pick where we left off tonight.

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Day 9: The Cold Becomes Something More

I was interested in getting an idea of how Kate was doing yesterday morning, so I tried to get her up for lunch. That would have given us time to be together as she was getting ready as well as at lunch. This was one of the many occasions when she just wanted to remain in bed. The first time I walked into the bedroom, she was lying in bed awake. I took a glass of water and asked if she would like some. She said, “In a minute.” She looked mildly confused or disturbed. When I asked if something were wrong, she held her hand up to let me know she didn’t want to talk about it. I sat down on the bed and said, “It looks like something is bothering you. Could you tell me about it?” She shook her head no. Then I asked if she would like me to let her rest a little longer. She did. I told her I would be in the kitchen if she needed anything.

About twenty minutes later, I went back to let her know that I would be going to the Y a little later and wondered if she would like to go to lunch with me or let the sitter help her dress and take her. She opted to stay in bed and let Mary handle things. Then I noticed she was wheezing slightly. It wasn’t much, but I took that as a warning sign and called her doctor. Unfortunately, they had just closed for lunch, but her doctor’s nurse called me back as soon as she returned to the office. She advised us to go to an urgent care center to have her checked.

We went to a nearby office that has quite a few locations in various parts of town. We have been to one of their other offices in the past. I like the fact that you can schedule appointments online and wait at home until they text you thirty minutes before your appointment. That doesn’t mean that you don’t wait in the waiting room, but the wait is significantly shorter. I also like that they have a TV that lists the order in which patients will be called. Both times we have used this system, Kate has been the next person called. That happened again yesterday.

This was a time I could have used my cards indicating that she has Alzheimer’s, but I forgot. Instead, I discretely told the woman at the front desk and the nurse who led us to the examination room. That was good because Kate had trouble following very simple directions like stepping on the scale to be weighed and where to sit. I knew that when we got to the x-ray room, she was going to have a problem. It worked out fine, but she did get confused and spoke fairly strongly (for her) to the nurse to be clearer about what she was supposed to do.

Her vitals were just fine. Her blood pressure (139/80) was higher than it used to be, but her temperature was 98, and here blood work showed no sign of an infection. She had lost five pounds since her last doctor’s appointment in the fall. Of course, scales can vary, but I couldn’t help thinking that might be a result of eating fewer blueberry muffins. That doesn’t happen nearly as much now that we are not at Panera every day. The x-ray, however, did show congestion in the bronchioles. Although it appears that she does not have a bacterial infection, the doctor put her on an antibiotic and advised us to contact her doctor on Monday.

She slept well through the night and had only one coughing spell that occurred shortly after going to bed. She was up at 6:30 to go to the bathroom. I took the opportunity to give her the next antibiotic and Mucinex. I didn’t detect any wheezing; however, a few minutes ago, I went to her beside and listened carefully. She was wheezing very slightly, less than she was yesterday. I hope we will see some improvement today.

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The Cold on Day 8

I am gaining a better perspective on the lives of other caregivers who deal simultaneously with dementia and other health issues at the same time. To be sure, I am getting only a small taste of what others live with, but it does reinforce what I have said before. Kate and I have been fortunate in many ways since her diagnosis. The fact that both of us have been healthy is one of those. Both of us have had colds before, but it is more challenging at this stage of her Alzheimer’s. In the past it was easier for her to manage her own care with limited help from me. The only thing she can do now is blow her nose and spit out the phlegm that accumulates in her throat.

Despite this, her cold has not been especially serious. Her cough is still infrequent. She coughed just after going to bed and didn’t cough again until 1:45. She coughed on and off for about fifteen minutes and stopped. I haven’t heard any coughing until a few minutes ago, and it is now 9:30. What I do hear is her nasal congestion, but it is not constant. I’ve mentioned the sensitivity of the audio from the video cam monitor. Depending on the volume of the music I am playing in the kitchen, I can hear her breathing. When she coughs, I can hear it over any of the music I might be playing.

Apart from the cough and nasal drippage, the only sign of how she feels is that she seems more tired than usual. As I mentioned in a previous post, she slept until 2:00 on Tuesday. Yesterday, I woke her up at noon because she had a massage at 2:00 and a haircut at 3:15. She got along fine. When we returned home, she rested an hour and a half before I got her up for dinner.

She had more trouble working her jigsaw puzzles last night. Part of her problem is visual. Even when there is only one piece left, she has a difficult time locating where to put it. Each puzzle is on a solid-colored background. When the pieces are scattered, the background color is displayed where the pieces go. Thus, when there is only one piece missing, there is a picture with a rather glaring space colored like the background. To any of us, it would be immediately obvious where the last remaining piece should go. It isn’t obvious to her at all. Even when I put my finger on the piece and then on the spot where it goes, she often doesn’t know where to put it. One additional problem that is easier to understand is that she sometimes puts a piece in place but not precisely in place. Kate can’t tell that, and the app does not indicate that the puzzle is complete. Then she calls me. I locate the piece that is causing the problem and push it into place. Then she goes on to the next puzzle.

When she started working her puzzles a few years ago, she chose those with 42 pieces. Over time, I have selected the number of pieces for her. I dropped the number to 25, then 16. I think it is time to go 9 pieces. That’s the fewest available with this particular app. I hope that it will be easier for her after her cataract surgery on February 12.