A Lengthy Conversation About a Delusion

Kate is not generally a big talker, but, periodically, she surprises me. I don’t always know what prompts her talkativeness, but I do know that it often involves a delusion of some type. She had one of those yesterday. As so often happens, she had been resting on the sofa in the family room. I was seated across from her. She rested over an hour before she opened her eyes. When she saw me, she said, “You can help me.” I asked what I could do, and she said, “Come over here.” When I did, she told me to “go over there.” I walked across the room and turned around. Then she said, “Come back over here.” I walked very obediently to her again. This time she told me to take a seat and pointed to the table in front of the sofa. I sat down and asked how I could help her. That opened the door to a conversation that lasted over an hour.

At first, it was very hard to make sense of what she was saying. She acted as though there were other people in the house with us. It turned out that she was talking about a group of longtime friends. At an earlier point in life, they were very close. Over the years, however, they had developed different interests. As a result, the occasions they were together were not as much fun as they used to be. As near as I could tell, some bitterness had developed among them. She never said there was one particular person who was the problem. She did say that they had all tried to reclaim the closeness of their previous relationship, but nothing had worked.

During the course of the conversation, she drifted away from asking my help to a broader emphasis about the nature of people and their sensitivity to the actions of others. In the end, she felt there was probably nothing that could be done to help her and her longtime friends because many of the circumstances in which they found themselves were so different now. She wasn’t, however, ready to give up.

I was primarily a facilitator in the conversation. I said very little except to nod my head or agree or make a comment that indicated I was listening. Late in the conversation, I again asked how I could help. She indicated I already had by listening to her.

Conversations like this intrigue me because so much of what she says makes sense with respect to human nature and the problems we encounter. At the same time, she is obviously experiencing a delusion that represents a break with reality. It’s just one more thing for which I don’t have a good explanation. I can only say that some of the circuits in the brain are functioning while others are not. There is also a good bit of inconsistency. Sometimes a circuit works. At other times, it doesn’t. That happens for all of us, but it is more dramatic for someone with dementia.

Alzheimer’s Continually Presents Surprises

As I’ve said many times, change is a big part of our lives now. Sometimes the changes seem to come out of nowhere and, thus, are more surprising than others. Yesterday afternoon, Kate experienced two changes in her mood and behavior that caught me off guard. The first one demanded a lot of my attention. I welcomed the second.

Our day had been a very good one. She was up at 7:30. She was confused, but it was a time when she was ready to do whatever I suggested. I told her I thought it might be good to get up and have breakfast. I had already finished mine but enjoyed having my coffee while she ate.

After breakfast we adjourned to the family room where I thought she would immediately decide to rest, but she didn’t. Instead, she was interested in looking at a photo book. It wasn’t long before she was tired and rested until time for an early lunch.

She rested again as soon as we finished lunch. She didn’t sleep much, and the last hour she tried to read a booklet that her mother’s Sunday school class had given her for her birthday in 1989. It was filled with things the class had heard her say many times during the years she had taught. I asked several times if I could read some of it to her. She finally accepted, and we both enjoyed ourselves.

Then it was time for dinner. I placed an order at a nearby Mediterranean restaurant. On the way, Kate asked for her lipstick. I was surprised. It had been months since she asked about lipstick, and I stopped carrying it. (I suspected that she must have thought we were going to see someone, but she didn’t say anything that would confirm this until much later.) As it turned out, this was the beginning of the first significant change in her mood and behavior. I explained that we could get it when we got home. I never thought she would remember it. This was another time I was wrong. As we were eating, she asked for it.

I went to the bedroom and brought it back to her. I started to open it myself, but she wanted to do it. She extended the lipstick too far, and it broke off. She grabbed it with her hands and put it on her lips. In the process she made quite a mess on her hands and her cloth napkin. I got something to wipe her hands, but it wasn’t easy to remove all of it.

As we continued eating, she asked about the location of her salmon and her cucumber salad on her plate. I hadn’t thought much about it, but she had pushed them around after I served her. I told her it was fine. I added that she could put them wherever she wanted.

It got more serious later. She had finished eating and was now applying her aesthetic tastes to the arrangement of her leftover food. That would have been fine, but she wanted my help. I said something that was a playful response to her request. That was the wrong thing to do. This was a serious matter for her. She had pushed all the remaining food together toward the center of the plate. She was concerned about a couple of blank spaces where there was no food. I picked up a couple of pieces of cucumber and filled in one of the gaps, but she wasn’t satisfied. She started moving grains of rice and pieces of tomato to balance the “food art” she was creating. She picked up several things and put them on her placemat. During this process that took about twenty minutes, she mentioned that “she would like it better over here (referring to portions of the food). She wanted to know what I thought. I said, “It looks good to me.”

Then she extended her art beyond the bounds of her plate. She crumpled a piece of a paper towel and put it on the placemat and pushed it toward the center of the table. She also picked up the two coasters and made them part of the art. Subsequently, she added two catalogs, a coloring book, and crayons. At some point, she said something about wanting it to look right for “them.” In this case, she was talking about people who were coming to the house. Finally, she stopped, but she wanted me to put the plate with the food in safe place. I put it in the refrigerator.

Then we went to the bedroom where I helped her get ready for bed. She has been getting in bed around 7:15 or 7:30 recently. This time she got into her night clothes but wasn’t ready for bed. She wanted to know what she should do. I asked if she would like to look at one of her photo books. She did, and I brought her the “Big Sister” album. I knew she would have problems with it, but I figured she would probably give up and go to bed. Wrong again. This came at a time when I wanted to clean up a few things in the family room and kitchen before taking my shower. She was insistent on my helping her. She seemed to be under pressure for something.

She asked what she should do. I explained that she should go through the book looking at the pictures. I told her she would see a lot of pictures of herself, her brother, and her mother and father. This didn’t help her. I pointed to a picture and told her some of the things I noticed about it and told her that was the kind of thing she could do. I was surprised when she seemed to get the idea. She started her own narrative with a photo. Then she said, “It’s your turn.”

I told her there were a few things I needed to take care of and would also be taking a shower. I said I would come back to her. That’s when she said something about our preparing for someone to arrive and that we were going to put on a show for them with the photo book. She would tell her story with one photo. Then I would tell my story with another and so forth. I helped a little longer before telling her to continue while I took my shower.

I was sure she would become frustrated and give up on the album by the time I returned. That was when I got the second surprise. She had changed completely. She had gone through the entire book and was on the last page or two. This was a surprise because she doesn’t usually spend that much time when she is looking at it by herself. She was her happy normal self. Apparently, she had forgotten about the guests who were coming and no longer had to worry about being prepared for them. Whatever the reason, it was nice to end the day with her in a good mood.

I should add that I had not previously observed anything that would make me think she was “sundowning;” however, her behavior was different enough from other situations that I thought about that. In the future, I will be more attentive to this possibility.

Living in Kate’s World of Delusions

Kate has experienced delusions for several years, but they occur more frequently now, especially since we have been homebound. Prior to my experience with Kate, I was prone to think delusions were all bad. I am discovering that is not so. Most of Kate’s are benign. They are harmless, some puzzling, but most quite interesting and reflective of her personal values. A few have been disturbing. These have involved a belief that no one likes her, that she has done something she believes was wrong, or that she has some obligation for which she is not prepared. The most frequent delusions involve projects designed to help those who are underprivileged in some way. Often, they involve programs to educate women in third-world countries but also in the United States.

During the past 36 hours, she has had two separate but related delusions that led to unusual conversations. They were very one-sided with Kate playing the dominant role. In fact, soliloquy might be a better word than conversation. The first occurred Wednesday night when I got out of the shower. She began a conversation that lasted almost a full hour and a half during which I said very little. I played the role of facilitator by simply listening, expressing agreement, or asking questions that would lead her to say more.

The second conversation occurred yesterday morning at breakfast. Yes, I said, “Breakfast.” It was another time she had gotten up early before I had fixed my own breakfast. I took the opportunity for us to eat together, never expecting another lengthy conversation. This one was an hour.

Both of them were interesting and involved a school. In each case, she did not know my name and had not recognized me as her husband. That was true all day Wednesday and a large portion of the day yesterday. It was clear Wednesday night that she was talking to me as though I were a potential candidate to join their program. Unlike other similar delusions, she didn’t say much, if anything, about the students. Her focus was entirely on the underlying values of school for those who worked (volunteered?) there. It was a diverse workplace where everyone respected the talents and personalities of the others.

Like another conversation we had several weeks ago, she responded to me just the way she would have if she had known my name and our relationship. Like the previous one, she repeatedly referred  to her husband and used my name each time. She kept saying, “I wish Richard were here. He could give you a better idea (tell you more, etc.).” While she didn’t say much about the students, it was another example of a program designed to provide education to people who might not otherwise have gotten it.

The length and complexity of her conversation was a striking contrast with most of her delusions. She talked non-stop, though in a relaxed style, for a full hour and a half that night. Several times I suggested that we continue the conversation the next morning. She agreed the last time when I mentioned wanting to think about it and talk in the morning.

I never imagined that she would start a similar conversation the next morning, but that’s what happened as we sat down for breakfast. I was never sure that it was an extension of the previous night’s conversation, but it was strangely similar in length and complexity. She also periodically mentioned her husband (me) by name. This time it wasn’t clear if I was a candidate for a position. It sounded more like I was someone who had expressed an interest in what she was doing.

Conversations like these are rooted in delusions brought about by Alzheimer’s; however, they also involve powerful expressions of Kate’s feelings and values. I find that comforting. It reminds me that the real Kate is still here.

Our Busiest Day

From time to time, I’ve said I wish my memory would allow me to report more clearly the things that Kate and I experience while “Living with Alzheimer’s.” That has never been truer than the following account of what happened yesterday. The best I can do is to sketch what happened without the full details that would enable you to get a better feeling for what it was like.

It is unusual for Kate to get up during the night, but the day began at 1:00 a.m. when Kate said she wanted to go to the bathroom. We took care of that without any difficulty and returned to bedroom. I don’t think either of us was awake too long after that.

At 5:00, Kate was awake again and said, “What do we do now?” I told her it was early and that it would be good to go back to sleep. I think she did. I know I did and woke up for good about 6:15.

I had just finished combing my hair when she came to the bathroom door. She was looking for something. She had already gone to the hallway and family room just outside our bedroom and turned on the lights. I don’t remember what she said, but she had the impression that guests were coming to the house, and she needed to prepare for them. Typically, when she gets up, she is a little groggy. This time she seemed awake and on a mission.

I suggested that she use the toilet so long as she was there, and she agreed. Then she said, “What now?” I told her it was still early and that going back to bed would be a good idea. She was very compliant, and I got her back to bed. I went back to the bathroom to shave and then got dressed.

I had finished my breakfast and was about to take my walk when I heard her call. I went to the bedroom and found her ready to get up for the day. She was concerned about the guests who were coming and wanted to make sure the house was in order. I got her dressed and invited her to breakfast. I had a fruit muffin left over from our takeout meal the night before and heated it in the microwave for her. Although she said she was interested in joining me for breakfast, it was difficult to get her to the table. It was another example of the passive aggressive response she has given when I wanted her to get up, and she wanted to stay in bed. As she has done in those cases, she hears me but ignores me.

I heated her muffin in the microwave and invited her to the table. She said she was coming, but she didn’t come to the kitchen. Instead, she walked around the house looking over things to see if they were in order. She keeps some of the paper doilies she picks up from one of the restaurants we visit regularly on her dresser in our bedroom. Before leaving the bedroom, she meticulously rearranged them along with a hairbrush. She continued this effort in the family room and kitchen.

It took several requests before she sat down. I was both puzzled and frustrated that she didn’t come right away. Ultimately, she came, but she only ate a portion of her muffin and some sliced peaches.

From the time she got up, she was concerned about being ready for our guests. She didn’t seem to know anything about them. She repeatedly asked me their names and what time they were coming. I told her she had plenty of time as they weren’t coming for two or three hours. She expressed mild initial relief. Then she completely forgot and started her questions again.

Kate was much more talkative, and her aphasia was evident. I had great difficulty understanding much of what she said. That was true the entire day.

When it became clear that she was not going to finish her breakfast, I suggested we spend time together in the family room. I got her to take a seat beside me on the sofa and picked up her “Big Sister” album that her brother had given her two years ago. We spent a long time with it, and the distraction worked beautifully. She forgot about our guests and getting ready for their arrival.

Our daughter called while we were looking through the album. Kate talked a lot, and Jesse was able respond appropriately. By that, I mean that she only made facilitative responses to Kate’s sometime unintelligible comments. That kept Kate going. I was happy because Kate was enjoying herself.

It was soon time for lunch. I wanted something quick and easy and chose the Brunswick stew I had purchased late last week. We had a pleasant lunch, and she wanted to rest. I was surprised she hadn’t rested during the morning because she had gotten less sleep the night before and assumed she would rest a long time.

She didn’t rest long before she seemed wide awake. We spent more time with photo books. She was getting along quite well. I told her I wanted to show her something in the living room. I am beginning to sound like a tour guide, as I take her through all of the items that were in her parents’ home. I don’t think that was the key at all, but she was very moved by everything I showed her. It was a moving experience for her.

When we finished the tour, we sat on the sofa. She was very emotional and said, “I feel so good. I can’t remember having a day so good.” She repeated this with variations for a few minutes. It was a special moment for me as well. We still had time before dinner, and she was tired and wanted to rest.

I took that opportunity to get on my laptop and sit in a chair directly across from the sofa where she was resting. I wanted to write this post. I had a second thought and decided I would send an email to Jesse and Kevin to let them know that we were having such a good day. I also thought that would provide a good start for writing a blog post.

I didn’t get far before Kate was finishing her brief rest. That made me think about getting something for dinner. I told Kate I would be in the kitchen and would call her when it was ready. While I was in the kitchen, she got up and started wandering around the family room. She called to me. (Yes, she used my name and did so most of the day.) I found her attempting to disconnect the router. She had already unplugged the cable that powers her lift chair. I told her not to touch the router and attempted to explain while knowing she could not understand. This was a frustrating moment because I had been heating some bean soup that had overflowed on the stove top.

I went back to the kitchen. She called again. She was working on the router. I reminded her that she should not touch it. I left for the kitchen. As I was cleaning up the mess, she called again. She had forgotten about not touching the router. I reiterated how important it was to stay away from it and suggested she come into the kitchen with me.

She wanted to help me, but I couldn’t figure out anything useful for her to do. She wandered around the kitchen picking up things. I keep a stack of bills and other communication that deserve attention on my desk. She separated those and arrange them on the desk.

She was back in the family room when I put the food on the table and called her to dinner. She said she was coming but didn’t. I went to her and told her the food was ready, and she could join me. I went back to the table, but she didn’t come. I tried another time and she came.

She was very talkative. It began when she look at something across from her and thought it was a person. Some of her comments were addressed to her and some to me. She talked and talked, but she wasn’t eating. Her aphasia was active. I couldn’t understand much of what she said.

I began to think she might have a urinary tract infection (UTI). I called her doctor’s office. No one answered, not even the answering service. I tried to contact the nearest urgent care center. They had closed for the day. I called Virginia, Kate’s brother’s wife. She is a retired pharmacist with a good knowledge of health and medical issues. I wanted advice on how to proceed. She said she would probably go to a 24-hour urgent care center if one were available. I looked and didn’t find one in our area.

I went back to the table where Kate was still sitting quietly in front of her food. I decided to give her a breakfast bar. She was very calm, nothing like she had been minutes before. That made me think it was not a UTI but Alzheimer’s that was causing the problem.

I cleaned up, and we went back to the bedroom where I got her ready for bed. She had a little difficulty knowing what she should do next and understanding what I told her, but that is normal. She was in bed rather quickly, and I put on an Andre Rieu concert from Maastricht. She relaxed and listened to the music. Nothing eventful happened after that. When I got in bed a couple of hours later, she was either awake or I waked her. She was as loving an affectionate as usual.

It was quite a day. Kate was confused and busy all day. I didn’t get my walk. I didn’t check email. I didn’t write a blog post. The possibility of a UTI was disturbing on a Sunday evening. I have often said that when Kate is happy, I am happy. The converse is also true. We had quite a mixture of happy and disturbed yesterday. I was up with her, and I was down with her. On the other hand, a large part of the day was as good a day as it can be including the end of it. I am very grateful for those “Happy Moments.” They offset the difficulties encountered the rest of the day.

A Happy Day

I’m glad I’ve been able to relay so many good times that Kate and I have had since her diagnosis, but you must have noticed that sometime last year I began to talk about things that have been more challenging. These challenges seemed to escalate just before or during our recent holiday season. The good times were far from over, but I have had to work harder at problem-solving. Still, the balance between good times and trying times remains heavily tilted in favor of the good ones. I think that is a major reason for my lack of interest in adding more help, something I could quintuple without its costing me a penny.

There are also a few days that stand out because they are filled with happy moments. When they arrive, I think of each one as a gift. That is what is was like yesterday. It began at 5:15 in the morning. I was awake and considering whether or not to get up. It turned out that Kate was also awake. She moved closer to me and said with a slight chuckle, “Hello, how are you?” I told her I was fine. She reached across my chest, and we spent the next 30-40 minutes just enjoying being close. I don’t know whether she remembered my name or our relationship, but she conveyed her comfort and love that was very deep.

At 6:00, I told her I was going to get ready for the day and have breakfast. Just before 8:30, I heard her say, “Hey.” She often talks in her sleep. I waited a moment to see if she were calling me. She said, “Hey. I’m in here.” I went to see what she wanted. I found that she was quite cheerful. We chatted about ten minutes. I asked if she wanted to get up. She said, “I don’t know. What should I do?” Knowing this was earlier than usual, I told her it was up to her. I mentioned that if she got up, I could give her a blueberry muffin. Her eyes brightened, but that didn’t cause her to bounce right up. We talked a little more. She finally said, “Why don’t I rest a little more and you tell me when I should get up.” I did. Fifteen minutes later, I went back. She was ready to get up. She was confused about the usual things (where she was, where the bathroom was, what the toilet was, etc.) but not disturbed and needed my help with everything. More importantly, she happily accepted my help.

I warmed up her muffin and gave her a side of fresh blueberries as well as a few slices of canned peaches. I fixed myself some coffee and sat with her. She loved her breakfast, and each of us enjoyed the other’s company. When she finished, we adjourned to the family room where I picked up the photo book of Facebook pictures that I purchased two weeks ago. I wasn’t at all surprised when she said she was tired after only looking at a few pages. She lay down on the sofa while I got my laptop and returned to join her a chair across from her.

While she was resting, I received a phone call from a friend telling me about a popular lunch place that was serving takeout. We’ve eaten there before, but it had been a long time. I went to their website to look over the menu. I ordered a turkey melt for Kate and pulled barbecued chicken with a mixed green salad. We went to pick it up. She stayed in the car while I got the food. As I walked in, I saw homemade tomato basil soup and Brunswick stew to bring home as well.

After lunch, we walked from the kitchen into the family room. Kate immediately commented on the spring flowers in the back yard. The azaleas and dogwoods are in full bloom. She delighted in pointing out the things she especially liked. When we finished, she wanted to rest. I walked her to her recliner. She asked if that was where I wanted her to sit. I said, “Yes, and I’ve got your Dr. Pepper right on the table beside you. She was childlike in her excitement and chocked up about my having her favorite drink. Once in a reclining position in the chair, she said mentioned something about her friends. I said, “I hope I’m one of them.” She gave me a gentle and sincere smile and said, “I think you’re going to be.” She paused and added, “What is your name?” I said, “That’s one of the things I like about you. You are so honest.”

The biggest surprise of the day came late in the day after she had rested a long time. She was enjoying the beauty from her recliner, taking in all the spring flowers and new leaves on the trees.. I had been sitting a while and decided I wanted to walk around inside the house a few minutes. She asked me something about it, and I casually asked if she would like to walk with me. I was shocked when she said yes. That was the first time she has done so. She asked where I was going to walk. I decided to take advantage of this opportunity and told her I was going to walk down the street a short way and then come back. Off we went.

I wondered if she would back out before we got to the street, but she didn’t. The walk was short in distance (four houses down from ours), but very enjoyable. She was enthusiastic about everything she saw starting right outside of our garage. It took about ten minutes to get to the street. This continued down the street and back. She was like a little child at circus. As she does inside the house, she wanted to point out everything to me as though I couldn’t see it myself. Thirty-five minutes later, we were back in the house. I considered this quite a victory. I had finally gotten her to walk, and I enjoyed seeing how happy she was. It was a perfect day to be outside, lots of sun and temperature in the lower-70s.

I put on an album of Peter, Paul and Mary while we ate dinner. Kate and I enjoyed hearing so many songs that were popular just before and during the early days of our marriage.

The only rough spot of the day occurred after dinner. Thinking she was somewhere other than home, Kate was ready to leave. I explained that we were home and that we would spend the night here. She accepted that. It wasn’t long, however, before we ran into another problem. She got the impression that people were coming to our house. I mentioned that people were not supposed to gather together like that. She asked why. I told her about the coronavirus pandemic. It was impossible for her to understand. I could see that was a losing cause and tried to divert her. I was successful briefly, but the she would remember again that people were coming to see us. That is when I turned, once again, to music for help.

Most of the music we play on YouTube is either classical or Broadway. Hearing Peter, Paul and Mary during dinner prompted me to see what YouTube had. It was no surprise that there is a lot. The rest of the evening was devoted to PP&M. It was another happy moment and a perfect way to end an almost perfect day.

Delusions Seem to be Increasing

I’m not quite sure when Kate began to experience delusions and hallucinations. I do know I first mentioned it in a post almost exactly a year ago. She had experienced them periodically before then. Now they are commonplace.

Thursday afternoon after resting, she looked very concerned. I walked over to her recliner. I told her she looked worried. She nodded that she was. I asked if she could tell me about it. At first, she said she couldn’t. Then she started talking. She was worried about a young man that somebody wanted to kill. Our conversation lasted about ten minutes. As she talked, she mentioned the possibility of my helping the young man in some way. I assured her that I would. She was relieved. This is at least the third time she has mentioned something related to killing. Once she was worried because she thought someone wanted to kill her. Another time, she felt guilty because she had been aware of a killing sometime in the past and hadn’t told anyone.

That night after I joined her in bed she said she needed my help. This time she was talking about a young man who was very bright but didn’t have the resources to pay for college. She wanted my help in getting him some assistance. This is a theme that is similar to other delusions. As I have done before, I told her I would do everything I could to help.

Friday night, she had been trying with great effort to work her jigsaw puzzles. Her mind must have drifted off because she started talking about a couple who were considering divorce though she couldn’t think of the word. She wanted me to talk with either the man or the woman to see if I could help them. Again, she was all right when I agreed to help.

These experiences tend to occur after she has rested a while although not necessarily asleep. Not all of them are disturbing, but the ones that bother her stand out. On other occasions, she hallucinates. For example, at a restaurant the other night, she looked below the outer edge of my plate and smiled. Then she made a comment about a girl she thought was there. Occasionally, she looks up at the ceiling while she is resting and talks to someone she sees.

For the most part, Kate’s delusions don’t create a big problem. The exceptions are those that disturb her in some way. Fortunately, talking through the situation and my offering to help her seems to calm her.

I May Not Understand It, But a Lot Is Going On in Kate’s Brain.

Over the past three days, Kate has displayed a variety of symptoms that illustrate how active her brain is even if it isn’t working the way it is supposed to. It began Friday morning when she experienced the kind of fright that kept her in bed all day a couple of times in the last three weeks.

Based on the previous experiences, I decided I would be more relaxed this time. When she said she didn’t want to get up, I lay down in bed and talked with her a few minutes. I had already put on some music. She liked it and asked me not to talk so that she could hear it. We listened a little while, and she began to perk up. That made me think getting her up might be easy. I was wrong. She told me she was scared. When I asked what she was scared of, she said she didn’t know. I remained in bed until she appeared to be asleep. Then I took a seat in a chair beside the bed.

I decided not to worry about our having lunch together. The sitter could do that. Half an hour before the sitter arrived, I told Kate the sitter was coming and wondered if she would rather that I or the sitter help her get up for the day. She said she would prefer that I do it. That was two hours from the time I had started to wake her.

She was able to get up without a problem and was ready when Cindy arrived. Kate thought I was going with them and gave me a disapproving look when I told her I wasn’t, but she didn’t say anything. I helped her into Cindy’s car, and they were off.

We went to a different pizza place that night. The hostess asked if we wanted a table or booth. Kate has been having trouble sliding across the seat of a booth, so I requested a table. Before we sat down, Kate said she didn’t like the table and pointed to a nearby booth. That’s the first time I recall her indicating a preference. I went back to the hostess stand and asked for that booth.

I almost always take her to the bathroom at home before going out but had not done so this time. Right after the server took our order, Kate wanted to go to the restroom. I asked the hostess if it was a restroom for one-person knowing that is better in terms of my going with her. She said it had three stalls. I discretely explained that Kate has Alzheimer’s, and I like to help her. She checked and found no one was in there. She said she would watch for anyone else who might want to use it. I accompanied her, and all went well. I was relieved. I feel much better when we can take care of toileting at home.

Back at our booth, Kate was concerned someone was out to get her. I asked who, but she didn’t know. She didn’t say anything more and quickly forgot. The balance of the day went well.

At 2:30 Saturday morning, she woke up and wanted to know what she should do. I told her it was the middle of the night, that she had no obligations and could relax and go back to sleep. We went through a number of variations on the same question and answer for about fifteen minutes before she went back to sleep.

At 5:00, she was awake again and wanted to go to the bathroom. I got up to help her, but she changed her mind. We talked for a short time before we were both asleep. We were going to a luncheon following a funeral mass for someone we know from our music nights at Casa Bella. I was concerned that I might have difficulty getting her ready. She surprised me as I began my morning walk. I saw that she was getting up. I went to her and found that she was wide awake. We made a trip to Panera and returned home where she rested.

While resting, she chuckled a good bit. When I asked what was so funny, she said, “You know.” A little later, she said, “Don’t you like the ‘try.’” I had no idea what was so funny or what she meant by “try.” Her confusion with words is getting worse. The easiest one for me to understand is “shows” for shoes. Sometimes she uses “shows” for socks.

I was a little concerned about the luncheon because I expected a crowd of people she wouldn’t know. That turned out not to be a problem. We were seated with two people we have known for a long time. Of course, Kate did not remember them, but she handled things well. She did ask a lot of questions that were obvious signs of her memory problems. These involved asking the name of the restaurant several times while sitting with the daughter of the woman whose mother opened the restaurant eighty years ago. We have been sitting her three nights a month for six years. The people at our table were very understanding.

It was very noisy. At first, that startled Kate, but she quickly adapted. When we left, she said she had enjoyed it. I was surprised because it was just the kind of situation I try to avoid because it can be so hard for her.

When we returned home, she wanted to rest again. After a while, I noticed that she was uneasy. I asked if there was anything I could do to help her. She said there was and began a lengthy conversation similar to others we have had. She was worried about a young man. She said that I know him, but she couldn’t think of his name. I tried guessing. That didn’t help.

What I learned was that she wanted to offer some financial help to this man. As she talked, she moved from talking about this specific man to a program to help promising boys and girls who did not have the financial resources to enable them to continue their education after high school.

She wanted my advice. This was very much like a recent middle-of-the-night conversation. She talked about helping people in her hometown of Fort Worth and was concerned about locating young people and a person or organization to administer the program. I gave her several ideas, and she asked if I would coordinate everything. I agreed, and she felt better about.

There is more, but I will continue in another post.

More Delusions and Hallucinations

Kate has experienced delusions and hallucinations for several years; however, they are more frequent now. Let me tell you about two of them that occurred yesterday. The first is a variation of one that occurs most often. It involves her noticing small things like specs of food on a plate or table or other little things she sees at home on furniture or the floor. She often speaks of them as “him” or “he” or “thingies” and says other things that convey she believes they are alive. Sometimes I can see them. Often, I can’t. She likes to point them out to me. Whether I see them or not, I generally say I do.

As we walked to the car after lunch yesterday, she expressed concern that she had done something wrong. She didn’t know what it was, but she seemed quite worried. I told her I didn’t know anything that she had done. She asked if I was sure, and I assured her she hadn’t. Once in the car, she started to pick at her teeth, something she does frequently. A minute later, she said, “I got him.” She held out her hand to show me the finger on which “he” was resting. She asked if I could see him. I told it was hard to see while I was driving. Then she wanted to know what to do with him. I keep napkins in the car for moments like this and started to hand her one when she wiped her hand on the side of her seat. She looked sad and said, “I think I killed him.” She was very disturbed. I tried to console her, but she was bothered for a few blocks before her attention was diverted to something else. She frequently picks up “thingies” like this in restaurants. It is common for her to be saddened when she hears about any human suffering, but I had never seen her express any special concerns about the welfare of these “thingies.” This may be extreme example of how active her emotions are right now.

Last night we had another experience with a delusion. She had gone to bed early, 7:30, and went to sleep, something that rarely happens that quickly. She is often awake an hour or two before falling a sleep.

When I got in bed, she was glad to see me. That is not unusual. I think she finds it comforting for me to be in bed with her; however, this time she wanted my help with a project for children. She was concerned because it was her responsibility to carry out the project and didn’t know how. I didn’t find out who the children were or how she had become obligated, but I did learn that it was a project to use animals to help “boys and girls.” I told her I would help and asked what she wanted me to do. She wasn’t sure how to find either the children or the animals. I told her I had some contacts at United Way that would help identify children and could also direct us to existing agencies that might administer the project. I went on to say that I knew people who are involved with animal shelters who might be able to assist with animals. We must have talked fifteen to thirty minutes before I said we had identified a way to approach the problem and could get to work this morning. She was fine with that, and we went to sleep. She didn’t say anything about it this morning, but I am sure there will soon be something else to take its place.

A Very Good Week

It was two weeks ago that I described Kate’s sleep issues that kept her in bed all day for three different days. I was concerned about a new pattern that might be emerging. I am glad to report that for the past week she has either gotten up early on her own or rather easily when I have had to wake her. More important than that, she has been cheerful throughout the day. It’s been a long time since I have been able to say that.

Yesterday was another day that I didn’t have a problem getting her up, but it was a day when she was troubled several times with delusions that we were going to be with a group of people she wanted to avoid for some unexpressed reason. When I tried to get her to clarify who she was talking about and what the problem was, she seemed irritated with me and said, “You know.”

We are in Nashville for a visit with our friend Ellen this afternoon. Kate rested an hour after we checked in at our hotel yesterday. When I told her it was time for dinner, she was absorbed by a delusion that a woman had been in our room talking with her about a program to help women. Kate was disturbed that the woman was gone and wanted us to work with her in the program. It took me about twenty minutes to get her ready to leave. She didn’t need to do anything but go to the bathroom, but she was so caught up in telling me about the woman that she wouldn’t get up. Even after we were on our way to the restaurant, she talked about the woman and her project. Despite the amount of time she talked, she didn’t tell me enough for me to understand anything about the program except that it was to help women and that she wanted to be involved. She kept repeating the same things over and over.

This is another case when diversion worked to take her mind off this issue. Once we parked the car and walked into the restaurant, she apparently forgot about it. I haven’t heard another word since.

At 1:30 this morning, she woke up and was confused about where she was. For about thirty minutes, she repeatedly asked where we were. I told her, and she would ask again. Finally, she stopped. I am eager to see what today will be like. She has been awake off and on for almost two hours. She is in good humor although she has had several hallucinations about someone who is here in the room with us.

Diversion Seems to Work (At Least Yesterday)

Yesterday, Kate woke up and wanted to go home. We went to lunch. She forgot about home and didn’t mention it again. On a number of other occasions, I have found that going out for a meal is an effective diversion technique.

We had a sitter during the afternoon. When I got home, Kate was resting. I spoke to her, and she talked with me as though I were entering a dream with her. She thought someone had had a baby and asked me about him. At some points, I thought she was talking about having had a baby herself. Other times, it seemed like it might have been a son or daughter though she never said specifically. She was excited, and said, “We have a baby.” She asked “his” name, and I gave her the name of her father. She was thrilled. Not long after that, she asked “her” name. I gave her the name of her mother. She was equally excited. She continued talking about the baby after we were seated at the restaurant. She wanted to know when she would be able to hold it. She also wanted to know where the baby was. I found this to be a challenging conversation. Once I had started to go along with her, I found myself having to get more creative in answering her questions. I decided it might be good to redirect her attention and suggested that we go to dinner. She wanted to rest a little longer and asked if the doctor said it was all right. I told her he said it was fine, and we left for our Friday night pizza.

Her enthusiasm continued in the car and at the restaurant. It lasted so long that I thought the conversation might continue even after we got home. At one point, she asked if the children had called. I told her they hadn’t and explained they had been busy. She couldn’t believe they hadn’t even called and said, “But it’s our baby.” Fortunately, when the pizza arrived, her attention drifted to eating. I didn’t hear a word about the baby after that.