Our Strangest Day

It began with yesterday’s “Surprising Conversation.” The rest of the day was filled with strange incidents. I’m sure I would have noticed more if I had been home during the afternoon instead of the sitter.

The first thing I noticed happened as we were walking in the door at Applebee’s for lunch. Kate said she wasn’t sure she would be able to eat anything. That remark and the expression of concern on her face made me think that she might be sick. She walked very hesitantly into the restaurant and took an unusual amount of time to walk up the two steps to the booths where we always sit. She seemed very confused. I asked her if she felt all right. She told me she didn’t feel “all right,” but she wasn’t sick.

She could never explain the problem very well, but it turned out that she thought two people that she and I know were out to get her. When the hostess put the flatware wrapped in a napkin on the table, I unfolded the napkin, placed the knife and fork at her place, and handed the napkin to her. She refused to take it. It seemed she thought “they” had contaminated it in some way. Later when the food arrived, she picked through everything and put some of them on the table beside her. She shredded some of the chicken and said, “See that. They got this too.” She put it on the table as well. It took her a long time to finish her meal, and she didn’t eat all of it. That is unusual, especially recently. I suppose it was her belief about contamination.

Before the sitter arrived, Kate went to the bathroom. Since that is the bathroom that the sitter usually uses, I checked to see if any clean-up was required. I discovered that she had taken one of three artificial tulips out of an arrangement on the counter, torn off the leaves and all the petals of the flower itself. She left them in the sink where it appeared she had washed them.

When Mary arrived, Kate was picking up two ceramic containers that used to have small cacti in them. She filled them with water and started looking for a place to put them. She and Mary had gone outside to find a place as I was preparing to leave. I left, so I don’t know what happened after that. When I got home, I found them in the laundry room sink.

After Mary left, I sat down on the sofa beside Kate. She said, “Is my mother still upstairs?” (We have a single-story house.) I told her that her mother wasn’t here. She said, “Well, where is he?” I said, “Who do you mean?” She said, “You know.” I never figured out who “he” was.

We went to dinner at our regular pizza place. While we waited for the pizza, she  diligently tried to tear her paper napkin into multiple sections. She carefully attempted to make each tear a straight line. As you can imagine, doing that with a paper napkin is almost an impossibility, but she gave it her best effort.

As for eating her pizza, she ate almost every bite of it. I know that doesn’t seem strange, but she has never liked pizza crust or crust on any bread. (She also has a distaste for the peel of fruit like apples, grapes, or tomatoes.) All our servers know that when she eats bread, she eats from the center out to the crust. Recently, I have noticed that she has been eating much closer to the pizza crust. Last night, however, she ate everything. She only left specks on her plate.

As we were preparing for bed, she started looking through the drawers in her bedside table. She also picked up a coaster on top and asked what it was. I explained it to her, but she didn’t understand. When I got out of the shower she had 8-10 things from the drawer spread out on the bed. She was trying to figure out how to use them with the coaster. She wanted me to look to see if she was doing it the right way.

Before calling it a day, she said something about having a big day “tomorrow” and would be leaving early for church. A few minutes later, she asked me what time she should leave. I told her 10:30 would be fine. She said that was later than she wanted and would probably leave by 9:30. I feel sure she was living in a “flashback” to the years she was our church librarian. She gave that up in 2009 because she was beginning to have trouble doing the work the way she knew it should be done. That was a year and a half before her diagnosis.

What I have reported above is just what comes to mind as I write this post. She made other comments throughout the day that indicated she was experiencing delusions or hallucinations. Like so many things, I don’t know how to explain what she was experiencing. I do know that these symptoms are not unusual for people with dementia. For that reason, I don’t feel any sense of alarm. She has had periodic experiences for several years, but this was the first time so many different things have occurred over the course of a one day. I take it as a further sign of her overall decline.

What is in store for today? I am eager to see.

More Delusions/Hallucinations

Over the past week or two, Kate has experienced more “delusions” than in the past. I’m not actually sure that is the right word. Most often they involve things like a belief that we are somewhere other than our home, that there are other people in the house, and that she sees people or things when nothing is there. When I noticed that she was about to get up yesterday morning, I went to the bedroom. As I approached the bed, she said, “Don’t touch me.” I thought this might be a time when she didn’t recognize me at all, but then she added, “I’ve got a cold.”

As she got out of bed, she insisted that she do it herself without my help. She didn’t want to hold my hand on the way to the bathroom. Once there she continued to be careful about my not touching her because of her cold. What was especially unusual about this was that she has never before shown that kind of concern about spreading her germs to me. I have always been the one to be concerned about passing along a cold to her or her passing along one to me. I didn’t observe any signs of a cold. I didn’t know if she really had one or if she had a dream in which she had a cold.

After finishing in the bathroom, she went back to bed. It was 8:00. She had plenty of time to get back to sleep before getting up for lunch. When I went back to wake her at 10:45, I found that she was awake. This time she didn’t say anything about having a cold. Neither did I see any signs of a cold during the time she was dressing or as we drove to lunch. I didn’t mention anything a cold during lunch, but I did ask if she was feeling well. She said she was fine and never reported any health problem the rest of the day. I am left to believe that her earlier mention of having a cold must have been the result of a dream.

And More Emotional Experiences

When I arrived home to relieve the sitter on Friday, Mary heard me open the door and told Kate I was home. I walked into the family room. Kate had been resting on the sofa and gotten into a sitting position when she saw me. She had a big smile on her face but immediately burst into tears. She couldn’t stop and continued until after Mary had left. I sat down with her and we hugged. She said, “I’m so glad to see you. I was so worried.” This was the way she had reacted when I returned two weeks ago. There was one big difference. She didn’t recover as quickly. Over the next thirty minutes, she continued to express how happy she was to see me. It wasn’t until we went to dinner that she had fully calmed down.

Last night Kate had a very traumatic experience involving a delusion that I had had a fight with her mother who died in 2005. The way she described it this was something that she had just overheard. She had been in bed for about an hour, so I suspected that she had had a dream. After reflecting on it, she probably had never gone to sleep. On several previous occasions, I have noticed that she has had similar experiences, but this one was definitely the most intense. She was angry with me. As I tried to calm her, she shifted her story. Then it sounded like the fighting was between her mother and father. A few minutes later, she settled into its being between our neighbors.

Several times she said she wasn’t going to talk about it anymore. Then she would continue. She kept talking about the “foul” language they were using and how sorry she felt for the children. She was so upset that she said she wanted to move out of the neighborhood. Trying to calm her, I played along as though I believed what she said and suggested that we might talk about moving in the morning. I knew that it would all be forgotten then. I also diverted her attention by talking about how fortunate we have been to have a marriage that has been free of the kind of fighting that she had observed. That seemed to work. She settled down, and we called it a night. The entire episode lasted about an hour and a half.

On the way to lunch today, I played some music. She cried during “Try to Remember.” This is a song she likes, but I don’t recall its leading to tears before. Then at lunch our server approached the table to give Kate a hug. As she did, she said, this is a day when I really need a hug. Then she proceeded to tell us that her neighbor’s dog had killed her cat this morning. That was all Kate needed to hear. She was in tears, and the server felt bad about having said anything.

It’s not just the tearful emotions that are elicited so easily. This morning as well as other times recently, Kate has responded to me with anger when I tried to help her with something that she wanted to do on her own. She is very much on edge now.

Signs of a Cold or Alzheimer’s?

Kate’s cold and accompanying cough continued yesterday. I believe it was somewhat, but not dramatically, improved. It’s been an interesting cold in that her symptoms have been pretty even over the course of the past week. She hasn’t had a fever, and she goes long periods (an hour or two or more) without coughing. She doesn’t go quite as long without blowing her nose, but that also comes and goes.

Her overall behavior, however, suggests she has not been herself. She has been more confused and dependent. She has had greater difficulty working her jigsaw puzzles. She has actually had moments when she didn’t know what she should do with pieces once they were scattered across the screen of her iPad. I don’t mean she didn’t know the exact place to put them; she didn’t know what to do at all. She has also had several hallucinatory experiences. Two of those were a week ago, and one occurred last night.

We stopped at a traffic light on our way home from dinner, and she said, “Is there anything I can do to help you?” This came out of the blue for me. I didn’t know what she might have been thinking and said, “What made you ask that?” She said, “You’ve been going through so much.” I was still confused but decided not to question her. I simply assured her that I was getting along well. I told her that she had always been my support, that she should just continue that. She appeared relieved.

As usual, she worked on her iPad after we got home from dinner. She couldn’t remember how to start, that is, to open the puzzle app. This was not the first time. I showed her as I have done before. Once it was open, I showed her the various options she could choose. I walked away, and she immediately ran into a problem. She hit an arrow at the top left of the screen that took her to the store instead of selecting one of the puzzle options that filled the rest of the screen. That, too, was not the first time, but it is becoming more frequent. When she went back to the puzzles, she worked them for about an hour. Our son called as she was getting started. She said hello with her usual enthusiasm, but then quickly returned to her puzzles. While I was on the phone, she asked me for help several times. Her attention was clearly on the puzzles and not the phone call from Kevin.

When I got off the phone, she wanted to get ready for bed. First, she walked over to me and expressed her concern about me. She made reference to “that man.” I asked if she meant Kevin. She didn’t, but she was unable to tell me who “that man” is. I did grasp that she was again worried about me and the load I am carrying. One might think she was talking about my role as a caregiver, but it was not. I got the distinct impression that it had something to do with my work or volunteer activities. Interestingly, they are minimal these days; however, I am sure hallucinatory experiences often relate to distant memories.

She was tired and went to bed a little earlier than usual. She had done the same the night before. I think this could be related to her cold. After thirty minutes or so, she appeared to be asleep. I joined her thirty minutes later. When I did, I discovered that she was awake and whimpering. I asked her what was wrong. She didn’t (couldn’t?) explain but said, “The babies.” I told her I didn’t understand but wanted to help her. She went on to say, “I do want a baby, maybe two.” I mentioned our having had two babies who were now grown up. She was startled, not about having babies, but that she and I had babies. I told her I was her husband. She strongly denied it. I knew I needed to go in a different direction.

This was another time I felt explanations were irrelevant; she needed comfort. I told her just that and said, “I love you dearly, and I want to comfort you.” She said, “I know you do. I can tell by your voice that you’re not just saying that.” That began what may have been close to an hour of conversation during which she talked, and I gave supportive responses. I never fully understood what it was that prompted her worry. At one point, I asked her if she were afraid. She said she was. I was never able to discover why.

What I do know is that she thought she was young and unmarried. A couple of times she said, “I can have a child. I have one now.” One of those times she put both hands on her stomach as she said this. That may have meant she was carrying a child now. She also responded to me as if she knew I were her husband. I told her I loved her, and she said she loved me. Despite this, I don’t believe she ever recognized that I am her husband. I was just someone she felt very close to. She was very comfortable talking with me. Finally, she relaxed, and we both fell asleep.

It was a week ago yesterday afternoon that I noticed the first sign that she was getting sick. She coughed a few times, and it didn’t sound like a normal clearing of her throat. The next morning it was obvious she had a cold. It was that afternoon that she had an hallucination that involved our working in some kind of education project in another country. At the time I wondered if that could have been a side effect of the Robitussin DM or Zyrtec, the cold itself, or her Alzheimer’s.

One thing is clear. She has been noticeably different this week. I have eliminated the Robitussin and Zyrtec. I am left with the possibility of the cold itself or Alzheimer’s. At the moment, I believe Alzheimer’s is the primary cause and that the cold may have aggravated the situation. Time will tell.

Signs of Confusion

Kate’s imagination was active over the weekend. Before we got out of the car for lunch yesterday, she had a look on her face that signaled deep concern. She said, “I just don’t know what to think.” As often happens, she couldn’t explain what had happened. She said something about our daughter, Jesse. I asked if she thought something had happened with Jesse and her husband, Greg. She nodded. I said, “Did you think they were separated?” Again, she nodded. I told her everything was all right, that they had not separated. She said, “I must have imagined it.” Periodically, she has had experiences like this, and she seems to grasp that the origin is in her mind.

As we were leaving the house for dinner last night, she specifically went to our bedroom and turned on the lamp on the table next to here side of the bed. She asked if she should turn on the one on my side. I told her I thought we could leave it off. As we walked through the family room, she asked, “What time are they coming?” I told her we weren’t expecting anyone, that we would have the house to ourselves. She didn’t say anything else, and I didn’t ask.

While at Panera this morning, I received a phone call from Scott Greeley. We arranged for the Greeleys to visit us this Saturday. When we hung up, I told Kate it was Scott and that they would be in Knoxville on Saturday for lunch. She said, “Good. I really like them.” Then she added, “What’s her name?” I told her. Only moments later, she said, “Jan.” I said, “Right.” Then she said, “I know that you know her name; I just wanted to let you know I got it myself without asking you.” She had apparently forgotten that just moments before she had asked me for Jan’s name.

When I got home from Rotary, the Y, and the grocery this afternoon, Kate was ready to get out of the house. As she has done a number of other times recently, she was carrying a night gown, a robe, a pair of pants, and a top. She noticed that I was taking 6 new pairs of socks out of their packages and asked that I give them to her. She did not have her iPad and a cup. I got a cup and then used the Find my iPhone app to locate her iPad. When I returned to the kitchen with the iPad, she was still holding the clothes along with the socks I had just bought. I asked if she were planning to take the clothes with her. She indicated she was. I told her I didn’t think she would need them. She said that would be fine. I suggested we leave them on the love seat in the family room until we returned. She put them on the love seat. As we started for the car, she picked up the robe and brought it with her. It’s sitting in the car right now.

An Intense Emotional Experience for Kate

Over the past few years I have grown accustomed to Kate’s saying something to me as though she is responding to something I have just said. It puzzled me when it happened the first time. Out of the blue she said, “I can’t believe they would say that about my mother.” I responded with, “Who are you talking about?” She told me and then said, “You’re the one who told me what they said.” She has repeated variations of this as many as five or six times although I haven’t heard her say anything in quite a while. The issue has always involved someone’s saying something about her mother.

Today at Panera, I had just put a sandwich on the table in front of her. When I sat down, I noticed that she had a strange look on her face. She seemed puzzled. She could tell I was puzzled and said, “I think of both of them as mothers.” Although I quickly understood that she thought I had told her something, I couldn’t imagine what. I asked what she meant. She said, “I’m shocked.” I explained that I was confused. She said she was as well.

Then she said, “Stop. Just tell me slowly what happened.” I explained from my point of view and asked who she was talking about when she mentioned thinking of “both of them as mothers.” She told me she was talking about her mother and the youth director at her church when she was a teenager. The big surprise was that she thought I had told her that the youth director was her real mother. I explained that I hadn’t said that. As I did, I was prepared for her to dispute me because that is what she has done in the other situations. I was quite relieved when she believed me. She continued to talk about the emotion she felt before I straightened things out.

As we walked to the car to go back to the house, she brought it up again. When she got in the car, she said, “Well, we’ll look back on this and laugh, but it wasn’t funny at the time.” She brought it up again when we got home. This must have been a full thirty minutes after this episode occurred. The fact that she remembered for that long is a sign of the intensity of this experience.

Bizarre Case of Imagining Things

At lunch today, Kate asked me something about “a guy who wanted to make her naked.” I had no idea what she was talking about and said so. She looked frustrated with me and indicated I must have remembered. She went on to say that she had been in the restroom, and there was a man and a woman. The man wanted to disrobe her and walk her around the restaurant and parade her outside. She said she knew that I would not let that happen. I assured her that was the case.

A moment later, she asked me the name of our server. I told her it was Sandra. Then I said that reminded me of someone who was in her bridge club years ago. I could see that she didn’t recall and went on to tell her the names of each of the members and their spouses. She said, “Where was this?” I told her it was right here in Knoxville. I noted that two other members of the club as well as the two of us are the only remaining living members. She said, “Where was this? In North Carolina?” It was clear that she had little or no memory of the bridge club of which she had been a member for more than twenty years.
Then she asked me our daughter, Jesse’s, middle name. I told her. She asked what her last name is. She followed that by asking her husband’s name. After I mentioned the twins, she asked their names. I said something about having a son in Texas, and she asked his name.

These are not names that are lost forever. They come and go in her memory, but they are signs that the names will be forgotten sometime in the future. When I encounter moments like these, I am amazed that she functions as well as she does.

Another First (or Second) with Anger

Kate and I went to dinner and a movie tonight. The latter is a rarity for us now. I have not been scheduling anything at night beyond dinner for several months now. This time, however, The Flick, our favorite theater, had a Thai film that started at 7:00. It sounded intriguing, and I thought it was worth a try. During dinner, I was thinking about how well the visit with the sitter had gone. I also felt I should add another journal entry specifically about how good-natured Kate has been today. Right now I want to make it clear that she seemed remarkably agreeable and at ease. It was not only how she received the sitter but also how she responded to my help on getting her clothes to wear out this evening.

What I didn’t anticipate was how radically her mood would change as we left the movie. On the way to the car she mentioned how miserable she had been in the movie. I thought that was because she didn’t like the movie. It turned out that it was the result of not having paper napkins or some other paper product to Wipe the saliva from her mouth. I discovered this when I inquired as to why she had been so miserable. She let me know it was because she didn’t have any napkins. Then I made the fatal error of telling her that I wish she had told me because I had taken several napkins into the theater with me just in case she needed them. To my surprise that angered her because I had not offered them to her. I told her that I didn’t recognize that she had been miserable. She said I must not care for her very much if I didn’t notice her misery. I gave her a couple of napkins. “Too little, too late.”

In the car on the way home, she said in a very angry tone of voice, “And I have never exaggerated.” I told her I hadn’t said that. She said, “You certainly did just a little while ago.” I let it go because I could tell this was one of those instances in which she had had some kind of misperceptions (delusion) that I had done so, and it would do no good to argue. Later at home she expressed the strongest anger I have ever heard from her. Unprompted, she said, “I have never exaggerated about anything.” I told I knew that she never exaggerated. She didn’t say anything for a while. My impression was that she had gotten emotional over her salivation. She was burping and making other noises. In a few minutes, she came out of the bathroom with some toilet tissue that she was holding to her mouth. I told her I wished there were something I could do to help her. She looked at me and spoke in a gentle kind voice, “Oh, I’m fine.” She seems to be back to normal right now.

Something New and Disturbing

A few minutes ago I left Kate in the bedroom working on her iPad while I went to the kitchen to check on something. As I left, I said, “I’m going to get ready for a shower in a few minutes.” When I came back, she had put the iPad on the ottoman of her chair and was watching the news on TV. She also had an angry look on her face. She said, “You told me to put that thing (the iPad) down and watch the news for a change.” I told her I hadn’t said that. She said, “Yes, you did. Don’t deny it.” I leaned down by chair and put my arm around her shoulder. I decided arguing wouldn’t get us anywhere. I told her I loved her and that she didn’t need to watch the news. She sat quietly fuming for a minute. Then she said, “I just get so tired of being so dependent on you. I can’t go anywhere or do anything without you. Here I am in my 70s and I’m treated like a child.” I repeated that I love her and told her I knew it was hard.” Then I asked if she would like to watch Golden Girls. She said, “I don’t care.” I turned off the news and now Golden Girls is playing. She is working on her iPad again.

Although she has talked any number of times about her not liking to be dependent on me, this is the first time she ever blamed me or took it out on me. I realize that she is likely to have forgotten this tomorrow, but I can’t help wondering if this signals a change in her outlook toward me. It comes just after a period of several days during which she has been unusually cheerful and cooperative. What a dramatic change she has made tonight.

The drama is now over. She just got up from her chair and said, “Well, Babe.” She didn’t sound angry at all. I asked if she were going to get something to wear to bed. She smiled and said she was. I told her I loved her, and she walked to her room. I hope she returns in the same state of mind in which she left.

Wow! This came at me from left field. To underscore how dramatic this was for me, this was the first time I have ever heard her express anger with me from the beginning of our marriage to now. She has expressed irritation frequently over the past few years, but this reaction was well beyond anything I have seen before. I am very glad that it has blown over and, hopefully, won’t return again.

When she returned from her room, she was just as pleasant as she has been for the past few days. It is as though the angry outburst never happened.

Back Home

We arrived home again at 8:15 last night. All-in-all the Christmas visit had gone well. Kate seems to have enjoyed herself.

I spent about an hour checking email, unpacking and taking a shower before settling in to watch a Cowboys game on TV. I hadn’t seen Kate seen we got back and went to look for her. I found her in bed in the middle guest room working puzzles on her iPad. I asked if she were planning to come to bed. She said, “I thought you wanted me in here.” I may not have mentioned it before, but this is not the first time this has happened. This was the first time in a long time though.

On the trip home after a stop for lunch, Kate said, “I know I’ve said this before, but I am really excited about moving to Texas.” I said, “Yes, you have mentioned that before, and I know you are excited even though it will be a long time.” Neither of us said anything more. Jesse told me that she had mentioned moving to Texas in addition to the time she said something on a previous trip to Memphis. I moved behind Kate and shook my head to indicate this wasn’t so. They didn’t dispute or feed this conversation.

This morning was our monthly Y breakfast. I didn’t wake up until 7:06. I got up right away and reminded Kate. She initially said she wanted to go and got up to go to the bathroom. She came back into the bedroom and got in the bed. Then she told me to go on ahead without her which I did.

Sometime after getting home from the breakfast, I checked to see if she were up. She was. I noticed two pair of her black slacks thrown on my side of the bed. Then I found another pair on the floor beside the toilet in the middle bathroom. When I found her, she was wearing a pair of black slacks. I just hung up the slacks I found.