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Kate and Conversation

Over the past couple of months, Kate has been far more talkative than at any time since the first year or two after her diagnosis. We discontinued her Trazadone in late May or early June. I think that might account for the change. It doesn’t help to fret, but it makes me wonder if we should have done this a lot earlier. It’s been a long time, but I remember times when she was so tired that she kept her eyes closed when we were at restaurants waiting for our food. I used to feel a little embarrassed about what others looking at the two of us might be thinking. Did they think I had hurt her in some way? She often looked so sad. That might have been avoided if I had connected it to her medication.

Talking a lot more is not the only change. As her memory has declined, she has had less to talk about. When the two of us talk, we stick largely to how we feel about our life together as well as our families. She speaks frequently about her mother and expresses very positive feelings but very few details about her. She also feels that we are very fortunate people. Again, she can remember few details. She most often mentions how fortunate we are to have been happily married for so long and to be so proud of our children. I fill in the facts on all of these things. I tell her about her mother and father, the things we have done, and what our children are doing.

Increasingly, she is asking more questions. That was especially true yesterday. At lunch at Applebee’s, she looked at me and asked, “Are you my father or my husband?” I told her I was her husband. Then she said, “I was afraid of that.” (Yesterday was also a day when she teased me a lot.) A minute later, she asked, “What is your name?” I told her and moments later, she asked again. That was followed by “Where are we?”

Questions about our family and names of places dominate her questions, but she also asks more surprising questions. For example, shortly after asking where we were, she asked how many Applebee’s there are. That didn’t surprise me. She has asked quite a few times before though not enough for me to remember. I always pull out my phone and get the answer. It isn’t limited to Applebee’s. As you might expect, she also asks about the number of Paneras and other franchises. One time she wondered how many times we had driven on the street that leads to our neighborhood. I did some quick calculations and came up with a “guesstimate” of 40,000. She’s asked a similar question about the main road that leads from town to our house. I haven’t calculated that one.

I find it interesting that she retains some interest in news events. That occurs when I am either watching the news on TV or on the radio in the car. She picks up something that is said and doesn’t understand it. In those cases, she wants me to explain. I always try but am often unsuccessful. Those conversations frequently end when she says, “Why don’t you tell me about it later when I’m more alert.”

On the way home from lunch, she asked, “Where is our house?” I told her Knoxville, but she wanted to where in Knoxville. I gave her the name of a hospital that is near the house. That worked. Once home, she stopped in the kitchen and said, “I’ll follow you.” That is always a sign that she doesn’t know where to go.

After dinner, we spent some time in the family room relaxing. She worked on her iPad and periodically looked out on the dense growth of trees on our neighbor’s property behind our house. She loves that view. At that point last night, she may have still thought we were staying someplace other than our home as she had earlier.

After I took a shower, she came back to our bedroom where I turned on a DVD of Sound of Music that we had started earlier in the week. I thought that she might immediately take an interest, but she was more interested in her jigsaw puzzles. That led me to see if she would react differently to Les Miserables. I didn’t say a word to her. I just took out Sound of Music and inserted Les Miserables. As soon as the music came on she looked up. Shortly thereafter, she put way her iPad and devoted her attention to the music.

I was hoping to turn it off before 9:30 so that she could get to bed. When I mentioned that to her, she said she wanted to watch a little more. At 10:00, I stopped it and suggested that she get ready for bed. She agreed even though she would have continued watching for a good while. This was the seventh time we have watched it recently. Her response was as enthusiastic as it was the first time.

We were in bed around 10:15. I was the one who was ready to go to sleep. She was in a talkative mood. She talked a lot about how fortunate we had been as a couple. Although she has forgotten a lot of details, she does remember some important things. For example, she mentioned the fact that her parents and my parents had long and happy marriages. Her parents and mine really were devoted to each other. She said, as she has many times before, “The most important thing is that we have had a good marriage, and we are proud of our children.” That is interesting in that earlier in the day I had said something about our children. She said, “I have children?” The last time I glanced at the clock it was 11:00. She was still going but slowing down. I don’t remember much after that.

Although she has been more talkative with me, she is less talkative in groups. Except for greeting people when we get to Casa Bella for their music nights, she talks very little. I would have to say that it can be a challenge. We often sit with three couples. All three of the men are talkers. I don’t think, however, it is just that. She simply doesn’t remember enough things that people are talking about to make a comment. When people ask her direct questions, she usually looks to me to provide the answer.

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Last Night and This Morning

I was glad to see Kate get to bed a little earlier last night (9:00). That is something I am trying to encourage as a way of getting her to wake up earlier in the morning. I joined her about 45 minutes later. The other day, she told me the Russian choral music I like was beautiful. That and the fact that she was still awake led me to play that album as we went to sleep. It is very relaxing. I often play it while I meditate. I don’t know how long it was before we were asleep. I know that we only heard a portion of the album and that Kate mentioned several times how beautiful the music was.

This morning Kate gently opened my closet door where I was getting dressed. She was a bit groggy as she usually is when she gets up. She was looking for the bathroom. This is the first time I have been aware of her not remembering where the bathroom is. Of course, I am usually in the kitchen when she gets out of bed, so I wouldn’t know. Anyway, she was very confused. She was still dressed in her night gown but carrying the top she had worn yesterday. She said something about getting dressed. I told her it was still early (6:30) and that she might want to go back to bed after using the toilet.

I wondered how long she would sleep. It wasn’t long until I knew. She was up about 8:30. She had already taken her shower when I asked if I could help her. She told me I could get her something to wear. I put her clothes on the bed and showed her where they were and left her to get dressed. She was ready to go about 9:45 wearing exactly what I had picked out except for the shoes and socks. I considered that a small victory.

She has been in an unusually good humor this morning. As we drove away from the house, she said, “You’re a good guy. And you’re a good husband.” The she added, “What is your name?” When I told her, she said, “I knew that.” Then she asked my full name. I said, “Richard Lee Creighton.” She started to repeat it. Then she asked me to tell her again. When we arrived at Panera a few minutes later, she said, “Richard Lee Creighton.” She was beaming. We’re off to a good start.

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More Surprises This Morning

I got home from my morning walk at 8:00 and went to the pool to meditate. When I came into the house, I noticed that Kate had gotten up. I went back to our bathroom where I had everything prepared for her shower but found that she had not used our shower. I decided to let her get ready at her own pace and went back to the kitchen. Just before 8:45, I went back to check on her. She was walking into the family room dressed for the day. I was quite surprised for two reasons. First, She rarely gets up before 9:00 and recently been sleeping until after 10:00, often after 10:30. Second, it usually take her an hour and a half to get ready. I didn’t see any signs that she had taken a shower. That, too, is very unusual.

As she walked toward me, she held up a pair of socks and said, “I have extra socks.” We both walked to the kitchen where I had put her morning meds. Then she said, “Underwear.” When she wants or needs something she often just uses a single word, so I asked if she needed underwear. She did. That told me she had forgotten where she keeps her underwear. I got it and brought it back to her.

When she finished her meds, I was in the bedroom and heard her call my name. Once again, she was able to remember my name when she needed something. When I got to the kitchen, she held up the pair of socks she was carrying a few minutes earlier and said, “Look what I found.” I asked what she was going to do with them. She said she didn’t know. I asked if she would like me to put them in her sock drawer. She said she did, and I took them back to her room.

On the way to Panera, I said something and could tell that she preferred that I not talk. I said, “I’m not going to say another word.” She said, “We’ll see. You can’t help yourself.” When I didn’t say anything else, she said, “What do you know?” She obviously remembers that I am a talker.

When we turned into the parking lot at Panera, she said, “Surprise, surprise.” It was clear that she recognized where we were. Just before we got out of the car, she teased me about something. I expressed surprise. She smiled and said, “I guess I’ve been married to you too long.” Aha, she remembered that we are married.

We had arrived before 9:00. While we were seated at our table, she said, “Panera.” Then she beamed. She was proud to have remembered. Since she hadn’t gotten to bed any earlier last night, I figured that we might not stay there too long. About 10:00, she said she wanted to go. Then she looked at her iPad and asked, “Is this theirs or ours?” I told her it was hers. We got our things together and came home where she worked on her iPad a while and then rested about thirty minutes. We left for lunch a short time after that.

On the way to lunch, she asked me at least three times where we were. When we were ready to return home, she wanted to use the ladies room. Even though it is very close to where we sit, I have learned that it is best to walk with her. While she was in the restroom, I chatted with our server. I told her that Kate had been making a lot of changes in the past few weeks. She was surprised. She said, she couldn’t tell any difference at all. When Kate came out of the restroom, she had no idea where to look for me. Fortunately, I stayed within ten feet of the restrooms. I saw her puzzled look and walked over to her, and we left. On the way home, she again asked where we were. Right now her primary questions seem to be “What is your name?” and “Where are we?” Those must be the two most important things she needs to know. I can understand that. What is hard for me to understand is what it must be like not to know the name of the person with whom I have the closest relationship or the name of the city I am in.

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There are always little surprises.

About an hour before we left for dinner Thursday night, Kate came into the family room and brought with her two pair of socks and a tube of toothpaste with a missing top. She pointed to the photo book her brother made for her and asked, “Should I take this?” I told her I didn’t think she would need it at Casa Bella. She said, “Okay” and sat down in a chair with her iPad.

As we were about to leave for dinner, she picked up the two pair of socks she had earlier placed on the table beside her. She said, “I want to take these.” I said, “Do you think you’ll need them?” She said, “Not right now, but I really want these black socks.” Then she added, “These white ones too.” I got up to go, and she said, “I think I had better go to the bathroom now.” She had the socks in her hand and said, “I want to keep these.” I put out my hand and said, “I could put them in your sock drawer.” She gave me a big smile and handed them to me. The tube of toothpaste remained on a table.

We had a very nice time at Casa Bella. This was not one of their music nights, so we ate in the smaller front section of the restaurant. Until we started attending their music nights the first, second, and third Thursdays of the month, we always ate in this section. It felt a little like coming home. Over the years, this is where we had come to celebrate special moments as well as to console ourselves when we needed to be comforted. It is very quiet and offered just the right setting for reminiscing. At one point in our conversation, Kate asked, “What is the name of this place?” I shouldn’t have been surprised that she didn’t remember the restaurant’s name, but I was. We’ve been coming here almost 47 years. We are here at least three nights a month. We know the family that owns it. As Kate’s brother, Ken, reminded me yesterday morning, she doesn’t usually remember my name and we have been married 55 years and had our first date a year and a half before then. I shouldn’t expect her to remember the name of the restaurant.

Both the strange behavior and the increasing loss of memory continue to mix with many aspects of her behavior that are perfectly normal. I suppose that is what throws me. Some things are as they always were while others are new. We can’t have things the way they were and are adapting to a new world.

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The Rest of Our Day

When we got home from lunch, we spent a couple of hours in our family room where I played three Rachmaninov piano concertos. Kate sat down to work on her iPad but was tired and decided to rest on the sofa instead. A little after 4:00, I began to be concerned that she might not be sleepy at bedtime. I asked if she would like to go to Barnes & Noble. She gladly accepted my offer.

She asked more questions in the car. She asked my name as well as those of her parents. Then she asked if we have children. After being seated at B&N, she asked, “Where are we?” At one point, she commented on how nice it was to have a place like this (B&N). She has said this once before. I’m not sure what prompted her to say this. She hasn’t said it about Panera or any other restaurant we visit.

From B&N we went to dinner at our favorite Thai restaurant. We always get a coconut soup as a starter and then one entrée. We’ve been getting the same soup for a couple of years or more. Tonight she was completely blank on the soup. She didn’t remember it at all, but she liked it as always.

Upon returning home, we finished listening to a radio interview from a Lubbock station. Our son, Kevin, was interviewed about caregiving and his work as a geriatric care manager. We were both impressed with how well he did. It wasn’t long after that when he called, so we were able to give him our impressions. After Kevin’s call, Kate asked, “Exactly, where are we?” I told her we were in Knoxville, Tennessee. She said, “So we’re close to Fort Worth.” I told her we were a long way from there.

Kate was ready to retire to the bedroom, and it was time for my shower. Before leaving the family room, Kate pointed her finger toward the back of the house and wave her finger right and left and asked, “Which way?” I told her to the left. She started to turn right when I redirected her.

She worked on her iPad for a while but has now turned in for the night. I told her I would be right behind her. We’ve had another good day.

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Our Day So Far

I went to the bedroom to check on Kate about 10:30 this morning. I met her in the hallway as she was about to enter the bath off the guest room next to our bedroom. That is where she fell out of the shower the other day. I stopped her and suggested she shower in our bathroom. I feel it is safer and have steered her toward it each morning since her fall. I walked her into the bathroom and showed her the towels I had gotten out for her. As I was doing that she said, “What’s my name?” I told her and then left her to shower.

We left for lunch right after noon. As we drove to the restaurant, she asked my name. In a few minutes, she asked again. She asked again at the restaurant. Then she asked her name. After that, she asked if we have children. That led into a lot of reminiscing about our family and our marriage. Earlier this morning, I had seen a picture of a couple dining in the early evening on the riverside in Prague with the Charles River Bridge lit in the background. It reminded me of our trip there more than ten years ago. I told her a story of our sitting on the patio of a restaurant near where our friends’ picture was taken. Each table had a cup filled with peanuts. I looked at the table beside us and saw a bird eating the nuts on that table. Kate didn’t remember it but got a kick out of the story.

Over the course of our marriage, we have discovered that many special moments occur serendipitously in ordinary situations. This was one of those times. She seemed to enjoy my recounting of some of our travel experiences. I enjoyed remembering those good times myself. For the first time in quite a while, she addressed me as “MM,” My Memory. I told her I was happy to play that role.

On the way home, she reached over and put her hand on my arm and said, “You know what that means?” I said, “I do, and I feel the same way about you.” Then she said, “And I don’t even know my own name?”

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It’s amazing how quickly the memory comes and goes.

Yesterday morning I left Kate in the kitchen to take her morning meds. In a moment, she called, “Richard.” I went in to see what she needed. She pointed to the pills. That was her hand signal asking if she was to take them. This (asking if she should take the pills I had just given her) is not unusual. What I noted was that she very easily called my name. That has happened on a few other occasions. In each instance, it seems like it occurred when she needed something. I wonder if the extent to which she needs me helps to trigger my name.

Not long after that we got out of the car at Panera. She asked my name. Then she repeated it several times. It’s unusual that she is able to do that. After taking our table, she asked my name three more times. Interestingly, I don’t recall her asking another time yesterday. Of course, we had a sitter for four hours, but we did go to dinner together and spent the evening at home together as well.

At the last minute, I decided to have a more special meal and went to Emilia. We didn’t even split a meal as we often do. Naturally, we topped it off with a dessert as well. It was a nice change from our usual Friday night meal. It felt good to do something special.

When we got home, she picked up the photo album her brother had made for her. I looked along with her. That turns out to be a good thing since she doesn’t always recognize the people in the photos. Most notably, it’s pictures of herself that she seems to be unsure of, but it is also true of just about everyone else. Of course, all of us have changed over time. It’s not as though we still look the same. She thoroughly enjoyed  going through it and turned back to the beginning immediately after spending about thirty minutes the first time. As in the past, there are several pictures of which she is especially fond. One is the cover photo of her and her brother. The other is a picture of her and her mother. She is particularly attentive to her mother’s smile but also comments on the smiles of others including herself. It made for a nice end of the day. I didn’t even select a DVD for us to watch. We relaxed a little in the bedroom before turning in for the night.

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A Second Chance Comes Sooner Than Expected

As I noted earlier, Kate seemed to be fine this morning. It was late, but we got to Panera at 11:00. That gave us hour for her to have her muffin and for both of us to relax. On the way to lunch, something happened that all of us can relate to. We worry about things that never happen or surprise us when least expect them.

As we were driving, Kate asked, “Where are we exactly right now?” I’m accustomed to the question and told her we were on the road in the northern part of Knoxville. She said, “Is Knoxville a city?” I told her it is. Then she asked my name. I told her and told her how long we had been married. As always, she was surprised how long that had been. I mentioned our children. She wanted to know their names. After I told her, she asked again. She seemed more confused than she normally does.

We drove a little further, and, for some reason, I brought up the fact that we had visited Ellen last Sunday. She looked very surprised and said, “We did? I don’t remember that.” I said, “Yes, we did.” Then she looked perplexed and said, “I should have remembered that. What’s wrong with me?” Since we had had a similar conversation just last night, it caught me off guard. I made a quick decision to tell her what was wrong.

I said, “You may remember that some time ago, we learned that you have Alzheimer’s. That affects your memory and is why you have trouble remembering things. The good news is that most of the things we enjoy in life don’t depend on memory. We enjoy listening to music, going to Casa Bella for their music nights, as well as our local theaters, and spending time with family and friends. Not only that, but you have me to help you with anything you need to remember. I will always be with you for that.” She still looked a little puzzled, but she did say how good she felt knowing she could depend on me to help with her memory. By that time, we were arriving at the restaurant where we had a good lunch and a delicious dessert.

When we arrived at home, she asked, “What now?” I told her that we could spend a little time at home and that we had several options. I mentioned that we could look at some of our pictures from our 50th anniversary trip with our family to Jackson Hole. I also said I could put on some music, and we could relax in the family room. She saw her iPad and said she would like to work on it. For a while we enjoyed Tchaikovsky’s Symphony No. 6 as she worked on her iPad. Then she said she was tired and wanted to lie down on the sofa. I put on some softer music to play while she rests. I am finishing up this post. After that I am going to bring in the clothes from the dryer to fold and put them up.

At the moment, all is well. I am glad I decided to remind her of her Alzheimer’s. This  time it seemed like the right thing to do. Maybe that is because I had thought it through. She seemed to accept it well. At least, she didn’t indicate any concerns about the long-term implications. Perhaps that will never come up. If it does, I will continue to emphasize the good things that we will continue to enjoy and that I will cover the memory issues.

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More Ups and Downs

Yesterday was a day of confusion for Kate. Once again, we had two bright spots that balanced the down moments. One of those came after we returned from her monthly massage. We went into the family room where I picked up the “Big Sister” album her brother, Ken, had made for her and asked if she would like to look at it. I was thinking specifically about the trouble she had been having remembering her family and thought this might jog her memory. It worked beautifully. I sat down beside her, and we went through the entire 140 pages. It brought back great memories. When we finished, she started over at the beginning. She must have spent a full hour and a half looking at the pictures and commenting.

It wasn’t long before it was time to get ready for another musical night at Casa Bella. The musicians, especially the male singer, have been longtime favorites for many years. They are a little younger than Kate and I, but they know the music of our generation. I don’t think there was a single number we didn’t know. It was another great evening.

After we were in bed and ready to go to sleep, Kate said, “What’s your name?” I said, “I’m Richard Creighton, and I am your husband. We’ve been married 55 years.” She said, “Are you sure? I don’t know you.” I assured her I was right, but she still wasn’t sure. She decided to test me. She asked where we got married. I told her. She was surprised when I mentioned the church. It was the one in which she grew up. She still wasn’t absolutely convinced, however, and looked a little suspicious. I told her I loved her. She almost always says she loves me. She didn’t this time. I asked if she loved me. She said, “I don’t know.” I reached my hand to touch her, and she moved it away. She was tired and wanted to go to sleep. She said, “We’ll talk about it tomorrow.” In a few minutes, I moved next to her and put my arm around her. She didn’t push me away. Neither one of us said another word.

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Kate’s Intuitive Abilities Shine

Yesterday could have been just an ordinary day or, possibly, not as good as an ordinary day. As it turned out, it was a very good day. That wasn’t because Kate’s memory or confusion lessened at all. There were plenty of signs that her “rational” abilities continue on a downward slope.

She began the day slowly. I woke her up shortly after 11:30. She got ready for lunch rather quickly – just over an hour. On the way to lunch I played an album by The Kingston Trio, a popular musical group during our college days. I can’t remember the last time I had played it. I just thought it might appeal to Kate. She really enjoyed it.

When we got back home close to 3:00. Our housekeeper and her helper were in the midst of a major cleaning project. Fortunately, they had completed their work in the family room, so Kate and I hung out there. I played another Kingston Trio album. Kate picked up her “Big Sister” album that her brother Ken had given her in the spring. It’s a photo book that contains a large assortment of family pictures that begin at the time of her birth and goes through January of this year. She has enjoyed it immensely since receiving it.

She looked through it two times in succession. The first time I joined her as she turned from page to page adding her comments about the pictures. When I refer to her comments, I don’t mean the photos call back specific memories, at least not in terms of recalling specific facts. They are exclamatory. For example, “That’s a wonderful picture of Mother,” “Look at the way Daddy is looking at me,” “I love this picture,” or “Oh, there’s Nana.” There are a number of pictures that she singles out as favorites each time she goes through, most notably, the one of her and her brother on the cover.

She spent a good hour going through it the first time. Then she went through it a second time while I started to work on my earlier post. She couldn’t go through without expressing her reactions. This wasn’t like a silent reading of a book. She was enjoying what she saw and expressing it as she went along. That led her into talking about the two of us and how glad she was that I had become a part of the family. She mentioned what a good marriage we have had, the wonderful things we have done together, and how proud we are of our children. Then almost without skipping a beat, she asked, “What is your name?”

While she asks about names frequently, it seems like she is now focusing more specifically on my name and “Where are we?” This is a subtle difference, but I think she is losing her memory of things around her. Those are the things that are upper most in her mind. People and places that are far off simply drift out of her mind until something happens to bring them back like my mentioning our children or other friends. I’m always here, and we’re always in Knoxville. She can’t remember the names that seem most relevant at the moment and wants to know.

After finishing the book a second time, we went to dinner. When we returned home, I put on the Les Miserables DVD. We had seen most of it the two previous nights. This was icing on the cake for a day during which she had already enjoyed herself. I hope that as we go forward, she will continue to derive as much pleasure as she did yesterday. I’m going to be optimistic.