Difficulty Using the iPad

October 14, 2017

I have mentioned several times that Kate is having difficulty when she works on jigsaw puzzles on her iPad. At first, she tended to think there was something wrong with the iPad itself. Over time she has come to realize that “operator error” is involved.

The problem she experiences is that hits a button on the screen that takes her to options to buy more puzzles. She seems to recognize this is not something she wants to do. Her initial response was to close the iPad and put it down on the table when we are at Panera. Then I ask if I can help. She doesn’t answer. I pick up the iPad and get her back to the puzzle she was working on or a new puzzle if the problem occurred after completing her puzzle.

For months, I have encouraged her to simply ask me to help, and I would be glad to do so. This morning, for the very first time, it appears that she may be giving in to that. It occurred when she encountered a slightly different problem. She had almost completely finished a puzzle when she couldn’t see any more pieces. That was because there is a button at the bottom of the screen that removes all the unused pieces from the board when you hit it, something she had obviously done. When you hit it the next time, the pieces reappear. I showed her the button. Then I said, “But I want you to feel free to simply ask me to fix the problem if it happens again.” She said, “I will.” I said, “That makes me feel good. It makes me feel needed.” She smiled and went back to her puzzle.

I know that this doesn’t stop her from incurring any future problems. I do hope that it is one small step in strengthening her view of me as a willing helper when she encounters problems.

A Bad Experience with the New Sitter

As I probably conveyed in my earlier posts, I have been elated over the new sitter who has been with us twice. Today she failed us. I had planned two meetings this afternoon specifically because we would have a sitter. The first was with my friend, Mark, who is serving as an editor of my journal and uploading it to my blog. The second was a meeting I had arranged three weeks ago with our accountant.

Kate was tired this morning. She got up and had some juice and went back to bed. When she was still sleeping at 10:00, I was not worried and decided to let her sleep as long as she wanted. By 11:00, I felt I had to wake her up in order to permit her time to get ready for lunch and for us to go to lunch before we came back to the house in time to meet the sitter at 1:00. I try not to rush Kate and have found that this prevents problems. I checked on Kate shortly after 11:30. She wasn’t ready and asked me not to rush her. I went back one more time which irritated her. We finally got to lunch at 12:15. We had our meal at 12:28. I had to rush her to eat, and we left for home at 12:50. We were home at 12:55.

The sitter had arrived on time on her previous two visits. Today she was late. When she hadn’t arrived by 1:15, I called the agency. They tried to reach her unsuccessfully. I told them I could easily cancel the first meeting but that I really need to make the second one. They arranged for a replacement who arrived about 2:20. That gave me a short time to brief her before I left.

Kate had gone directly outside after we returned home from lunch. When I saw her working in the driveway about the time the sitter was to arrive at 1:05, I asked her to move to another location because I didn’t want to risk the sitter’s driving in the driveway in a hurry and hit her. Kate decided to come inside and got in the bed. She was resting when the replacement arrived. After giving her a short briefing, I got Kate up and introduced them to each other. Kate was just a little big groggy and not as awake as I would have liked, but I had to go. Kate decided she would go outside and was headed there when I left.

When I returned close to 5:00, the sitter was in the family room. Kate was in our bedroom working on her iPad. I thought that was fine but was a little disappointed because she had remained in the family room with the previous sitter even though Kate was resting on the sofa. It made me think that she had not been enthusiastic about the new sitter. After the sitter left, I was eager to hear what Kate thought about her. I went back to the bedroom where she had picked up her iPad. I said, “She seems nice.” She said, “Very nice.” That was all we said, but that was enough. I had feared that she might have had a negative impression. Even if she was not as enthusiastic as I had hoped, it was a positive response and definitely not negative.

I actually like the new sitter. Her name is Mary, and she is older than the one she replaced. Her husband is retired from the UT Medical Center. She has a daughter in college and a daughter in high school. She has been working for the agency since 2004. She is scheduled to return on Friday, but she is not available on Mondays at all. That means we may end up with at least two different sitters, one for Monday and another for Wednesday and Friday.

I will call the agency in the morning to discuss where we go from here, but it was a great disappointment that the original sitter did not show up. The agency told me that they would have to let her go for that. I have mixed feelings about that because I really liked her, but I also understand that the agency cannot accept “no shows.” It is a good illustration of what happens when trust is broken. I hope we can soon work out the kinks we are running into.

Salivation Problem

This afternoon Kate and I went to a movie, Columbus, at The Flick. This is the second time at there this week. Two days ago is when I made the entry about her being angry with me over not recognizing her salivation issue that lasted for the entire movie. Today I went with a minor concern over whether or not she would like the film, not thinking about salivation. After picking up our tickets and ordering soft drinks, we started to enter the theater when Kate asked for a napkin. I went back to the lobby and picked up several of them knowing that one would never be enough.

We went through the introductory video with recognition of the donors and some advertising as well as the previews. She used one napkin and asked for another about the time the film started. That left me with only one. At that point I knew she would not have enough to get through the movie, but I didn’t worry because she doesn’t usually have napkins throughout a movie. Today I was more sensitive to her salivation than two days ago. She was obviously struggling. She burped out loud a number of times and had used up her last napkin. I was getting concerned about burping and the possibility that it was loud enough to be annoying to others. I asked her if she thought we should leave. She nodded. We got up and left. As we walked to the car, I asked if she could explain what she was feeling. I asked if it seemed just like ordinary saliva. She said it was. I then asked if it was coming up from the throat or within her mouth. With her hands, she indicated that it was coming up from the throat. I then asked if she were able to swallow the saliva. She tried and was successful. I told her to keep doing that and see if that helped. She did. I didn’t say anything more.

She continued to have the problem all the way home but did not burp again. She did stop swallowing the saliva and kept a napkin to her mouth until we reached home. When we got home, she wanted to know if she could work outside. I told her that would be fine. As she is accustomed to doing now, she asked if she could use the clippers. Then she asked me where she could go. I told her she could choose to start any place she would like. She said the thought she would start out front and looked to see if that were all right. I told her that would be fine. We were now back to normal.

I should comment on what I mean by normal. It still appears that she doesn’t swallow her saliva most of the time. As I noted a week or two ago, she does periodically stop. I suspect that when for some unknown reason she thinks about the salivation, she stops swallowing. In the case of the movie, she is very inactive and, perhaps, that heightens her awareness of salivation. Then she has a reaction like many I have witnessed before. The interesting thing is that she uses paper products to wipe away the saliva all the time; however, she doesn’t always have the negative emotional response that she had on Wednesday and today. I don’t yet have an explanation for that.

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.

Déjà vu

It has been a good while since I mentioned anything about Kate’s Deja vu experiences. I am only doing so now to indicate that they still continue. For example, as we sat at a stop light coming to Panera this morning, a man walked across the street in front of us. Kate said, “There he goes again.” She also continues to see people she “remembers” at the restaurants we frequent. I typically say, “So you’ve seen him/her/them before.”

Speaking of things that continue, Kate is still not swallowing her saliva, and I have not heard from her doctor’s office since I left an email message for the doctor. I have called the office and left a message for the doctor’s nurse. She called me about 3-4 weeks ago. I explained my attempts to contact the doctor. Two weeks ago, I sent a letter to the doctor who started her practice. In that letter I told him about the events that had transpired since the end of June. I have not heard from him or Kate’s doctor. Something is really wrong with respect to communication. I am only glad that it does not appear to be a significant problem. It was a year ago this fall that I first mentioned the problem to Kate’s original doctor who is no longer in the practice.

The Sitter’s First Full Visit

I have often said that we worry about lots of things that never happen while we are surprised by things that we never anticipated. That certainly applies to the first full visit of our sitter for Kate.

Kate went outside about ten minutes before the sitter was to arrive at 1:00. I told her that I was going to the Y and asked if she remembered Brittany who came to our house the other day. She didn’t remember at all. I would have been surprised if she had. Then I told her that Brittany would be here while I was gone. Kate asked why she was coming. I told her what I had said before her visit on Wednesday. I told her that I was just feeling bad about leaving her alone when I go out. Then without any coaxing she said okay. I was thrilled. It was so much easier than I had expected. I had worried about something that didn’t happen. At the same time, I interpreted this as another indication of the progression of her illness. I told her I wanted to give her a hug before I left. I did so and told her I loved her. I held her tight and tears welled up in my eyes. We kissed. Then she went outside to her yard.

The sitter arrived a little late (1:06 instead of 1:00). I started to tell her that I was a stickler for time, but I decided not to make anything of it. I could just wait and see if it is a habit. Kate was working in a flower bed in the back yard. I thought that worked out well so that I could show Brittany around the house and tell her a little more about my expectations. I reminded her that Kate has no short-term memory and would not remember her. I also told her that I thought the most important thing she could do was to make friends with Kate, “just get acquainted with her and also let her know more about yourself.” I told her that Kate could stay outside as long as she likes but to keep an eye on her.

It was 1:30 before I left for the Y. I left there at 3:45 and went to a Panera store in a different location from the one we usually visit. I did so to buy a gift card for the sitter to use if they went there sometime while I was gone. It was almost 4:30 when I got home. Brittany was sitting in the family room watching TV. She told me Kate was still outside. I looked and noticed that she was in almost the same place as when I left. That is the longest Kate has spent outside since the spring when the weather was cooler. Today is one of the most pleasant days we have had.

I went to the bedroom to take my gym clothes out of the bag and put them in the clothes hamper. Then I went to the closet and opened my top drawer to return the Y membership card that I had taken out of the drawer right before I left for the Y. I noticed that the top drawer was in more disarray than usual. I can’t claim that it is usually or ever neat, but I know where things are and can see them pretty easily. At first, I wondered if I could have messed up the arrangement of things in the draw that much when I took the Y card out. Then I opened the top draw to the right of the one where I keep my keys, wallet, and some cards. When I opened that drawer, I immediately saw that the contents were very differently arranged than usual. I use a microfiber cloth to clean my glasses. I keep it on top of the other things. It is a good size cloth and covers almost the full width of the drawer. I could only see a trace of it under several envelopes and cards. It was obvious that someone had gone through the contents. The last time I opened the drawer was yesterday morning. I went into the family room where Brittany was watching TV. I asked if she was sure that Kate had not come inside while I was gone. She said she was. Then I asked if she could have gone into two of my dresser drawers. She said she hadn’t. I didn’t push it. I didn’t expect her to say she had. It was still about 15 minutes before time for her to leave. I told her she could go. Then I went back to the bedroom to see if there were any other unusual things. The only thing I noticed was that a top drawer to Kate’s dresser was pulled out slightly. I think Kate has completely forgotten about having anything in it, and I have never opened that drawer at all.

I can’t be sure that Brittany was the one who got into the dresser drawers. It is possible that Kate had done it. I just think that is very unlikely. I have known her to go into one of the other drawers that has socks in it, but not the top two drawers. Despite not being sure that Brittany did it, I just didn’t feel comfortable having her back again. I called the agency immediately. They apologized and jumped right on a replacement for Monday. They seemed very pleased with this person who has worked with them a while. They said that everyone has liked her, and the person for whom she had been carring had died and would probably be available on a permanent basis. I shall look forward to meeting her on Monday.

Salivation

I am still in a quandary concerning Kate’s salivation problem. I have new information that gives me another slant on things but no solution. Yesterday at lunch and again at dinner, Kate had the “reflux/salivation” problem. At dinner, as she was trying to calmly wait it out, she said, “There it goes again. I asked her what she was talking about. She told me, “A hiccup.” I was surprised at the answer because I wasn’t hearing any noise that would suggest a hiccup. That led to my asking, “Do you mean that it was like a hiccup, or did you really have a hiccup?” She told me she really had the hiccups.

To me this really sheds a different light on the situation. Even though I have felt she wasn’t showing clear signs of reflux, I have given her omeprazole and Gascon which are intended to address reflux. No wonder they haven’t stopped the problem. I noticed something else last night. She had only taken only one or, possibly, two bites of food before encountering the problem. That alone made me question whether it is reflux.

As was the case on Sunday night, Kate went to bed after taking her evening medications. She seemed rather calm and went right to sleep. She slept well and is fine this morning. That makes me wonder if the hiccups induce some measure of anxiety that makes it hard to stop it.

The real question is what is causing the hiccups. I did an online search about it. Although hiccups are an annoyance, it doesn’t appear that they represent a serious medical issue. I noticed some of the old home remedies for hiccups. I got her to hold her breath as long as she could. I also got her to drink some water. Those didn’t work.

This morning I sent another message to her doctor telling him about the hiccups. Maybe he will have a thought about it.

Now I am wondering if the salivation and the hiccups could be a result of a common cause, or are they unrelated. It seems to me they are different issues altogether. I say that because she seems to have the salivation at all times of the day. The hiccups only seem to appear at meal time.

Taking Stock Again

Kate and I just returned from a local theater where we left another performance at intermission. This is only the second time we have ever left a performance. Yesterday’s Live in HD at the Met was the first. The interesting thing is that they had something in common. Both were farces, something that Kate does not enjoy. In each instance, they were “bedroom” farces. I do enjoy farces when they are done well, and yesterday’s and today’s performances were quite good. The Met, of course, was especially good. Neither was good from Kate’s perspective.

This makes three performances in three days that she didn’t care for, and I know she couldn’t follow. I can’t help believing that it also may be a sign that Kate’s further decline. I don’t intend to immediately discontinue trying to find things that she will like, but I will be more careful in my selection of things we attend.

I must admit that this also has an impact on the way I feel about the way things are going. Right now I am feeling a bit discouraged. It is interesting that this occurs the day before I make my first public presentation about being a caregiver for someone with Alzheimer’s. I had been a little concerned that I was going to be overly optimistic. I wonder if this will cause me to be more balanced.

Continues To Be Tired

When I hadn’t heard from Kate to pick her up from her PEO meeting, I drove over to the house where the meeting was held. I waited for about 40 minutes Then she came out to the street with two of her friends. I wasn’t sure whether she had arranged for one of them to take her home. I started the car and moved up to where she was entering the street. She got in the car with me as though we had arranged it along. In the car I asked her if she had planned to call me. She said yes. That may have been the case. I’ll never know.

When I had dropped her off earlier, I gave her my business card with my cell number written on it. She was offended. I was just remembering that the last time she was confused.

She seemed tired on the way home. I asked her how the meeting went. She said, “Fine.” She was not talkative. I didn’t push it.

She came home and rested for about an hour before we went for haircuts. She was tired on the way home and rested for another hour before getting up for us to go to dinner and a play at the Bijou. She dressed in something unusually casual. She told me that I had told her she could wear anything she wanted because we wouldn’t see anyone we know. I told her I couldn’t guarantee that and that we were going to Bijou. When I said that, she immediately decided she was too casual and has gone to change.

Social Withdrawal?

This morning Kate has her monthly PEO meeting. Last night when I mentioned it to her, she groaned. I recall that she has shown less enthusiasm about going to PEO over the past 6-12 months, but this is the first time that her response made it sound like a chore. A few minutes ago I got back from my morning walk. I went into her room to remind her that this was her PEO day. She groaned again saying, “I know.” I said, “You’ve always enjoyed going.” She went on to say that she wasn’t enjoying it the way she used to. Then I went back to my computer to see if this is a day when they have lunch. It turns out that it is. I went back to Kate and told her this was a day when they are having a lunch at the home of the hostess. She said, “That’s even worse.”

For some time I have felt that there has been a change in the way she fits in with the group. Sometimes she is waiting outside for me to pick her up. Typically she would remain in the house socializing until I arrived. She also hasn’t appeared to have enjoyed the meeting. They have taken in several new members in the past few years. They have also lost a few that she really liked. I suspect Kate is feeling like she is a stranger in her club. She doesn’t know the new people, and she can’t remember all the older members. I feel sorry for her. I am especially concerned because it would be the loss of another social contact that could be good for her. On the other hand, if she isn’t enjoying herself, why keep it up.