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More on Sleep

For at least four or five years, Kate has gone to bed before me. When she is ready to go to sleep, I go into the family room where I listen to music and read or work on my computer. Though I sometimes accidentally wake her, she has almost always been asleep when I came to bed. The past three or four nights, however, she has been awake. That in itself is not a problem. I hadn’t thought much about it until two nights ago. Each night she has indicated that she is glad that I finally came to bed. Two nights ago, she said more than that. She said she couldn’t imagine where I was or what I was doing. She sounded somewhat disturbed (not irritated, but afraid). She also went on about it a little longer than I thought would be natural for her.

Her response made me feel as though I had abandoned her. Knowing that she can’t remember, I should have thought about this. The fact that this has been our pattern for so long prevented my even considering that she might get worried or feel she had been left alone. I try not to overthink things like this, but I also don’t want to overlook something that might call for me to make a change in what I am doing.

I have not given her Trazadone for the last three nights. That could easily account for her not getting to sleep. Yesterday, I emailed her doctor about the Trazadone as well as her knee. He said she is already on a low dose, but that I could cut it in half and discontinue it entirely after a week. We’ll see how that goes.

In addition, I might address her concern about being alone by staying in the bedroom with her when she goes to bed. The only complication is that she likes the lights off. I like to have more light. I can easily read a book on my iPad. I usually do that anyway. I started to do that last night, but she assured me she would be all right, and she was. I still found her awake when I got to bed about forty minutes later. She said she was waiting for me. I’ll stay with her tonight.

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Thoughts on Sleep

During the first few months of this year, Kate’s sleep pattern has changed. She is still going to bed about the same time as always, between 8:00 and 9:00, but the time she gets up has been more erratic. I generally let her sleep as long as she wants, but several times I’ve had to wake her. She has slept until noon or shortly thereafter a couple of times and 10:30 or later more times. In between those late sleeping days, she has gotten up as early as 7:30, but more often 9:00 or a little later. Prior to taking Trazadone, she had difficulty sleeping at night. Trazadone changed that. That’s been a good thing. She has slept beautifully since then.

My personal problem, not hers, is that I am particularly interested in her getting up earlier on days when we have a sitter. Early would be 9:00. That way she can get showered and dressed leisurely which normally takes up to an hour and a half. Then we can have lunch without being rushed. It also gives me more time with her. A number of times over the past few weeks, we have rushed to lunch and back to meet the sitter. Neither of us likes being rushed.

During the past ten days, I have not given her Trazadone the night before the sitter comes. That seems to have worked. She hasn’t gotten up too early, and it allows us a comfortable amount of time in the morning before I have to leave.

This change seemed to have worked until this past Thursday when she slept until noon. She had taken Trazadone the night before. By the time she was ready for lunch, it was almost 1:30. That wasn’t a day for the sitter, but I still felt that requires a greater change in our days than I am ready for right now.

I have also begun to wonder if taking less Trazadone could relate to her unusually good mood over the past week. Her moodiness has always been limited to the early morning. She is slow to get going. That was true before Alzheimer’s. She sleeps later than I do, and she is not ready for conversation until she is fully awake. For that reason, I don’t ever recall our having breakfast together in our 55 years of marriage except when we are traveling. Even that is extremely rare. What has been different the past week is that she has been more cheerful when she gets up than I have seen in quite a while.

That is leading me to consider dropping the Trazadone altogether. I plan to explore that with her doctor in the coming week. He had opened the door to our eliminating some of her medications in one of Kate’s recent visits. I think Trazadone could be a good place to start.

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Her sleep pattern keeps changing

For years, Kate has had a pretty predictable pattern of sleep. At least that is true since she started taking Trazadone. That was shortly after her diagnosis just over seven years ago. She used to go to bed between 9:00 and 10:00. She would wake up around 7:00 or 8:00 and get some juice and yogurt. Then she returned to bed and worked jigsaw puzzles. She would get tired and fall asleep for a little while and get up for good between 8:30 and 9:30.

Early this year, she gave up the juice and yogurt routine as well as going back to bed. Her morning routine was rather stable until she got the flu. It wasn’t long after that when she had a lingering cold. I think that upset her sleep pattern. Since then, there have been several times when she has slept close to noon. I woke her up one day about 12:20.

Until this morning, I thought she might be working her way back to a regular pattern. I woke her at 12:25. I’m not entirely surprised. Last night she didn’t get into bed until after 10:00. Once she was in bed, she was talkative. She was talking about how fortunate we are. As she and I often do, she talked about our marriage, our children, grandchildren, and her extended family. I suspected she might sleep a little later today. I just didn’t anticipate how late.

That’s not an unfortunate thing for me. I got in my morning walk and took care of a variety household responsibilities that I have been putting off for a while. Being a creature of habit, I’m just thrown off a bit when I can’t be sure when she will be up. One of the ways I have adjusted is not to schedule anything during the morning. That works well. It certainly did this morning. I’m glad I didn’t have to rush her. Next week we are going to Memphis to spend a couple of days with our daughter and her family. I decided to make it a very leisurely trip by stopping overnight in Nashville. That afternoon we will visit Kate’s friend, Ellen, who is still in rehab after a bad fall. The next day we will have a leisurely drive to Memphis.

Some things are more of a challenge. Two weeks from today, I have a routine doctor’s appointment. I am scheduled for my labs the day before. Because I’m not supposed to eat breakfast before hand, I try to schedule the earliest appointment of the day. That’s not a time when I have a sitter, and I don’t want to get Kate up early enough for us to make an 8:00 appointment. I have scheduled this one for 10:30 and hope that I won’t have any problem getting Kate ready. If it is a normal day, that should be no problem. If it’s a day like today, I may have a challenge on my hands.

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Sleeping Late Again

In recent weeks I have noted that Kate has been sleeping later that has been her custom for quite a while. In the past few days, however, she has been getting up at what I would consider an ideal time, around 9:00. That gives her what has usually been an adequate amount of sleep, 12-13 hours. It also gives me time to take care of a few things before she is awake.

Just when I thought she might be establishing a new pattern, she changed again. This morning, she was still in bed at 9:15. I checked on her a little later and discovered that she had gotten up from our bed and gone back to sleep in her room. Just before 11:00, I checked once again. She was back in our bed. At 11:25, she had gotten up and was making up the bed. Then she went to take a shower and dress. It was getting close to 1:00 when we got to Panera for lunch. I felt a little pushed because she had an appointment for a facial at 2:00. I tried not to rush her. I must have been successful because she didn’t express any irritation or have a panic attack. A couple of times she did say, “Just a minute” when I checked to see if she were ready.

As a caregiver, I am always trying to determine what, if anything, Kate’s current behavior signals for the future. In this case, I know that people with dementia require more sleep as the disease progresses. Sooner or later, I know that might happen with Kate. Am I seeing the first signs of this change? Is this judge a random shift from her regular sleep habits? Is there something else that I haven’t identified that might be causing the change? At the moment, I would answer “I don’t know” for each question. Because I am seeing so many other signs of change, I suspect this is part of a normal progression, and that will gradually sleep more than she used to. I will be looking closely to see if there is another explanation.

I had already been avoiding any commitments in the morning. Just last week, I changed the location of her next doctor’s appointment to a less convenient office so that she could see him in the afternoon. I will continue to be more rigid about this in the future. It will be easier for both of us.

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Trying to Figure Out Kate’s Sleeping Pattern

If you have been reading my recent posts, you may recall that I have commented on a change in Kate’s sleeping pattern over the past several weeks. She has been sleeping later than usual. I have had to waken her a couple of times around 10:00 or so to get someplace. Most of the time I simply let her sleep as long as she wants. One day she slept until 12:20. There have been several days she slept until 11:00 or after.

During this same time period, there have been a few days when she has gotten up early. One of those days was this morning. I was working in the kitchen when she walked in about 8:10. She was dressed and ready to go to Panera. Then I had to get ready, but we were there by 8:30. That is still earlier than our average arrival time before she started sleeping later.

I wondered how the morning would go since I knew she wouldn’t want to remain at Panera until lunch time. As it turned out, she was ready to leave by 9:30. She was tired and wanted to rest. She came inside and is still in bed at 10:25. I hope she will get up shortly so that I can get her lunch before I have to leave for Rotary. The sitter is scheduled to arrive at noon. If she is not awake before 11:00, I’ll get her up.

Over the seven years since her diagnosis, she has made a number of changes in her sleep habits. When first diagnosed, she wasn’t sleeping well at night. That led to her sleeping later in the morning. A little later she settled into a fairly regular sleep routine. I think we can thank Trazadone for that.

(At this point, Kate walked into the room. She was ready to return to Panera.)

We are now at Panera, she apparently had enough time to rest. This works out well for me because it also gives us plenty of time to get her a sandwich before we go back to the house to meet the sitter, and I leave for Rotary.

As I was saying, Kate got into a pretty regular sleep routine. She usually awoke fairly early (between 7:30 and 8:30). She got up, got some apple juice and yogurt, and returned to our bedroom where she worked jigsaw puzzles on her iPad. That continued for a long time until the past few months. She started getting up slightly later and getting dressed. After that, she was ready for Panera. That meant she was drinking less juice and eating less yogurt. A couple of weeks I had to throw out yogurt that had expired. I had already stockpiled a good bit of apple juice. Now I am only buying V8 for myself.

At first, I thought that the current change might be caused by our having the flu, but she has continued to sleep later, and it was well beyond the time we recovered. The problem that her sleeping later presents for me is that I spend less time with her in the morning. In addition, I sometimes have to rush her a bit for us to get lunch before the sitter arrives. I guess time will tell where this is going.

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Update on Sleeping

The time is 11:39 a.m. as I begin this post. Exactly one hour ago, I tried to wake Kate up so that we could have lunch before the sitter arrives at 1:00. She finally got up about five minutes ago. As I have noted in recent posts, she has been sleeping later over the past couple of weeks. One Saturday, I let her sleep until 11:30. Another day I woke her at 12:20. In each of those cases, she got up without a problem. I can’t account for why it has been so difficult for her to get up today. She went to bed around the same time as usual. The past couple of days she has slept until ten o’clock. At first, I was associating her sleeping later to the impact of having had the flu. Now I am wondering if this might not be another of those normal symptoms of her Alzheimer’s. Of course, it could be some combination of the two.

This morning, I received a reminder that I have an ophthalmologist’s appointment at 10:15 Friday morning. That makes me wonder how much trouble I may have getting her up and ready to go with me. I don’t want to leave her alone. At the time I made the appointment, I would not have thought it would be a problem for Kate to be ready that early in the day. At least we are not going out the night before.

This is just one more of the many little things that crop up that would have been of no consequence before Alzheimer’s.

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Sleeping Changes

It is 11:22, and Kate is just getting up. Even that is only after I started gently waking her about 10:50. I hate to wake her, but the sitter will be coming at 1:00, and we need to get lunch before then. As I have noted before, since coming down with the flu, she has been sleeping more. That has meant getting up later since she has still be in going to bed about the same time. Last night we went to Casa Bella for dinner and didn’t get home until 9:00. Still, this is unusually late for her to get up.

Although I think she should be over with the flu now, it may be that this is one of the aspects that is hanging on. She is not coughing much at all now, but once in a while she does. It sounds very much the way she did when she got sick almost two weeks ago. Her being tired may be another residual symptom.

I’ll continue to monitor her sleeping to see if this represents a more permanent change. I have to remind myself that two or three years ago, she was sleeping more than she has in recent years. The difference is that she was taking both morning and afternoon naps. She gave that up a good while back though she had a long nap while the sitter was here two days ago.

I have very carefully arranged for the sitter to come in the afternoon so that Kate and I could spend the mornings together. If she starts sleeping this late every day, I will spend much less time with her. On a day like today, I will have about an hour or so with her for lunch. Then the sitter will have her for four hours. When I return, it will be within an hour of dinner time. Then we are winding down for the day. That would be a big change for me. I’m not sure I am ready for that.

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Off to a Late, But Good Start

As she has done several times lately, Kate slept late. She opened her eyes when I walked into our bedroom about 8:30, but she didn’t get up until 10:30. That is after going to bed around 8:45 last night. Until recently, she had been going to bed between 8:00 and 8:30 and getting up around 9:00. It is quite possible that our recent trips to Texas have thrown her off a bit. On the other hand, I always wonder if she might be establishing a new pattern.

This is a light day for us. The only commitment we have is to get haircuts at 3:00 this afternoon. Because we have plenty of unscheduled time, I decided to drop by Panera for Kate’s muffin even though it was 11:30. I thought it would be good for her to be occupied for an hour here before we go elsewhere for lunch. It’s a sunny day though a bit chilly. I suspect she may want to work in the yard a little between lunch and our haircuts. That will leave us with another hour and a half or so before having dinner. I find that the day seems to go well when Kate’s activity is divided into small “chunks” of no more than two hours.

She is in a good mood today and is happily working her jigsaw puzzles on her iPad. She hasn’t asked me to help her once, and we’ve been here about fifty minutes. That is a rare event. I am optimistic we will have another good day.

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Still Tired

In my recent posts I have noted that Kate has been very tired. That has been especially since our return from Texas this past Monday. After lunch yesterday, Kate came inside and went directly to bed. She slept three hours. When she got up, she was hungry. That led to our having an early dinner. Of course, that meant we were home earlier. I put on a DVD of The Merry Widow. She worked jigsaw puzzles on her iPad while it was on, but she enjoyed the music. By 7:30, she put away the iPad and went to sleep. I went to bed close to 10:00. I discovered that she was awake. I am sure that was a result of her having slept so long during the afternoon. It wasn’t long, however, before she was asleep for the night.

At 7:45 this morning, she came into the kitchen where I was working on the computer. She was ready for Panera. We were there at 8:00. I think there has only been one other time we have gotten there so early. By 9:00, she was ready to go back home. I could tell she was tired. I asked her if she would like to lie down on the sofa in the family room while I read the paper. I told her I would build a fire. She took me up on that offer and rested for more than an hour and a half. She asked if she could go outside. I told her that would be fine. As she does so often, she then asked if she could use her clippers. I told her she could. She gave her customary response. She looked quite surprised and said, “What’s got into you?” I always think this is funny because I have never said anything about her not using the clippers nor have I ever said no when she asks if she can use them. We are having a slight break in the cold weather, and I’m actually glad that she has a little break to go outside. She hasn’t done that much lately.

In another twenty minutes we’ll leave for lunch. At 1:15, we are going to The Greatest Showman. I haven’t had much luck finding movies that Kate enjoys lately. She did enjoy Darkest Hour. This will be very different, but I hope she will like it.

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Quiet Time With My Music

We had our usual lunch at Bluefish today. We had missed last week because of our trip to Fort Worth for her cousin’s funeral. I had thought about calling our server to let her know we wouldn’t be there but was caught up in all the preparations for the trip. I wondered if she would be worried. It turns out she was. She told us she has a number of customers who come in on a regular basis, but we are the most predictable. She knows about Kate’s diagnosis and wondered if we had run into a problem of some kind. (I tell most of our servers about Kate. I feel it is important for them to know in case something unusual happens. The most common thing is getting lost on her return from the restroom.) Anyway, our server was relieved that we were all right and gave us our usual hugs as we came in and when we left. The only other server who does that is the one at the restaurant where we eat on Sunday.

Kate didn’t talk at all on the way to and from Bluefish. Nor did she say anything during lunch except in response to our server, and that was minimal. As soon as we returned to the house, she brushed her teeth and then got into bed. It’s been almost an hour and a half, and she is still in bed. This would not have been unusual two or three years ago, but since that time she has not been napping until very recently, especially since we got back from Fort Worth. I have noted previously that she has recently shown other signs of decline. I can’t help wondering if we are in for something more in the upcoming months. We have been fortunate that her decline has been so gradual up to this point, but I am well aware that this can change at any time. Two friends who have lost their spouses in the past year to Alzheimer’s after they experienced a more sudden change that occurred in the last months of their lives.

I had washed clothes this morning and put them in the dryer before we left for lunch. When Kate started her nap, I put on a Chris Botti album, Impressions, and folded the clothes. As I have mentioned before, music has always been important to me. That has been especially true since Kate’s diagnosis. I find it very comforting. It’s also been a pleasant way to make a few last-minute edits to my blog for its launch tomorrow.