Social Situations

May 3, 2019May 5, 2019

Insecurity at Casa Bella

Yesterday was not a typical day. Kate seemed to be in a cheerful mood, but she was also irritable off and on throughout the day. I observed that very early when I told her I thought she should shower before getting dressed. It had been four days since her last one on Sunday. Each of the previous mornings I had encouraged her but let it go when she resisted. I did the same yesterday.

We commonly hear about anger and violence as symptoms of people with dementia. There is another school of thought that suggests that such behavior is not a direct symptom itself but a bi-product of symptoms like confusion and misperception. According to this interpretation, anger and violence are or can be natural responses to the way the brains of people with dementia work (or don’t work).

If I employ this line of thinking to what happened between Kate and me yesterday, I would say that Kate wasn’t just in a bad mood, she may have been responding to the way I told her it would be good for her to take a shower. In fact, I don’t believe I was as gentle in my suggestion as I usually am. If I had thought of a gentler way to do it, she might have willingly agreed to shower. Instead, she dug in her heals. I didn’t push her.

I told her I had her clothes for her, and she thanked me. When I started to help her dress, she was resistant. She said, “I can do that myself.” Ultimately, she had to have my help with her bra and her pants, but she was determined to be as independent as possible. As I helped her, she snapped at me. Then she felt bad and said, “I’m sorry. I shouldn’t have said that.” She clearly understood that was not typical for her. I think her reaction related to my not being gentle enough in my attempt to get her to shower.

While she went to the bathroom to brush her teeth, I went to the kitchen to get her morning meds. Shortly, I heard her call, “Daddy!” I called back from the kitchen, but she didn’t hear me. She called again. “Daddy!” I walked toward the bedroom and said, “Here I am.” This was a time when I thought it was best not to tell her that I am her husband. When I reached her, she looked a little frightened and said, “I didn’t know where you were.”

As we drove to lunch, I played some music that she likes. She didn’t talk much. When she did, it was to comment on the music. She enjoyed it. We had a pleasant lunch. It was as if the problems getting up had never happened. The afternoon also went well. We spent a couple of hours at home. She worked on her iPad a while and then rested on the sofa. After her rest, she wanted something to eat. It was ninety minutes before time to leave for opera night at Casa Bella. I took her to Panera for a bagel. We got home in time to change clothes and leave for dinner. That’s when another problem occurred.

I made a complete change of clothes and had picked out a different top for her. She didn’t want to change and snapped at me. I tried not to push her. She consented, but she wasn’t happy.

As usual, she enjoyed the evening of music. The man with whom we share a table commented several times about her enthusiasm. He and his wife got to observe an example of Kate’s memory problems when she looked at me and said, “And what is your name?” I said, “Richard.” She frowned. I knew that meant she wanted my full name and said, “Richard Creighton.” She frowned again. I said, “Richard Lee Creighton.” That was the right answer.

The biggest problem of the day occurred just before we left. I was seated across the table from her. The seat to my left was empty. I was seated with my back to the singers and moved to the empty seat and turned halfway to the right so that I could see them. When the program ended, I looked at Kate who was disconcerted. She looked at me and said, “Is that you?” It turned out that she had lost sight of me even though I was only four feet diagonally across from her. She was quite relieved to see me.

The man in the seat to my right got up, and I started to follow him out. He stopped to help his wife with her walker. The two of them were standing between Kate and me. I chatted briefly with a man at the next table. When I finished, I went around the couple to see Kate. That’s when I saw that the couple and another man who had been at our table were trying to comfort her. She had been very disturbed because she didn’t know where I was. When she saw me, she said sternly, “Don’t ever do that to me again.” I am sure the three people who were trying to soothe her were shocked that these words expressed so strongly came out of the mouth of someone they had no doubt viewed as very soft spoken.

It amazed me that she had become so anxious in such a short span of time. It couldn’t have been more than a couple of minutes. Of course, with no perception of time, it could have seemed much longer to Kate. I was standing within six feet of her the whole time, but she couldn’t see me. I apologized and told her I would never leave her. As we walked through the restaurant to leave, she continued to be a little upset. My apology must have been too light-hearted because she said, “This is no laughing matter.” By the time we got to the car, she was fine. I played several pieces of music she loved on the way home. That made her even happier. The crisis was over.

It is obvious that Kate’s insecurity is increasing and that I am her “security blanket.” I also think the events of the day illustrate how much her emotional reactions are tied directly to her perceptions of the events around her. Her rational abilities are not working well enough understand what is going on. That misunderstanding leads to insecurity that is sometimes expressed in behavior that is not typical of her.

April 26, 2019

Ken’s Arrival

Like so many things, especially when it comes to airline travel, Kate’s brother, Ken, and his wife, Virginia, experienced a delay in their arrival yesterday. We were to have had dinner with them last night, but their flight didn’t get here until close to 9:00. I regretted not having that time with them but invited them to drop by our house on the way to their hotel.

They arrived at the house just after 9:30. Kate and I were in the family room when I heard them at them at the door. I got up to greet them. Kate stayed in her chair where she was working a puzzle. Ken and Virginia entered the family room ahead of me and said hello to Kate. They hugged, and she greeted them warmly. Everything seemed perfectly normal. It was a beautiful reconnection with her brother.

We talked about the day’s travel experience and laughed. They were both able to take it in stride. We caught up with their children and grandchildren. We talked a little about our courtship and a letter that her mother had sent to my mother talking about our “friendship.” There were times when Kate was confused and asked for clarification and spoke very little. Otherwise, she was enjoying the conversation along with the rest of us.

After an hour, Ken and Virginia left for their hotel. As soon as they walked out, and I had closed the door, Kate whispered to me, “Who are they, and what are they doing here?” I told her their names. She didn’t recognize them. Then I explained that Ken is her brother, and Virginia is his wife. I was floored that Kate had not realized this. She must have spent the entire time without knowing who they are.

This experience is a good illustration of a couple of things. First, it shows that even someone (me) who knows her condition best makes mistakes in judgment. I know that her memory is gone, but in many ways she still seems very normal to me. That often leads me to expect more of her than I should.

Looking back, I see that I didn’t handle the situation the way I should have. We had been sitting in the family room for over an hour without my reminding her that they were on the way and would be here soon. Of course, she forgot about our earlier conversations about their upcoming visit. I can’t remember exactly what I said when I heard them at the back door. It was probably something like, “They’re here.” That would mean nothing to Kate. In my haste to welcome them, I didn’t even walk ahead and tell Kate, “Your brother Ken and Virginia are here.”

The experience is also an example of how poor Kate’s memory (rational ability) is and how well she is able to handle a social situation through her intuitive abilities. Ken and Virginia are well-informed about Kate’s current decline. I am sure they noticed some changes since their last visit. On the whole, however, my guess is that they didn’t sense just how poor her memory is. I will be eager to get a chance to find out today.

April 12, 2019

A Different Day Yesterday

Kate has been unusually cheerful the past two weeks. Yesterday was different. It’s not that she was in a bad mood. She just wasn’t especially cheerful. Getting her up earlier than usual may have had something to do with that. On the other hand, it may have been one of those things that we can never explain.

We had a busy day that started with my appointment for labs prior to seeing my doctor next week. Until the past year, I have always had the earliest appointment I could get. Since Kate sleeps later than she used to, I have changed to 11:00. That is still early for Kate, but I am eager to eat as soon as I am up. I woke Kate at 9:15 in order to give her time to get ready without rushing too much. It was one of those days when she didn’t want to get up. She told me to go on without her. I told her I didn’t want to leave her alone. I apologized for getting her up and explained the reason. She still didn’t get up. I asked her to do it for me. She agreed and did so well getting ready that we had time for a quick stop for a muffin at a Panera not too far from my doctor’s office.

From the doctor’s office we went directly to lunch with one of our associate pastors. We had a nice time, but Kate was not very talkative and cheerful. She actually snapped at me as I offered my hand to assist her in getting up as we were leaving. She had a hangnail on her left thumb and thought I was going to grab it. It was a nice lunch, but Kate wasn’t at her best.

We had a couple of hours before taking her for a massage. She rested at home most of that time but got up easily when I told her it was time to go. The past couple of times she has said she didn’t want to get a massage. This time she didn’t say a word. She went happily.

Two weeks ago when she had her last massage, I talked with one of the staff in the front office. I told them I thought we might be coming to the end of her massages. I told them I would like to try at least once more. We talked again this time. Kate had been so accepting that time, I thought it would be good to try again. I scheduled yesterday’s appointment. When I went back to pick her up, I waited a few minutes. Then the woman who gives her the massage came out and told me that they had finished, and she had left Kate to get dressed. When she went back, Kate was lying down on the table and had not dressed. I went back and helped her. She was confused. I don’t think she realized that she was supposed to get dressed. When she was ready, we walked back to the front desk where I discreetly cancelled the next appointment. I don’t plan to schedule any more.

The highlight of the day came when we returned home. Kate noticed the photo of her and her brother on the cover of her “Big Sister” album and said, “I just love that picture.” She commented on the smiles of the two children. I said, “Do you know who they are?” She did. I asked if she would like to look through the book. For the next hour we went through most, but not all, of it. She expressed more enthusiasm than she had all day.

I continue to find mystery in the way her brain works and doesn’t work. As we looked at pictures of her family, she sometimes recognized her mother, father, and brother. Other times, she had no idea who they were. Often she looked at two pictures of her father that were side by side on the same page. She asked, “Who is he?” I told her, and she asked, “What’s his name?” I told her. Then she looked at the other picture and asked the identical questions. We went through the book for an hour repeating these questions and answers. Of course, some of the confusion involves the fact that the way people look changes significantly over time, but the big problem is Alzheimer’s. I’m just glad she had that hour to really enjoy herself.

Last night we went to Casa Bella for jazz night. That is always a hit. She enjoyed it, but the experience wasn’t as good as usual. We always sit with the same couple. Often no one else joins us. If so, it’s just one other couple. Last night we were at a table with seven other people three of whom we hadn’t met before. This made conversation a bit more challenging. Kate was quieter than usual. She enjoyed the music, but I am sure she was uncomfortable in the larger group.

Looking back, it wasn’t a bad day at all. It just wasn’t like the ones we have had recently. Most days are very good. I’m sure we will have many more in the days ahead.

February 27, 2019February 27, 2019

A Very Good Day

My video cam continues to help me monitor Kate in the morning. About 7:30 yesterday, I saw that she was about to get up and went to the bedroom. When she saw me, she said, “Do I have a meeting I have to go to?” I told her she didn’t. She asked if I was sure. I assured her she had no obligations and could rest a little longer. I took her to the bathroom and then back to bed. She asked again if she had a meeting. She must have had a dream that she did. She was glad to be able to return to bed.

About 9:30, I saw that she was getting up again. When I got to the bedroom, she said she wanted “to get out of here.” I helped her up and to the bathroom and turned on the shower. Before getting in the shower, she said, “You’re really nice to do this.” I said, “I’m glad to help you whenever I can. I love you.” She hadn’t said anything that would indicate that she remembered my name or that I am her husband, but I felt that she did.

As she was getting dressed, she joked with me about something. I said, “You have quite a sense of humor.” She said, “So do you.” I said, “I guess that’s why we’ve gotten along so well.” Then I asked if she knew how long we had been together. She guessed fifty years. I told her we had been married for fifty-five years. Then I added “Fifty-five great years.” She didn’t express any surprise and said that we had done a lot of great things. Before walking out of the bedroom, she saw a wedding photo of our daughter and asked who she was. I told her that was our daughter. Again, she didn’t act surprised.

We had a little time before a lunch and dropped by Panera for a muffin. In the car she said, “What is my name?” I told her. Then she asked my name. After I told her, I asked, “Do you know how we’re related?” She said she didn’t. I told her we were married. She said, “When did that happen?” I told her it was fifty-five years ago. She found that hard to believe. I told her we had a daughter who is fifty and a son who is forty-eight. She didn’t respond with any alarm or elation. After we were seated, she asked me to tell her my name. I gave her my name and told her I was her husband.She expressed surprise. I said, “Does that bother you?” She said, “No, I’m glad. You’re a nice guy.”

From Panera, we went to our church where the seniors were having a Mardi Gras luncheon. The entertainment was a saxophone player playing music closely identified with New Orleans. She enjoyed it. About mid-way in the program, she tapped me on my shoulder. I leaned toward her so that she could whisper in my ear. She said, “What’s your name?” A few minutes later, she said. “Where in the world are we?” When I told her we were at our church, she gave me a strange look. I quickly realized she didn’t think it looked much like a church since we were in our fellowship hall that used to double as a gym.

We both enjoyed seeing people we know but hadn’t seen in a while. The seniors meet once a month, but I somehow forget to make reservations. This time someone called to remind me. The highlight for Kate came when the saxophonist played some Dixieland music, and his wife led a conga line around the room. Only fifteen or so participated. I was one of them. Kate got a real kick out of seeing me dance around the room.

Later, as we walked to our car that was parked in front of the sanctuary, she asked, “What’s the name of this church?” I told her. She had no recognition. Then I told her this was where she had been the volunteer church librarian. At first, she didn’t remember. Then I told her what a good job she had done there. That jogged her memory, and she mentioned a few things she had done in that position. On the way home, she said, “I love you.” She followed that by asking my name. She was remarkably at ease during each of these moments her memory failed her.

It had been over a month since her last pedicure. I was beginning to feel a little guilty so I made an appointment shortly after getting home. It was no surprise that she didn’t remember anything about the procedures involved. I helped her into her chair. She commented on the water. I left her in the hands of the attendant but waited in an area where I could watch her. She hadn’t been seated long before I heard her say, “What’s the name of this place?” The woman attending her answered. Then she asked what kind of place it was. As I watched, it looked like something she must have enjoyed. When I asked her afterwards if she had enjoyed it, she shrugged. I suspect by that time she didn’t remember even though we were just outside the door to the salon.

We went back home where she rested in the family room for an hour. Then she picked up a photo album of her father’s family. She had not looked at it recently and was taken with it. While she had to ask me the names of all the people multiple times, I felt the major problem was not her vision but the Alzheimer’s impact on here sight. She seemed to have a keen recollection of most of her family except some of those who had moved away from the Fort Worth area.

The best part of the day occurred when a childhood friend from Fort Worth called. Kate was quite alert. A few minutes before the call I told her the friend was calling, but I didn’t expect Kate to remember her. If she didn’t remember, she fooled me. She handled the call with poise. I sat beside her during the call and chimed in from time to time. The biggest surprise was when she remembered the name of another childhood friend.

In addition to being so “with it,” she was unusually expressive in her appreciation to me. That was true even for things I had nothing to do with. One of those involved the photo album of her family. She gave me credit for everything I had done. I told her I hadn’t done it, but she said I had assisted in getting it done. Actually, I had nothing to do with it. It was put together entirely by her brother Ken.

The rest of the day went smoothly. She was in a good mood all day. Except for the various questions she asked about names and places, no one would have ever suspected she is into her ninth year of Alzheimer’s and what I estimate to be the middle of Stage 6 of the Seven-Stage Model of the Progression of Alzheimer’s. How lucky we are.

February 15, 2019

Valentine’s Day

Kate’s celebration of Valentine’s Day started late in the afternoon on Wednesday when a high school student and neighbor of ours delivered a dozen red roses to her. The young lady had called me several weeks ago to let me know she was selling roses as part of a fund-raiser at her school. When she arrived at our door, I invited her in to give them to Kate. I realized the likelihood that Kate would think the roses were from the girl but didn’t tell her otherwise. She responded with enthusiasm and appreciation for her thoughtfulness and gave her a big hug. After she left, Kate selected a spot in the family room where she put them. Yesterday morning she had long forgotten the girl and the flowers but she saw the roses on the table. I told her they were from me. I got the same enthusiastic response and hug, and she got to celebrate the same present twice.

She lived the whole day without recognizing that it was Valentine’s Day except in the moments when someone would mention it, but it was a day filled with nice moments. At lunch, our server took time to show us a picture of his three-year-old daughter dressed up for Valentine’s Day. He is from Romania where they celebrate “Name Day.” He explained that his daughter’s name is Valentina so Valentine’s Day is really special for her and her parents. Kate loves children and was delighted seeing his daughter’s photo. She wouldn’t remember, but we met the mother and daughter one other time when we had lunch there. As we were leaving, we walked by a table where two grandparents were celebrating the day with their new grandbaby. Kate had to stop and comment on her and how beautiful she was. We had a brief but pleasant conversation with them and then left for home.

At 2:00, Kate had a massage. I still don’t detect any sign that she thinks having a massage is special, but it seems to me that she must derive some immediate pleasure from it. There is always some turnover in the staff, but she has only had to change massage therapists once. We come often enough that the rest of the staff knows her and watches out for her. When I first started taking her, the staff let her walk out. When I arrived, I couldn’t find her. Then I saw her walking along the store fronts in the shopping center where the spa is located. After that I have made sure that all the staff is aware of her Alzheimer’s. I also take my laptop or iPad and walk a few doors down to Whole Foods where I wait. Then I go back about five minutes before she is ready. We’ve had no problems since.

We hadn’t been home long before a church friend stopped by to visit Kate. When Kate served as the volunteer church librarian, the two of them went out to lunch regularly. Her husband had Lewy Body Dementia, and she has been good about checking in on Kate since he died a few years ago. They visited for over an hour without a break in the conversation. I was in the kitchen and couldn’t hear what they were saying except when Kate called me in one time to help her answer a question and also when her friend was leaving. I heard enough to know that she was handling herself well. She can’t recall specific facts, but she can express her thoughts about education and children and many other things. This reminds me that even at times when she doesn’t know my name or that I am her husband, she does remember my personality. She regularly surprises me with the accuracy of her perceptions of me.

Last night we went to a Valentine’s dinner at Casa Bella. They didn’t have music this time, but we were seated at a table for four with the 94-year-old couple with whom we always sit on music nights. On those nights we have six or eight people at our table. That makes for a different kind of experience than last night. Larger numbers of people create more difficulty for Kate. Sitting with this couple we like so much was a real treat. They are both in remarkably good shape. He is the oldest living Hall of Fame basketball player at UT. I’ve always been impressed with his memory and learned last night he has a photographic memory.

We had a pleasant conversation throughout the dinner. Even Kate got into the act. The couple is aware of her Alzheimer’s. Even if they hadn’t been, they would have suspected something. A number of times she was unable to follow the conversation and asked questions that she should have known from what had been said previously. She also got wound up talking about her school experience. This is one of those occasions she didn’t stick to her feelings but communicated what she was reporting as fact. She reported things I knew didn’t happen or that she could not have remembered. She also interrupted the man several times to continue talking after he had started talking about something else. They are very understanding and no harm was done. It was a nice way to end Valentine’s day. I hope we’ll be able to enjoy their company for much longer. Since they are 94, and Kate is already in the late stages of her Alzheimer’s, the end may come sooner than I want. Like everything else, we will continue to enjoy these moments as we experience them and be grateful.

February 9, 2019

Another Good Day

I guess I was so happy about our previous day that yesterday’s posts didn’t mention that Kate showed almost no signs of a cold. Wednesday was her best day in the past two weeks. I was relieved that we had avoided anything more serious. Yesterday she was even better.

It was the second day in a row that she got up early, took a shower, and went back to bed. This is a time when I could have let her stay in bed longer, but I wanted to have lunch with her before the sitter arrived. I was glad I did. We had a nice lunch and were back home in time for me to set up the TV in our bedroom with YouTube videos. I chose Andrea Bocelli. I also showed Mary how to search for other videos if they wanted something else. Kate said she wanted to rest a while and got in bed.

While I was at the Y, I checked the video cam several times. Each time they were still in the bedroom watching videos. The same was true when I returned home four hours later. Kate had been up a while and was fully engaged with the music. So was Mary.

Setting up the TV for YouTube or DVDs before I leave has become a regular thing now. That seems to have replaced their afternoon trip to Panera. I still mention the possibility of their going to Panera, but Kate isn’t responsive to that. Yesterday was an exception. She was excited about going but wanted to rest first. After resting, she only wanted to watch Bocelli.

Because my primary focus is on Kate, I don’t say much about other things I do while the sitter is here. Of course, I have my Monday Rotary meeting and my trip to the Y on Monday, Wednesday, and Friday, but I also meet my friend Mark Harrington every Friday afternoon at Starbucks. We hadn’t met the past two weeks because of Kate’s cold. In both cases, I had forgotten to let him know I wasn’t coming. That’s just one of the things I discover that I have slipped up on lately. I find more things slip through the cracks than they used to. I know some of that might have occurred just because of my age, but I feel sure that my responsibilities for Kate also play a large part.

Anyway, it was good to see Mark again. He’s an interesting man, and we always have a lot to share. He is the one who takes care of the technical issues in connection with the blog. Right now he and I have been working on a book I am editing. The first half consists of three and a half years of emails that I wrote under my dad’s name after his stroke that left him unable to use his computer. The second half is devoted to over 100 pages of Dad’s own biographical notes that he had written for a writing class he attended several years prior to his stroke. We’re close to printing time now. When it is finished, I plan to give copies to the family and a few close friends. That would have happened long before now if I hadn’t found it difficult to work in with my other responsibilities.

Every few weeks I also meet with a church friend whose daughter was diagnosed with frontotemporal dementia in her fifties. We met for coffee Wednesday afternoon. Our experiences are vastly different. Talking with him underscores how fortunate Kate and I have been not to have other complicating factors beyond the illness itself. Despite our differences, we also have a lot of common experiences. I enjoy being with him. I hope our lack of complications don’t make it less enjoyable for him.

While we were out for our Friday night pizza, we bumped into one of my long-term clients and his wife. They sat down with us and chatted about forty-five minutes. It was good to catch up with them. Kate also enjoyed it. These experiences continue to reinforce my belief that the primary benefit of eating out is that it is a social occasion. Most importantly, it is the type of social occasion that Kate handles quite well. The time is short. We exchange pleasantries and are on our way. It is good for her and for me.

January 20, 2019

Follow-Up to Yesterday’s Shaky Start

As Kate had wanted, I went back to the bedroom to wake her about 10:30. Although she was sound asleep, she woke up easily. I reminded her that she had asked me to wake her, something I don’t recall her doing before. (I jumped on that opportunity.) She was a little groggy but got right up with a little help. I walked her into the bathroom for her shower and turned on the water. As she took off her night gown, she asked my name. I gave her my name but didn’t mention that I am her husband. She didn’t ask.

When she finished her shower, she asked if she could lie down a little bit. I told her that would be fine. She asked me to come back and get her up. I came back about twenty minutes later. She got up willingly and asked about her clothes. I picked them up from the chair where I had put them earlier and put them beside her on the bed. I gave her a bra and said, “Let’s start with this.” She looked at it strangely. I explained that she could put it on over her head just like putting on a top. I told her it was easier than most bras. She looked at me and said, “How do you know so much about bras?” I chuckled and told her that I had observed her having some difficulty with her other bras that fasten in back and went online to find something easier. I found a company that makes clothing for seniors and ordered several of them.

Although she asked my name off and on throughout the day, she seemed to know that I am her husband. Again, I didn’t ask, but we did talk about her parents and our children. We relaxed at home in the family room after lunch. About forty-five minutes passed. Then she asked, “What is your full name?” I told her. She asked me to repeat it. I did and said, “I’m your ‘Hubby.’” She laughed, not in a way that suggested she didn’t believe but just the opposite.

She continued to work on her iPad for at least another hour before deciding to rest. I thought that was a good idea since we were going to an opera (Tosca) last night and would get home late. This was only the second time in about a year that we have attended an evening event this late. All the music nights at Casa Bella begin at 6:00 and end around 8:30. The opera started at 7:30. We didn’t get to bed until 11:30. That’s a good bit later than our normal routine.

I had been looking forward to the opera and enjoyed it; however, Kate’s experience and mine were quite different. We bumped into a number of people in the lobby we have known from various places around town. I enjoyed seeing everyone, but I think it was a bit overwhelming for Kate. She didn’t appear to recognize anyone. Fortunately, each of the encounters was brief. We were seated beside and behind people we knew. Kate talked with them at the intermission.

When it was over, she was eager to get home. She said she hadn’t been able to understand anything and had “just tuned out.” She said she enjoyed the music but didn’t know what was going on. That fit with my impression during the performance. Several times she responded enthusiastically to a number of the arias. Often she is able to enjoy various performances whose plot she can’t grasp. That happens when she can enjoy the characters or situations in which they are involved. That wasn’t the case last night. In two weeks we are going to see the Live in HD at The Met’s production of Carmen. That will be a good test. If she doesn’t enjoy that, live opera may soon be a thing of the past, not because of the music but a lack of understanding of the plot. I am hopeful that she will continue to enjoy opera night at Casa Bella for quite a while. In that case, the focus is on the music itself.

January 18, 2019January 19, 2019

A Day of Confusion

For the second time this week Kate did not recognize me when she woke up. These occurrences come only days after my saying that she almost always recognizes me as someone she knows and trusts. That is still true, but it makes me question my optimism as to how long this will last.

As I have seen so often, this failure to recognize me came with a mixture of other signs that she sensed more familiarity than her rational ability could express. She didn’t display any sense of surprise when I walked into the room. She appeared to respond to me as she normally does. Then she said, “Who are you?” I said, “Do you recognize me at all?” She said she didn’t, and I gave her my name and told her I am her husband.” She seemed more puzzled than usual by this news. She didn’t recognize either my name or that I am her husband.

At that point, I decided not to make this a point of discussion. I was confident that with a little time she would put it all together. I suggested that she get up and let me take her to lunch. She responded the way she always does and got up. She let me help her dress. She went to brush her teeth, and I went to the kitchen. In a few minutes, I heard her say, “Hey, where are you?” That, too, is very normal. She doesn’t know her way around the house and looks to me to tell her where she should go. As I walked toward the family room, I said, “I’m in the kitchen.” She was standing in the doorway coming into the family room from our bedroom and saw me. We went back to the kitchen where I had her morning meds waiting for her. When she had taken them, I picked up our iPads and cups and we left for lunch at Panera.

While waiting for our order, she asked my name. I told her and said, “I am your husband.” She seemed puzzled and asked how long we had been married. I told her. She didn’t question me. Instead, she asked me her name. That led to her asking if we have children. When I told her, she wanted to know their names. That led to further conversation about our marriage. I told her we had had many good times during our marriage. She agreed and asked me to tell her some of them. After that, I didn’t see any obvious signs that she didn’t know me.

We stayed at Panera about an hour and a half and then returned home where Kate rested almost two hours. Then we went back to dealership to pick up my car that I left the other day. When the service rep walked us to our car, I walked directly to my side. Normally, I would have opened the door for Kate and helped her get settled in with her seat belt. Before I got in the car, I looked back and she was standing at the rear of the car waiting for me to tell her where to go. It is very common for her not to know which side of the car she should use. I know this but had fallen down on the job. I walked her to the passenger’s door. Once she had gotten in she didn’t know where to put her cup. The service rep was waiting for me at the driver’s door. She is the same one I had given my first “Alzheimer’s card” two days before. If I hadn’t already given her one, I would have this time. There was no need now. She understood.

Last night was Broadway night at Casa Bella. Kate’s confusion continued. She was seated beside the woman whose mother started the restaurant almost 79 years ago. We sit with Signora Rizzo and her husband for all the music nights. We hadn’t been there too long before Kate leaned over to the Signora and said, “What’s the name of this restaurant?” Everyone at the table is aware of Kate’s diagnosis, and Signora Rizzo responded beautifully. She told Kate the name of the restaurant and that her mother had started it. She also gave her a little of the restaurant’s history. Kate was surprised and interested in what she had to say.

I’m not sure why, but it took longer to get our meals last night. Several times after we had ordered, Kate asked me if we had ordered and when we were going to eat. Finally, she said, “Does this place serve food?” Signore Rizzo, who was seated beside me, said, “I was wondering the same thing, Kate.” We have always enjoyed sitting with this couple. The way each of them responded to Kate last night is consistent with the kind of people they are. I hope we have many more music nights together.

These little public incidents of Kate’s confusion are trivial. No one was embarrassed or disturbed, but they do make me wonder what lies ahead.