Morning Confusion and Fright, But a Pleasant End of the Day

Kate was sleeping soundly when I woke her about 10:45 yesterday. She got up without a problem. I thought everything was fine. It wasn’t until I helped her out of bed that she showed any signs of fright and confusion. It was a time when she didn’t have any idea of who I was but gladly responded to my assistance in every way. I told her I was her husband, and she said, “No.” I said, “How about good friends?” She said, “That’s better. She depended on me to tell her what to do and how to do it. For example, washing hands and brushing teeth were like she had never done either before. I was very careful not to rush her. I knew she had plenty of time to be ready for the sitter. That may have helped. I know she didn’t get irritated with me at all.

After she was dressed, she was disoriented. I took her through the hallway outside the bedroom to see photos of her mother and grandmother. She often guesses the photo of her mother is of her. This time she had no idea. She also expressed less interest in the photos than the past. Then we went directly to the kitchen for her morning meds. That went smoothly. When she had taken the last one, we had a few minutes before the sitter was to arrive. I told her she would be going to lunch with Cindy, and I was going to Rotary. I don’t remember her exact words, but she sternly said something like, “You are not.” I asked her to come with me and took her to the family room. I showed her The “Big Sister” album. She didn’t recognize herself or her brother in the cover photo.

We sat down on the sofa, and I opened the album and showed her the pictures on the first few pages while giving her a commentary on them. Her interest grew. A few minutes later when Cindy arrived, she was happy. Cindy sat on the other side of Kate, and I went to the kitchen to get my things. I walked back to the room to say goodbye and noticed that they were looking at a picture of Kate’s parents. I made a comment about them, and Kate said, “How did you know?” I told her that I knew her parents. She turned to Cindy and said, “I don’t even know who he is.” I said goodbye while the two of them continued looking at the photos. She didn’t show any concern that I was leaving. I felt good that she was comfortable with Cindy.

When I returned home, Kate was, as usual, lying down on the sofa but not asleep. She didn’t express any enthusiasm about my being home, but she wanted me to help her up. I discovered a few minutes later than she was ready to leave. She wanted to go home. I took her to Panera and got her something to drink. She worked on her iPad, and I did the same on mine. She got along pretty well on her puzzles without much help from me. An hour later, I suggested that we eat dinner there instead of going for our usual Mexican meal. When we finished, I took her back home. She didn’t say anything more about going home. This routine of leaving the house for “home” has worked each time I have tried it. That makes it an easy to address this problem. It is certainly better than telling her she is already at home.

Kate worked on her iPad for almost an hour after our return, but she had great difficulty with her puzzles. I was seated in a chair across the room from her watching the evening news. Every few minutes I had to get up to help her. She tired of this before I did and asked if she could get ready for bed. I turned on YouTube with a series of Andre Rieu videos that she enjoyed for an hour and a half. Then I put on some especially relaxing music on our audio system. When I got in bed, she was still awake but very relaxed and happy. That was two hours after she had gotten to bed. That is rather commonplace now. It may be that she isn’t really that sleepy. She just needs to rest her brain for a while. The music relaxes her. She doesn’t have to hurry to get somewhere. And she doesn’t have to experience any of the normal frustrating or intimidating situations she does at other times of the day. Living with Alzheimer’s is an emotional ride.

Yesterday’s Roller Coaster Ride

One week ago today, Kate had her most difficult day. Yesterday was another day, the third in a week, that Kate has experienced similar symptoms. She was very tired, confused, and troubled/sad. She was smiling when I got her up. I helped her dress without a problem.

Everything was fine until we started to leave for lunch. I walked ahead of her from the bedroom toward the kitchen. She was coming out of the bathroom and didn’t see where I had gone and called to me. I turned around and went back. She was frightened. She said, “I know you wouldn’t leave me, but I didn’t know where you were.” That set the tone for getting to the car for lunch as well as leaving the restaurant and getting in the car there. She was simply frightened but didn’t know why. As she had done the day before, she said, “Help me. Help me.” as she got in the car. She got along well at lunch.

The worst time was during the afternoon after she had been resting for almost two hours. After that, I suggested that I read to her. That appealed to her, and I read a little from Charlotte’s Web. Her eyes were open, but it didn’t appear that she was paying attention. I stopped and asked if she was enjoying my reading to her. She seemed to be in a trance. I told her I would stop if she wanted me to. When she didn’t respond, I said in a louder voice, “Can you hear me?” Although she had her eyes open, she responded as though I had waked her from a deep sleep. Then I repeated my questions. She didn’t want me to read. She was tired and wanted to rest.

I agreed to that and remained in my chair close to her recliner. She became talkative but was delusional. I told her she looked frightened. She said she was. I asked if she could tell me why. She said, “I don’t know.” I told her I would like to help her. She said, “They want to kill me.” I asked who, but she didn’t know. We had just finished a chapter in Charlotte’s Web in which they talked about Zuckerman’s intent to kill Wilbur. I suggested she might have gotten the idea from that. She acted like that might have been a possibility. I feel sure it was.

Once again, she said she was tired. I felt like I should do something to divert her attention to whatever she was afraid of. Instead I let her rest a little while. It wasn’t long before she was talking about the house. It was obvious she didn’t realize we were at home. I shifted gears and told her I would like to show her something and asked her to come with me.

I took her hand and walked her to the living room where I pointed out several things that had come from her parents’ home. She was interested but sad because she said, “I never got to know my parents.” Then she went on to say that they had had a rough life and grew up poor. She also said she couldn’t remember anything about them.

She was most interested in a fresco we had bought in Italy fifteen years ago. It was the first time in the past year or two that I recall her being taken with it, even more so than some of the things that had belonged to her parents. She wanted to sit down on the sofa. Then she began to talk about the room. She said she “liked what they had done to the room.” My reminding her that we bought the fresco did not convince to her that this was our house.

It was very clear, however, that her mood was changing. By the time we got to the dining room, she was quite interested in several other items that had come from her parents home. It wasn’t quite 5:00, but I suggested that we get ready for dinner.

She was a little bit skittish getting in and out of the car and from the car to the restaurant, but she seemed fine otherwise. When we got home, I suggested that we sit together on the sofa in the family room and go through one of her photo books that features a family wedding veil that had been purchased by one of her aunts for her wedding in 1924. She was enraptured.

When we finished, we began a conversation about our marriage and the happy times we have had. It was a touching moment for both of us. Earlier I had made several recordings. I am especially glad that I recorded this one. There is quite a contrast between this conversation and the others. She was happy again.

When we finished, we went back to the bedroom where I put on some YouTube videos and helped her prepare for bed. Everything went smoothly. She was fine, but we had had some rocky moments. It was another successful example of diverting her attention from whatever was bothering her. It also reinforces my previous guesses that when she is passive, her mind wanders. She begins to imagine things that are problematic. Yesterday, it was women who were out to get her. I don’t know how long I’ll be able to divert her. I am glad that I have a number of different things that help – music, photo books, tours around the house, conversations about family and our marriage. I can’t depend on just one to come to the rescue now. The good thing is that it is still possible to turn her around, but it’s getting harder.

I was very disturbed by her rambling during the afternoon and suspect I haven’t seen the last of this. She is entering a new phase of this disease, one I don’t like. When she bounced back, I did as well. We had an especially good time with the photo book, and the day ended on a high note.

Although I feel better now, I believe she has taken a sudden decline. I have read other caregivers accounts of similar declines. In fact, one of those was reported in a Facebook post yesterday. I also know of a former college roommate who took a steep decline and died about a month after Kate and I had been with him and his wife. I know someone else with dementia who died less than six months after I last saw her and thought she was doing quite well. While I am not ready to let her go, I would prefer that she go quickly rather than lingering for years. I have suspected the latter since she currently has no other medical conditions that might shorten her life. That, of course, is beyond my control. I will continue to focus on keeping her happy and secure.

Another Day of Confusion

Kate got off to a rough start today, and I feel that I may have played a part in creating the problem. This is a day when I felt I didn’t need to rush her to get ready. I turned on some relaxing music to wake her gently. After thirty minutes, I decided it was time to get her up. I did something I don’t usually do. I turned off the video cam and went to the bedroom. She was sleeping very soundly, so I decided to let her sleep a little longer.

About ten minutes later while I was in the kitchen, I heard her make a noise. I heard her again as I walked to her. (I would have heard her get up if I hadn’t turned off the video cam.) I could tell she wasn’t in the bedroom and said, “Where are you?” She said, “Right here.” She was in the hallway walking toward our bedroom. She had gotten up but didn’t know where she was and must have wandered to one of our other bedrooms. She was frightened and said, “Help me. Help me.” I went into “comfort mode” and told her I could help her with anything she needed. She told me she didn’t know what to do and repeated “Help me.”

I took her to the bathroom and then back to our bedroom where I had laid out her clothes a little earlier. She continued to be frightened and repeated her plea for help numerous times. There were moments when she seemed to calm down. One of those occurred when I showed her a photo of her mother in the hallway outside our bedroom,  another as we walked through the family room. When we reached the kitchen, I gave her her morning meds. She didn’t know what to do with them. I explained and coached her step by step.

She was very unsure of herself as we went to the car. As you would expect, I put on some music that I thought she would like. I think she did, but she was very quiet all the way to the restaurant. I remained silent thinking that the music would do a better job calming her than I could.

She was very confused at the restaurant, at least until she had eaten most of her meal. I worked hard to show her the salmon on her plate. She couldn’t distinguish the salmon from the sweet potato fries. I gave up and used her fork to pick up a piece and fed it to her. After a couple of forksful, she fed herself. She enjoyed her meal. She even ate about half of the mixed vegetables. She rarely eats any of them. She was calm until it came time to get up from the booth and walk to the car. She was very insecure, actually frightened, and held on to me tightly.

We returned home about 2:00, and Kate rested in her recliner. She was in and out of sleep. At one point, she opened her eyes and lifted her arms toward the ceiling. It appeared that she was looking at something or someone. She smiled. Then she closed her eyes again. Moments later she opened them and looked uneasy. I got up, walked to her and held her hand. I said, “You looked frightened? Are you?” She nodded. I asked if she could tell me what was frightening her. She didn’t know. I told her I was here with her and would help her with anything she needed. She didn’t say anything but squeezed my hand, and I took a seat in the chair beside her.

She woke up a little while later. I asked if she was relaxed. She said she didn’t know. I asked if she was frightened. She didn’t know. Then I asked if she would like for me to read to her. She wasn’t sure about that either. I told her I would like to read something to her and picked up The Velveteen Rabbit and started reading. As I read, she kept saying “Huh” as I read something new. The more I read, the less she did this, but she never completely stopped. And I never stopped reading, I wasn’t entirely sure that she was enjoying what I was reading, but she didn’t show any sign of going back to sleep. Several times she responded appropriately to parts that were sad.

When I finished, I said, “Isn’t that a nice story?” She nodded. Then I asked if she was glad that I had read it. She smiled and said she did. It was clear that her mood had turned around. She became more animated as she looked out at the back yard where the wind was blowing through the trees and shrubbery. She kept pointing to things that she wanted me to see. As we looked through the sky lights, I commented on how fast the clouds were moving, and we watched as they drifted by from West to East. We must have watched and talked about what we were seeing for fifteen minutes before she took note of the poinsettias in the room. She was quite cheerful.

Then I went picked up a photo of her and her brother when they were about four and two and showed to her. I was pleased when she said, “That’s my brother.” She commented on his smile and then looked at her picture and said, “That’ me.”

I had put on a Chris Botti album a little earlier. The last song on the album is “What a Wonderful World.” It caught her attention, and we talked about the song and how much we liked it. She was again at ease. Reading, admiring the trees and shrubs, photos, and the music turned out to be the highlight of our day.

She was fine until we got ready to leave for dinner. Once again, she seemed afraid. She was distracted by her meal. It was a big serving, and she ate almost everything and seemed fine as we left for home.

At home, she worked puzzles for a few minutes before wanting to get ready for bed. That took a little more time than usual. She required more help from me. After she was in bed, I turned on a series of YouTube videos of Andre Rieu. She is lying down in bed listening to the music and seems content. I think the chances are good that we’ll be back to “normal” tomorrow, but one never knows.

A Mixture of Happy and Sad

I am always glad to report the Happy Moments that Kate and I have. This is only the fourth day of the new year, but we’ve had a lot of them so far. At the same time, we are experiencing sad ones as well. I can’t say that we’ve had anything as serious as this past Monday when she was confused, frightened, and experiencing delusions off and on most of the day. She has, however, experienced some of the same things periodically all week. That has been accompanied by being tired and generally lethargic.

She is still responding positively to photo books as well as the flowers and photos in our family room but with somewhat less enthusiasm than in the past. She has also seemed more dependent on me. She wants my guidance on many things. She wants to do what is right, but she doesn’t know what that is. Increasingly, she asks me where to put her napkin. At least once this week, she couldn’t understand what I meant when I said she could put it on her lap and asked me to do it for her. She more regularly needs my help with toileting, washing her hands, brushing her teeth, and showering.

On the other hand, each of us enjoys being with the other. I have actually enjoyed not having a sitter twice during the holidays because both Christmas and New Years fell on a Wednesday, a day for the sitter. Yesterday, she was very tired when we got home from lunch. I was afraid she might not be as receptive to the sitter, but that wasn’t a problem at all. She really seems to have developed a comfort level with both of the sitters, especially Mary who comes on Wednesdays and Fridays and has been with us over two years. She does ask about me (where I am and when I will return) while I am gone. She also displays varying degrees of enthusiasm when I come back. Yesterday, she was especially happy to see me.

All in all, it seems like she has not been doing as well over the past week or so. I have noted before that mornings are her most difficult time. I find that understandable since she hasn’t had any external stimulation for eight to twelve hours. She usually recovers a short time after she is up. Now she seems to be having similar experiences in the afternoon when she rests. The other night she wanted to watch the news with me. I think it overwhelmed her brain. The next thing I knew she was having a delusion.

The last few times we have looked at her photo books, she has told me she is tired and needed to rest not too far into the album. When she is resting her mind wanders, and she imagines people and situations that I am supposed to know about. She says things like, “What time will she be there?” Or “Who else will be coming?” “Who are we meeting?” I try not to ask who because she always believes I know. I give her an answer knowing that she won’t remember what I said.

Music, whether on YouTube, or our own audio system is often good for her. I think that is because she can enjoy it passively. It doesn’t require her to try to understand or remember. She simply enjoys it. She does, however, frequently ask me who is singing. That happens a lot with the YouTube videos.

I take all of these things as signs that 2020 will be a very different year for us.

Our Roughest Day, But, Again, a Nice Finish

Yesterday, as I walked out of the bathroom to get dressed, Kate said, “Hello.” I went over to the bed. She was uneasy. It turned out that she had awakened while I was in the bathroom and didn’t know where I was. Several times over the next ten minutes or so, she said, “I didn’t know where you were. I thought I had done something wrong.” (She is very sensitive about doing the right thing.) I took her to the bathroom. She was very unsure of herself and needed my help even more than usual. She was still emotional when I took her back to bed.

It was no surprise that she wanted me to stay with her. I got in bed with her and stayed for another thirty minutes. She seemed calm though not asleep. I told her I was thinking about getting dressed and having breakfast and then returning to the bedroom and working in the chair beside her side of the bed. She said that was fine. I was encouraged.

Less than an hour later, she started to get up. She wanted to go to the bathroom again. This time she took a shower and then rested in bed for almost another hour. I don’t recall anything unusual until just before we left for Panera. She said she felt a little sick. Then she said, “Maybe I’m just hungry.” On the way, she was talkative, but she had much more trouble than usual speaking her words correctly. In addition, I was clear about the content of what she was saying. She was delusional. She mentioned people we were meeting or had been with. I really couldn’t make sense of what she was saying. At Panera and on the way home, she exhibited the same symptoms. They were noticeably more severe than in the past. Before finishing her muffin, she took it off her plate and set it on the table. Then she picked up every crumb that was on the plate until it was spotless. This is something I have seen her do a few other times. Occasionally, she does the same thing with the table top.

I began to wonder if she might have had a TIA, but the only symptoms she had were ones that she has had before, and they didn’t seem to be like those we generally associate with a stroke. Nevertheless, I gave her four baby aspirin as soon as we got in the house. She was very tired and lay down on the sofa.

Only minutes later, the sitter arrived. I met her outside and explained what was going on and encouraged her to call me if she needed anything while I was gone. I didn’t hear from her and felt that was a good sign. Generally, by lunch problems like these would be gone. When I returned, she was resting on the sofa. Cindy told me she had eaten a good lunch and had been resting since they returned home.

After Cindy left, I asked Kate if she would like to look at one of her photo books or read something. When I mentioned Anne Frank’s diary, she expressed interest. I picked up the book and sat beside her on the sofa. I read several entries before she said she was tired. She rested about thirty minutes before I suggested that we go to dinner. She was still very tired but got up without a problem.

She was talkative on the way to the restaurant. Once again, however, I had difficulty understanding what she said. I know it involved other people that she thought I knew. She also had trouble with her words. At one point, she said something about “blee.” I finally realized she meant blue.

We sat in a booth at the restaurant, and she wanted me to sit beside her. That happens much more now. She had two cheese burritos. She still had one remaining when I finished my meal. I had cut the first one into bite-size pieces. She tried to do the same with the second one. I offered to help. Instead of eating them, she started moving them around on her plate using her fingers. It soon became clear that she was creating a “work of art.” She tried to explain, but I couldn’t fully understand except that she wanted me to take a picture of the plate of these pieces. She wanted one picture of the plate and piece alone and one with her in the photo. I obliged her.

When we walked up to the counter to pay, there were two other people in line in front of us. Kate was restless. She didn’t understand what they were doing and wanted me to go ahead of them. I explained a couple of times that we needed to wait until they were finished. The woman immediately ahead of us had opened the door to leave when Kate called to her. The woman stopped and looked around. Kate asked her if she would take a picture of the two of us. By now there was another waiting behind me. I started to tell Kate that we should let the woman go. Then I agreed. I told the man behind us to go ahead, but he said he could wait. The woman took our picture. I paid the check, and we headed home.

Typically, I would turn on the news after we are home, but I didn’t last night. It had been an unusual day for Kate. She seemed very tired. Her speech might have been a little better than it was in the morning but not significantly. I thought it was a good time to refocus her attention. I went back to YouTube. We watched a playlist we had seen before and liked. As it did the night before, the music captured her attention from the time I turned it on until I turned it off.

Even better is the fact that today (as of 2:45), I haven’t seen any of the same symptoms that she displayed yesterday.

Changes Abound

This has been a week when I feel I’ve had more to say than I’ve said. I’ve been busier with Kate, and a few holiday related tasks. In addition, I have been dealing with a few household issues, a leak in our pool, a leak in a pipe under the house, a toilet that needed fixing, and some minor electrical work. Perhaps more than anything else, I haven’t been exactly sure how to express what I want to say. It’s all wrapped up in a single word: change.

Haven’t I said that before? Yes. Maybe that’s why it’s hard for me to say it again in a way that distinguishes what is going on now from the past. I’ve devoted a little more time this week to paying attention and thinking about that rather than writing. I haven’t considered this a waste of time at all. I’ve read about authors who have made a point of saying that the “thinking” part of writing for them is the most valuable part. With that in mind, let me tell you about some of the things that are going.

Kate  more frequently expresses insecurity about what to do when she wakes up, when brushing teeth and bathing, when we are in restaurants. She was especially uneasy during our Christmas dinner at Ruth’s Chris. That may have related to the somewhat more formal nature of the room, the service, and the fact that this is not a restaurant we often frequent. It had been several years since our previous visit. That was with the staff at the office and a time when her Alzheimer’s affected her much less than it does today. Whatever the cause, she was never fully at ease.

Her morning confusion seems to be more severe now. On several occasions, she was so frightened that she hasn’t wanted to get out of bed. Each time I have been able to help her recover, but it takes longer than the past. That happened day before yesterday. She didn’t know “anything.” I talked with her very slowly and calmly. She didn’t know who I was, but she trusted me. I was eager to get her up so that we could have lunch together before the sitter arrived, but I knew that rushing her would make things worse.

I put on some soothing music at a very low volume, and we talked for fifteen minutes or so. Though I talked about her parents and our children, nothing rang a bell. She became comfortable talking with me, but she was still confused. Then I decided it was time for something more upbeat. I remembered that several weeks ago she had recognized and liked the song “A Bushel and a Peck.” I played it. The minute she heard it she laughed. We were making progress. I was streaming the song from a playlist of Doris Day music, so we heard a couple of other old songs we both recognized. Then I switched to the soundtrack of My Fair Lady. By the time we got to the third track, I suggested we go to lunch. She didn’t jump right up, but she did let me ease her up, and we got ready. She was fine.

She struggles more with her clothes than in the past. Sometimes she wants to be independent, and I let her do what she can. It isn’t long, however, before she asks for my help.

Her vocabulary is diminishing. She often says, “I don’t know how to say this.” She can’t pull up the words that express what she wants to say. That is more than a vocabulary problem. It is also a problem organizing her thoughts.

Along with that she sometimes fails to recognize common objects. Ironically, that almost always happens with her iPad. When she sees it, she asks, “What’s this?” Last night I handed her toothbrush to her and didn’t know what it was or what it was for. I explained how she should use it. At Panera this morning, she looked at a napkin and asked what it was.

I have no way of measuring this, but it seems like she does not know my name or our relationship for a longer time each day. On the other hand, she almost always feels comfortable with me. She trusts me. It is when she first wakes in the morning that she is least likely to know my name or relationship. She does, however, know to call me in the morning. Most of the time, she just says, “Hey.” Interestingly, there are times during the day when she needs something and calls me by name. This seems to be a example of a simple “stimulus/response” behavior. She occasionally asks my name shortly after using it.

Our Christmas Day conversation when she couldn’t remember anything about her mother was a striking first. She has always retained strong and very positive feelings for her mother. I thought that would be the last memory to weaken. Of course, that didn’t last. I haven’t seen any similar signs since then.

There are more times like this when she seems to be in a fog. These seem to occur most frequently in the morning when she wakes or during the day after resting a while. It is like her brain closes down while resting or sleeping. Then when she opens her eyes and looks around, she doesn’t recognize anything or in some cases, she has hallucinations. After resting in her recliner a while the other day, she opened her eyes and pointed to something across the room and said, ““It’s been a long time, you know.” <pause>. Then she pointed to the ceiling and said, “Hey sit down.  All of you.” (Chuckles)

She talks in her sleep more. Sometimes I talk back to her, and she speaks to me while still appearing to be asleep.

Her vision is worse. I think that accounts for some of her uneasiness when walking from the car to a restaurant and back as well as her difficulty getting seated or going up and down curbs. She frequently fails to eat food on her plate because she hasn’t seen it. Occasionally, I walk to another room after we have been talking. When I walk in moments later, she doesn’t recognize me and asks, “Where did he go?” If I say, “Who,” she usually says, “The other guy. The one I was talking to.”

She loses me easily. Sometimes that occurs when we are within a few feet of one another. The other night at a nearby pizza place, I saw that there was just one remaining booth and walked ahead of her to claim it before someone else. When I looked around she was looking for me. We looked at each other, but she didn’t recognize me until I walked closer. She was frightened that she had lost me.

Surprisingly, she seems to be rather good at seeing small spots. It is not unusual for her to eat everything on her plate and then look for tiny specks of remaining food that she picks up with her finger.

Her sleeping pattern is more erratic. She had a long period of time when she slept regularly until 11:00 or after or when I woke her. More recently, she went through a period when she would wake up early and go to the bathroom then go back to bed. I’m not sure there is a pattern anymore.

She has more problems with eating. She is particularly confused when she has both a fork and a spoon. If she has soup, she usually begins to eat it with a fork. Then I show her the spoon. After she uses the spoon, she uses it for everything else.

She also uses soups and condiments as sauces for other parts of her meal. For example, we eat lunch at Bluefin on Saturday. They prepare excellent grilled salmon that she likes. It is not unusual for her to dip her salmon in the ketchup that accompanies her sweet potato fries. I brought some lobster bisque home from lunch on Christmas along with Our sweet potato casserole. She used the bisque as a dip for the casserole.

As she was finishing her meal last night, she poured all of the remaining ice and tea onto her plate with a few pieces of chicken and began to eat the dozen or so flat, square pieces of ice along with her chicken. She didn’t leave a speck of anything on her plate or the two cups with her side dishes of strawberries and applesauce.

She is beginning to forget how to take her pills. Sometimes when I hand her a pill and a glass of water, she asks what to do with it. She occasionally puts the pill in her mouth, drinks the water, and doesn’t swallow the pill. When I hand her the next one, she says, “What do I do with this one?” I have to watch her more carefully than in the past. She can take one pill and forget the others.

Yes, life is changing. There are more things that demand my attention. Having said that, we still have a good time together. I’ll say more about that in another post.

A Christmas Afternoon Conversation

Kate and I had just returned from a late Christmas lunch around 4:30. We went to the family room, and Kate asked what she could do. I told her I could read something to her or she might like to look at one of her family photo books. She was unsure. I picked up a photo book of her father’s family and suggested we go through it together. I handed it to her and let her look for a few minutes while I brushed my teeth.

When I returned, she was looking at the first page. She told me she didn’t know anything. I told her I would help her. For about ten minutes we went through a few pages with my commentary on the people and places. She said she was interested but this was too much for her. She couldn’t absorb or remember anything. I suggested that it might be a good time for her to take a break and just rest. She said, “Let’s just do a couple of pages.” I agreed, but she stopped me again to say it was too much. This time she accepted my suggestion to rest. We closed the book and began an interesting and touching conversation that I was able to record. I have transcribed the beginning portion below.

Richard:         So you don’t remember anything right now.

Kate:               No. <pause> No. I don’t.

Richard:         Do you remember anything about your mother?

Kate:               No.

Richard:         What about your daddy?

Kate:               You know, right now, I just can’t even (Trails off)  This is so much to remember. It’s just too much right now.

Richard:         You know what you do remember though, I think? You can tell me if I’m wrong. You remember that you liked your mother very much. Do you remember that?

Kate:               No.

Richard:         You don’t?

Kate:               But that would be wonderful thing.

Richard          Do you remember what a nice and great woman she was?

Kate:               I don’t know much about her. I hardly know anything about her. I know I’ve been told, but I <slight pause> I mean, I must have, must have, but I have no (Trails off)

Richard:         No memory.

Kate:               This is why I don’t want to go too fast, and  I’d rather just go (Trails off)

Richard:         We don’t have to hurry at all. There is no reason to rush.

Kate:               Well, see, uh, that’s, that’s good.

Richard:         There are a couple of things I’d like you to know from me.

Kate:               All right. If I could tell you, I will.

Richard:         No, I just want to tell you something, and it’s the way I, it’s something I feel. One is that I love you very much.

Kate:               I love you too.

Richard:         Second is I want you to know you can depend on me.

Kate:               I think so too.

Richard:         I will help you with anything you need – anytime, and I believe that you know that I will.

Kate:               Oh, I know. Definitely.

Richard:         We’ve always cared for each other.

Kate:               Yes, we have.

Richard:         And we always will.

Kate:               That’s right too.

Richard:         You know, it takes us back to our wedding vows, doesn’t it? We said we would always stick together. For better or for worse.

Kate:               And we have.

Richard:         And, fortunately, its been mostly, almost entirely, the better for us. Hasn’t it? Haven’t we been fortunate?

Kate:               Oh, yes, yes, yes. I don’t remember much of it, but, you know, I’ve never had an anybody that . . . No <pause> no problems, they were all. I mean I don’t remember in (Trails off)

Richard:         You’re right. We just have had good times. We enjoyed the places we have lived. We enjoyed the people we’ve met. We’ve enjoyed our experiences in our work and going to school. You know, one of the things you enjoyed most was being a church librarian. It was one of the most fulfilling things (for you), and, you know, you did a good job. You helped so many. . . You’ve led a fulfilling life.

Morning Hallucination

As I was finishing my previous post, I heard Kate talking on the video cam. I walked into the bedroom and saw that she was lying on her side facing my side of the bed. She seemed to be watching something that moved from place to place. She said something like, “I see you. There you are,” and she moved her hands from one spot to another as if she were trying to catch whatever it was.

She saw me and smiled. I told her it was nice to see that smile. She looked at my shirt, and said, “I like that. They have them every year.” It was clear to me that she was having one of her “dreaming while awake” experiences. Maybe it’s better to say she was hallucinating. I stayed with her a few minutes and then asked if she wanted to get up or rest a little longer. She said, “I think I’ll just stay here a while.” I told her I would be in the kitchen if she needed me.

She continued to talk off and on for the next fifteen minutes or so. I haven’t heard anything for a while. She must have fallen asleep.

A Difficult Morning

I have often said that I am able to lead Kate to a recovery whenever she has challenging moments. Most of those involve her confusion in the morning. More recently, she seems more frightened by sudden noises like those we hear at restaurants. She is also more irritable. I attribute that to her not understanding or anticipating my intentions when I help her. Yesterday morning all of these came together.

It began when her overnight underwear (pull-ups) failed. I was in the kitchen and heard her say something. She was upset. When I asked if I could help she said, “Get me out of here.” I got her to the bathroom. As I helped her get cleaned up and brush teeth, she alternated between wanting me to tell her what to do and resisting my help. As she usually does, she got tears in her eyes and apologized to me several times. While we were standing at the sink, I put my hand on her arm. She shrieked as though I were going to harm her. I asked why she was so upset. She cried and said, “I don’t know. I don’t know.” I believe that was a very honest answer. She really doesn’t know why, but she still feels she shouldn’t respond to me this way. I tried especially hard to respond in a gentle, caring way to comfort her.

Several times she said, “Why did you bring me here? I just want to go home.” I told her I would take her home. Then I got her dressed and took her to Panera for a muffin. Once we were in the car, she seemed fine. She even spent more time on her iPad than usual. In fact, we would have stayed longer except that it was almost time for the sitter who comes at noon on Monday. She didn’t mention going home again. The sitter came a few minutes after we got home, and Kate was just as natural with her as she is with me. I felt good as I left.

Looking back, I see the only difference yesterday morning from other challenging mornings was how upset Kate was. I don’t believe it lasted any longer than other mornings when she is confused. It does reinforce my belief that remaining calm with her and easing her into her daily routine brings about her recovery.

I hope this will continue, but I know I can’t be sure. I am reading a memoir written by a doctor who cared for his wife who had Alzheimer’s. I have identified with him in a variety of ways, especially his desire to care for his wife in such a loving way. Last night I read a section in which he relates the severe anger that his wife experienced in the late stage of the disease. Is that ahead for Kate? As they say, “only time will tell.’

Yesterday’s Early Start

I woke up at 5:20 yesterday morning and found that Kate was awake. I asked if she would like to go to the bathroom. She did. She wasn’t as confused as she was the day before, but she was a bit uneasy and wanted to hold my hand. I got her back in bed right after 5:30. I thought I would go ahead and get up, but she wanted me to stay with her. I was surprised because she didn’t seem that alarmed. Once I was in bed, she wanted to hold my hand. (That is something she often resisted in the past. Now it seems to be a source of security.) At 6:00, I started to get up, but she wanted me to stay. At 6:20, I told her I was thinking about getting up and getting dressed and would come back and sit in the chair beside the bed. She said that would be all right.

Just as I was finishing breakfast about 7:15, I saw on the video cam that she was about to get up. When I got to her, she said she wanted to go to the bathroom again. Then she spent a little time washing her hands, arms, and face. She got her nightgown wet while washing up, and I got her a dry one and walked her back to bed. After she was in bed, she looked up at me and asked where I was going to be. I asked if she would like me to stay in the room with her. She said she would feel better if I did. We didn’t talk, but she didn’t go back to sleep for a long time. It might have been as late as 8:30. Once she said, “Who are you?” I said, “Richard, and I am your husband.” She didn’t believe we were married. I started to say something more when she said, “Let’s not talk about it.”

Just before 10:30 Kate opened her eyes and smiled. That was a good sign. I thought that would indicate I would have no problem getting her up. That wasn’t the case. She didn’t want to get up. I started a conversation about its being a special day for us. It was the fifty-eighth anniversary of our first date. Of course, she couldn’t remember that, but it did get her attention. Then I mentioned a variety of experiences we had had since then. She was especially interested that we have children and wanted to know a little about them. As she seemed more relaxed, I told her I would like to take her to lunch. She accepted my offer.

Getting up and dressed went smoothly. On the way to the kitchen, I showed her pictures of her grandmother and mother. As always, she was especially touched to see her mother’s photo at the age of nineteen or twenty. She stopped in the family room to admire the poinsettias and look out to the back yard that doesn’t look so beautiful right now. To her, it looks the same even with all the leaves gone. Before entering the kitchen, she stopped to look at a poinsettia that the Robinson’s brought the day of their visit. She stops there each day and comments on how beautiful it is.

The balance of the day went quite well. We ended the day with dinner and a program of favorite Christmas music at Casa Bella. We were grouped at a larger table of eleven, but Kate handled it well. We were seated near the end of the table next to someone we see each time and across from a 91-year-old woman and her caregiver. At one point, Kate was actively engaged in a conversation with the three of them. She was talking about some of the things she used to cook. I don’t know that what she said was true, but she was happy. The program itself was a winner as well.

It is now 8:45 the next morning. She has talked a little in her sleep. Otherwise, I haven’t heard a thing from her and can’t help wondering what she will be like when she gets up. I’m thinking good thoughts but not making any predictions.