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Little Things from the Past Two Days

Each day brings with it a variety of little things that characterize our lives. For example, Kate is losing more of her vocabulary. That leads to her saying things I may understand but are not precisely what she meant to say. Yesterday morning as we walked through the family room, she once again took note of her ceramic cat. I had walked ahead of her a few steps and heard her say, “Kitty Pat. Kitty Pat.” I looked back and said, “What?” She pointed to the cat and repeated enthusiastically, “Kitty Pat.” This is just one example of changes in her speech. She continues to forget common words like salmon, steak, and sweet potato fries. There are many more. By the way, when she stops to look at the cat, she seems to understand that it is not real. Other times I’m not sure. As she looked at it yesterday, she said, “He’s looking at me. Now he’s looking at you.”

At the same time she loses certain skills, she continue to amaze me with her self awareness and, especially, her insights about me. She was a little uneasy when we went to lunch yesterday and asked me to sit beside her in the booth rather than across from her. In a few minutes, I said, “It looks like you are relaxed now.” She said, “Not quite, but I’m getting there.” Then she surprised me. She put her hand on mine and very gently said, “If I were really upset, you would say, ‘You’re going to be all right. Just relax. You’re going to be all right.’” These might not have been my exact words, but they were pretty close. Her tone of voice was “right on.”

Later in the day, she asked where we were. Before I could answer, she said, “I must make you miserable asking you the same question over and over.” She forgets many things, but she clearly remembers things of which I thought she was unaware. It’s not only that she remembers, but she also grasps that it could be irritating. Of course, I told her it doesn’t, and it’s true though I’m not sure she believed me.

She is often concerned about what she should do or say in social situations. This usually comes up before we are going somewhere, but other times it is out of the blue. That happened yesterday as we got in the car after lunch. She said, “It’s really good to see you.” She wanted to know if that was correct. I told her it was. Then I said, “As a former English teacher, you could appreciate that there are different ways you could say the same thing. Some could have slightly different meanings.” I went on to say, “For example, you might simply say, ‘It’s nice to see you.’” I explained that it wouldn’t convey the same degree of pleasure or emotion. Then she asked what she had said. I said, “It’s really good to see you.” She immediately said, “Or I could say, ‘It’s so good to see you.’” Because there is so much that she doesn’t remember or understand, it is easy to think that she wouldn’t be able to grasp something like this. That would clearly be wrong – at least this time.

There is something else that has occurred regularly for a long time. I don’t think I’ve ever mentioned it. She has ridden with me a lot over the eight years since I bought it. We’ve had only one car since December 2013. For the past three or four years she has been unable to identify it at all. The fact that I point and say, “That white car is ours.” doesn’t help. In addition, she doesn’t know which side of the car she is to enter (even when I take her, and I always do.) or whether to get in the front seat where I have opened the car door or the back seat with the door closed. It’s a good reminder of just how much her rational thought processes have diminished. I should add that she has never had any interest in cars. That was long before Alzheimer’s. I know that she knew she drove a Volvo station wagon for a few years, but I’m not sure she ever knew what kind of car I drove.

There is one other thing I should add. I’ve mentioned a lot about her poor eyesight. She frequently will not see specific food items on her plate at meal times. She has salmon and sweet potato fries every Saturday for lunch, but she often doesn’t see the salmon. When the server put her plate in front of her, I am careful to turn it so that the salmon is right in front of her and the sweet potato fries above that. I feel certain her love of fries is part of the reason she sees them. When I point out the salmon, she has great difficulty seeing it even when I use a knife as a pointer and touch it. The surprising thing is that she frequently sees small specks on the table or floor or in the car. They must stick out because there is usually nothing around them, but it is a reminder that her eyes are working. It is the brain that has trouble differentiating different items that are close together.

Let me close with something I’ve said before. We still enjoy ourselves. Yesterday and Friday were especially good days. These days may be waning, but, obviously, it is possible for a couple “Living with Alzheimer’s” to derive pleasure even at this late stage of the disease. I know that everyone’s experience can’t be like ours nor would I deny the low points that are a part of everyone’s journey. From the memoirs of other caregivers, however, I know that our experience is not unique. That should be encouraging to people who have recently received their diagnosis. It’s good to know that life after Alzheimer’s is possible, at least for a while. For us that has lasted almost nine years.

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Ups and Downs This Week, Mostly Ups

It’s been a busy week. My daily schedule has been interrupted more frequently than in the past. That means I’ve been less regular with my posts. Several times I have started one and not been able to finish because of something else I needed to do. Kate has required more attention than usual, but that doesn’t explain everything. The other things have involved household chores.

Tuesday was one of those days about which I didn’t say anything. I was especially interested in writing about the events of the day as a follow up to Monday when she had a rough beginning. Fortunately, I jotted down a few notes so that I can cover the highlights.

The day started like the day before. Her brain seemed to be “blank.” She was very dependent on me; however, she didn’t appear to be disturbed the way she was on Monday.

I don’t know that my own behavior played a role in the way she responded. I do know that I tried to be more careful in waking her than I had done the previous day. I played a full 20 minutes of relaxing music before going to the bedroom to wake her. When I entered the bedroom, she was awake. I said hello and sat down on the bed beside her. This wasn’t planned or intentional, but I think it may have played a role in conveying a relaxed morning, not a moment when I was eager to get her up.

She didn’t know her name or mine nor our relationship. When I said I was her husband, she couldn’t accept it. As I have done on other occasions, I suggested she think of me as a friend. She liked that. I mentioned a shower, but she didn’t want it. I didn’t push.

I told her I loved her. Though a bit unclear, she responded with what she meant to be “A Bushel and a Peck.” I pulled it up on the audio system, and we sang it together several times. Then I suggested she get up so I could take her to lunch. She got up easily. I had started to wake her with plenty of time for her to take a shower. When she didn’t shower, we were left us with additional time to get ready.

As a result, we got to lunch earlier than usual. She was very talkative and initiated a conversation as though we had never met before. She asked me what I did for a living. I explained that I had started out as a college professor. She wanted to know what I taught. When I told her sociology and social psychology, she asked me to explain. I did, and she said that sounded interesting. I went on to say I ended up with my own market research company. She didn’t know what market research is. I explained that, and she also thought that was interesting.

When I finished, I said, “Why don’t you tell me about yourself.” I knew this might put her on the spot but thought my question wasn’t especially threatening. She handled it well and said, “There really isn’t much to tell.” I told her I knew a lot about her. Then I recounted her academic background and teaching career. I pointed out that she had been a good student and had earned two masters degrees. Then I told her about her volunteer career as our church librarian. She was quite interested and added her own comments.

It had been almost a year and a half since she had had a cortisone shot for the arthritis in her knee. Over the past couple of months, she has complained about it periodically, so we went directly from the restaurant to the orthopedic clinic. She was very childlike throughout the visit but handled herself well. We waited in the lobby for about fifteen minutes. Assuming we might have to wait a while, I took along her “Big Sister Album.” I thought that would occupy her for a longer period of time than her iPad. She enjoyed looking at it and made a lot of comments. There were only a couple of others in the room. I am sure they wondered a bit as they heard me identify all the people including Kate herself as she responded much like a child listening to a parent read a book.

We didn’t wait any longer after going back to one of the examining rooms. We met with two different people. Kate didn’t understand a lot of what was said and asked for clarification. I helped interpret what they said. She never understood, but she was satisfied. As we left, she thanked everyone including those in the waiting room.

The most important thing I should say about the day was that it was one of the nicest days we have had in a long time. I think that relates directly to her mood. She was very happy and quite at ease. Her memory wasn’t any better nor was she any less confused about things like whether we were in Texas or Tennessee, but she enjoyed herself. I couldn’t understand everything she said in our conversations, but she was surprisingly sharp in terms of her understanding about the importance of values and the role of parents in teaching them to their children. She has lost so much of her rational ability that I really enjoy hearing her express her opinions, beliefs, feelings, and values that remain intact. It keeps me in touch with the Kate I have always known.

Recently, especially this week, our lives have vacillated between highs and lows. The highs have been very special, and we experienced them every day. They far outweigh the lows. I know greater challenges are on the way. I am counting on the Happy Moments to sustain us.

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Another Morning Surprise

It was just a few days ago that I reported on the unpredictability of our mornings. That continued this today. Kate was awake, or woke up, when I got up at 5:50. I thought she might want to go to the bathroom, but she declined. I had been in the bathroom only a few minutes when she opened the door. I walked over to assist her to the toilet but found that it wasn’t the bathroom she wanted. She said, “Is she all right?” I did what I should know not to do. I said, “Who?” She gave me a dirty look. Often she says, “You know who.”, but just as often she gives me a look that communicates the same message. Fortunately, she asked “Is she all right?” several more times. That gave me a chance to say the right thing. Each time I said, “She is fine.” That seemed to provide her with momentary relief, but she continued to be concerned. During the next few minutes, she made other comments like “Are you sure she is all right?”  “I love her so much.” And “Could I see her?” I feel sure she must have been thinking about her mother but never found out.

When we got back to bed, I asked if she would like me to stay with her. Of course, the answer was yes. Unlike the other recent times when she has wanted me to stay, I hadn’t already dressed. I put on an album of very soothing music and got back in bed with her. I stayed there until just before 7:00. She was still awake but relaxed.

I knew she was likely to go to sleep and expect I wouldn’t hear from her until I woke her at 10:45. I was wrong again. I saw her on the video cam at 8:10. She was sitting up. When I reached her, she was wide awake and ready to get dressed. This was another day when she wanted me to take her “home.” That has become more frequent in the past few weeks. I told her I would. Strangely, she wasn’t persistent this time. She mentioned going home a couple of other times but seemed to have forgotten before we left for Panera. We got here about 9:15. She is just now finishing her muffin. I suspect it won’t be long before she will be ready to leave. How long depends on how well she is doing with her puzzles.

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This Morning at Panera

Kate was up this morning at 7:00 to go to the bathroom. She took a shower and then went back to bed. She was up in time for us to make a trip to Panera. As we got out of the car, she said, “Help me. Why do I do stupid things when I’m so (stumbles on the word) I said, “You’re smart.” She said, “Tell people that when I do something stupid.”

We walked in the front door, and she said, “What’s the name of this place?” I said, “Panera.” She repeated it as we were about to walk by a woman working on her laptop. Kate stopped at her table and asked, “Do you know the name of this place?” The woman nodded. Kate started to say the name but forgot it and turned to me. I told her again, and she told the woman. She said this in a childlike way but also very outgoing.

After I had gotten our drinks and her muffin, I took a seat across the table from her. She was unusually talkative. She said, “What’s your name?” I told her. Then she said, “What do people call me when I am with you?”  A short time later she asked again and then said, “Am I your nephew?” When I told her I wasn’t, she said, “You’re not my ____?” I said, “Yes.” She frowned. She brought up our relationship several other times. At least two times she was happy about our being married. Other times she wasn’t.

While there, she asked my name almost as many times as she asks Frank Sinatra’s name at Andriana’s each Sunday.

At one point, she said, “I’m learning my colors.” Then she looked at her gloves and said, “Look. They’re black.” I pointed to the lid of her cup and asked, “What color is this?” She wasn’t sure. I told her it was blue. The lid has a small plastic part on the top of the lid that slides over the hole. I pointed to it and said, “If the lid is blue, what color is this?” She hesitated a moment. Then she said, “Light blue.” I told her she was right, and she was as excited as a child might be.

Throughout our conversation she made references to growing up as though. Once she mentioned her age. I said, “How old are you?” She thought a minute and said, “Thirty or forty. Forty. I’m more mature than thirty.”

We left after she finished her muffin. We walked by a table of women who were there for a meeting of their book club. We know one of them from church and spoke to them briefly. Kate was very talkative. She would have continued talking longer if I hadn’t encouraged her to move on.

As we got in the car, she said, “What would I say if I were introducing you to someone?” I said, “This is my husband Richard.” She didn’t want to accept that I was her husband. I said, “You could say, ‘This is my very good friend, Richard.’” She wanted to drop the word “very” and just say good friend.

On the way home, she talked about our marriage and mentioned my name at least twice. She also commented on my being nice to her. She said, “You’re nice to me. You take care of me.” “You have taught me a lot of things. You’ve taught me to be polite.” Again this was said the way a little child might have said it.

When we walked into the house, she asked my name. It’s a good example of how quickly her brain works and then doesn’t work. It had been no more than two or thee minutes since she had called me Richard. Continue reading “This Morning at Panera”

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Mornings Are Unpredictable.

Predicting what Kate will be like when she wakes in the morning is challenging. Some mornings she is cheerful. Other days she seems disturbed. Recently we had experienced several especially good days in a row. That came to an end yesterday.

I went into the bedroom about 10:15 when I noticed that it looked like she might be getting up. She was awake, but I quickly recognized that it was one of those times when she didn’t know anything. Her mind seemed to be a complete blank. I spoke to her very calmly and explained that I could help her. I began to tell her a little about her mother and father and mentioned that we had some photo books I could show her. She didn’t want to get out of bed, so I brought in her “Big Sister Album.” I showed her a few pictures, but the light was too dim for her to see well as she was still lying in bed.

We went through our usual routine of her asking and my telling her my name and hers, but nothing sounded familiar. Very early I told her I was her husband. She didn’t take to that, and I said, “Just let me be your friend.” That worked.

She told me she didn’t know what to do. I suggested that she get up and go to the bathroom and then get dressed. She surprised me by taking my suggestion. She was a bit insecure as we headed to the bathroom and held my hand all the way. Once there, she depended on me to tell her what to do.

When we finished in the bathroom, we went back to the bedroom where I proceeded to help her dress. She had everything on but her shoes when she wanted to lie down. About twenty minutes later, I told her I would like to show her something that I thought she would like. She got up without a problem. She put her shoes on, and we walked to the hallway outside our bedroom where I showed her pictures of her mother and grandmother. She wasn’t as interested as usual but did enjoy seeing her mother’s photo. Things were getting better. Several times she asked, “Who are you?” I gave her my name without indicating our relationship. That seemed to suffice.

Once in the family room, I picked up the “Big Sister Album” and showed her the cover photo of her and her brother. She sat down in a chair to look at it. She took interest in the photos of the little girl but didn’t know who she was. I pointed at one in which she had taken special interest and said, “That’s you.” She said, “What’s my name?” I told her. She was elated and said, “Now I have a name?” It was a special moment of joy for both of us.

A few minutes later, the sitter arrived. I met her in the garage and explained what had been going on. She asked if she should still take her to lunch. I told her I thought that would actually be helpful for her. Then we walked into the family room. I said, “Look who’s here. Your friend Cindy, and she is going to take you to lunch.” Kate received her enthusiastically and said a loud “Yippee!” I was relieved and left for Rotary. Kate didn’t express any reservations about my leaving. She was happy, and so was I.

 

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Saturday Afternoon Conversation

 

Kate and I had a pleasant day yesterday though she was somewhat confused about where she was for an extended period of time. She also experienced some delusional behavior during the afternoon. Here is a sample of some of the things she said.

As we walked into the family room after lunch, she said, “I remember being here before.”

As usual, she rested and actually went to sleep. She woke up and said, “It’s really nice to be back here.” I said, “Yes, it is.” She said, “You know I was born here, don’t you?”

A few minutes later she said, “It’s a nice place. The owner has done a lot of things.” I asked, “Do you know the owner? She said, “I think I am one of them.”

She moved from the recliner to the sofa to rest a little more. Off and on for an hour she made numerous comments. I jotted down a few of them. In each case, she seemed to be talking with someone else, not me. She often does this while sleeping at night, and sometimes responds to me if I speak to her. Yesterday’s experience was different. It was much more like something I reported on a week or so ago. She was awake but talked in a style that was more like she was dreaming. Her eyes were open and displayed nothing that would suggest she was asleep. She also talks to herself. It was more like that except that I was just a few feet away from her. What she said frequently seemed out of context as though I were hearing her side of the conversation and not the person with whom she was speaking. Here are a few examples.

“She said we could stay this night and see what we like about it.”

“I think I will close my eyes, but not for long. Then I will get up and make some friends.”

Looking up at the ceiling and laughed she said, “I can see you. . . Oh, look.” She was pointing to the trees out back.

“Wouldn’t it be nice if we could sleep here.? That would be nice.”

“I like this room.” <pause> “You know, this is bigger than I thought.”

“Yeah, I like this place.”

“Do you live here? <pause> I don’t remember her name.” (She chuckles.) “Yeah.”

“Well.” <pause> “Uh huh.” (She chuckles.)

“It looks so pretty out there. Those tall trees. I don’t know what that blue thing is. That real pretty blue. Can you see it?  <pause> Uh huh, right over there. You got it.”

“I’ll just rest here a while.” “Yeah, we’ll come back. You’ve been so nice.”

“That girl over there talked with us a little. She lives here. <pause> To live here. That would be fantastic. We’ll just have to see.”

“My goodness, when did you come in. You’re a pretty lady. <pause> Uh huh. There are a lot of people here.”

I wondered what she would be like when I got her up for dinner. She seemed normal. I didn’t notice anything during or after dinner that was like the way she was in the afternoon. It reminds me somewhat of the urinary tract infections that my dad used to get during his time in a skilled nursing facility except that she exhibits the symptoms so infrequently. This was only the second time she has been like this other than when she is sleeping at night or when I am in another room. I will be watching out for any further signs and be prepared to contact her doctor if I think it is necessary.

 

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Problems with Toes, Teeth, and Hair

Kate’s “hair-pulling” is an old story, but I’ve said less about her toes and teeth. They are beginning to play a more prominent role in her personal care. Let me tell you about an episode earlier this week.

It was a very good day. Kate got up to go to the bathroom around 5:30 and went to bed. She got up around 7:30, and we went to Panera shortly after 8:00. We came back to the house and relaxed until lunch. She was in a good mood. We had a nice conversation at lunch. The sitter came at 1:00. Kate received her warmly and didn’t seem disturbed in the least when I left. She was happy to see me when I returned but didn’t express any sense of relief as she has on a few occasions. We had a good experience at dinner.

While we were eating, she told me she was likely to get to bed early. I didn’t think much about it since she often says that but doesn’t get in bed. I have to admit, however, that she has been getting into bed earlier lately now that she hasn’t been occupied with her iPad. That night was one of those times.

First, she went to the bathroom. She spent 20-30 minutes “brushing” her teeth. She didn’t really brush them all that time. Much of the time she was rinsing her mouth with water and using her fingernails like dental floss. She always feels like she has food caught between her teeth. I often help her with flossing, but that doesn’t seem to work. She finally gave up and came back to go to bed. I got her nightly meds and helped her get into her night clothes.

She was disturbed about her teeth. She mentioned she hadn’t been able to get all the “bees” out. She followed that by other words that didn’t fit what she meant. She was talking about something in her teeth. She also talks the same way about things between her toes and in her hair. Sometimes she refers to them as “these little things” and says they are “smart.” She says they know when you’re trying to get them. I was able to calm her by talking to her softly and telling her I would help her. That is when she focused her attention on her toes. She wanted me to get a towel or wash cloth and get “them” out. I followed her instructions, and she felt better.

Then she got in bed and started pulling her hair. It wasn’t long before she became frustrated. She said she was tired and hadn’t been able to finish and would have to do it tomorrow. A few minutes later, she asked me to come over and pull her hair for her. I did that for a couple of minutes before reminding her she was going to rest and work on her hair in the morning. She said I was right that she needed the rest and thanked me for helping her. She was fine after that; however, I don’t expect this to be our last episode with “them.”

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“On the Road Again”

“Real” travel is a thing of the past for Kate and me, but we occasionally take one-nighters. I am writing from Nashville where we will visit our friend, Ellen, this afternoon. She has been in memory care for almost two years. We have visited her about every 4-6 weeks since here stroke four years ago this past August except for a couple of times when she was in the hospital or rehab. Sometimes we also visit with other friends who live here. We’re just visiting Ellen on this trip. As we have done for the past 6-8 months, we stayed in a hotel overnight. That makes it a little easier than going and coming in one day. Besides that, we have a nice meal at one of several restaurants we like. It makes a nice change from our regular routine.

We got off to a good start when Kate woke up early. After a trip to the bathroom, she took a shower and returned to bed. I let her rest until 11:30 when I got her up for lunch. We had a relaxed lunch at Bluefish before leaving town and had an especially good time. Kate said something that led into a discussion about religion. It wasn’t a deep discussion, but she talked about the contribution that make religion makes in support of programs designed to help others.

We had an unusually good time at dinner. We ate at a very nice Italian restaurant. I am grateful that we can still have experiences like this. At some point, I suspect we will discontinue eating out. In the meantime, we both enjoy it and living as normal a life as we can at this stage. I gave out two of my Alzheimer’s cards, one to the hostess who seated us and another to our server.

There were only a few things that might have given clues to her diagnosis. The first was getting to our table and getting seated. She performs both tasks with great care. That’s because she is unsure of what to do. We had to go up one step to the area where our table was located. That adds an extra challenge for her. Getting into her seat presents two problems. One is knowing which chair is hers. That happens even though I pull out the chair, stand there to help her, and tell her “This is your chair.” That seems a simple thing but not to a person with dementia.  The other issue is getting into the chair. She is as cautious with that as going up and down steps.

Along with our bread, we were served a bowl of white beans in olive oil. She prefers butter with her bread, but she asked about the beans. I put a few on her bread plate. She started eating them with her fingers. She liked them. She took the bowl and used the spoon that came with them to eat them as she would a bowl of soup.

The manager stopped by our table near the end of our meal. Kate told him “We come here a lot and really liked the meal.” He looked at her a bit strangely. I suspect he wondered why he didn’t remember her. The answer was clear. This was only the second time we have had dinner there. The first time would have been almost a year ago. We have eaten there for lunch, but that would have been more than five years ago.

Kate went to bed early but not to sleep. She has been up twice this morning to go to the bathroom, once at 5:00 and once at 8:00. She is sleeping soundly as I write this post. I’ll get her up in time to make our noon reservations for lunch. We should be at Ellen’s by 2:00 and head back to Knoxville around 4:00.

For years, I left Kate for a short time to eat breakfast in the dining room or area. I remember preparing signs with large lettering telling her where I was and that I would return soon. I gave that up about a year ago when I no longer felt comfortable leaving here for even a short period of time. Now I just order breakfast from room service. It’s not quite the same, but I like to eat right after getting up. Kate likes to sleep later. With room service we both get what we want though I much prefer breakfast in the dining room to our dark hotel room. Like so many other things, this is something with which I can adapt.

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Dreams, Delusions and Hallucinations

Here’s another post in which I will never be able to capture the details. Let me start and see where it goes but understand you will not be getting the whole story.

Kate has talked in her sleep off and on during her life with Alzheimer’s. In the early years, the focus was almost always her teaching and library career. Most, if not all these experiences, involved her speaking to students. She was very deliberate in what she was telling them. Her memories of those days faded away long ago, but she continued her talking just in different situations.

Yesterday morning at 3:00 she had another “dream” experience similar to one she had a week or two ago. She seemed wide awake and very clear-headed. She wanted to go to the bathroom. On the way and back to bed, she looked and sounded normal but she appeared to be “dreaming while awake.” That’s hard to describe, but she talked as though we were someplace away from home. She mentioned other people. Then she said, “What do we have planned for tonight?” I told her we were going to have dinner at Casa Bella. She asked if we were going with anybody. I told her we would go by ourselves and sit with the same people with whom we usually sit. She was pleased we were going by ourselves although I thought she missed the fact that we would sit with others.

I thought that was it, but after we were in bed we spent the next fifteen minutes or so repeating the same conversation. Then we both went back to sleep. This kind of thing has occurred several times in the past. I think she has a dream about some obligation and is concerned about it. In a couple of instances, it was clear that she thought she had an appointment and needed to get ready. Most often, she just asks the question and the repeats it a number of times without any expression of anxiety.

About 10:15, I noticed that she was sitting up in bed. I went back to see if she wanted to go to the bathroom. She smiled as I got near the bed. It looked like everything was fine. We chatted a few minutes. She said, “Where am I?” When I told her we were at home, she wasn’t satisfied with the answer. She wanted to go home. At first, I told her she was at home, but that didn’t sink in.

I tried to divert her attention by taking her to the family room. She enjoyed seeing all things she usually admires, but she still wanted to go home. She was also tired. I led her back to the bed. She didn’t want me to leave her although she didn’t remember who I was. I brought my laptop and sat with her for another thirty minutes before suggesting that we go to lunch. By that time, she had forgotten about going home, and she didn’t say anything more the rest of the day.

When we got home, she had a brief hallucination as we got out of the car. She pointed to something leaning against the side of the garage. She thought it was a girl. There wasn’t anything I could see that might cause her to think that, but I just went along.

She had another unusual experience after she was in bed. She pointed to the ceiling and mentioned something about the “people over there.” I was never able to make much sense out of what she was saying. Then she said she wanted me to help her understand what was going on. I told her I would be glad to and asked what she needed to know. She pointed around the room and said something I never understood. It was another sign of her aphasia. She used a word that had nothing to do with whatever she meant. I think she was talking about all the objects in the room, but I was never clear. Periodically, she would say, “See them over there.” A couple of times, she mentioned animals in the room.

We got through the night without any special “happenings.” She was up early to go to the bathroom and was in a cheerful mood. She has been back in bed for almost two hours. I noticed on the video cam that she is moving around in bed. I’ll check on her. It’s about time to get her up for lunch. I wonder what’s up for today. Clearly, her brain is making changes. I never know where it will lead.

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An Example of Kate’s Self-Awareness

Over the past few days, Kate has snapped at me several times. As in the past, she quickly apologized with tears in her eyes and said, “I shouldn’t have said that.” I’ve been struck by her awareness that she has spoken to me in a way she hasn’t done before Alzheimer’s entered the picture. Two nights ago, I was even more surprised.

We had just finished a very pleasant dinner at Bonefish Grill. I started the car, and she said, “May I tell you something?” Her tone of voice made me think she was going to say something nice about my caring for her as she often does. I was surprised when she said, “I know I’ve been hard to deal with lately, and I want you to know I’m sorry.” I was both touched and stunned. Here she is trying to adapt to the changes taking place in her brain, and she feels bad about the way she has treated me. Apart from that, I was amazed that she said this “out of the blue.” I think it had been more than twenty-four hours since she had last snapped at me. That tells me this is something that really disturbed her. That matches her other concerns related to not knowing “anything.” To me it is a remarkable example of her kind heart and self-awareness. It also increases my desire to see that she gets the best care I can give her.