A Week of Challenges

If you’re a regular visitor to this blog, you have no doubt noticed the long delay since my last post. There are good reasons. Apart from the temporary focus on our recent election, they all involve Kate’s changes that have consumed more of my time. Here is an outline of what happened.

I’ve commented numerous times on Kate’s morning confusion. Sometimes, her response is uneasiness or fright. Until last week, that has been infrequent, and I have been able to get her up. Once she is up, her uneasiness subsides in a short time (10-15 minutes). Periodically, I have also reported that she has refused to get up in the morning. That happened four consecutive days last week.

She had a good day on Monday. She was in good humor and didn’t rest much at all during the day. In fact, I was surprised that she got up early enough for breakfast the next morning. It wasn’t long after that when she rested for 30-45 minutes. We started to look at one of her photo books before she wanted to rest again. This didn’t seem strange because she had lost so much sleep the day before.

The problem occurred when I couldn’t get her up for lunch. I didn’t push her at all but periodically checked to see if she was ready to get to dinner. She awakened periodically during the time she rested and seemed very relaxed. Then she went back to sleep. She was ready to get up about 4:15. We went out to dinner. She went back to sleep right after getting home. That made me think that she would be up early yesterday, but I was wrong.

Not only did she not get up early, but she didn’t want to get up at all. I tried to get her up starting at 11:30. I hoped that I could get her up in time to eat lunch before the sitter arrived at 1:00. She was uneasy, but I got her up. Things fell apart when we got to the bathroom. She wouldn’t go in. It often takes encouragement to get her to use the toilet. She was adamant about not going into the bathroom and insisted on going back to bed.

I tried one or two other times to get her up before deciding to let the sitter handle it. The sitter tried several times before succeeding after 2:30. Thursday and Friday brought variations on this same theme. I was able to get her up before 1:00, but she was very resistant. She was scared and kept saying, “I can’t.” I repeatedly encouraged her and told her I would help her (something I always do anyway). Both days I got her into a sitting position, but she wouldn’t stand up. She sat on the side of the bed between 30 and 40 minutes each day before I was able to help her stand and go to the bathroom.

In addition, getting her to bed is becoming a problem. For a long time, she has been getting ready for bed between 7:15 and 7:30. Several weeks ago, she didn’t want to get ready that early. That broke a well-established pattern, and it started requiring more time and effort to get her to change into her night clothes. That was especially difficult two nights last week. I won’t go through all the details, but here is what happened Friday afternoon and evening.

Although Kate was slow getting up, she lighted up when the sitter arrived. They were having lunch together when I left. She was disappointed I was going but handled it well. When I returned, she and Mary were talking. Kate hadn’t rested at all while I was gone. She was tired and rested about twenty minutes before we left to pick up our dinner. She was very talkative when we went to the bedroom after dinner. She was delusional but happy. I listened to her for almost an hour before attempting to get her ready for bed. I was successful getting her to the bathroom, but she was hostile and refused to get into her night clothes. I decided it was not worth it to try any longer, and she went to bed in her clothes.

Saturday was a good day. She was up in time for me to give her a shower before going to lunch. We had a pleasant afternoon and had no trouble that night.

Yesterday (Sunday) brought other problems. I’ll comment on that in my next post.

So, How Are Things Going?

It’s very hard for someone who doesn’t live with a person with dementia to grasp how far one has traveled on this journey. I know that was true for me. I am sure my dad noticed signs of my mom’s dementia years before I was aware.

I believe the typical image of a person with Alzheimer’s is heavily influenced by our perceptions of the last stage of the disease. Before that, many people don’t recognize the dementia at all or fail to understand how far the disease has progressed. Kate was diagnosed almost ten years ago, but it is only in the past 2-3 years that it has been more obvious to those who spend little time with her.

That is what prompts me to write this particular post. We have crossed another milestone on Kate’s journey. It is easier now for people to tell that she has Alzheimer’s. That is true even for people who are with her a short time. Having said that, I don’t believe many people would recognize just how far along she is. I see it because I am with her so much. That gives me many opportunities to observe how she functions. Overall, her changes have been very gradual, but they have been much more evident even in the past month or two. It even seems like she has changed a lot in the past two weeks. Let me summarize a few of the things that make me say this.

First, and foremost, she has reached the point at which her rational thought/abilities have almost completely vanished. By that I mean her memory for names, places, events, and processes (how to do things) is at a disturbing low point.

Simultaneously, her intuitive thought/abilities are on high alert. Her experience of joy, sadness, fear, and anxiety are more evident. The fear and anxiety are troublesome to me as well as to her. On the other hand, all the positive emotions related to her to her senses bring intense moments of pleasure as well. Sometimes we experience a mixture of both good and bad.

Two days ago, I helped her up after she had rested. She was confused and uneasy. She knows something is seriously wrong with her, and it was evident. I looked in her eyes and said, “I love you, and I want you to know that I will always be here to help you.” She cried, and we embraced. It wasn’t that the underlying problem was solved, but she was comforted. It was touching moment for us, and we were able to move on.

For a long time, she has been insecure, but that has increased considerably. She has always wanted to do the “right thing.” Now that her memory is gone she doesn’t even know the right thing. When I give her choices like “Would you like to get up now or rest a while longer?” Her typical answer is “I don’t know.” It is evident in the morning when needs instructions on everything she is to do in the bathroom.

She often doesn’t recognize her napkin and wants to know what to do with it. When I tell her she can’t understand what I have said. When we eat out, I generally put the napkin in her lap. Invariably, she removes it. She often wants to use it as a placemat. When that happens, I simply ask the server for another napkin. She never remembers what she is drinking or if the glass is hers.

The most obvious sign of her insecurity is her hesitation when walking or sitting down. She walks as though she is blind, very short shuffle steps without lifting her feet very much. Any change in elevation is a problem. Naturally, that involves stairs, but it also includes small variations like flagstone walkways, or any surface with color variations that she perceives as differences in elevation.

I have long heard that putting a black carpet or doormat in front of a door can prevent wandering outside. It is only recently that I have observed this phenomenon with Kate. She is very cautious about stepping where there are contrasting dark and light surfaces. We have a dark blue rug with a white border in our bedroom. She is now very cautious when we enter the bedroom. She is careful to step over the border.

It is often very difficult to get her to see things I want her to notice. That comes up most frequently when we are eating. I always cut her food for her and usually put a bite on her fork and place it right in front of her on her plate. When I try to tell her where her fork is located, I almost always fail. Even when I pick it up and attempt to put it in her hand, she has a hard time understanding what I want her to do.

At lunch the other day, I noticed that she hadn’t eaten any of her rice, something that she usually likes. I mentioned it to her. She couldn’t see it, and none of my explanations helped. I finally picked up her hand and let her feel it.

It is very difficult to predict what she will be like at any moment. Quite a few times, I have mentioned this in connection with her sleep. Sometimes she sleeps or rests in bed far beyond her wake-up time. Sometimes she gets up very early. In itself, I don’t think of that as a problem except for me to adjust my daily routine. The relevance is that it is another sign of change in her condition.

Along with that, she experiences far more delusions than ever before. Sometimes I feel as though her day is one of delusions, and they are positive and negative. We can have great conversations when she is in a cheerful mood although I often don’t understand much or any of what she says.

Unfortunately, she has more negative delusions now. They usually involve things that seem minor to me but very important for her. The most typical is believing there are people in our home, and we are preparing to go out, or do something, with them. She is very concerned and often relieved when I tell her “it’s just the two of us” except when she doesn’t accept that or forgets moments after I tell her.

Another significant change is in our relationship. She is more likely to experience moments when she doesn’t recognize me at all. In some of those moments, she doesn’t immediately feel comfortable with me although she becomes more at ease in a very short time. There are times when she is experiencing anxiety and wants me but doesn’t recognize me. She will say, “Where is Richard?” or call to me by name as though I am in another room. Another interesting thing is that she sometimes refers to herself as “she” and to me as “he.” This can be confusing. At first, I was quick to ask who she was talking about. She can’t answer that, but I’ve learned through experience that “she” and “he” are “we.”

All of this is to say that our world has changed substantially. “Living with Alzheimer’s” is definitely more challenging these days. I am grateful for the good run we have had and that we continue to share so many “Happy Moments.”

An Unusual Saturday

I never know when Kate will be ready to get up in the morning. More often than not, it’s between 11:00 and noon. That means having our lunch rather than breakfast after she is dressed. That happens often enough that I have my own morning plans. When she awakes earlier, I just shift gears. That’s what happened Saturday morning.

I had just finished in the bathroom and was going to the closet for my clothes when I heard Kate say, “Hello. <pause> Hello?” It was just before 7:00. I walked over to her bedside and said, “Hello, I’m glad to see you.” She said, “I’m so glad you are here.” She was very uneasy although not as frightened as she is sometimes. I asked her what was wrong, and she said, “I don’t know.” We spoke a few minutes, but she was unable to tell me what the problem was. Then she said, “I’ve got to get out of here.” I told her I would be glad to take her.

At that point, I figured that if I could get her up and dressed, she would begin to feel more at ease. Then she might be fine. That didn’t work. She got up easily, and we got to the bathroom. She refused to use the toilet or to brush her teeth. She just wanted to get out. I asked her to take off her night gown. She didn’t want to. I explained that if she wanted to put on her clothes, she needed to take it off. She still wanted to get out of the house and soon agreed. We were in the car a few minutes later. I turned on the second movement to the Brahms Violin concerto, and we didn’t talk at all. She settled down.

My intention was to drive around for 20-30 minutes and then return home for breakfast. On the way, I saw a new breakfast place near our house and thought it might be nice to try it out. I drove a little longer before asking Kate if she would like to stop someplace for breakfast. She said she would. I turned around and went back to the new restaurant. She was fine, even cheerful, and we had a good, but heavy breakfast. The ride and music had done what I had hoped.

We were home by 9:00. It was no surprise that Kate wanted to rest and did so for almost an hour while I took a walk. By that time, she was ready for the bathroom. Then we sat down on the sofa to look at one of her photo books. We hadn’t gotten far before she wanted to rest again.

She rested for over two hours and was asleep most of that time. About 1:15, I asked if I could take her to lunch. She wanted to rest a little longer. I tried several times over the next hour and a half. Still no luck. I had been playing very relaxing music for her and shifted gears to something more lively around 2:30.

That didn’t have any effect either; however, I was able to rouse her at 3:15. I decided to go out for an early dinner. We arrived at the restaurant at 4:15 and had a pleasant meal, and the evening went well. We hadn’t followed anything like a normal day, but everything was fine. It pays to be flexible.

Saved by The Velveteen Rabbit (Again)

For the past year or so, especially since COVID-19, Kate and I followed a well-established after-dinner routine. I watched the evening news while she worked on her iPad. She gradually lost her ability to work her puzzles. That left a void that I tried to fill by watching less of the news and turning on YouTube videos of musical performances for her. She often liked to go to the bathroom, put on her night clothes before getting in bed to watch the videos.

Over the past week, she has balked on brushing her teeth, going to the bathroom, and getting ready for bed. The first time this happened I pushed her too far, and she let me know it. I needed to try a different approach. Past experience taught me that she often accepts things she doesn’t want to do if given a little time. On subsequent nights, I let her postpone these things until near the time for me to get in bed. That worked but I still had to push a little. Night before last I tried something else.

First, I asked if she wanted to get ready for bed. She didn’t. I told her that was fine and that I was going to take a shower. I hoped that she would be ready after that, but I found that she was already in bed wearing the clothes she had worn all day. I asked if she wanted to use the bathroom and put on her night gown. She said she would do it later.

I waited another ten minutes or so and tried again with similar results. Her resistance was increasing. It seemed like a good time for the “Rabbit,” The Velveteen Rabbit, that is. It has been helpful before, but each time I use it I feel I may be pressing my luck. I brought the book to the bedroom, got in bed and told Kate I was going to read something to her.

It often takes a while for her to become interested. That night she was fully engaged all the way through. When I finished, I said, “Isn’t that a nice story?” She sighed and agreed. Her mood had changed completely.

I thanked her for letting me read to her. She said, “I liked it.” Then I told her I needed to get ready for bed and asked if she would like to as well. She said, “Yes.” I helped her up and to the bathroom. She was cooperative as I helped her get out of her clothes and into her gown. The battle was over. It was a much better way to gain her cooperation than pushing her.

Last night she was also resistant. I gave her plenty of time and got her to bed without a problem; however, when I was about to go to bed, she had a delusion that involved other people in our house and disturbed her. Again, I brought The Velveteen Rabbit to bed and read it. She forgot all about her worries and fell asleep before I finished.

Happy Day

When people ask about Kate, I often say that she is now at Stage 7 in her Alzheimer’s journey. I sometimes add that it is the last stage that can last for years. I feel sure my reply conveys the seriousness of this phase of the disease. For that reason, I usually add that it doesn’t mean that we don’t continue to have moments of joy. We do, and one of the interesting things to me is how often those moments are intertwined with the common symptoms of this stage. I am grateful because her life is now filled with more delusions, hallucinations, and confusion than she has experienced before. Yesterday is a good example.

Shortly after 8:00, I heard her say something and went back to the bedroom. When I reached her, she seemed wide awake but confused. That may seem a strange combination. What I mean is that she looked and sounded fully awake, but her confusion was obvious as I tried to get her up and into the bathroom.

I told her I was glad to see her and asked if she was ready to get up. She was but said, “What should I do?” I suggested she first move her feet and legs to the side of the bed. She didn’t understand what I meant, so I gently pushed them to the side. She said, “What now?” I told her to hold my right hand while I lifted her with my left. Some mornings this is difficult. She seems to be dead weight. This time she pulled my right hand, and I was able to lift her to a sitting position. It is not unusual for her to scream when I do this. She didn’t this time.

She was very uneasy getting to her feet, but we got to the bathroom without a problem. When I told her to take a seat on the toilet, she was confused and didn’t want to. That is pretty common, but this time she wanted to know why she should sit on the toilet. I gave a very simplified explanation that she couldn’t understand. Then I told her we could skip it. After I said that, she agreed to sit down. Afterwards, we washed her hands, and I gave her a toothbrush to brush her teeth. She didn’t understand what she was to do with it. I helped her get started. Then we went back to the bedroom to dress. That went smoothly.

For a very long time, Kate has responded with great interest when she sees the plants and flowers in our family room, on our patio, and the back yard. That has been less frequent in the past few weeks. It was back yesterday, and we took a few minutes to enjoy them together.

Once she was seated at the kitchen table, I gave her a glass of apple juice and her morning meds. She loved the juice (which she refers to as water) and took her pills without a protest. She actually seemed pleased I had given them to her.

The best was yet to come. I fixed her a slice of cheese toast. Kate didn’t remember having eaten it before and responded with enthusiasm. She ate it more quickly than usual, and I fixed another one. She was quite talkative while eating and after. (I may have noted in an earlier post that she seems to feel especially comfortable at the kitchen table and often wants to linger long after she has eaten. I think she likes the fact that the table is located beside a large window overlooking our neighbor’s front yard and that of another neighbor across the street. Two different sitters have commented on her wanting to stay at the table for as long as an hour after eating.)

I joined her at the table right after fixing her cheese toast. She asked my name. When I told her, she gave me her name, something she often doesn’t remember. It was one of many times during the day she didn’t remember my name or our relationship. Then she began a lengthy conversation. I wish I could tell you what she said, but her speech was so garbled that I couldn’t make any sense of it. Everything she said emanated from a delusion. I do know that she mentioned her mother and later in the conversation made references to other people (“she,” “he,” “they”) and assumed that I knew them. It was light-hearted chatter, and she laughed a lot over 30-45 minutes. I loved seeing her enjoy herself.

During all this, an album of very relaxing music was playing. “Clair de lune” caught her attention. She stopped talking and said, “Listen.” For the balance of that piece and into the next, she closed her eyes and put her hands together as though she were praying. This is not the first time she has done this. I always find it touching. The day was off to a good start. It was a very “Happy Moment” for both of us.

We finally adjourned to the family room where she wanted to rest. I took that opportunity to take my morning walk (inside the house for those of you who are new to this blog). I hadn’t walked ten minutes before she was sitting up. Then we spent a short time looking at one of her photo books before getting a takeout meal for lunch.

The sitter arrived just as we were finishing lunch. I got up from the table to get ready to leave, and the sitter took my place. It was a very natural transition. Kate was perfectly happy with Cindy as she has been since her first few visits . That makes me feel much better when Ieave.

When I returned, they were seated on the sofa looking at a photo book and having a grand time. Kate was sorry to see her go. Their relationship is everything I could have wanted and more.

The rest of the evening went well. We had a pleasant dinner with a takeout meal at home and encountered no challenges getting ready for bed. Kate had not rested at all during the day. That’s rare. As a result, she went to sleep rather quickly but awoke briefly when I got in bed. She was still happy, and so was I.

Unpredictability: Part 2

Early last week, I wrote a post in which I talked about Kate’s unpredictability and illustrated with the changes in her sleeping pattern. By itself, that is not a serious problem. It’s something to which I can adapt; however, the source of this change concerns me. She is far more insecure than ever and is often uneasy about getting up. For a long time, she has experienced anxiety upon waking, but it seems more serious now. Previously, I was able to get her up without any problem. Then she would begin to feel better. Her response now is to withdraw. That makes it hard for me to help her.

The change that has bothered me most is the first signs of hostility. So far, that has involved occasions when I am helping her in the bathroom, dressing in the morning, and getting her night clothes on.

One of these occurred one evening last week. We had a good afternoon though a short one since she got up a little later than usual. As sometimes happens, it was almost 3:00 when we finished lunch. She rested about an hour or a little longer. She was in a good humor when she finished resting and expressed an interest in the house. That led me to take her on a tour, something we haven’t done lately. We didn’t get very far, but that was because of her interest. It took a long time for me to point out items of interest and listen to her own reactions.

She rested again before going out to dinner. She seemed fine at the restaurant. All was well until we got to the bedroom. Our normal routine is to go first to the bathroom to brush our teeth. When I mentioned it, she said, “I’ll do it later.” I brushed my teeth. Then I got her night gown and took it to her. That’s when the trouble began. She snatched the gown from my hand and said, “I’ll do it later.” I told her that would be fine and settled in to watch the evening news.

At 8:00, I asked if she was ready for bed. She wasn’t, I told her I was going to take my shower but was very careful not to say it in the same tone of voice she had used. I knew that would exacerbate the problem and hoped that when I got out of the shower, her mood would have changed. That wasn’t in the cards.

When I came out of the bathroom, she was looking intently at the bedspread and running her fingers over it as though she were writing. I didn’t say anything. In a few minutes, I asked if she would like to get ready for bed. She was ready, and I told her I would help her. I walked to her side of the bed, picked up the night gown and put it next to her. Then she said something I didn’t understand. All I picked up was that she saw other people in the room and for some reason wanted me to sign my name on her gown. I did exactly what she had been doing on the bedspread. I pretended to sign my name on the front of her gown. After that, she asked a couple of questions about the people in the room. I told her they were gone now.

When I picked up the gown, she said, “I’m not wearing this.” She was adamant about it and added, “Get me something else.” I took the gown and went to the closet and came back with another. I said, “Let me help you.” She gave me a stern look and said, “You can, but we’re going to do this together. You understand?” I said, “That’s fine. I like for us to work together as a team.”

She took the gown and tried to figure out how to put it on. Quickly, she realized that she needed my help. Soon after that, she was in bed. She was awake when I called it a day over an hour later. She seemed to have forgotten the whole incident. It was a typical close to our day. I told her I loved her. She said the same to me.

The next day, we had a similar experience. She was up even earlier and was very cheerful and talkative. As she did the day before, she expressed great interest in the house. We tool a brief tour of the dining room and living room. Then we came back to the family room where we looked at photo books until time for lunch. It was a very nice morning and afternoon. That evening we had a repeat of the night before. Since then, there have been a couple of other times when she was rather hostile.

Concurrent with this change is an increase in her delusions. They often involve people who are in the house. This results in her whispering so that “they” can’t hear her. She is very insistent on my speaking the same way. Other times, she is concerned about some kind of project on which she is working. I haven’t been able to figure out what it is, but she is very worried.

My impression is the hostility with me arises for two reasons. First, I think they come at moments when she has forgotten who I am and doesn’t trust me. Second, she is worried or frightened by her delusions.

Once again, I turned to The Velveteen Rabbit (TVR) as a way to calm her and ease her concern about me. It is amazing how effective that can be. A few nights ago, she was quite troubled when I got in bed. It involved an event on which she was working and was concerned about the people working with her. I tried to divert her attention to other things. That didn’t work. Then I read TVR to her. She was attentive and responded audibly from the beginning. That is not typical. It usually takes a while. She calmed quickly. At the end, I thanked her for letting me read to her and told her I liked the book. She said she liked it as well. She asked me a number of questions about it. I was surprised because the questions indicated that she had grasped at least some of the content.

This morning I saw a tweet that said, “The #dementia caregiver’s goal is to communicate “Let’s solve this together.” I try to emulate this approach, but I don’t seem to be doing so effectively at these moments. That is something I will have to work on.

Although many things are unpredictable, I am happy to report that the day virtually always ends on a positive note. I would say 99.9% of the time. When I get in bed, I say, “Thank you for another nice day. We always have nice days, don’t we?” She agrees, and I tell her I love her. Occasionally, she does not reciprocate by saying she loves me. That’s when she doesn’t remember that I’m her husband. On those occasions, she sometimes laughs. Regardless of what she says, she is both at ease and happy. I can accept that. It’s far better than butting heads.

One More Surprise for the Day

Not long after my previous post, I checked on Kate. She was awake and said she was ready to get up. I’ve learned not to rush her and was very careful not to do so. When it came to actually getting up, she was very hesitant despite my precaution. This has happened several times over the past week. Once on her feet, she began to talk as though people were in the house or would be. She assumed I knew what she was talking about. This is also something that is not particularly unusual.

On the way to the bathroom she continued to talk. I have no idea what she was talking about. Her words were a mixture of words I understood with those that were garbled. She was having hallucinations about people and things in the room. She was very uneasy about going into the bathroom. It took me a while to coax her.

While on the toilet, she got some toilet paper in her hand and looked at it. She asked me if I had one too. Then she said something that made me think she thought the toilet paper was a man. It was a challenge to talk with her because I didn’t understand much of what she said.

She said she didn’t know what to do. I told her to get up from the toilet. My plan was to give her a shower. I have found that it is easier to get her in the shower if I don’t inform her until just after she gets up from the toilet. That didn’t work this time. She didn’t want to take off her gown. I tried to explain that she would need to take it off for me to get her clean. She continued to resist.

I decided the shower would make things worse. We brushed her teeth. She was still agitated. I felt it would be better to let her rest a while. Perhaps, she would be fine after that.

I went back one or two other times. She seemed to be over whatever had gotten to her; however she still didn’t want to get up. I bought a new bed last week. It was a little too high for Kate, and the mattress company was sending out someone to lower it for me. It was almost 2:30 when I received the call that they were on the way. That was when I felt the need to get her up. She responded well and was fine after that.

Last week, I bought her a robotic cat that meows, purrs, raises its head, and blinks its eyes. For almost an hour she was entertained by her cat. Then we had a Zoom call with our son. When we finished, it was time for dinner. We went to Andriana’s and had a very nice meal. She was rather confused when we got home. She asked where we were. When I told her, she wasn’t happy but didn’t say why. Fortunately, I had no trouble getting her ready for bed. She is resting peacefully though not asleep. It’s been a full day. I wonder what tomorrow holds.

All’s Well That Ends Well

Morning confusion isn’t something new for Kate. She isn’t usually frightened by it, but that happened earlier this week. She was sleeping soundly at 11:00 when I went in to wake her. The look on her face is always the first sign of how she is feeling. She often smiles. Sometimes, she is quite cheerful. Sometimes, I see the look of confusion. This time, I sensed fright and said, “You look scared. Are you?” She nodded.

I launched into what has become a common routine. I try to be reassuring and say, “I can help you. You and I met at TCU and have been together ever since.” She looked doubtful that I could do anything for her. I went on to tell her that I knew a lot about her and her family. Then she said something that I’ve never heard her say before and can’t remember her exact words. She conveyed that she wasn’t able to think of anything, something that fits what I have perceived before as her mind’s being a “complete blank” though she had never been able to articulate it.

When I repeated that I would like to help her, she said, “What can I do?” I told her it would probably help if she could get up and get dressed. I went on to say that I thought she would feel better after she got up. She surprised me when she said, “You’re probably right.” I was encouraged by that, but when I asked her to give me her hand to help her, she said she couldn’t do it.

I sat down on the side of the bed and talked with her a few minutes and tried again. She wasn’t ready. I gave her a little more time but continued to sit with her. When I tried again, she was cooperative. She was very uneasy as we walked to the bathroom and had the normal confusion about what to do once we were there. As we completed each step, she seemed to be more at ease. By the time we walked into the family room on the way to the kitchen, she seemed fine. We stopped a few minutes for her to enjoy the flowers and plants and to rearrange a few things on one of the tables.

Breakfast went well. She enjoyed her food, and the music I was playing. When she finished eating, I asked if she would like for us to spend some time together in the family room. She wanted to stay at the kitchen table. I don’t think I have commented on this before, but she seems very comfortable sitting there. One of the sitters told me that once she wanted to remain there after lunch, and they stayed there for a couple of hours.

That evening she was fine when she got in bed. Two hours later when I was about to get in bed, she had that look of fright on her face and asked who I was. She wasn’t reassured after my telling her. Then I thought of The Velveteen Rabbit. She wasn’t particularly interested, but I read it anyway. Midway through the book, she was making her audible responses to the passages I read. She was fine when I finished. I said, “I love you,” and she said, “I love you, too.” Another rough edge smoothed out.

Sleep and Rest

Long ago I learned that people with dementia reach a point at which they sleep more. I’ve been mindful that would happen, but I wasn’t prepared for the way that is happening with Kate. I just thought she would simply start going to bed earlier and getting up later.

I’ve not been able to identify a consistent pattern for her. Until two years ago, she went to bed between 8:00 and 9:00 and got up early enough for us to get to Panera for a blueberry muffin between 9:00 and 10:00. In addition, she would rest a while after lunch. That would give us time to spend an hour or more at the café at Barnes & Noble before going to dinner.

When she started sleeping as late as 11:00 or 11:30, we stopped going to Panera. It was time for lunch. Along with that, our afternoons changed. She wanted to rest immediately after lunch. That would last as long as two or three hours which took up most of the afternoon. That put an end to our visits to Barnes & Noble.

This pattern changed with the arrival of COVID-19. Kate was losing her ability to work jigsaw puzzles on her iPad long before then, but she lost it completely after we began sheltering. That was her last self-initiated activity and had a significant impact on her sleep and rest. As recently as a year ago, she could easily spend 6-8 hours a day working her puzzles. That lessened during the day because she was either sleeping or resting, but she continued to work on her iPad for an hour or more each night. That meant she got to bed between 8:00 and 9:00.

Without her puzzles, she had nothing to do after dinner. I tried to interest her in looking at her family photo books, but she really needs someone to identify all the people. That was a time when I would try to catch a little of the evening news and get my shower. The result was her going to bed shortly after dinner. Since we have started eating out some evenings, that means she gets to bed around 7:30 although she is rarely asleep when I get in bed.

Several times a few months ago, she refused to get up when I tried to wake her. Before that, she wasn’t always eager to get up, but she never refused. Since that first time, there have been several other times like that. One day she remained in bed until 5:15 in the afternoon. Then she began to wake up early on a few mornings. I am now used to her getting up early almost once a week, sometimes twice.

Until recently, she has always gotten up rather quickly in the afternoon. The exceptions occurred in the last week or ten days. The first time happened when I wanted her to get up for dinner. After a couple of efforts within 15-20 minutes, I let her rest another hour. Then she got up agreeably.

Thursday afternoon last week we had hair appointments at 3:30. She was resting, not asleep, when the sitter arrived for me to meet a friend for coffee. I returned just a few minutes before we needed to leave. She was still resting. I told her it was time for our hair appointments and fully expected her to get up easily. I was wrong. She was just like she has been in the morning. She was very relaxed but also very firm in saying she wasn’t going. I called the stylist and told her I was having trouble getting Kate up and that I might have to cancel. I gave her another ten minutes and tried again. I could see it was no use and rescheduled our appointments.

I stayed in the family room with her while she rested. An hour later she was ready to get up. She was in a good humor. I feel sure she didn’t even remember that I had tried to get her up earlier. It wasn’t long before we left for dinner at Casa Bella and had a good evening. It was as though nothing had happened at all. We both felt good.

Saturday morning she was up very early. I had just gotten up and walked into the bathroom when I heard her moving. She had gotten out of bed. I helped her to the bathroom and took advantage of the early morning and confusion to give her a shower. When we finished, I helped her dress. She wanted to lie down on the bed. Because it was so early, I was happy to tell her that would be all right. That gave me time to comb my hair, shave, and dress. She remained in bed until time for lunch.

Sunday morning, she was up before 9:00. She was unusually cheerful at breakfast. Afterwards, we spent about forty-five minutes looking at one of her family photo books. It didn’t surprise me when she got tired and rested over an hour before lunch.

She awoke early again this morning, about 7:30. I went to her and found that she seemed wide awake and in a good mood. When I told her it looked like she was ready to get up, she said, “I don’t know.” We talked a few minutes. I told her I would be happy to help her get up and dressed. She said she wanted to rest a little more. It’s my day for Rotary, and I like to have her ready for the sitter who comes at noon. We had plenty of time, so I let her continue to rest. I don’t plan to get her up until 11:00. If she wants to stay in bed, I’ll let the sitter handle it.

The only thing that’s clear is that Kate hasn’t settled into a consistent sleep pattern. I’m not sure whether the present irregularity is something that is long-lasting, or she will gravitate to something else. As Kate herself is prone to say, “We’ll see.”

Still Having Good Times

I hope I’ve made it clear that Kate and I face more issues to deal with than at any other time since her diagnosis. I am also happy to say what I have said before. We still enjoy life and each other. This past weekend is an excellent example.

Saturday morning she was slow to get up. That meant we didn’t get to have our regular lunch at Andriana’s. Ordinarily, that would not have been a problem. We would simply have had a late lunch; however, this time I wanted to attend a virtual memorial service for a church friend who died unexpectedly. It started at 2:00, and I knew we would be unable to get home in time.

As it turned out, Kate hadn’t quite finished her lunch when it started. I had expected to have finished eating and that she would rest while I watched the service. Instead we watched it together at the kitchen table. She had no idea who our friend was, nor was she able to follow everything that was said. That didn’t keep her from finding the service to be meaningful. She was especially moved by the music and prayers. Periodically, she reached her hand out to me. When she does this, I put one hand on top of hers. She puts her other hand on mine, and I top it off with my other hand.

I have often attended services for other church friends but haven’t been able to do so for a while because they have always conflicted with my responsibilities for Kate. Before that, I had been touched by memorial services because they made me think of a time when we would have one for her. Given that, it isn’t surprising that I found both the service and Kate’s response equally touching. It was a special time for the two of us.

Thirty minutes later, we had a Zoom call with our son Kevin. That, too, was special. Most of his calls are on the phone, and often Kate has been resting or in bed for the night. The result is that she isn’t up for a conversation. To be sure, a Zoom call is a little confusing for her. Her vision problem is part of the reason. She has a hard time seeing anyone on a Zoom call. In addition, is the fact that she can’t quite comprehend that she could be seeing someone on a call. It took a while at the beginning of the call to get her to look at the computer screen and see Kevin. Even after that, she drifted away from the screen.

The good thing is that we were able to talk comfortably. Some of the time, she and I talked to each other. I felt that was a good thing in that Kevin was able to catch a glimpse of the way we relate to each other. It was very much like it would have been if he were not on the line. It was an hour of pleasure for the two of us and, hopefully, for Kevin as well.

The rest of the afternoon and evening went well, and we have added something new to our evenings. I ‘ve been reading a bedtime story just before turning out the lights. I started with The Velveteen Rabbit, but that is a little long. I learned about Love You Forever from a Twitter friend. His wife is in memory care now and still likes it. It is much shorter, and I found that Kate likes it as well. It is short enough that I added I’ve Loved You Since Forever by Hoda Kotb who wrote it for her adopted daughter. Together the two books work out just right for a bedtime story. I plan to add a few more. It’s a nice way to end the day.

Sunday was also a good day. Kate was ready to get up at 8:30. That gave me enough time to get her breakfast, spend a little quality time with her, and let her rest before lunch. The highlight came while we were still at the kitchen table after breakfast. I’ve mentioned before that she often cleans up her plate, but I don’t believe I have said much more than that. She uses her index finger to pick up the final specks of food and put them in her mouth. There are always some things she doesn’t like. She puts those on the table or her placemat.

She did something different yesterday. She likes to arrange things and often changes the arrangement of items on her bedside table and dresser. Not too long ago I reported on her food art. That was when she spent time placing her napkin, utensils, glass, and food in various places on her plate and placement. Yesterday, she did something similar.

I made cheese toast for her using Dave’s “PowerSeed” bread. As the name suggests, it is loaded with seeds, and a lot inevitably fall on the plate or placemat. I noticed her carefully studying her plate. She was arranging the fallen seeds on her plate along with her fork and one remaining bite of cheese toast. I complimented her on her artistic eye as she continued to arrange and re-arrange. She enjoys things like this, and I enjoy seeing her entertain herself. This and other simple pleasures provide us with plenty of good times.