An Unusual Visit with Ellen

Sunday’s visit with our longtime friend Ellen Seacrest was different from those in the past. I’ve always expected that the declines in Ellen’s vascular dementia and Kate’s Alzheimer’s would ultimately change the nature of our visits. To a large extent it has, especially Ellen’s loss of speech. We can only understand a small portion of what she says. Our latest visit, however, was affected by our arriving at a time when the residents had gathered together for a program put on by a dance group from a local church.

Ellen was already seated in the middle of group. One of the staff helped to seat us next to her. We didn’t get to talk much before the program began. The pleasure Kate experienced came from the afternoon activities. The dancing was followed by ice cream that the dancers dished up and delivered to each of us in the audience.

We had only a thirty-minute break to talk with Ellen, but being in the middle of the audience made it challenging to talk with her. Several others around us joined in. In some ways that was helpful since we can’t understand Ellen; however, it also meant that we didn’t get to focus our attention on her the way we have in the past.

We had a big surprise when Ellen told us about someone she wanted us to meet. We couldn’t understand all that she said, but she was enthusiastic about him. In a little while, she rolled away in her wheelchair to greet a man. Then I began to understand. She had found herself a boyfriend. She called to us and told us his name is Mike, but we didn’t get up and go over to them because we were in the middle of the crowd, and the “Music Lady” was about to begin her music program. One of the staff told us that Ellen and Mike had established a relationship, but Mike’s wife hadn’t yet been informed. I know this is not unusual in memory care of skilled nursing facilities, but I hadn’t thought much about Ellen’s establishing such a relationship. I think that is because I felt that most of the residents are significantly further along in their dementia than Ellen. Mike, however, is a new addition. He was among the few not in a wheelchair and did not appear to be much different than Ellen.

We enjoyed the music for about forty-five minutes before we departed. Kate thoroughly enjoyed herself, but I regretted not having more time with Ellen.

Kate was talkative on the way home, especially during the latter part of the trip. She expressed her appreciation to me for caring for her. We talked about things we had in common that had made our relationship strong. For that reason, I was somewhat surprised when we got out of the car for dinner. She said, “I want you to know that I think we will get married sometime.”

Most of the time when she doesn’t know my name or our relationship, I am not very surprised. I realize these moments of recognition come and go all the time. The nature of our conversation and, more specifically, her own comments about our relationship made it seem like it was one of those times when she clearly recognized me as her husband. Of course, it is quite possible her recognition of our relationship was coming and going all the way home. That’s another thing I will never know.

Each time we have these out-of-town trips, I am sensitive for any signs that suggest its time to discontinue them. Nothing happened on this trip that would prevent our going back again. Kate and I had a good dining experience on Saturday night and Sunday for lunch. She also enjoyed the dancing, ice cream, and music even if she didn’t get much of a visit with Ellen. Considering everything, the trip was clearly worth it. We’ll be back.

Reflecting on Visits with Out-of-Town Friends

This past Saturday Kate and I went to Nashville to visit our longtime friends, the Greeleys. It was a visit very much like recent ones we have had with two other couples who are also longtime friends. All three were good visits for me, but they presented a challenge for Kate. I had exchanged emails with each couple prior to the visit. I told them that she is sensitive about being excluded from our conversations. All of us were interested in seeing that she was a part of the group.

In practice, that is very hard to do. We have a long history of conversations, and we fall back on the way we have always interacted. We would have to devote all our effort to make Kate an integral part of the conversation. This is not a problem that is the fault of our friends. I get caught up in the conversation myself and am the biggest talker of them all.

There is no problem when it is just Kate and me. We are able to converse easily. That involves a significant amount of repetition and a narrower range of topics. It would be hard for a group to spend a visit of two or more hours doing that. Eventually we would be back to where we are now, three of us involved in a conversation while Kate sits and tries to listen but can’t follow.

When I face a situation like this, I like to think of the things that are within my control and those that are not. One of the things I can’t control is Kate’s Alzheimer’s. She is on a course that will eventually prevent her from participating at all. We may be approaching that now. I never really thought about this issue before being faced with it. If I had, I probably would have expected a transition in which her ability to participate and her desire to be part of the conversation declined at the same time. That is not happening. I shouldn’t be surprised. She can neither remember things from the past nor learn new things, but she still wants to remember and learn. I am reminded of what I have heard so many times in the past, “Well, at least she doesn’t know.” Well into Stage 7, Kate clearly does know that something is wrong with her. But still she wants to remember, to learn, and to converse like everyone else. This is frustrating and sometimes frightening for her.

As for what is under my control, I would say my options are limited. I could avoid having these visits. That is something I don’t want or intend to do unless the problem is more serious than it is now. I could also make a few suggestions to our friends about things that Kate can appreciate. One thing that comes to mind is beauty. Everyone has artwork, flowering plants, or other items of aesthetic value they have collected over the years. Kate might take an interest in those. Her tastes now are very simple. She still loves the paper doilies she brings back from one of the restaurants we visit every week. She loves children. She might enjoy looking at photos of friends’ children or grandchildren.

There is also something else that I plan to consider. I could withdraw from the conversation periodically. That would leave the conversation to Kate and our friends. That combined with the knowledge of things that might appeal to her could be just enough to help Kate enjoy herself. Right now, I haven’t decided what to do. We don’t have any other visits scheduled and won’t for a while. My inclination, however, is to make a last attempt to include her in some way. If that doesn’t work, I will accept that the time has come when it isn’t possible for Kate to be as much a part of the conversation as I had wanted. That’s what I’ve had to do with her loss of memory and her ability to take care of herself. Alzheimer’s requires caregivers to accept a lot of things that we cannot change.

Visiting Friends

I have talked a lot about the role that music and eating out have played in our lives, but I haven’t said as much about our connection with friends. I am thinking especially of friends who live out of town. With one exception, our friend Ellen who is in memory care in Nashville, Kate and I don’t see them frequently, but they, too, have provided with a support network that continues to be important to us. Saturday, we visited Ann and Jeff Davis, a couple we first met in graduate school at the University of Wisconsin. Later, John and I were colleagues at the University of Tennessee. They moved away more than twenty years ago and now live in Nashville.

Kate has changed a lot since we last saw them, and I was glad when Ann sent an email asking if we might plan a visit. Kate’s memory of them has diminished, but I thought she would probably respond well to them once we were together. For the most part, I was right about that.

After taking our seats, we quickly broke into two different conversations, one between Ann and Kate, the other between Jess and me. It sounded like Kate was doing well though I recall her dodging a question she couldn’t answer by tossing it to me.

We were there a couple of hours. The conversation soon drifted to one among the four of us. That can be, and was, hard for Kate. She wanted to be involved, but that is difficult. Her poor memory means her vocabulary is substantially reduced and she doesn’t remember the past and is not familiar with current events. That’s makes it tough. She didn’t, however, say anything that made me think she was uncomfortable. That’s good.

As I look to the future, I am hopeful that we will continue with these trips. Right now we have another one scheduled to see Jan and Scott Greeley in Nashville two weeks from now. That’s another special connection for Kate. Her parents were close friends of Scott’s parents. Kate and Scott were crib mates in the early days of their lives. She no longer retains a memory of their times together, but she almost always beams when I mention a visit with them. At this time in our lives, relationships like these are especially meaningful.  We have shared a lot of experiences together, and I plan to keep them up unless it becomes uncomfortable for Kate.

Our Visit with Ellen

Yesterday’s visit with Ellen was different than usual. As I think about it, the last few visits have been a bit different. I looked back and know that I made a similar comment in September. Both Ellen and Kate are changing. I have come to accept that I can’t predict Kate’s behavior as well as I used to. It is only natural that our visits will also be unpredictable.

Ellen lives in a facility dedicated to memory care and is divided into three “neighborhoods,” each with about twelve residents. They are free to move about from one neighborhood to another during the day but not outside the facility itself which is locked. We usually find her sitting in her wheelchair near the lounge with a television or in the dining area. Last time and again yesterday, she wasn’t in either place or her room. We asked one of the staff if they had seen her. She left to find her. In a few minutes, she returned with Ellen. Although she has been in memory care for two years, she has always recognized us. This time she was unusually excited to see us.

We pulled her up to a table and took our seats. We had only talked a few minutes when she tried to tell us something that we couldn’t understand. I finally understood that she wanted to go back where she had been. It seemed very urgent. We offered to take her, but she wanted us to wait and said, “Back in twenty minutes.” After she was gone, I looked over at the staff member who had brought her to us and explained that she wanted to do something in the other neighborhood. She offered to go get her, but we told her we knew our way around and would find her.

A few minutes later, we found Ellen in her wheelchair beside another staff member who was on the phone. Ellen seemed eager to talk with her. The three of us chatted while the staff member continued her conversation. We were able to gather that Ellen thinks the world of this person but never learned why she wanted to see her so much right then. When she got off the phone, she told us she needed to tend to something else. The three of us headed back to Ellen’s neighborhood.

On the way, Ellen appeared to be looking for someone. I think it may have been the staff member she wanted to see before. As we passed by the clinic, Ellen stopped and opened the door and looked in. Two or three staff members were there, and the one Ellen was looking for came out. She nicely explained that she had to take care of something and walked away. At the same time, I saw that someone else was delivering ice cream to each neighborhood for their afternoon treat.

We went back to Ellen’s neighborhood and sat together at a table where all three of enjoyed our treat. We talked a little while before Kate looked at Ellen and said, “We’re going to have to leave now. Then a visitor we had seen on one other occasion stopped by and introduced himself. There was a woman with him whom I assumed was the person he was visiting. That began a lively conversation, at least between Kate and the man and the woman and me.

When we finished, Kate looked at me and said, “I want to go home.” I knew it was time. We had been there an hour and twenty minutes. That was probably our shortest. We are usually there close to two hours. We recently went over that time when the music lady was there. We were all enjoying the group singing and dancing.

The drive home was not pleasant. It rained all the way, and the traffic was heavy. As sunset approached, it seemed unusually dark. The traffic was moving at seventy or more when a message popped up on the dash, “Passenger Seat Belt Unbuckled.” I looked over to see that Kate disconnected it and was letting it ease back into its stored position. I told her she needed to put it on. She didn’t know what to do. I explained that I couldn’t drive and help her. She asked me where it goes. I put my hand on the connector and touched her leg to show her. She still didn’t know what to do. I pulled onto the shoulder and got her fastened, and we were off again. We were back in town by 5:30 and stopped at Panera for quick bite. I was glad to be off the road and home.

I don’t intend to stop our visits to see Ellen, but the challenges are increasing. Except for the initial greeting, I’m not sure Ellen enjoyed it that much although she didn’t want us to leave. I’m going to keep an open mind about the future.

A Visit with Friends

In my previous post, I commented on what I might call my “Care Team” (professionals, friends, family) and my “Arsenal” (my personal resources I can use as needed). I didn’t specifically mention our visits with out-of-town friends. We have a number of them in the Nashville area whom we have known since our undergraduate and graduate school days. It’s not a great distance from Knoxville, and we have gotten together periodically for years. We have continued to do so since Kate’s diagnosis.

Angie and Tom Robinson are among that group and were in town this past Saturday. We joined them for lunch and afterwards at our home. Prior to each visit, I always wonder how Kate will respond. In the past, everything has gone well. Over time they have been able to pick up on some of Kate’s changes, but not nearly to the degree they did this time. Of course, they were not with us long enough to get the full picture, but they saw far more than in the past. I think they would say that for the first time they could really see her as a person with Alzheimer’s.

The annual Christmas parade had just ended, and a weekly market on Main Street was still underway. That meant we couldn’t park as close to the restaurant as I had wanted. As we walked from the car to restaurant, Kate was bothered by the cold and wind. When something bothers her, she wants it eliminated immediately. The walk didn’t allow for that. She complained about the weather in a way that expressed more irritation than she would have done before Alzheimer’s.

They got to see some of her confusion with respect to ordering and remembering what I had ordered for her. The good news is that she was perfectly at ease with both Angie and Tom. In an email, Angie told me that Kate had asked her to “help me not to do anything stupid.” That is something she often says to me. Angie also said that Kate put her hand on hers several times. In addition, they got to see her confusion regarding her drinks. Kate asked her several times if she could drink her tea and water.

When we finished our meal, I went back to the car and found a parking place in front of the restaurant. While I was gone, Angie said they had a good conversation with Kate “and her responses were pretty good.” It was another good illustration of her ability to respond to people she has known in the past although their names and the things we have done together are long forgotten. As long as she is able to do that, I am optimistic our visits will continue for a good while.

More Restroom Issues and Our Visit with Ellen

I am glad to report that I was able to get Kate up with sufficient time to arrive at Maggiano’s fifteen minutes before our noon reservation. I want to say in passing that Kate did not want to get up but was in a cooperative mood and got up with a little urging. After going to the bathroom and starting to get dressed, she wanted to lie down again. She seemed quite tired, and I gave her a few minutes to relax.

Before arriving at the restaurant, I decided to use the valet. Previously, we have found parking easily at that time of day, but it is getting to be more trouble for Kate to walk. In the past, I tried to give her this opportunity to walk because she needed it. At this stage, my priority has shifted. Now I am influenced more by Kate’s convenience than her need for exercise. That worked well yesterday, and I will use it next time we are there.

Our meal went well. We had an appealing server, and the manager whom we have met on previous occasions dropped by our table to speak. Ellen’s memory care facility is located about forty minutes from there. I suggested that it would be good for both of us to use the restroom before leaving. As we arrived at the door of the women’s room, a lady was coming out and told me no one else was in there. I walked in with Kate and took her to the stall. Then I went to the men’s room and returned to wait for her just outside the door. In a couple of minutes, a woman came out and asked if my wife was inside. I told her she was. She told me it sounded like she may have been having some trouble and that no one else was in there. I went in to check on her. She was still in the stall. She said she was all right and was just coming out. She wasn’t sure how to open the door that she had locked with the latch. I was able to poke my finger between the door and the side of the stall. That enabled me to show and tell her how to lift the latch. That went smoothly.

She came out and I was about to walk out when she said, “Don’t leave me.” She looked a little panicked as though I were forsaking her. I remained with her and helped her dry her hands and arms. This may seem like a little thing, but when she washes her hands or brushes her teeth, she almost always washes her arms and, sometimes, her face. In the process she can get pretty wet.

We finished up and left the restroom before anyone else came in. Then we made our way to see Ellen. She was sleeping in her wheelchair in front of a football game on TV along with several other residents. She awoke quickly and was glad to see us.

The visit went well, but it was different that those in the past. During the past year and a half her speech has declined significantly. We could understand very little of what she said. We only picked up snatches here and there. Once in a while, she would say something in a short complete sentence. Then we wouldn’t understand anything that followed.

Ellen may have recognized the problem as well. I know she wanted to move around more than in the past. Previously, we have stayed either in her room or one of the other public spaces. This time we started out in the activities room. It wasn’t too long before she wanted to go to the main open area between five or six resident rooms on one side and an equal number on the other. From there we went back to her room. Then she wanted to go around the entire interior of the facility that consists of two other “neighborhoods” identical in design to the one in which she lives. She is wheelchair bound, and this may be her way of “walking around” the way other residents in memory care walk “around and around.” We ended up at the table where she eats her meals. It was about forty-five minutes before dinner, but she wasn’t the only resident who had taken a seat early.

Just before we left, another resident in a walker stopped by and told us she was having a bad day. She mentioned several things that had happened to her that day including losing her purse. I doubt if any of these things happened, but Kate and I sympathized with her. She seemed to appreciate that and said so when we left. We had another conversation with a resident as we entered. We had seen her on a few of our previous visits.

We were there almost two hours and around a lot of other residents as well. Sometimes I am concerned about how Kate is responding to being in a memory care facility. She could easily qualify to be in memory herself. Does she ever think about this? I don’t think so. I haven’t seen the slightest indication that she sees herself like any of the residents. Does she even understand that all the residents she sees have some form of dementia? Again, I think not. I doubt that she has a grasp of what dementia is. She knows she has problems, but I believe she still sees herself as normal. When Kate was at an earlier stage, I avoided taking her with me to visit friends in memory care. Now I don’t think she processes much about the nature of the facility itself or the residents who live there.

Despite the restroom incident, the day had gone well. Nothing happened that would make me think we should stop coming to see Ellen. I say that even though Kate can’t remember who Ellen is before we get there. While we are there, she seems to sense the connection. That, and the fact, that Ellen clearly remembers us is enough for me to continue our visits though I know we are approaching the end.

Visits with Nashville Friends

The recognition that Kate is now entering the last stage of her Alzheimer’s motivates me to do what I can to maintain our longstanding friendships with out-of-town friends. With that in mind, Saturday we drove to Nashville to visit Ann and Jeff Davis. Our past visit had been a good one, and I was eager to see how this one would go. Although she didn’t remember them before our arrival, Kate accepted the fact that we were going to see them without any reluctance at all. A couple of times on the way (and after I had mentioned our visit again) she did ask me to remind her of who they were. She was never straight on that.

As on our previous trip, she was immediately taken with the flowers outside. Ann saw us and came out to greet us. Our greeting was as natural as ever. I think Kate felt completely at ease. We went to their sun room where we enjoyed catching up with them. Since our last visit, they had taken a Danube River cruise and also made a trip to Mexico for a Spanish immersion course. Our conversation was lively, and the two hours we spent with them went quickly.

Kate was less talkative this time. Some of that may have been because the rest of us talked so much. I know she could not have followed everything we said. Throughout our visit, I was concerned that she was uncomfortable. It was a surprise when we got in the car to hear her say she had enjoyed the visit. She didn’t say anything that would have given me the idea that she was ignored or bored.

My own reading of the situation is that she was confused by our conversation and may have been uncomfortable. She chose to remove herself from it, an easy way to adapt to a challenging situation. I suspect this is something that I am more likely to see in the future. It reminds me of my mom when she and dad were with us in any group. She was very quiet.

Our visit does make me think about ways that I could have brought Kate into the conversation. Much of our conversation related to our past experiences, something that is impossible for her to handle. She does, however, retain her feelings. She could talk about her feelings for her family, especially her family. She also retains a strong sense of social justice and the fact so many people live in underprivileged conditions. These are things that are easy for the two of us to discuss. It seems like it might be more contrived in a typical social get together like the one on Saturday. I am going to think about creative ways in which I might encourage at least some conversation on topics that we could all appreciate.

Staying overnight in Nashville has worked out well for us. We had a nice dinner the night before, and Kate was able to sleep late before our going to lunch and then visiting our friend Ellen at her memory care facility. Our visits with her continue to be challenging. We understood very little of what she said. In addition, her memory is also declining. Her daughter told me to ask about Ellen’s visit from her son’s family the previous weekend. They live out of state and don’t get to visit very often. When I asked, Ellen didn’t remember their coming at all.

A few weeks ago, we saw a woman from the church where Ellen directed the choir for forty years. She told us about several videos of her daughter singing solos with the choir. She had posted on YouTube. I played them for Ellen. That was a treat for her and for us.

For the third time in a row, we were there for the “music lady” who comes to the facility about twice a month. She plays the piano and sings and invites audience participation. The residents love her. I can see why. Kate and I enjoy her as well. Kate seemed a little more controlled in her expression of enthusiasm than the first time we were there, but she danced and sang a little as well as clapping her hands and swinging her arms with the music. She was enjoying herself so much that we stayed thirty minutes longer than I intended.

I feel good that we can still have weekends with visits like this at this point in our journey and plan to keep going as long as we can.

Sunday in Nashville

We had a nice day in Nashville yesterday. I had made noon reservations for lunch at Maggiano’s near our hotel, but we got there at 11:15 because Kate woke up earlier than I expected. I always like it when she wakes up on her own. That means I don’t have to be concerned about waking her and the challenges that sometimes presents.

We had a good meal and a pleasant time. The last time we were there it was Father’s Day and a little noisy. It was much quieter yesterday and very relaxing.

Before leaving, Kate went to the restroom. I took the opportunity to go to the men’s room rather than waiting outside the ladies room. Moments after I went in, I heard her call me. When I opened the door I saw her looking around for me. She expressed a big sigh of relief when she saw me. I felt bad about not being there as she walked out, but she came out so quickly. She could not have used the toilet. I suspect she got confused and just turned around and came out.

As we left the restaurant, Kate saw a poster with a photo of Frank Sinatra. She stopped to look and naturally asked me who it was. We had been to this restaurant several times before, and neither of us had noticed it. I chuckled because she always asks who he is in posters on the wall at Andriana’s when we are there. She said something to the hostess who told her that Sinatra died some time ago. Kate said, “He did. I didn’t know that.”

Our visit with Ellen went well although understanding her is a big problem. She hadn’t declined since last time, but it is hard to have a good conversation when you can only understand about 10% of what she says. I relied on YouTube videos that she and we enjoyed until Emily, the music lady, arrived to entertain the residents in Ellen’s “neighborhood.”

As we gathered around the piano, one of the staff dropped something that made loud noise at the nurse’s station. Kate is getting increasingly sensitive about surprises, especially sudden noises. She responded audibly that was almost as loud as the noise that frightened her. One of the residents spoke up quickly and told Kate that she had the same problem.

Remembering how Kate had sung, danced, and cheered last month made me eager to see how she would react to the music. She did enjoy the music and sang along rather quietly but was never tempted to do any of the things she did last time. I guess she was just in a different mood. She was more like herself than the previous visit.

Later as we drove to Knoxville, I told Kate we were close and would stop for dinner before going home. She said, “I don’t have any money.” I told her I had money. She said, “I will pay you back when we get home.” When I parked the car at Andriana’s, she again told me that she didn’t have any money. I told her that was all right. It was all “our” money. She said, “I guess that’s right.” She quickly forgot, however. As we walked from the car to the restaurant, she told me she didn’t have any money. I told her I would pay. She said she would pay me back. One other time she mentioned it while eating. This was something unusual. I don’t ever recall her saying this before.  Of course, it fits if she thought I was a friend instead of her husband. It would still be the first time she has raised a question of her paying for anything when we are together. On quite a few occasions, she has been concerned about not having money when I leave her with a sitter. In those cases, I have always told her that I left money or a card with the sitter.

While we were waiting for our meal, she asked our server if she knew her name. The server said, Yes, it’s Kate.” Then Kate asked the server’s name. This was shortly after the server had introduced herself since she sensed that Kate had not recognized her. The server said something about “your husband,” and Kate said, “We’re friends.” I said, “Very good friends.” Kate said, “Yes.” All of our servers know about Kate’s Alzheimer’s, but this particular server has had the opportunity to observe her memory problems more than any other. I don’t think it’s because Kate is more comfortable with her. I believe it is just a chance occurrence.

I mentioned earlier that Kate had taken interest in a poster of Frank Sinatra when we had lunch at Maggiano’s. At dinner, she may have set a record for the number of times she said, “Who is that?” while looking at a poster of him at Andriana’s. I didn’t count, but I am sure it was well over ten times, some in rapid succession.

When we got home, she started going through two of the guest rooms. She acted as though we were moving, and she needed to decide what to take with us. She went into a guest room and picked up a couple of things. I suggested we relax a while and that she could work on that tomorrow. She agreed.

When we got to the bedroom, she asked what she should do. I told her she could start by taking the pills I had put on her bedside table. It looked like she was going to do it but started to undress for bed. It seemed like she was just randomly selecting what to do although she was asking me to tell her. She didn’t seem to follow any of my instructions after asking for them.

While I was brushing my teeth, she called to me and said, “Where is he?” I asked who she was talking about. She said, “You know.” I told her I really didn’t and that she and I were the only ones in the house. She was puzzled but didn’t pursue it further.

She went to bed almost an hour before I did. When I got in bed, she was still awake. We talked about having had a nice day and that we have many nice days. That led to a comment or two about our marriage. Then she said, “We are able to talk to each other. We’re able to be really honest with each other.” Then she suggested something I never fully understood. She talked about how our relationship could grow even further by talking with other people about it. I said, “Do you mean a counselor?” She said, “That could be, but I was just thinking about people we know.” At first, it sounded to me as though she thought we had a problem we needed to work through. The more the more she talked the more it sounded like just improving on the relationship we already have. I don’t know how long she talked, but she sounded very thoughtful as she considered the benefits of exploring ways of enhancing our relationship.

This conversation and a couple of others we have had recently has impressed me with her rational ability to think through something like this. Sometimes she says that I underestimate how smart she is. She may be right.

Another Overnight Trip

These days it is quite unusual for us to travel two weekends in a row, but that is what we have done. We are currently in a hotel in Nashville where we visited yesterday afternoon with a longtime TCU friend and former housemate of mine. It had been a while since we saw him last, but we have communicated by phone, text, and email. He met us at the hotel.

It was a good visit. Of course, Kate couldn’t remember him, but when I told her he was a friend from TCU, her eyes lit up. She participated in the conversation and enjoyed herself as she has done on several other out-of-town visits with people she had never met or not remembered. Although she needs to ask people to repeat and explain themselves, I take it as a good sign that she is interested. Yesterday’s experience reinforces my belief that she is heavily influenced by the situations in which she encounters people. She does better in small groups, only one or two others besides us, and in situations where there are minimal distractions. Large groups like those at a reception are intimidating for her. Our music nights at Casa Bella are typically an exception, but that is because we are often at a table with only one other couple. It was very quiet in the hotel yesterday afternoon. That was great for conversation.

Travel is no longer something special for Kate. After checking into our room, she was ready to go home. She does still enjoy specific experiences while we were away. For example, she loves the flowers around the hotel. As we walked to and from dinner, she stopped multiple times to admire their beauty. When we got back after dinner, she mentioned going home. When I told her we were staying overnight, she frowned.

What she doesn’t realize is that I have only chosen to stay overnight so that she can sleep late on the day we leave and the next morning before we visit Ellen. It makes the trip much more leisurely and enables us to have a nice dinner out as well. I’m trying to make a special occasion out of it, but it is working better for me than for her.

We will go to lunch after checking out and then visit Kate’s friend Ellen at her memory care facility. Last time we visited, we joined the residents in a music program that Kate enjoyed. The woman in charge said she is coming periodically on Sundays. I hope she is there today.

Day 2 of our Trip to Nashville

Yesterday’s visit with the Greeleys turned out well though Kate had a rough start first thing in the morning. Morning confusion is becoming more common now. That is especially understandable when she wakes up in a strange place.

As usual, I had gotten up a good while before she awoke about 8:30. She said, “Hey.” I walked over to the bed, and she said, “Who are you?” I asked if I looked familiar to her. She said I did. I gave her my name and told her I am her husband. She said, “Who am I?” When I told her, she wanted to know where she was and then why we were there. I explained about our coming to Nashville to see the Jan and Scott. She said, “Who?” I gave her the background to our friendship and specifically that she and Scott had been friends her entire life. Nothing rang a bell. I didn’t say anything about our having been with them the previous afternoon or having dinner with them. I relied on something I frequently tell her when we are at home. “It’s early in the morning. Sometimes you are confused when you wake up, especially when you are in a strange place. Once you are up you’ll feel better.” Then I told her it was still early and asked if she would like to get up or rest a little longer. She wanted to rest. I told her I would be just across the room at the desk and that I wouldn’t leave her. She said, “Good.” She woke up again two hours later. As she did earlier, she asked where she was and then why we were there. I went through the same explanation as I had done previously.

We checked out of our room in time to meet the Greeleys at our hotel for lunch. I didn’t want Kate to have to walk to the car and back, so I kept our suitcase and computer case with us until they arrived. I made a mistake when Jan and Scott walked in. I should have said, “Look Kate, it’s Jan and Scott Greeley.” Instead I greeted them as I always have. That would have worked in the past, but this time Kate needed me to remind her of their names and that we were having lunch together. Of course, I had told Jan before they arrived, but she had forgotten. When I realized, I called them by name, and Jan gave her name. Then I suggested that I take our things to the car and for the group to wait a moment. That is when Kate got up and said, “I’ll go with him.” That prompted Scott to say, “You don’t have that much. Why don’t we just take them with us to our table.” That worked well.

The lunch also went well. It was a buffet, and Kate and Scott remained at the table while Jan and I got our food. I also brought Kate’s to her. Even though it was not crowded, it was much easier than her doing it herself. Kate accepts this very naturally. This was not one of those times for independence.

As happens so often now, Kate asked that we repeat ourselves a number of times. This is commonplace. It is difficult for her to follow conversations. Even when we are alone, she asks me to speak more slowly. Apart from that and the insecurity she showed when I was about to leave her to put our things in the car, she enjoyed herself as did the rest of us.

Prior to the trip, Scott and I had exchanged emails in which he and I mentioned continuing care retirement communities. He told me that they were looking at one, and I told him about the commitment I had made to one in Knoxville. After lunch, I asked if he and Jan could drive us by the CCRC he had mentioned in his message. I might have expected that it would mean little to Kate, but it turned out to be a good thing. We not only drove around the campus, but we went into the main building. Kate loved the beauty of the place and took special note of the flowers both inside and outside. As I reflect on it, this was the kind of experience in which she can enjoy herself in the company of others without any pressure at all. She was free to walk around on her own and take in things without our pointing them out. It took away all the pressure that conversation represents for her. It may seem strange, but it reminds me of trips to the zoo. She enjoys looking around at things of beauty or special interest to her.

When we left for home, she mentioned how much she had enjoyed the Greeleys. She always has. I knew she would this time. It just took a little longer to feel at ease. I take that as another sign of the progression of her Alzheimer’s.

After dinner last night, we spent some time in the family room looking at the “Big Sister” album that Kate’s brother Ken had made for her a year ago. That has become far more important to her than he could ever imagine. She is enthralled by the cover picture of the two of them. She spends more time with that particular photo book more than any of the others. Last night, she went through it twice with me. I left to take a shower, and she started on it a third time. After my shower, she was still looking at it. I told her it was getting time for us to get ready for bed. She asked if she could take it with her. She held it in her arms and said, “I love it.” She was tired, however, and didn’t look at it again. She got ready and got in bed. She had had a full day and, except for her confusion in the morning, enjoyed every minute.