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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.

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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.

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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.

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A Visit With Nashville Friends

We drove to Nashville yesterday afternoon to have dinner with longtime friends Jan and Scott Greeley. Kate and Scott have known each other since infancy. Their mothers were friends and pregnant with the two of them at the same time. We spent the night in a hotel and will have lunch with them before going home this afternoon.

It had been about six months since we last saw them. Kate has changed so much since then that I was eager for us to visit before she declines much more. I am glad we did. This was the first visit with any of our friends in which Kate’s changes have been so obvious. I had already prepared them in terms of conversation with her. What I hadn’t done was to let them know of her physical changes as well. In fact, it is something I have only mentioned in passing in my blog. They discovered this before we even got in the house.

They saw us drive up and came out to greet us. We walked up two or three steps to enter their house. Kate is fearful of falling, and she struggled to get up the steps and into the house. She also expressed audible expressions of anguish. This, too, is something that is common. As we entered the house she wanted to hold my hand. This is something that has become increasing common just in the past few weeks. She is very unsure of herself in unfamiliar places. It’s more than a fear of falling. She doesn’t know where she is going, so she holds my hand to guide her.

Over the past few days, I had been trying to refresh her memory about our relationship with them. Of course, I know that she can’t remember, but I wanted to try anyway. It was of no use. Even after reminders as we got close to their house, she had no idea where we were going and who we would see. For the most part, she handled herself well. I don’t think she said or did anything that suggested she didn’t know them. I believe she felt a general sense of familiarity with them but not as strongly as I had hoped.

The Greeleys are making a trip to New Zealand in December and had asked me to bring pictures from our visit there in 2014. We chatted about hour before looking at our slides. Kate was tired and wanted to lie down. She took a seat in a lounge chair and rested while we continued the slide show. When we were finished, we walked into the den where Kate was resting. Scott said something, and Kate said, “You’re a pretty nice guy, and I don’t even know who you are.”

Going out to eat gave the Greeleys another sign of her physical challenges. There was nothing dramatic, but she walked very slowly. She was unsure of herself as we entered the restaurant. She wanted to hold my hand most of the way to our table. Getting into and out of the booth she seemed like a person much older than she is.

I find moments like this to be sad ones. Because of their history together, Kate has always felt very close to Scott. It was sad that she couldn’t remember him. He and Jan gave her two photos taken when the two of them were in high school. I will put them in the three-ring binder that I call her memory book, although they didn’t prompt the enthusiasm that I would have liked. Kate has clearly reached a new stage.

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Visit With Friends

On Saturday, Kate and I visited Angie and Tom Robinson in Nashville. That followed my previous post about Kate’s difficulty with conversation. I think that put all of us on alert. Before we left, I had a brief phone conversation with them. I didn’t have any good suggestions except to keep in mind that she can talk about her feelings about things without remembering the actual facts. I also told them I didn’t have any special concerns and thought the visit would go well. That belief was based on the fact that we have a long history together. Our friendship goes back to undergraduate school. Even if she couldn’t remember their names or any of the facts about them, I thought her intuitive abilities would help her feel at ease. Having felt that way, I also told them I would step in if I felt there was a way that I could facilitate the conversation. As it turned out, the visit went well. The best indicator of that was Kate’s remark right after we got in the car. She said, “They’re a nice couple.” If she had felt otherwise, she would have said so.

We had a good time, but this visit was distinctly different from others. To me, it seemed like Kate exhibited more of her symptoms than before. When she said goodbye to Angie, she said, “It was nice to meet you.” Tom later told me in an email that she had told him “It was good to see you and, Oh, . . .” and then pointed to Angie. It was obvious Kate couldn’t remember Angie’s name. They also got to hear her snap at me one time. There were a number of other times that she hadn’t been able to follow or understand something that was said and had to ask us to repeat or explain.

One especially interesting thing happened. Kate picked up a book by Bishop Spong that was on the table in front of her. We have heard him speak at Chautauqua on at least four different occasions, but I doubt that she remembered him. I think she was caught by the book’s title, Unbelievable. She leafed through it and found a number of topics that intrigued her. Once she wanted me to read a portion of a chapter. I read a line or so. It was obvious that this was going to be too much for her (and for the rest of us as well). In a follow-up email, Tom took note of her interest. It’s the kind of thing one might assume is unlikely for a person with dementia. As I have noted in other posts, this represents an interesting intersection of rational and intuitive abilities. She no longer possesses the rational ability to understand many things, but she retains an intuitive feeling that intellectual things are important and/or interesting. She wants to know far more than she is able to grasp. That’s a sad thing, but she doesn’t seem to be disturbed. Once she realizes she can’t understand something, she lets it go. I am always glad to see that she retains her interest in intellectual and social issues.

One final note about our time with the Robinsons is that they did notice her physical deterioration. She has considerably more trouble getting up from a seated position as well as walking, especially when it comes to going up and down curbs or anything that she thinks is a high elevation. I have been increasing concerned about this myself. I attribute it to the fact that she is far more sedentary now than in the past. She doesn’t exercise at all, and we don’t go out as much as we did before. When we are at home, she spends all of her time resting, sitting while working on her iPad, or looking at family photo albums. At the rate she is going, she will soon be using a walker. I would like to postpone that and a wheelchair as long as possible. There is always something new that requires attention.

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The Challenges of Conversation

Kate has always been adept at handling conversations in ordinary social situations even though she is a bit introverted. Her mother was very gifted in the same way. In addition, she grew up in a large family, many of whom lived in the same town and went to the same church. Her life was filled with many experiences that enabled her to develop her conversational skills.

The skills she developed over the years served her well when Alzheimer’s entered the picture. She was able to get along quite well without feeling insecure or revealing her Alzheimer’s to other people. That has gradually changed over the years. She is now handicapped in three ways. First, the loss of memory deprives her of a significant amount of information that is useful in conversation. Think a moment. When you bump into a friend or acquaintance, you are usually able to call them by name or remember the connection you had with that person (someone you worked with, played bridge with, was a member of your same book club, etc.). You probably remember if that person is married, has children, has a particular interest, and many more bits of information. When Kate encounters someone, she has none of those things to go on.

The second deficit she has is that she has difficulty understanding the conversations in which she finds herself. That leaves her unable to follow up on something the other people have said. These days her participation is heavily oriented to questions that ask who or what is being talked about and asking for explanations of the content or specific words. Her vocabulary has decreased significantly. That has to add another measure of confusion.

Third, dementia makes it harder for a person to process information. It is never easy to understand what is said, but it is especially difficult given the normal speed with which people speak. While Kate is trying to process the first bit of information someone is saying, the other person is already on to the second, third, fourth, or fifth bit of information. It is simply overwhelming. In restaurants where Kate experiences most conversations, there are also many distractions that occur simultaneously. The noise level itself can present a problem understanding what others in your party are saying. Sometimes a serving tray overturns or the server comes to the table to take your order. All these things make it hard for Kate and others with dementia to process information.

I’m thinking of these things because Kate and I had dinner the other night with a couple we know from our music nights at Casa Bella. Apart from sitting with them at Casa Bella, we have eaten out with them at least six or eight times in the past eight months. Two of those times were overnight trips to Flat Rock, NC, where we had dinner and attended a show at the Playhouse. She cannot remember them at all. I’ve never seen any sign that she recognizes them – even intuitively.

That night we went to a new restaurant and had an excellent meal. The other couple and I are the talkers. The restaurant was very noisy, and we sat near a server’s station where they dropped dirty dishes on top of one another. Kate hardly spoke during the entire evening. I believe the only words she spoke were questions regarding the menu or for clarification about something that was said. We ordered a cheese and hors d’oeuvres platter. Her vision problem prevented her being able to identify some things. Kate and I shared a large platter of paella for our entrée. She liked it but said nothing about it. I worried about how she was getting along, but there was simply no way to make the situation much easier for her. When I asked how she enjoyed the evening after we left, she said it was a nice evening. By that time, I’m not sure she could even remember what it had been like.

That is just one of a few other similar occasions with friends. It is just one more marker on this journey. I am grateful that she has gotten along so well in the past, but I don’t like the direction in which we are moving. In addition, it feels like the changes are coming more quickly now.

This afternoon we are visiting our longtime friends Tom and Angie Robinson in Nashville. I will be eager to see how that goes.

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Our Weekend Trip to Nashville

Kate and I don’t travel much any more, but we did make an overnight trip to Nashville this past weekend. I have pretty much ruled out trips of anything more than a couple of days, so I’m glad to say that this one went well. We had a nice dinner at McCormick and Schmick’s after leaving the Davises. Kate turned in early while I watched the Texas Tech/Michigan State game.

When Kate woke up Sunday morning, she looked over at me at the desk where I was working on my laptop. I got up from my chair and walked toward her. She said, “Richard?” I said, “Yes, did you think I was someone else?” She said, “I was hoping it was you.” I said, “That must have been scary if you thought I might be someone else.” She said, “Not really scary, but . . .” She couldn’t think of the words to say what it was like, but she was definitely relieved to know it was me. This is just one more occasion when I try to imagine what it is like to wake up and not have any idea of where you are. Even though this happens to her at home, I feel sure there is a certain amount of comfort in being in “familiar” surroundings. Being in a hotel doesn’t offer that.

From there we went to brunch at Maggiano’s. When we checked in at the hostess stand, the managing partner was standing there. I don’t know what he said, but he and Kate got into a brief exchange in which each was kidding the other. I had a difficult time getting her away to follow the hostess to our table. It was one of those times that I pulled out one of my Alzheimer’s cards. Shortly after we were seated, the manager came to our table and thanked me. He said he had an aunt with dementia, and something Kate had said made him think she might as well.

Kate had brought a TCU magazine with her. He noticed that and said that he had worked in several restaurants in Texas. He and Kate connected once again. She enjoyed hearing him talk about her home state, especially since he had enjoyed his time there. Our server was very helpful with the menus that included both brunch and regular menu items. She was also very attentive. We were off to a good start. About mid-way through our meal, an assistant manager dropped by to check on us. We had a good conversation with her. When she left, she dropped a card for a free dessert. We took advantage of the offer and had an enormous piece of flowerless chocolate cake.

After eating, we were off to Ellen’s memory care facility. We had another good visit with her. We chatted for about an hour before turning to YouTube for music. This time we viewed segments from several Andre Rieu concerts. Once again, music played an important role in our visit. That is becoming more important as her ability to talk continues to decline though not too much since last time.

It was a successful trip. I will consider making Nashville an overnight trip in the future – at least as long as it works for Kate. Seeing friends in the afternoon, having a nice dinner that night, brunching at Maggiano’s, and visiting Ellen makes for a nice weekend.

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A Nice Visit with Longtime Friends

Several of our longtime friends live in Nashville, and we have visited all of them periodically for many years. During the past six to eight months, we haven’t done as well. We have continued to see our friend Ellen who is in memory care there, but I have not been good about arranging visits with the others. I miss seeing them and need to make a serious effort to see them more during the rest of the year.

As a first start, I arranged for us to see Ann and Jeff Davis in connection with our regular visit to see Ellen. Because Kate has often slept so late, we have been getting to Nashville late in the day to see her. That puts us back in Knoxville later than I like. This time I decided to visit the Davises in the afternoon and stay overnight at a hotel. That way Kate can sleep late, and we will be able to see her earlier. So far that is working well.

Even though she can’t remember, I always tell Kate where we are going and who we will see. I did that the day before we left, the morning we left, and even in the car on the way. When we parked at their house, I said, “This is the Ann and Jeff Davis’s new house. She said, “Who are they again?” I explained a little about our history together and told her that she and Ann had been very close when they lived in Knoxville. She surprised me when she said, “She and I used to talk a lot about our daughters.” That was the first time in recent memory that I can remember her recalling something like that. She didn’t say anything more specific, but I remember they talked about their daughters who are the same age and attended the same schools during middle school and high school.

In advance of our visit, Ann and I had several email communications. She had asked advice about engaging in conversation with Kate. I gave her a few suggestions and explained how well she has been able to get along and that I expected it would be the same on this visit. We got off to a good start when Kate noticed the flowers planted around their house. Ann and Jeff had seen us coming up the walk and came out to greet us. Ann and Kate had a few minutes to connect as they talked about the flowers and trees at the back of the house.

As we walked inside, we took a tour of their new home. It wasn’t planned at all, but we divided up so that Ann took Kate and Jeff took me. I think that made for a good beginning. I believe that gave Kate a chance to reconnect with Ann before the four of us sat down to visit. Kate took great interest in their home. For the next two hours we sat on their sun porch and talked.

Some of the conversation was between Ann and Kate and some between Jeff and me. For the most part, however, it was the four of us. Kate was not especially talkative, but she was comfortable and participated without any problem. As in other conversations, Kate said things that are not correct. For example, Ann asked if we used our pool very much. Kate told her that she used it more than I. The truth is that neither of us has used in much in recent years and that I am the one who occasionally takes a swim. In fact, I have recently suggested that we use it more this summer. Each time I’ve mentioned it, she has balked. I don’t mean to suggest that Kate wasn’t telling the truth. She just can’t remember. In conversation, her imagination takes over.

We could have talked much longer, but I felt it was time for us to check into our hotel and have dinner. As soon as we closed the doors to our car, Kate said, “I like them.” Once again, I thought about Kate’s intuitive abilities. Kate and Ann had been very close friends. Kate can’t remember that, at least not very well, but her feelings for Ann were rekindled just by being together. I don’t think it relates to something special that Ann said to her. I think there was something Kate was able to pick up intuitively that made the difference. Once again, I am struck by the power of her intuitive thought. It has carried us a long way.

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Social Engagement and Music

I have often expressed how fortunate Kate and I have been. We’ve not had to face some of the problems that others encounter. Social isolation is often a problem for couples living with Alzheimer’s. That has not been an issue for us. It is true that we don’t attend many events that keep us out past 9:00, but in other respects we still get around. I’ll never know if that has played a role in Kate’s doing so well. I do know it has helped us maintain the quality of our lives.

Wednesday night we had dinner with friends we originally met at Broadway night at Casa Bella. We’ve gotten together with them for dinner a number of times in recent months. Kate and I have enjoyed their company. We always have a good time.

Yesterday we had lunch with a church friend. He and Kate became friends when she was the church librarian. His wife died about four years ago. She had Alzheimer’s, and he has been very sensitive about our situation. He stays in touch by phone, but this was our first time to have a meal together. We talked about our getting together again and look forward to that.

It was Opera Night at Casa Bella last night, and we had an especially good time. A new couple joined our table, both church friends. The husband is a professor of voice at UT. The two singers were students of his, both working on their PhDs. There were a number of ties that made it an interesting evening. Our church friends also knew the couple we sit with. For many years, they had been neighbors. The music was also outstanding. Kate and I first heard the male singer when he was an undergraduate four or five years ago. It was amazing to see how much he has improved since that time. The soprano was someone we remembered having sung in our church choir several years ago.

I was pleased to see Kate insert herself into the conversation, but I felt she was just on the edge of doing it inappropriately. We had an active conversation. That can be difficult for her. She handled it well. We have come to know (at least recognize) many of the people who attend. As the crowd gathers, people “greet and meet” those already there. Some of them are aware of Kate’s Alzheimer’s and are especially attentive to her. I like that because large groups are challenging for her.

As we left, Kate was on a high. She loved every minute. As we talked about the evening on our drive home, she expressed how much she enjoyed herself. She said, “I’m so glad we enjoy the same things. It wouldn’t have been as much fun without you.” I told her I felt the same way. She mentioned how much we have in common and that we were “on the same wave length.” Then she said, “And what’s your name?” I told her. There was a pause in our conversation for a few minutes. Then she said, “I’m glad we came.” I knew immediately that she thought we were in Texas. I said, “Me too.”

When I turned into the driveway at our house, she said, “I like the place where we’re staying.” After we pulled into the garage, she commented on what a nice garage it was. Once inside, she needed me to guide her to our bedroom and bathroom, but I didn’t hear anything more that suggested she thought we were in Texas. That is becoming more common these days.

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Our Trip to Nashville to See Ellen

Yesterday we paid a visit to see Ellen Seacrest, one of our longtime friends who lives in a memory care facility in Nashville. It is now three and a half years since she had stroke. It affected her mobility and her speech. For a while the speech improved, but it has been much worse since having a couple of seizures a year ago. During our last two visits we could only understand about 25% of what she said. Yesterday it was even less. For the first time, that may have had an impact on Kate’s response to her.

We met in the activities room. Kate noticed some jigsaw puzzles on a shelf and brought one to the table where we were sitting. She never opened it, but she never seemed as engaged in the conversation as she had been in the past. It also seemed like Ellen directed more of her comments to me. That could have made Kate feel less involved. On our next trip, I think I will make more of an effort to excuse myself for a few minutes and let them have some private time. I am sure Kate would take more initiative if I were not in the room.

After we were there about an hour, I brought out my iPad. Ellen was enthusiastic about viewing musical performances as we have done for the past eight months or so. Apart from her career as an ETV producer, Ellen directed her church choir for almost forty years. I selected videos of the Wartburg College Choir in Lincoln, Nebraska, thinking that might be of special interest. I was right. She loved it. What’s more, Kate did as well. They were seated side-by-side with eyes fixed on the iPad. It was hard for Ellen to express her feelings except by the expression on her face, but she did convey that she liked the pageantry of some of the videos. Several of them featured the choir’s entry as they marched down the center aisle to the choir loft. Several of the pieces were accompanied by a small orchestra. I don’t think she has been to church since her stroke, so it was an especially meaningful experience for her. I am glad we got to share it with her.

After we left, we went to dinner. I was reminded of how closely I need to watch Kate when we are out. We were seated near the restrooms, but I always walk her to the door and often open it for her. Then I wait near the door for her to come out. As usual, it took quite a while for her to finish. I noticed others who had entered and come out. I went to the door and pushed it open enough to see Kate was standing at a sink washing her hands. A woman and her daughter were at the sink beside her. I closed the door assuming she would be out shortly. The mother and daughter came out, but Kate didn’t. I went back to the door. This time I knocked and slowly opened it. Kate was walking to the door. I don’t know what happened, but she apparently didn’t remember where the door was. She thanked me and showed no sign that anything had happened. It reminded me of times when I have lost and found her. She was very calm.

When we got to our table, I showed her where she had been sitting. That seems a simple thing, but she never knows where to sit. She often doesn’t understand when I show her. As she started to sit down, she said, “Where is my husband?” I said, “Right here.” She looked at me and realized she hadn’t known I was the one ushering her from the bathroom to her seat.

After dinner, I was leading her to the exit when I got too far ahead. I looked back. She was about fifteen feet behind and looking for me. I walked back and led her out. She looked at me and said, “Where is my husband?” I looked at her, and she realized again that I was the one holding hand to the car.

In both of these instances, I was struck by two things. First, was the fact that she said “my husband.” She is far from completely forgetting that. It is simiar with my name. She still occasionally calls me Richard when she needs something. Most of the time she just says, “Hey.” (That reminds me that the sitter told me that on Friday, Kate asked, “Where is my daddy?”) Second, these were clear instances of a problem with her sight that relates to her Alzheimer’s and not to her cataract. We know that she can now see out of both eyes. When she misses things, it can’t be a problem with vision.

I sense that we are going through another transition when she wakes up. I’ve previously noted that she is often confused, but the past few days she has seemed more confused than usual. She hasn’t remembered my name or relationship. It is not unusual for her not to know that she is at home, but that has been more puzzling to her when I tell her. It’s like she is in a deeper fog than usual.

I am settling into telling her I am her husband if she asks about our relationship, but I am not intending to dispute her if she thinks I am her daddy. I just don’t want to create any unnecessary problems for her. She is still alert enough to recognize that she should know she is in her own house and that I am her husband. Sometimes it can be difficult to know exactly what to say.