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Expecting a Good Day

Good morning. It’s a beautiful morning here. I hope it’s the same wherever you are. I slept a little later this morning (6:00) but still got in a morning walk. While walking I finished listening to Bradbury’s Dandelion Wine. It’s been around a good while, but I had never read it. My friends Tom Robinson and Bruce Morton had recommended it to me. Great recommendation. One of the best books I’ve read in a while. The balance of the walk I started Hemingway’s The Sun Also Rises. I thought this was one I had read as an early adult, but I don’t remember a thing. I Know that I read a couple of his books long ago and liked them.

We had a good experience with the sitter yesterday. On Monday, Kate seemed less enthusiastic about her time with Anita. Most of the time I don’t tell Kate I am going to be going out until just before the sitter arrives. Yesterday I told her at lunch. It didn’t appear to bother her at all. About fifteen minutes before Mary arrived, I told her again that I would be going to the Y and that Mary would be with her. Once again, she seemed fine with that. She expressed no reservations at all. When Mary arrived, Kate greeted her as warmly as ever.

When I got home, they were both sitting in the family room. They had been to Panera though Mary said they didn’t stay long. She said that Kate wanted to come back home to see if I had come home. Although that may have been a sign of wanting to see me, it did not appear that Kate had been disturbed at all that I had been gone. After Mary left, Kate commented on how nice she is and what a good driver she is. Now I am eager to see what happens with Anita on Monday.

Over the past ten days we have had an unusual amount of time with old friends. Kate and I have enjoyed that. Today is bound to be another good one. The Greeleys from Nashville are coming in for the afternoon. They’ll be here for lunch.

The couples we’ve seen recently led me to think about our very closest friends. There are five couples. We have known them for more than fifty years. (Scott Greeley, who will be here today, and Kate have known each other since infancy. I know there must be others, but that’s the longest-lasting friendship among any of the people I know.) Each couple has been married over fifty years. All of the men have been college profs though two of us found a home in the business world. We come from very similar religious backgrounds and we share similar religious and political views. All of these ties make for very special times when we are together. Today will be another good day.

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Another Good Visit with Friends

Tuesday, Kate and I drove to Nashville for a visit with our long-time friends Ann and Jeff Davis. We have had an unusual amount of social contact in the past week. Both of us have enjoyed being with close friends. I wasn’t surprised that this visit was also a good one. Kate was very actively engaged in conversation. That was mostly when she and Ann were talking to each other. It is much harder for her to participate in a conversation with all of us. I suspect part of that is not being able to easily follow what is being said. I also think it’s because we quickly move from one person to another. I know this requires a lot on her part. Despite that, she held her own and enjoyed herself.

Although Kate can carry on a conversation, her memory loss means that she no longer retains many bits of useful information. For example, she loved and admired her mother and talks a lot about her. With her memory loss, she has forgotten most of the specific things about her mother, but retains her feelings and impression of her. Thus, she communicates what a special person her mother was, but the examples she uses are often inaccurate. Of course, these are things that the typical listener would not catch, but I do. This makes me think of fiction writers who have created characters and situations in which they are placed. The facts may be fiction, but they often tell a truth about life. Kate is doing something similar with people and places. It doesn’t tarnish my own satisfaction that she is able to function in a very normal way.

As we drove away, I commented on what a good visit we had. Kate agreed. Then she said, “What is her name again?” I told her, and she said, “And his name?” I told her, and she asked, “Where are we?”

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Our Day in Nashville: Part 2, Visiting with Ellen, Kate’s Best Friend

After lunch, we drove to the other side of Nashville to visit Ellen. Three years ago in August, she had a stroke while visiting her daughter who lives in Nashville. We had been with her the night before when she told us that she had finally decided to stay in her home in Knoxville rather than move elsewhere. She had been considering a move for several months. She was in the hospital a while and then in rehab. As soon as her daughter said, we could visit, we went to see her. Since then, we have tried to visit about once a month. Two times she has had other issues to deal with. Those kept us away as long as a couple of months, but we are back on schedule now.

As usual, we had a good visit despite the fact that Ellen has never fully recovered her speech after the stroke. She made progress for a while. Since the first six months to a year, there has been no change. We can only understand 30-40% of what she says. She understands us perfectly which helps. We can ask yes no questions. Then she can nod to indicate if our guesses are on target. That’s a slow process.

This is the second memory care unit she has been in. The first was a unit of her assisted living facility. This facility is totally dedicated to memory care.
For the past few years, I have been sensitive about taking Kate to anyplace that offers memory care. My concern was that she might find this depressing knowing that one day she will be in the same condition as the current residents. There are at least 3 people I have known in memory care that I haven’t visited just for this reason. I have made the visits to Ellen with some reservation but decided to go anyway. I see absolutely no sign that Kate is bothered. As with everything else directly related to Alzheimer’s, I have not discussed this with her.

We were there almost two hours. The first hour we sat with Ellen at the table where she was to have dinner. When they set up for dinner, we decided to stay so that we could spend more time with Ellen. As it turned out, this didn’t work very well. There were three other residents at Ellen’s table. Only one of them, Wally, was verbal, and she was quite a talker. She is 90 and showed signs of dementia but was very communicative. At one point when Ellen picked up her chicken cordon bleu with her hand, Wally told her to put the chicken down and pick it up with a fork. Ellen gave her a dirty look and said something that led me to believe this is not the first time she has said something like this. For the balance of the meal, Wally dominated the conversation. It completely shifted the focus away from Ellen.

While this was going on, Kate tried to engage the other two residents in conversation without any success. One of them does not speak at all. The other has limited speech. Although Kate was actively trying to interact with them, she did not appear to be bothered. If it did, I am sure that she forgot it almost immediately.

I will continue going back on our once a month schedule. The next time I will make sure that we arrive earlier so that we leave before they eat dinner at 4:30. That’s what we have done on previous occasions. That has worked out.

I want to add that Kate still remembers Ellen although she often doesn’t recognize the name when I mention it. One thing she remembers is that the two of them used to go out for lunch every Monday when I was at Rotary. Kate brought that up several times over the course of yesterday’s visit. I’m not sure what else she remembers. I know she doesn’t remember the names of Ellen’s husband or her children. I believe the regular visits we have made help maintain some of her memory for Ellen. It will be interesting to see how well the visits go as her condition and Ellen’s progress.

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Our Day in Nashville: Part 1, Lunch with the Robinsons

Yesterday we made a day trip to Nashville to visit friends. We had lunch with the Robinsons. Our friendship goes back to TCU, and we have visited back and forth between Knoxville and Nashville for almost 47 years. Our children were very young, and we carted the various paraphernalia likes cribs, diapers, and snacks for an overnight stay. As we have aged, we’ve made the trips much simpler. We have lunch out and then go back to the house for conversation before going back home for dinner. Yesterday’s visit was simpler than that. We met the Robinsons for lunch and dessert and then went on to visit Kate’s best friend, Ellen, who now lives in a memory care facility.

Given Kate’s recent changes, I feel it especially important for us to be with old friends as much as possible. I was especially pleased that our visit with Tom and Angie went so well. In an email this morning, Tom said they thought Kate was pretty much the same as she has been during other recent visits. I agreed with him. She was an active participant in our conversation as she was at lunch with the Greens the other day. I continue to be encouraged at how well Kate does in these kind of social situations. I am hopeful this ability will remain with her for a good while.

The Robinsons were already there when we walked into the restaurant. Kate hadn’t remembered we were meeting them and said, “What a nice surprise.” Of course, I should have reminded her as we walked into the restaurant. This is one of those times I had talked about it a number of times including in the car. It just slipped my mind to remind her just before we saw them. It’s a good illustration of the fact that I can often treat her as though she can remember. She is so normal in other respects that I just forget.

I received an email this morning from my former TCU roommate, Bruce Morton. He and Tom and I send multiple emails to one another daily. He asked if Kate remembered the Robinsons. I told him that is a good question and that it involved what it means to know someone. There is no question that she has trouble remembering their names. Even after spending almost two hours with them yesterday, she asked me their names when we got in the car to leave. She had done the same thing on the drive to Nashville.

She greeted them exactly the same way she would have done in years past. I am sure, however, that she would not have been able to remember our past visits together, that they have children, where they live, etc. She recognized them as people that she has known before. It’s an emotional connection that remains even though all of the names and facts associated with our relationship have faded away. It is something that I did not understand when she was first diagnosed nor quite a while after that. I am glad to have discovered this. It has extended our ability to get together with friends much longer than I would have predicted 7 ½ years ago.

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A Good First Day of Travel

Except for a delay because of construction on the way to see Kate’s friend, Ellen, everything went well today. Ellen is in a very nice memory facility, not just a section of a skilled nursing facility. Memory care is all they do. She was about the same as last time. Her mind seems clear. By that, I mean that she seems to understand us without any problem. Her speech is the big problem. I recognize, of course, that she wouldn’t be in a memory care facility if she did not have vascular dementia.

I have some trepidation about taking Kate to a place like this and deliberately avoid doing so except for our visits to Ellen. Most of the residents appear to be much further along than Ellen or Kate, but Kate doesn’t seem to notice at all. She doesn’t say anything nor does she evidence any sign that she is in a memory care facility.

Tonight we had a great dinner at McCormick and Schmick’s. Our server was fantastic. Knoxville is a college town, so we are accustomed to having students as servers. They do a good job, but it is striking when you run into one like we had tonight. She’s a real professional.

I have commented a lot lately about how cheerful and agreeable Kate has been. There is one other characteristic that I should also mention. She is appreciative of my help. That has been true for the entire time I have been caring for her. Lately, however, it seems less perfunctory. It’s not just saying “Thank you” or “You do so much for me.” Tonight, for example, as we were finishing our meal, I commented on how good the meal was. She said, “I don’t want your head to swell, but I always have happy times with you.” Then she said, “I always like being with you. I really mean that.” I told her it meant a lot to me that she said that, and it really did.

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Our Lunch with Longtime Friends

We had lunch with Dorothy and Mitch Hinely at Casa Bella today. Our friendship with Dorothy goes back to the early 1970s when we were members of a local Unitarian Fellowship. Our daughters met at that time and are still best friends. She and Mitch married several years ago and quickly became a valued addition to this longstanding relationship.

Prior to going, I told Kate we would be joining them for lunch. She couldn’t remember them. I told her their names and something about them. That didn’t help. Even when I mentioned the friendship of our daughters, she didn’t seem to know who I was talking about. That changed the moment she saw them. In fact, Dorothy stooped down to Kate’s chair, and Kate said enthusiasm, “No, I’ve got to stand up and give you a hug.” This reminds me of my earlier post that asked, “What does it mean to know someone?” Kate clearly knew her in some way even if recalling her name and other things about our friendship were drifting away.

The conversation flowed easily. I am sure we could have taken much longer to catch up on our respective lives and to reminisce together, but it was time to go. I worried about Kate since Dorothy and I tended to dominate the conversation with a little help from Mitch. It’s hard for Kate to keep up, and I am sure she couldn’t follow everything we talked about. The moment we got in the car she told me how much she had enjoyed the lunch and how smoothly the conversation had gone. I was happy about that. It shows that she felt a part of the group even though her speaking time was decidedly less than that of the rest of us.

I took special note of the fact that she then asked me the name of the restaurant where we had eaten. This surprised me since we have been coming to Casa Bella since 1971. When they added their musical evenings, we started coming three or four times a month. We were there just last Thursday evening and will be there this Thursday. It is a place we have eaten to celebrate good times and to console ourselves when things were not so good. I remember a couple of years ago when she forgot our favorite dessert. Now the restaurant’s name is slipping away as well.

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Off on a Short Trip

We left this morning for a visit with our daughter and her family for a few days. I am glad that it comes right now as she is having more difficulty remembering their names. I know it won’t last, but I want her to remember them as long as possible.

I am making this a leisurely trip. We stopped after lunch for a visit with Kate’s good friend, Ellen, in Nashville. Today was her last day at the rehab center. Tomorrow she moves into a new assisted living facility. It was a very good visit. She has improved physically since our last visit a month ago. Her speech is still a problem. I don’t know how much of that is a direct result of her stroke and how much it is now the vascular dementia that is creating the problem. At any rate, it is quite difficult to understand her. Given our long-standing relationship, we will continue to visit her on a monthly basis for as long as we are able to do so. Ellen’s condition and Kate’s are the determining factors in that.

After leaving Ellen, we drove to a B&B outside of town where we are spending the night. We are the only guests tonight and have enjoyed our time with the inn keepers. We asked them to recommend a place for dinner and ending up asking them to join us.

The travel itself went well. I am glad that I have broken up the trip. Since we don’t talk much while we are driving and Kate doesn’t like to work on her iPad because of the occasional bumps in the road, I worry that she must be very bored. She doesn’t say or do anything that suggests that. I just know that under the same conditions, I would be bored.

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Kevin’s Visit: Day 4

Kate and I have enjoyed each day Kevin has been with us. Yesterday was an especially good day. It is interesting that music played a role in making this a day to remember, but it wasn’t just any music. It was music played by Kevin and his former piano teacher, Marian Covington. On two of his previous visits, we have paid a visit to see her. She will be 90 in June and still plays beautifully. She made her debut in Carnegie Hall when she was around 19 and has spent her entire adult life teaching piano. She has always been especially fond of Kevin who was one of her star pupils for many years.

During his college days at TCU, he focused more on the organ than piano and has served as organist and interim organist at several churches over the years. With the growth of his family and his involvement with his career, he has played much less. Marian has encouraged him to practice so that they he might play for her on another visit. This time he had worked on Debussy’s “Clair de Lune.” He played it for her and then invited her to play it. She took the opportunity to give him another piano lesson.

The music they played was beautiful. Kate loved it. So did I, and we were both touched to watch the two of them talk about the pieces. They were two people sharing a common bond with the music of the piano. Kate kept commenting on the way in which Marian spoke to Kevin. It wasn’t just that of a teacher speaking to a student. It was more like one colleague discussing music with another colleague. Another comparison would be that of a private master class with a mentor and her protégé. Kate was so proud of Kevin and the way he has grown. As I sometimes say, Kate is not moved by as many things these days. When something like this happens, I am moved to see her so engaged. It was a wonderful afternoon.

Though clearly the highlight of our day, there were other good experiences. We had lunch at our church with the seniors group. Today, a retired rabbi spoke to us about Jerusalem focusing on archeological findings. We had met him some years before at the home of our friends, Ellen and Gordon Seacrest. We had a good conversation with him before his presentation. Coincidentally, we also saw him at dinner this evening and got to see his wife.

Kate handled herself well again with this group. In particular, she participated actively in our conversation with the rabbi and with a former Methodist minister who are friends of ours. She was just as natural as she could be. No one who didn’t already know about her diagnosis would have ever guessed.

This visit Kevin has been able to observe some of Kate’s symptoms that I have told him about. That includes his missing clothes as well as a number of other little things. He also saw her express some irritation with me and her growing openness about not remembering things. As we left a conversation with our friend, the former Methodist minister, she said with a little frustration, “I don’t know why I can’t remember his name.” I sloughed it off in the same way that many others do. I said, “Remembering names can be hard. Everyone has trouble.” At this point, I don’t see any good reason to remind her that she has Alzheimer’s and that it will only get worse.” At dinner, she asked me to stop talking and give her a simple explanation of something I was telling her. Just as important, he has been able to see how well she can function despite the many symptoms of her disease.

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A Special Moment with a Dear Friend

Sometimes I wish I were a gifted writer. Now is one of those times. Bear with me as I try to explain why.

Kate and I have lots of good days, but yesterday was a day I would like to remember exactly as it happened. We got off to a good start. Kate was in a very good mood. She got up early enough that we could make our morning pilgrimage to Panera and then to lunch without having to rush. That worked out perfectly because I had arranged a trip to Nashville to see Ellen Seacrest, her closest long-term friend. She lived in Knoxville until suffering a stroke two and a half years ago. Since then she has spent time in rehab and two different assisted living facilities in Nashville. Following two seizures, she went back to assisted living but in the memory care section.

We have known Ellen and her husband, Gordon, since the early 70s when we lived in the same neighborhood in Knoxville. Our children grew up together and attended the same schools from pre-school through high school. We celebrated many special occasions with them including many New Year’s Eves. After Gordon’s death in 2013, Kate and Ellen spent much more time together. They lunched together. They shopped together. Ellen was unquestionably Kate’s closest friend. To this day, Ellen is the only person one than her brother, Ken, that Kate has told about her diagnosis.

When Ellen had a stroke in August 2015, Kate’s life changed dramatically. That left her with no close friends in Knoxville. I have not only played the role of husband but best friend as well, but it’s never really been the same. For a few months after Ellen’s stroke, we were unable to visit her but kept in touch through her daughter who lives in Nashville. As soon as she gave the word that Ellen was up for a visit, we went to see her. Since that time, I have tried to arrange a visit once a month. I wanted the two of them to maintain their relationship as well as they could.

While in Knoxville, Ellen was well-known in many circles. She is a musician who was employed by ETV as a program director and later TV producer. Her first program was a musical program for children. Many children grew up knowing her as the “Music Lady.” She was also a producer of many other ETV programs that did not involve music at all. Simultaneously, she was a very active member of her church and had directed the choir for almost 40 years before retiring a few years ago. She loved to entertain her friends, co-workers, and those she knew at church.

Try to imagine the impact of her having a stroke in Nashville and never returning home again. She was immediately removed from a host of people who could have been of great support to her during a very difficult time. The distance between Knoxville and Nashville as well as the ages of her best friends made it difficult for people to visit her. Besides us, I know of only one person and a couple who have visited her since she has been there. The visits of the others occurred only once. Ellen made a good recovery; however, her speech never returned to normal. That makes it challenging to carry on a conversation with her. That, too, may have discouraged others from seeing her.

We had the flu in late January. When we had fully recovered, I contacted Ellen’s daughter about our coming to see her. That is when we learned that Ellen had fallen breaking her hip, shoulder and elbow. Yesterday’s visit was our first in about seven weeks. She is still in rehab at a new place that is closer to her daughter who has been a devoted caregiver for her mother. She does this while holding down a challenging job with Bank of America and fulfilling her responsibilities as a single parent of two teenagers.

So we have two very close friends each of whom has experienced life-changing health issues, separated by geographical distance, and who haven’t seen each other since Ellen’s traumatic experience with her fall. Now they see each other for the first time in weeks.

I know Ellen’s daughter must have told her we were coming, but the look on her face suggested that she was floored that we had come to see her. Kate took her hand. They both had a teary moment as each expressed her pleasure in seeing the other. The sight of this reunion and what it meant to each of them caused my eyes to well up with tears as well.

About mid-way into our visit, I mentioned something about our not having attended the music club for a while. Ellen and Gordon had sponsored our membership years earlier. Then I told her about our having recently seen Tosca and La Boheme. That reminded me of Kate’s experience with music I had played for her this past week. I keep all my CDs on my phone and pulled it out of my pocket and played “Danny Boy”. That had been a special favorite of Ellen’s. When her son was about 10, he sang it at a piano recital at which he also played the piano. Once again, Kate’s eyes watered as did Ellen’s. I was teary myself. When it was over, I played “Shenandoah,” and “Swing Low Sweet Chariot.” We listened quietly as the music played. All of these are beautiful arrangements on an album by the Susquehanna Chorale. I knew they would be special for Ellen after her career in choral music. It was equally special for Kate. We will be back for other visits, but I suspect I will remember this particular for along time to come.

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Two Surprises Yesterday. One for Me, and One for Kate

Yesterday was another good one for Kate and me. She was up a little earlier than usual, and we spent almost two hours at Panera before having our customary lunch at Bluefish Grill. After lunch, I asked her if she would like to go directly home or stop by Barnes & Noble. I was pleasantly surprised when she said she wanted to go home. I say that because she hasn’t wanted to spend much time at home recently. It turned out that she was tired and wanted to rest a while.

After resting for almost two hours, she told me she was going outside to “pull leaves.” Again, I was surprised and very pleased. It has been weeks since she has worked outside. That is something that used to occupy most of her time during the day. More recently, the winter weather, our having the flu, and the fact that there are barely any remaining leaves on our shrubs has kept her inside. That hasn’t last long before she was ready to get out to Panera or Barnes & Noble. I had begun to wonder if, not when, she would pick up her yard work again. She was outside for a full hour before coming in. She was happy. As I have said before, working in the yard is her therapy.

The second surprise, this one for Kate, came next. She received a phone call from Meg Wright, a very close personal friend from Texas. She and I had exchanged emails a couple of days before to work out a good time for a call. When I mentioned to Kate that Meg was calling, she immediately recognized the name but asked, “Where do I know her from?” I told her they were old friends from Fort Worth and that she had been one of her bridesmaids in our wedding. She remembered that. I also conveyed to Meg that Kate would be weak on remembering any details of their past as she is with our children and grandchildren. I suggested that Meg might mention some of the old memories and that would help her remember.

As I expected, the phone call went very well. It wasn’t a long call, perhaps twenty minutes, but the impact was as great as if it had been an hour. By last night, I am sure she had forgotten all about the call, but it had been a moment of pleasure with a very dear friend from her past. Once again, she had had a very good day, and so had I.