Conversation

One of the things I have heard from other spouse caregivers is how much they miss the kind of conversations they used to have. That is something with which I can easily relate. If you are a regular visitor to this site, you have heard me talk about how well Kate and I get along. That is possible because we have let go of the things she can’t do and focused on what she can. That has enabled us to enjoy many things together – travel, music, theater, and social engagement with friends, family, and even strangers. I never imagined that we would be able to get along this well so far into our journey.

Having said that, our story wouldn’t be complete if I didn’t recognize the impact that Kate’s Alzheimer’s has had on conversations between us and her conversations with others. There is much in life we can enjoy without depending on our rational thought processes, but much of ordinary conversation depends on memory of people, names, and events. We tell others about a book we are reading, or the movie we saw yesterday, the meal we had last night, what our children and grandchildren are doing. As Kate has lost her memory, she has significantly less that she can talk about. There is little content left.

Another consequence of her memory loss is not understanding what has been said. She often stops me and asks me to repeat what I have said. This is something that has become a greater problem recently. It is as though her brain’s processing has slowed down and the conversation is so rapid she can’t understand. Several times recently when we have been with a group, she has jumped in to say something like, “Wait, stop! Who are we talking about?” I have been pleased that she speaks up in this way. It shows she hasn’t dropped out of the conversation. That is her typical way of responding.

When it is just the two of us, she asks me to repeat a significant portion of what I say. Most of the time, it is because I am giving her information too quickly. She also misunderstands certain words. Sometimes I have to repeat a word several times before she gets it. She may have a build up of wax in her ears. She experiences that from time to time, but I don’t recall its affecting her hearing. I need to check this out.

It is especially easy for her to get lost in a group, even when we are with just one other couple. When we are at a table of six or eight for one of Casa Bella’s music nights, she simply withdraws. We have an hour for dinner and conversation followed by an hour and a half of music. In that case, the music saves the day.

Kate’s most successful conversations have been one on one. I can think of three of those that have occurred over the past year. One of those occurred with our friends, Ann and Jeff Davis. We were in their home when the conversation drifted into one between Jeff and me and another between Ann and Kate. It continued for quite a while. I recall overhearing Kate say a few things that were not accurate. When she can’t remember things, she fills in with something else. Otherwise, Kate appeared like a person without Alzheimer’s.

Another was a few months ago when she received a visit from a church friend. I left the two of them in the family room while I did a few things in the kitchen. I was amazed at the flow of conversation. It was a perfectly normal conversation between two friends. The most recent was two weeks ago today when our housekeeper was here. When we returned from lunch, she and the housekeeper sat down and talked for about thirty minutes. In all three of these conversations, Kate was an active participant. I loved hearing her speak so comfortably.

Earlier this week, we ran into a couple we have met at Barnes & Noble. They asked us to join them at their table. We spent about an hour in conversation. I was surprised at how active Kate was although she did not appear as natural. I had told the couple about Kate’s Alzheimer’s on a previous occasion, so I suspect they appropriately attributed her behavior to her illness. Instead of pulling back in the conversation, she gently worked her way into it. The problem was that she kept talking about her mother and interjecting her comments in the middle of what others were saying. Her comments were totally out of context. It appeared that she wanted to participate but couldn’t judge the appropriate timing and didn’t know what to say except to talk about her mother. As with other things, she doesn’t remember a lot of specifics about her mother. Thus, all her comments are expressions of how thoughtful and kind her mother was. She often says, “She liked to help people.” She repeated essentially the same things several times.

There is something else that happens when she speaks. This is new within the past six months or so. She can’t think of the words she wants to say. Sometimes she mispronounces a word incorrectly in a way that I don’t understand. When it is just the two of us, she often says, “Well, you know what I mean.” Most of the time, I don’t.

Overall, the nature of our conversation has radically changed. We talk less. When we talk, we express our feelings about life, our family, and things we have done together. I often tell her about specific things that I know she can’t remember. I do have a concern that when I tell her things it also serves as a reminder that she can’t remember. So far, she seems to like this, especially when I tell her about our children and grandchildren as well as her parents and grandparents. What I like best about our conversations is that they always focus on good things. I think that is good for both of us.

Confused Upon Waking

Adapting to Kate’s sleeping later may be getting more complicated. Yesterday, she was up early. That worked well because she and I had a 1:30 appointment to have our picture taken in connection with the foundation on whose board I served for nine years. Not having to wake her made it less stressful getting her ready so that we could have lunch before then.

Today, however, she slept late again, and it is a day for the sitter. I turned on some music at 10:15. Then at 10:45, I tried to wake her. She wanted to sleep a little longer. At 11:30, I tried again. I sat down beside her on the bed and put my hand on her shoulder. She opened her eyes and looked at me. She looked confused and asked, “Who are you?” When I told her my name and that I am her husband, she looked shocked. Here is my best effort to describe the conversation we had over the next twenty minutes or so.

RICHARD:              “Yes, I am your husband, Richard, and we have been married for 55 years.”

KATE:                       “What is your name?”

RICHARD:              “Richard Lee Creighton.”

KATE:                       “Say it slower.”

RICHARD:              “Richard <pause> Lee <pause> Creighton.”

KATE:                       “What is my name?”

RICHARD:              “Kate Franklin Creighton.”

KATE:                       “Say it again.”

RICHARD:              “Kate Franklin Creighton.”

KATE:                       “Let me say it. . . Kate . . . Wait a minute; say it again slowly.”

RICHARD:               “Kate <pause> Franklin <pause> Creighton.”

KATE:                       “Kate Franklin Creighton.”

RICHARD:              “Yes, and we have two children.”

KATE:                       “We do? <pause> What are their names?

RICHARD:              “Jesse Brewer and Kevin Creighton.”

KATE:                        “What is your name?”

RICHARD:               “Richard Lee Creighton, and I am your husband.”

KATE:                        “You are?” (with a look of disbelief)

RICHARD:              “It seems like you feel comfortable with me even though you don’t recognize me as your husband.”

KATE:                       “Yes.”

RICHARD:              “That’s probably because we have been together so long. We have been very happy together.”

KATE:                       “We have?” (with her first smile of the conversation)

RICHARD:              “Yes. I think we are a perfect match (she smiled with approval), and we have two children that we are very proud of.”

KATE:                       “We do? Why can’t I remember that?”

RICHARD:             “Well, sometimes our memory fades as we get older.”

KATE:                      “I don’t believe you, but it’s nice of you to say that.” (She is still perceptive.)

RICHARD:            “I love you, and I’d like to take you to lunch.”

KATE:                     “Where are my clothes?”

RICHARD:           “They’re right here on the chair.”

Then I helped her get up. When she was dressed, she said she wanted to go to the  bathroom. She said, ‘Where is it?” There was more than I have quoted above, but I think this captures the essence of the conversation. There was a good bit of repetition, both in her questions and my answers.

From this point on she did not appear to be confused though she was still unable to remember that we have children. That has been common for weeks, perhaps months, now.

Music and Time with Friends

After returning from the museum yesterday, I decided to make dinner reservations at Casa Bella. I knew it was one of their Broadway nights and that they were having another performance of the music from Les Miserables. We had already seen it once, so I wanted to see if we could eat in the front room that is separated from the music. To my surprise, they told me that I had reservations for four people in the room with the music. At first, I started to decline. Then I thought it might be fun to go and take someone with us. We’d been to dinner with Angela and Marvin Green a couple of weeks ago and have talked with them about the music nights at Casa Bella several times. I called, and they were able to go with us.

Kate and I had a wonderful time. Both the conversation and music were “as good as it gets.” It was a lively audience. That meant it was noisier before the music started. That didn’t prevent our own lively conversation. I do think it was harder for Kate to understand what was being said, but she enjoyed herself as much as the rest of us. She was moved by the music and expressed her joy audibly though softly enough that only those seated close to her could hear.

It was a day that could have been an ordinary Thursday, but it turned out to be special. The visit to the museum and the dinner and music with good friends were the highlight. I make a point of this because so many of my recent posts have focused on Kate’s decline, and I like to communicate that we continue to enjoy life. I don’t mean to minimize the sadness that accompanies Kate’s Alzheimer’s, but the stimulation of getting out as much as we can makes a significant difference in how well we are able to adapt. It works.

After dropping the Greens off at their home last night, Kate said, “Are we legal?” I said, “Do you mean ‘Are we legally married?’” I told her we are, and she said, “Good.” Later, when we got in bed, she said, “I love you.” I said, “And, we’re legal.”

A Visit to the Art Museum

I’ve been thinking about taking Kate to our local museum of art for some time . The past several days have been cold and rainy. It seemed like a good time to act on that desire. We went right after lunch yesterday. I didn’t tell Kate where we were going until we got out of the car. That’s when I mentioned that the museum had been undergoing a renovation, and I was interested in seeing what it was like.

Once in the gallery she was quite interested. I was surprised that she seemed to express more interest than I have noticed on previous visits to that museum or any other. Her interest was diverse and included sculpture and paintings of different periods and styles. It did not surprise me that she was taken by several paintings that included children and babies. One sculpture that she liked was of a young boy unclothed sitting in a chair. The accompanying information indicated that it was a depiction of childhood innocence. Moments later, perhaps seconds, she turned around to look at something else. When she turned back, she saw the sculpture again and responded as though it were the first time. She did the same thing with another favorite painting. It was a mother with her infant child in her lap. She had a hard time taking her eyes from it.

We had been there almost an hour when Kate wanted to find a restroom. I walked her to the door and waited just outside. In a few minutes, I heard her say, “Hello. . . Hello.” I suspected she was “lost.” I opened the door and said, “Hello.” She hadn’t been able to find the door. It was located so that she couldn’t immediately see it from either the stalls or the sinks. She hadn’t panicked, but she was relieved to see me. (This reminded me of an incident in Memphis the last time we visited our daughter Jesse. Kate locked herself in the restroom and couldn’t figure out how to unlock the door. This past Saturday when we visited our friend Ellen in her memory care facility, an attendant showed us the restroom and said that the door was always locked from the outside but not from the inside. They were not going to take any chances of a resident’s being locked in. One doesn’t usually think about little things like this until coming face-to-face with Alzheimer’s.)

I decided we had had a good visit. It was time to go back home. I plan to return soon.

More Confusion in the Past Two Days

Changes in the Past Two Days

Two things happened night before last that are indicative of the kind of changes Kate is making. After returning home from dinner, she sat down with her iPad. It wasn’t long before she asked for help. It turned out that she thought the puzzles were photos and was trying to figure out how she could label them. At first, I didn’t understand that and tried to show her how to put the pieces together. She responded by asking me to put the pieces in place. I worked two puzzles and asked if she didn’t want to work them herself. She said something that made me realize that she didn’t understand they were puzzles. Then she said she was tired and thought she would put the iPad aside and work on it “tomorrow.” I told her I would put on some music she might enjoy. She said she would to get ready for bed.

After she was in bed a few minutes, I noticed that she was shaking. I asked if she were all right. She said, “I think I made a big mistake and hope I didn’t mess things up.” I asked her to tell me about it. She didn’t know what she had done. She just thought she had done something she shouldn’t have. I told her I was going to take my shower. She said, “When you finish, will you come to bed.” I told her I would even though that would be a little early for me. After my shower, she was still worried about having done something wrong. All I could do was hold her and try to assure her that everything would be all right. I didn’t convince her, but she gradually calmed down and went to sleep.

Over the course of her illness, she has had periodic episodes that involved her thinking I had told her something that I hadn’t or that someone was coming to visit that wasn’t. I can’t help wondering if she is going to experience more of this kind of thing in the days ahead. I hope not. In the past, what she has imagined has bothered her. I hope we can avoid that.

During dinner last night and afterward, Kate was especially confused. She always asks the name of the restaurant as well as the hostess and our server. She just asked more times than usual and also appeared to be struggling more to get it right. She works so hard to remember names and places.

We had the following conversation on the way home.

KATE:            “What are we?”

RICHARD:    “Do you mean the nature of our relationship?”

KATE:            “Yes.”

RICHARD:    “We are married. Are you disappointed?”

KATE:            “No, I’m glad. What is your name?”

RICHARD:    “Richard Lee Creighton.”

KATE:            “What is my name?”

We are working our way into a regular routine when we return home. She said, “I’ll follow you.” She was impressed with the family room. As in the past, it was as though she had never been here before. Then something new occurred. She saw her iPad on a chair and asked, “What is this?” I said, “That’s your iPad” She gave me a look that I interpreted as, “What’s an iPad?” I explained it was something that she could use to work jigsaw puzzles. I wish you could have seen the excitement on her face. She said, “Oh, I’d like to do that right now.” I was shocked that she didn’t know what her iPad is, but it obviously caught her attention. As with people whose names she can’t remember, she didn’t recognize what it was, but she knew it was something familiar.

She mentioned wanting to brush her teeth. I told her to follow me to our bathroom. When she walked in our bedroom, she said, “Oh, this is nice.” Once again, she seemed not to recognize having ever been here before. After she went to bed, she said, “It’s been nice to stay here.” Apparently, she thought we were out of town.

When I got into bed, I moved close to her and put my arm around her. She accepted that as naturally as ever. Then she said something that made me think she didn’t recognize that I am her husband. I said, “You remember that I am your husband, don’t you?” She couldn’t believe it. Then she said, “Could we talk about this tomorrow?”  It seems like she is making noticeable changes on almost a daily basis. I don’t like the direction in which we are going.

Shopping

Until yesterday, it had been at least two years, maybe three, since I had taken Kate shopping. I find it easier to shop online for everything she needs. With our recent cold snap, she lacks winter clothes that fit. I was going to go online, but we are leaving for Texas next week and wanted to make sure she had something new for the trip. Thus, I took her shopping. I was looking for two types of things. One was tops that were a little heavier than what she normally wears. The other was a tunic-length cardigan sweater.

I had stopped taking her with me years ago when I found that it was confusing for her. She found it a challenge to make a decision as to what she liked and what she needed most or would wear. We often bought things she didn’t wear. I initially gravitated to shopping in her favorite stores without her. I stopped that because the clothes were generally expensive, and Kate would often wear them when working in the yard.

With this in mind, I was interested in how she might feel about going shopping again. To start with, she didn’t express any special interest in going. When I told her I wanted to take her to look for clothes, she simply went along with that the way she does with everything else I do. I shouldn’t have been surprised at her lack of enthusiasm. Since I started shopping for her, she hasn’t mentioned a need or desire to shop for anything. In fact, it doesn’t appear that she has ever noticed that I shop for her. When I give her something new to wear, I don’t mention that it is new or that I bought it. Yesterday, I told her I thought she could use a couple of tops like the one she was wearing, she simply accepted that without comment.

We went to a local department store that has a good selection with reasonable prices. Once we were in the shop, we both found a variety of things that were appropriate. The key was identifying something that fit, and, equally important, that Kate liked. One of the sales people directed us to two tables of tops and several racks of cardigans. We were able to locate tops that met our criteria. Kate was quick to identify the ones that she liked and those she didn’t. She tired very quickly and was ready to leave. I bought two tops and left the cardigans for another day when Kate is with the sitter. I didn’t even ask her to try them on. If they don’t fit, I’ll take them back. Handling her clothes continues to be one of the most troublesome chore for me.

Another Unusual Start

As I was about to get up this morning, Kate was slightly shaking and whimpering. I asked what was the matter. She didn’t say a word. It seemed like she was trying to hide whatever was bothering her. I stayed in bed and held her for a while. She calmed a bit, and I told her I was going to get up and that I would be in the kitchen if she needed me. I told her I loved her and wanted to help if I could. She said she loved me. I felt good because she didn’t seem to be experiencing the same kind of anxiety I have seen on several other occasions. When I first heard her, I immediately thought of her being afraid because she didn’t know where she was or who she is. If she was experiencing the same thing as before, it was much milder.

I could hear her whimpering again after I had dressed. I sat down on the bed beside her and asked what I could do to help her. She said she wanted to go to the bathroom. I helped her out of bed. She said she would be fine, but I asked if I could show her the bathroom. She nodded. I took her hand and walked her to the bathroom. When she came out of the bathroom, she asked, “What should I do now?” I told her it was still early and that she should probably get back in bed. She liked that. She was very groggy and confused. I helped her into bed and pulled the covers over her and reminded her I would be in the kitchen if she needed me.

About 10:00, I checked on her and found that she had gotten out of bed. I didn’t see her in our bathroom or the one for the bedroom next to ours. I found her under the covers in the bedroom where she keeps her clothes. She was awake but wanted to rest a while. I left her to do that. It is now about an hour later. I will check on her again and see if she would like to get up for lunch.

The Rest of Our Day Yesterday

Since our sitter was unable to come yesterday, I decided to see just how long Kate would sleep if I didn’t wake her. When she was still sleeping soundly at 11:30, I decided to put on some music. About fifteen minutes later, I checked on her. She opened her eyes as I approached the bed. I won’t know how long she would have slept, but I decided it was better to get her up. Although she sometimes takes as long as two hours to get ready to leave the house after getting out of bed, she was ready in an hour and fifteen minutes. Except for needing help getting her pants on and misplacing the underwear and socks that I had put with her clothes, everything went smoothly.  (I haven’t gotten used to the rapid disappearance of things like her underwear and socks. I looked in the obvious places around the chair where I had put them without any luck. I keep a large supply of both items. It comes in handy at times like that.) I asked if she wanted my help getting dressed. She didn’t, so I felt sorry for her when she had to ask. She still wants to be independent. That is something I understand.

We went to lunch at Panera and stayed there for about two hours before going home. When we came inside, Kate went directly to the bathroom off the laundry room. I went to the back of the house. I walked back to the family room where I expected to see her. She wasn’t there. I looked in several rooms and still didn’t find her. I called to her. There was no answer. Then I went to the living room. She was lying down on the sofa. It was obvious that she wanted more sleep. I let her stay there until 4:30. Then I decided she would be awake all night if I didn’t get her up. It turned out that she was awake although she must have been dreaming something. When I walked in, she said, “That’s funny.” I asked what was funny. She thought a moment but couldn’t remember. I asked if she had been dreaming. She said, “Maybe so.” The she asked, “Where are we?”

We went back to Panera. As we got out of the car, she asked, “Where are we?” I told her we were in Knoxville. She said, “I know that.” Then I said, “Panera.” After we sat down, she said, “I think I remember this place.” A few minutes later, she said, “You’re a nice guy. I guess that’s why I married you?” I said, “And we’ve been married 55 years.” She looked skeptical and said, “You must have been gone a lot.” Then she said, “What’s your name?” She asked me to repeat it slowly. Not too long after that she said, “I think I’ve been here before.”

From Panera, we went to dinner. She told me she was sleepy and might go to bed soon after we to home. When we returned to the house, she said, “They take very good care of this place.” Once we were inside, she commented on how much she liked the family room. She does this almost every time come back home. It always sounds like it’s the first time she has seen it. Sometimes she doesn’t recognize it as our house. I’m not sure what she was thinking last night. She asked what she should do now. I suggested she might want to brush her teeth. She said, “Where’s the bathroom?” I said, “I’ll show you” and showed her the way.

She had asked if there were something on TV that we might watch. I decided to try the DVD of Les Miserables again. This was the first time I recall that it did not get her full attention. She worked on her iPad, but put it down periodically to focus on particular songs, but it was clear that it did not grab her the way it had in the past.

Our son called, and we had a nice conversation with him. I handed the phone to Kate to answer. In previous occasions when I have done this, she has declined and handed the phone back to me. This time she accepted it and took the lead in our conversation. She handled herself well except for getting confused about what Kevin was telling her about a recent business trip. After his call, she got ready for bed but was still awake an hour later when I got in bed.

A Different Kind of Monday

So much of my attention is focused on Kate and the changes she experiences that I often overlook the fact that change us occurring for everyone on a daily basis. I think of that now because Kate hasn’t even stirred yet, and I know this Monday will be different for us. Last night, I received a phone call from the agency that provides the sitters for Kate. Marilyn, who was supposed to be here from noon to 4:00 is sick and will not be able to come. They were quite willing to send a new person, but I declined. I would rather change my plans for the day than bring in a sitter that Kate has never met. Actually, I am rather glad to have another day without a sitter.

Kate’s morning routine continues to be erratic. After thinking that she was settling into getting up late, she got up early several days in a row. The past few days she has gone back to sleeping late. Yesterday was another day when I had to get Kate up earlier than she wanted. Fortunately, she was very cooperative, but I felt bad about it. She has been very tired in the morning. I thought it might be good to let her sleep this morning but knew that the sitter comes at noon on Mondays, and I didn’t want her to wake up after I had left for Rotary. It’s not that I don’t think she could handle it. I just know that she often needs my help when she gets up. Of course, at some point, I will probably have a sitter to help in the morning. I don’t think either of us is ready to do that right now.

I often mention that Kate either sleeps late or surprises me by getting up early. She has experienced one other change in the past week or two. She doesn’t seem to go to sleep as quickly as she used to. There are some nights when she hasn’t gone to sleep as long as an hour or two after going to bed. I don’t ever recall that before. Of course, that could easily play a role in her needing to sleep in the morning. At dinner, she frequently tells me that she is going to “crash” early; however, she seems to get her second wind after we are home. When she was on Trazodone, she went to sleep rather quickly, but I don’t want to go back to that just yet. On the whole, I think she has been more alert since we discontinued it six or seven months ago. Her only groggy moments occur when she wakes up in the morning. Trazadone could exacerbate her confusion.

At any rate, I don’t plan to go to Rotary today. I also had a United Way meeting scheduled at 2:00. I will skip that as well. Kate and I usually have nice days together. I’ll take advantage of this change in the sitter’s schedule to enjoy the day with her.

I should add that yesterday was another good day. Since Kate got up late, we went directly to lunch. That gave us a brief time at home before going to see the musical Buddy at one of our local theaters. We had a good time. From there we went to dinner and then back home to relax the rest of the evening.

Another Slow Start and Strong Finish

Because we were going to Nashville yesterday to visit our friend, Ellen, I wanted to get Kate up a little earlier and hoped that would be possible given that she went to bed earlier the night before. That wasn’t to be. It took over an hour to get her out of bed. She was very tired, but I didn’t rush her. She never got upset with me. Nor did she give me any strange looks as though she didn’t recognize me. Close to the time she got up she said, “Where am I?” I told her she was in her bedroom at her house in Knoxville.” She said, “Who are you?” I said, “I’ll bet I don’t look like a stranger.” She said, “No.” Then I told her that I am her husband. She didn’t express surprise or any other emotion. Then she asked, “What’s your name?” After I told her, she said, “What’s my name?” I told her. Again, she asked, “Where am I?” Then, “What’s your name?” She asked me to repeat my name slowly. Over the course of the next 10-15 minutes, she repeated these questions several times.

She wanted my help getting out of bed. She also wanted me to tell her what she should do. I suggested that she go to the bathroom and then get dressed. That gave her too much information. I led her to the bathroom. After using the toilet, she wanted to know  what she should do. I told her she should brush her teeth. When she was finished, I helped her with her clothes. She still likes to do as much as she can, but she also likes me to help, especially determining the front and back of her pants and top. She also gets her feet stuck in the pant legs. I get the bottom of the pant legs over her feet. Then she is fine.

After she was dressed, she began to appear normal. We had a quick lunch at Panera and left for Nashville where we had a good visit with Ellen. She was surprised and glad to see us. I am sure that her daughter had told her we were coming. She just can’t remember. That is one of the few signs I can see of her memory problems. She is always surprised to see us. I also notice it in other things like her not remembering the names of her grandchildren. During our last visit, I noticed some signs of confusion. This time she seemed more confused. I was surprised, however, that I was able to understand more of what she said this time than the last. It could be that her ability to speak goes through ups and downs in the same way that Kate’s memory does.

We were with Ellen a full two hours. We don’t often stay that long, and it didn’t seem long at all. I didn’t play as much music as our two previous times, but it was just as meaningful as before. I played a series of YouTube videos of Renee Fleming. At one point, Kate reached out and took Ellen’s hand, and they shed a few tears as they enjoyed the music. I love seeing each of them express such enjoyment. I sometimes wonder how long we will be able to keep up these visits. Both of them are declining, but I don’t see anything yet that will prevent our continuing to come. I hope that’s so.

We stopped for dinner on the way home. It was a restaurant that is a cut above most of the ones we frequent, but it seemed like a good way to celebrate such a nice afternoon. It made for another nice moment for Kate and me. We got home late, so I’ll be interested in seeing when Kate gets up this morning. I checked on her a few minutes ago. She had gotten up to go to the bathroom and then went the guest room and got into bed. When I asked if she wanted to rest a little longer, she smiled and said she did. I didn’t see any sign of confusion, and she seemed both cheerful and relaxed.