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More Happy Times

I like good news, and that’s my report today. In my post yesterday, I noted that Kate was in a good mood and had accepted having the sitter without any reservation at all. When I left them, they were beginning to watch Fiddler on the Roof. When I got home, Mary was in the family room watching TV. Kate was in the bedroom resting. Mary said Kate had watched Fiddler for a while and then got sleepy. She got in bed and went to sleep.

When I went to the bedroom to see Kate, she wasn’t asleep but still resting. She was very relaxed but cheerful. This was Mary’s first time to see Fiddler and loved it. I explained that to Kate. I also said that it was nice that she (Kate) could share this experience with Mary. Kate, then, felt she had done something nice for Mary. I mentioned that she might share other musicals with her in the future. Kate liked the idea. I know that she won’t remember that, but I also know that she would feel good if she is able to introduce Mary to something she hasn’t known before.

Last night I asked if she would like to watch Fiddler. Yes, that’s the same show she had watched with Mary. She was excited about that. She was engaged right at the beginning. At 9:30, I suggested that we stop and watch more another night. She said she was getting sleepy but wanted to watch more. We continued for another 45 minutes before I said, “I think I’ll stop it here, and we can watch the rest another time.” She said that was fine, and we were off to bed.

I thought that was the end of the day, but Kate was wound up. We had quite a conversation. I can’t remember all that she said, but I was impressed with her expression of feelings about life and the two of us. She talked about how well-matched we are. Once again, I was struck by the accuracy of the things she said about our respective personalities. That reminds me of something that happened this morning. We stopped by Panera to get a muffin for Kate to eat in the car as we went to the airport to pick up our son, Kevin, who is visiting us for a few days. When I mentioned that she could eat the muffin in the car, she gave me a look of amazement and said, “What’s gotten into you?” The reason I mention this is that I have always been particular about not eating in the car. This time I felt we didn’t have enough time for her to eat it inside. I also knew that she wanted something to eat before we would be able to eat lunch. She may not always remember my name, but she knows me well.

Kevin arrived shortly after 11:30. We had a nice lunch and have been back at the house watching a little football. Kate has continued to be very cheerful. She has teased me a good bit today. I told Kevin that at times she seemed like a child trying to show off with company. He is also getting to see a few of the things that I have told him about. For example, she asked me to tell her where the “restroom” is. I walked her there. As she walked into the hallway, she said, “This looks familiar.” She saw a picture of her mother on the wall and stopped to look at it. She remembered it was her mother, but she had to ask me her name. When she came to a doorway that opens into family room, she said, “Oh, I like this room.” It was just like she had never seen it before.

We are meeting a high school friend of Kevin’s and her mother for dinner. We’re having happy times.

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Good News for Me

If you have been following my recent posts concerning Kate’s acceptance of a sitter, you know of my concerns. In a nutshell, as she becomes more dependent on me, it appears that she has also felt less secure when I leave her. I am glad to report that her response today was very different. I should add that she got up in a cheerful mood this morning. I hoped that was a good sign, and it was.

Usually, I don’t say anything about a sitter’s coming until shortly before she arrives. Today, I decided to give Kate a little preparation. While we were at lunch, I told her this was one of my days to go to the Y and that Mary would be with her while I was gone. I mentioned that they could stay at the house or go to Panera. She seemed to like the idea of Panera which is typical. Then she asked what she should do for money. It is interesting how often she asks this since she has never had to pay at all. I told her that I had a card that Mary could use. She accepted the news without any further questions.

When the Mary arrived, I told them they could watch a DVD of one of our musicals and mentioned Fiddler on the Roof and Les Miserables or one of the others. They liked the idea and were both very agreeable regarding which one. Mary had never seen Fiddler, so I chose it. I explained that it is almost 3 hours in length and that they might want to take a break at some point. I also pointed out to Kate that she could go to Panera any time she wanted. As I left, the movie was playing, and Kate seemed happy. I left with a good feeling. Now, I’m eager to see how they got along during my absence. Since they got off to a good start, I suspect it is going well.

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More Good Times

It’s 10:15, and were sitting here at Panera. Kate was up early enough for us to get here by 9:30. Of course, that makes me happy because today is another day for the sitter. I want to spend as much time with her as I can. To top it off, Kate is in a very cheerful mood. That certainly gives me a boost. It continues to amaze me how much that offsets the sadness that I might otherwise feel when I see all the changes that accompany this stage of her Alzheimer’s.

Some of those changes make caring for her easier than in the past. In particular, I am thinking about managing her clothing. She is much more compliant than in the past. That relates to her increasing dependence on me. For example, we got home from Panera around 5:00 yesterday afternoon. I planned for us to leave the house for dinner at Casa Bella at 5:30. The attire for their music nights is informal, but I felt that both of us should change into something a little nicer than what we had been wearing all day. Past experience led me to be concerned about suggesting that she change clothes. That was especially true last night. I wanted her to change her top, pants, and shoes. I approached this carefully saying, “We have a little time before we leave for dinner. I thought it might be nice if we changed clothes.” She said, “Okay” without any concern or question. I had already picked out what I wanted her to wear and brought it to her. She changed clothes without a problem. She looked terrific. The top I had picked out was one I had bought several months ago. I had tried to get her to wear it previously, but she thought it was too dressy.

Our dinner and the music was terrific last night. Kate enjoyed herself although she is talking less and less in situations like this. We were seated at a table for 8. When the singers were not on, the conversation was lively. I didn’t see any sign that Kate was bothered by this. I think the music made the difference. If we had been at dinner for 2 ½ hours without it, she would have been very bored. I wouldn’t have blamed her. I would feel very alone if I were in a group of people I didn’t know and couldn’t remember anything to talk about.

This makes me think of my mom who had dementia. My dad took her with him almost everywhere long after she engaged in conversation. I didn’t really think about it then. I know much more now that I wish I had known then. I do believe we treated her the right way. We expressed our love for her, and we considered her a part of all gatherings up to the time of her death. Today is their anniversary. Sixteen years ago, we celebrated their 70th anniversary at our home. She died less than a month later.

I also think of my dad. I have done that frequently as I have learned to care for Kate. He was quite a model of a husband who devoted himself to caring for his wife. He did it with very little help. He took her to day care every Wednesday morning while he attended Kiwanis and ran errands. The only other help was from me. That was primarily remaining in almost daily contact and providing evening meals. Otherwise, he was on his own. I should add that it was his own choice. My brother, Larry, and I tried to bring in help or get him to move to assisted living. He fought it and won.

Now Kate and I are traveling the same road. I think we are also handling the situation well. I am comforted by the belief that we will continue to enjoy the days ahead even as life changes for us. Already I am beginning to adapt to Kate’s not knowing her way around the house. It was somewhat shocking when I noticed the first signs. Now, it is becoming routine. When we got home last night, she very naturally asked me where the bathroom is. Just as naturally, I took her.

Before leaving the house this morning, I went to our bathroom to brush my teeth. When I returned, I couldn’t find her. I called her name, and heard her respond but didn’t immediately locate her. I followed the sound of her voice and found her in the living room. She was waiting for me. That is unusual. Like many people these days, we almost never use our living room and keep the doors to the front of the house closed most of the time. She obviously didn’t know where to go and wandered there waiting for me to find her. That is a change from her usual behavior. Normally, she goes to the car and waits for me there.

Her loss of memory for the rooms in the house is sad, but as I said before, her cheerfulness and the good times we have more than balance the sad times.

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Reaction to My Leaving Her with the Sitter

Sometimes there are dramatic moments that one can recall as a point when life changed. The moment Kate’s doctor delivered the news of her diagnosis was one of those. It was mid-day on January 21, 2011, exactly one week after Kate’s 70th birthday. That was a clear marker in our lives. Most other changes are less defined. They just creep up on you. That has been the pattern for Kate and me the past 7 years and 8 months.

Although our changes have been very gradual, I frequently wonder if we are entering a new phase when I notice any difference in Kate’s normal pattern. The changes in her sleeping late in the spring made me think that a signal of an important change. Of course, I couldn’t be sure at the time. Looking back, it appears I was right. Since then, Kate’s changes in memory and confusion have increased more significantly than at any other time since her diagnosis.

One of those changes has been her behavior in connection with the sitters. For months, she happily greeted them. That made me feel good as I left her. Over the past few months, I’ve noticed less enthusiasm when the sitter arrives. On several occasions, Kate has asked if she could go with me. She seemed disappointed when she couldn’t. Along with that reaction, there have been some occasions when she and the sitter didn’t go to Panera. She is also spending more time resting while the sitter is here.

During this same period of time, she was growing more dependent on me. I have mentioned several times, once in the last day or two, that Kate has told me she likes being with me, that she feels safe with me. She hasn’t said this around the time the sitter has been here, but I have always wondered if there might be a connection. An experience yesterday strengthened that suspicion.

We arrived at Panera for lunch a little later than I had wanted and called the sitter to meet us there rather than at home. A few minutes before Mary arrived, I reminded Kate that I would be going in a few minutes and that Mary would take her home. She gave me a big frown. I said, “Do you feel like I am deserting you?” She said sternly, “Yes, and I don’t like it.” All of a sudden I felt like a parent leaving her young child on the first day of school.

When I got home, Kate was resting on the sofa in the family room with the sitter who was watching TV. I walked the sitter to the car and asked if they had stayed long at Panera. She told me they stayed “a little while.” She said Kate had wanted to go back home where she rested for a while. Then she got up several times and returned to the family room. She worked on the iPad a little but also rested a good bit.

In our conversation, I suggested that if this happens again that she might take her back to Panera. She seemed a little surprised. I told her it is not uncommon for us to go back more than once in a day or to Barnes & Noble. I also told her that Kate gets bored staying at home for long stretches and that we are rarely home for more than 2-3 hours in a day. I will convey this to our other sitter the next time she is here. I am hoping to work with the sitters to address the issue. I feel that is a better direction than reducing the sitters’ time.

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Waking Up This Morning

Kate was sleeping soundly when I woke her this morning. I put on some music, but she continued to sleep, so I went into the room and sat down on the bed beside her. She opened her eyes but didn’t say anything. I asked if she would like me to take her to lunch. She nodded. I sat there a few moments. Then we had the following conversation.

KATE:  “What’s your name?”

RICHARD: “Richard Creighton.”

KATE: “Richard Creighton.” (pause) “Say it again.”

RICHARD:  “Richard Creighton.”

KATE:  “Richard Creighton.” (pause) “Who are you?”

RICHARD: “I’m your husband.”

After another moment or two:

KATE:  “Where am I?”

RICHARD:  “At home in your bed.”

KATE:  “Where’s my home?”

RICHARD:  “Knoxville, Tennessee.”

Shortly after that, she got up and is now taking her shower.

I relate this incident to convey just how much of her memory she has lost in the past few months. There is something else. I am amazed at how well she adapts to having so little memory. Except for several attacks of anxiety mentioned in other posts, I haven’t noticed any display of anguish. That doesn’t mean I haven’t observed anything else that might be a symptom of her concern. Day before yesterday, she was quiet most of the time I was with her (until bedtime when she was talkative). When she has her quiet moments, I wonder what she is thinking. Is she thinking about herself and what she can’t remember? Is she wondering what is the matter with her? I suspect so. She is very perceptive and insightful. I am still surprised when she makes comments about me that are very much on target. She can’t remember my name. Sometimes she doesn’t recall that I am her husband, but she has a good grasp of who I am in terms of personality. She knows my OCD tendencies. She has always been a good observer of her own qualities. That makes me think that she may be suffering more inside than she lets on.

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People Make a Difference

I have often mentioned the importance of our eating out as a way of minimizing the social isolation that is often a side effect of a diagnosis of Alzheimer’s. That and our regular visits to Panera and Barnes & Noble go along way to keep us socially active. The beauty of these social encounters is that they are not lengthy ones that place any special demands on Kate. One might think of them as very superficial and unimportant, but I have found them of significant value. Yesterday, we had three that were especially nice.

The first occurred at Panera. As Kate was getting something from the drink dispenser, I put our things down at the table where we often sit. I was opening Kate’s iPad and the jigsaw puzzle app when I noticed a young woman with her laptop at another table. We exchanged “good morning” greetings. Then she told me that she had seen us a number of other times and was struck by what a loving couple we seemed to be. She had noticed my setting up Kate’s iPad, getting her a muffin, and helping her coming in and out of the restaurant. I thanked her and I told her that Kate and I have been married 55 years and about her Alzheimer’s. I hadn’t remembered seeing her before. It was a short encounter, but I was touched by her words and the way she expressed them. She probably doesn’t think did anything of importance. For me, it was an great way to start our day.

The second experience was having dinner with a couple with whom we have shared a table on several occasions at Casa Bella’s Broadway nights. They called on Monday and asked us to have dinner with them last night. Kate, of course, could not remember them, but I told her she would recognize them. Several times, before meeting them she had me repeat their names and try to remember them. It was impossible. It’s one of those times I try to imagine what it must be like for her, not remembering the names of anyone around her. It turned out to be a good evening. They are very easy to talk with, and Kate was not put on the spot in any way. They had remembered Kate’s drinking iced tea and brought her a box of tea to take home with her. We had a good time. I don’t believe they invited us thinking that they were doing something special for us. It was just a simple invitation for dinner, but it’s just one more uplifting social encounter.

We bumped into someone who stopped us on the way out. She had remembered me from my visits with Dad when he was in a nursing home. Her father sat at the table next to him. We often chatted, especially with her little boy. We talked with her family and her for about ten minutes. It turns out I have another connection to the woman’s husband. I had worked with his mother when her company was a client of mine quite a few years ago now. It’s been five years since I had seen her. She said her father, who was a good bit younger than my dad, is still there. It was another unanticipated encounter that was meaningful to me. Kate had not known the woman, so I know it didn’t mean much to her, but she enjoyed seeing her son. Children always brighten her day.

Once we were home, we watched a little of South Pacific. It was interesting to see that Kate was familiar with all of the music and some of the words. It was another good day and one that illustrates the power of both people and music.

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More on Insecurity

It was just two days ago that Kate got up and was worried because she couldn’t find me. I had been in the kitchen, and she hadn’t done a lot of looking. She was still in the back of the house when I found her. What was important was that I hadn’t seen her react this way before. Although I haven’t walked for three weeks because of a pinched nerve, I decided the days of my morning walk are over. I also wondered how soon it would be before I saw other signs of her insecurity. I didn’t wait long.

This morning I left the door open from the family room into the hallway where our bedroom is located. I have been closing it for years so that I might not disturb her while she was sleeping. I thought leaving the door open would help her find me the next time she is looking.

When I checked on her about 9:00, she was just getting out of the shower. I left her with the clothes I had laid out for her last night. A little after 9:30, she walked into the family room. She was wearing the pants I had put out for her but with her night gown instead of the top I had put out for her. She said, “Oh, there you are. I couldn’t find you.” Unlike the other morning when she seemed a little worried but still calm, she was definitely more concerned and said, “Don’t ever do that to me again.” When I told her I wouldn’t ever leave her, she said, “Promise? Promise?”

When I was assured she was all right, I went to the bedroom to get her top. I gave her it to her, and she asked (using hand signals) if she should take off her gown. I told her she should. Once she had the top on, we were off to Panera.
From there, we went to lunch. As we walked along side the restaurant, I walked ahead of her. That is has been her preference for years. That seems to be the most comfortable way for her to know where she should go, just follow Richard. I was about 8 feet ahead of her when I heard her call my name. I don’t ever recall her doing that before (that is, while following me). I stopped to let her catch up. Then I turned around. When I reached the corner where we would turn toward the entrance, she called again rather sternly. I stopped and waited for her. I was going to do that anyway. I have learned the hard way that she loses me when I turn left or right. I don’t recall exactly what she said, but she almost seemed frightened. I apologized, and told me she needed me to stay with her.

There have been several times over the past few years that I have lost her. Each time was when we were traveling, and each time she was very calm during and after the time she was missing. Now she is expressing a degree of fear of being lost, and not just in “foreign territory” but right here at home. The changes seem to be occurring with greater frequency all the time.

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First Day With the New Sitter

Yesterday was Kate’s first day with Marilyn. She’s the interim sitter while Anita is out. Having interviewed her last week and spending time with her at lunch, I felt comfortable leaving Kate with her. It turned out that we got to Panera a little later than I wanted, so I called Marilyn and asked her to meet us there. Just before she arrived, I reminded Kate that it was my day for Rotary and that someone new be with her while I was gone. A few minutes later, Marilyn arrived. I re-introduced Kate to her. When I did, Kate said, “I really don’t need anyone, but it’s nice to have company.” I took that as a positive sign even though she was making her point about not needing anyone. It is likely she was doing that more for the sitter than for me.

When I got home, they were in our family room. Kate was resting on the sofa. Over the past several months, she has frequently been resting when I arrived. I have also discovered from the sitters that they have not been spending as much time at Panera as they had before. Had this occurred earlier, I might have thought it was a result of some embarrassment to be out with a sitter. She has never shown any concern about that.

I am speculating that it may relate to her increasing dependence on me. It’s not just that she lets me do more things for her. It’s that she periodically tells me that she “feels safe” with me. The first time she said this I didn’t attach much significance to the word “safe.” Since it comes up occasionally, I’m thinking she really feels more secure when I am with her outside the house. That is when she would be most puzzled by her surroundings. At Panera yesterday, I walked her to the restroom because she was unsure how to get there. If she is unsure there, I can only imagine what it must be like other places. That insecurity, of course, may extent to her feelings when she is with the sitter at home. I know that the sitters have told me that she asks when I will be home.

Last night, she got in bed shortly after 7:30. I was a little surprised because the sitter said she had rested most of the time I was gone. I took a phone call from our son and went into the family room so that I wouldn’t disturb her. After his call, I went back to the bedroom to get ready for my shower. She was still awake and asked if I were coming to bed. I told her it was a little early for me to go to bed and that I would be close by in my chair right beside the bed. After my shower, she asked again about my coming to bed. I got into bed with her. She was very calm, but she was relieved that I had come to bed and said, “I’m glad you’re here. I feel safe when I am with you.” That was just the beginning. She talked for a good while. It was like many other conversations in which she talked about how fortunate we are. She never gets very specific because her memory won’t allow that, but she clearly retains her feelings about her family, our marriage, and our children.

Looking back, she had been in a good, but calm, mood earlier before Marilyn arrived. I wonder if she might have felt insecure because I wasn’t there. That might have led her to think about her memory loss and inability to do so many things. I know that she was quieter at dinner, but she didn’t really look depressed. I’m not going to speculate too much. This is something I may never understand. I will, however, be looking for any patterns that may be developing.

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Confusion in the Morning

Kate was getting dressed when I went to check on her at 10:30 this morning. She asked my name. I told her, and she said, “I knew that. I just couldn’t remember. What’s your name again?” I told her again. She said, “Oh, you’re a nice guy.” Then I said something about our being married. She said, “We’re married? How did that happen?”

She sat down in the family room to take her morning meds. I heard her call my name. (She still does pretty well recalling my name when she needs something. I suspect it is a conditioned response. It occurs without thinking.) She had noticed a TCU magazine on the table and asked if she could take it with us. A minute or two later, she had forgotten asking me. She asked, “Is this ours or theirs?” She may have been thinking we were in a hotel. I told her it was ours. She said, “So I can take it with us?”

As we were leaving for lunch, she decided to use the bathroom. She pointed to the door beside her and asked, “Is this a bathroom?” I confirmed her suspicion. It’s just another indication of how the house is becoming less familiar to her.

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A Nice Way to End One Month and Begin Another

Good Morning. I hope it is as pleasant a morning for you as it is here. The sun is shining brightly, and the temperature is a little bit cooler. Sometimes days when you don’t do anything special turn out to be especially good. That was certainly true for us yesterday. I was pleased that Kate was up early. So early, in fact, that we beat the group of Catholics who come to Panera after mass. We spent an unusually long time at Panera. We were there 2 ½ hours. Not only that, but we spent the entire afternoon at home after returning from lunch. That was almost 4 ½ hours. It’s hard for me to remember a time when we spent more than 3 hours at home in one stretch (during the day, of course). It would have been when Kate used to work in the yard. During that period of time, she could easily spend as long as 4 or 5 hours working outside. That hasn’t happened in at least two years.

During our time at home, Kate worked continuously on her iPad. She does have more problems working puzzles now than in the past, but she feels comfortable asking for my help. Her biggest problem is accidentally getting into the puzzle store to buy more puzzles. The creators of the app she uses make it very easy to buy more puzzles. I do that once in a while to make sure she has a good supply, but it doesn’t mean a lot to Kate. She has her favorite puzzles and works them over and over, often repeating a puzzle immediately after completing it.

For a long time, I thought it was just completing the puzzles that was appealing to her. Recently, however, she comments a lot on the beauty of the colors. She has one puzzle in particular that she frequently points out to me. She likes the colors and the kitten in the middle of a bouquet of flowers.

Apart from getting herself into the puzzle store, the second biggest problem is her eyesight. She often loses puzzle pieces when they are on top of pieces that are already in place. I admit that sometimes the patterns make it challenging, but it is mostly her eyesight that is a problem. I often move the pieces she can’t see to the side where they are clearly visible. I’m going to buy her some reading glasses and see if that helps. She’s had plenty of them in the past, but they get lost or broken rather quickly.

There are also two other possible reasons she doesn’t see well. One of those is her cataracts. In discussions with her ophthalmologist, we have decided not to have surgery. That’s true at least for now, but the likelihood of surgery decreases as her Alzheimer’s progresses.

The other reason involves dementia itself. I don’t fully understand but people with dementia often don’t notice things that the rest of us would see easily. One of the best examples is that Kate often doesn’t notice her iPad that is in a bright red case. I bought that case to make it easy to find. She often looks right over it. It’s not that her eyesight is that poor. She has 20/60 vision. That would make reading a problem and also identifying the right puzzle piece, but not seeing larger objects lets me know there is something else going on.

Kate is awake but not up yet. I expect she will be soon. We have a new sitter coming today. She is filling in for Anita who had minor surgery last week. I’m not sure when she will be back, but I feel good about Marilyn. While she is here, I will get to Rotary and then to a United Way meeting. I’m hoping for another good day and believe it is likely to happen.