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Returning to Our Routine

After six days on the road, Kate and I returned to our normal routine today. It felt right. It wasn’t completely normal. I actually got up over an hour later than I often do, 7:15 compared to a normal get up time between 5:30 and 6:00. I woke up earlier at 4:20 and 6:00 and decided to sleep a little more. That decision was prompted by the fact that I am still nursing a cold that has been hanging on far longer than usual. I felt like this was a good day to take it easy. I didn’t even take my morning walk. That was partially influenced by the temperature around 30.

Kate was up before 8:30 and ready for Panera about 9:30. We were there an hour before she was ready to come home and wanted to work outside even though it was still 36 degrees. After she had worked for an hour, I suggested we go to lunch at Carla’s Trattoria. We go there almost every Tuesday. Even though we had eaten well, actually too well, over the holiday, we splurged and finished our meal with some of Carla’s homemade salted caramel gelato. From there we dropped by the church to make a last-minute payment on our church pledge and then by Walgreens to pick up a couple of prescriptions.

When we got back home, Kate told me she wanted to go back outside. I told her that would be fine. Since it was then 39 degrees, I thought maybe she might not be out too long. I underestimated the attraction of the yard. She was outside over three hours and happy as a lark. She and I have often said that working in the yard is her therapy. There is more truth to that than we originally believed. She is able to work for hours though not usually with weather in the thirties. I think I mentioned in an earlier post that she had wanted to “pull leaves” at Kevin’s house. On two occasions she actually did pull a few as we walked from the car to the house.

We finished the day by going to dinner at one of our other local favorites. We enjoyed our dinner and then came home to relax. Kate got ready for bed, and I watched the PBS Newshour that I had recorded earlier. It was a good first day home.

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Coming Home

I am glad to report that our travel home yesterday was uneventful, that is, we had no trouble at all. Anytime we are facing activities or appointments that have definite time demands like airline flights, I worry a little about making sure Kate is ready. It may seem strange, but we actually encounter fewer problems like that now than in the past. I find that Kate really works harder to get ready than she used to. That is part of a general pattern. It is as though she recognizes that she is not in control and feels the need to work harder. I don’t mean that she appears frantic about it. It is just that she seems more attentive to doing things “the way they should be done.” For example, until Alzheimer’s began to take its toll, she always made up the bed shortly after she got up. Over the years I have heard her say, “My mother taught me to always make up the bed.” She stopped that for quite a while. Within the last six months she has begun to partially make it up once in a while, not daily and not completely. She pulls the covers over the bed and throws the pillows in their approximate places. She also hangs her clothes up more regularly though she doesn’t hang them in what I consider to be the “proper places.” Although it saddens me somewhat to see that she has to work hard to do the right thing, I believe it is a good thing that she is taking more responsibility. She still wants to be independent. I want that to continue.

She was still sleeping soundly yesterday morning at 8:15 when I woke her up. Kevin came over for a short visit before we went to the airport. She didn’t want to get up, but she did without a complaint. Kevin dropped by at 9:15. She was ready, and I had everything packed. That gave us a brief time to be together before leaving at 10:00.

The rest of the trip went smoothly. We arrived in plenty of time. I had been a little worried that we might be rushed, but we had sufficient time to gas up the rental car, return it to Avis, check in, have lunch, and still be early enough to have some waiting time before boarding. This eliminated any potential stress that might have occurred otherwise.

We stopped by our favorite Mexican restaurant on the way home from the airport. Our server last night was a comparatively new one. It turns out that she is from Venezuela. I had a nice conversation with her entirely in Spanish. We told her that we had visited Venezuela many years ago. I think she liked that. We also bumped into an acquaintance from the Y. He was with his wife, children, and grandchildren. We had a nice conversation with them as well. For me it was just another reminder of the value of eating out.

Kate got into her night clothes pretty quickly and right into bed. She worked puzzles on her iPad for well over an hour before calling it quits for the evening. She and I both slept well although she coughed a good bit during the night. She seems better this morning, but we are both still struggling from the cold we got three to four weeks ago.

We got right back into our routine this morning. We made it to Panera about 9:30. Kate was ready to come home at 10:30. After a short break, she wanted to work in the yard despite the fact that it was 36 degrees. At least the sun is shining brightly. She has been out there almost an hour. I am about to call her in so that we can make our way to lunch.

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A Great Day In Asheville

As expected, we had a nice day in Asheville yesterday. I had made reservations for lunch for 12:15 at one of our favorite places. I never quite know how easy or difficult it might to meet a specific time like this and also get in her muffin at Panera, but she had been getting up early enough for us to make it. It turned out that I had to wake her, something I don’t like to do. That meant I did have to “gently rush” her to get ready. She wasn’t entirely happy about it, but we avoided a big problem. I called the restaurant to get a later reservation.

When we arrived at the restaurant, our server came up to the hostess desk to greet us. I had made the reservation on Open Table and requested Melissa. This was the fourth time she has served us. We like her and she seems to like us. She even brought us an order of their warm banana bread on the house, a recent addition to their menu. The last time we were here was in September. At that time  I told her about Kate’s Alzheimer’s. I didn’t get a chance to say very much before Kate came back from the restroom; I’m afraid it was a more abrupt announcement than I had intended. Her eyes were filled with tears as we left. As we walked to our table, I was able to let her know how well Kate has been getting along even though her memory is just about gone.

Near the end of our meal, I got a call from our hotel letting us know that our room was ready. When I picked up the key at the front desk, they let us know it is the “Christmas” room. It is beautifully decorated for Christmas and is the only such room in the hotel. Right now, I am sitting in front of the fireplace in a sitting room adjoining he bedroom. At the end of the sofa to my left is a gorgeous Christmas tree. It’s no wonder we always choose to stay here. They have always been so very nice to us.

A few years ago, I told the front desk about Kate’s diagnosis. I usually do this at the hotels we visit. It may not be necessary, but I like them to know in case she should come out of our room and not be able to find her way back, especially if is during the night. On a few occasions, she has gotten up to go to the bathroom during the night and tried to go outside. On one occasion she had gotten into the hallway before I caught her. I have been confident that I would wake up when she gets out of bed. Recently, however, there have been a couple of occasions that I haven’t waked up.

At 3:00 yesterday afternoon, we went to see the musical Annie. We have seen other productions at this theater and been pleased. I wondered how well they would do with this one since the cast consists of so many children. I got my answer. These were exceptional children, especially the young girl who played Annie. This is a very upbeat musical. I knew Kate would like it, and I was not disappointed. She expressed her enthusiasm throughout the show. In fact, this is one of the things that I am trying to watch carefully. She gets so excited that she expresses her emotion audibly with things like “Wow” or “She is good.” She frequently says these things after many of the songs. So far the volume of her expressions has been low enough that I doubt people around us felt disturbed. It does make me wonder though if the volume might increase as she declines further.

On the way back to dinner after the show, Kate said, “Where in the world are we? New York? San Francisco? Dallas?” I told her we were in Asheville. She said, “I knew that.” She has asked the same question at least one other time on this trip. That is not unusual and is understandable given the limits of her memory.

At dinner, we had a nice conversation with a couple sitting at the table next to us. We learned that they were members of a church whose former pastor is a former student of mine at UT. They were both educators, and we discovered other connections we have in common.

During the night, Kate got up twice to use the bathroom. This hotel has a very good night light for the bathroom. There are two small ceiling lights that are controlled by a switch just inside the door. They provide a soft light that enables you to easily find the bathroom in the dark. That is something about which I would have given a thought before Kate’s diagnosis. Now it’s a very important thing. I wish they were available in all hotels.

Kate is still sleeping. She awoke about fifteen minutes ago and started to get up. She asked, “What can I do?” I told her she could get up and go to breakfast, stay in bed and work on her iPad, or sit on the sofa with me in front of the fireplace. She chose to stay I bed. I told her there is no hurry, that she can stay in bed as long as she likes. I may go back to the lobby where they served a continental breakfast and bring something back to the room for her. That is just in case she gets up after 10:00 when they take up the breakfast.

I am happy to say that our visit here has been a good one.

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The Value of Social Contact

Occasionally, I have the impression that there are some people who wonder why we always eat out for lunch and dinner. I suspect there are several things that make them feel this way. It is cheaper to eat at home. It is also easier to eat nutritionally at home. There is just something nice about eating in the comfort of your own home, especially in bad weather. I acknowledge all of these things, and I am sure one could argue for more benefits. On the other hand, the longer we have done this, the stronger my belief is that eating out has been one of the wisest decisions we have made. It has little or nothing to do with the objective of eating a meal. It is for the social contact that it has provided us. Take today’s lunch for example.

We ate at Carla’s Trattoria today as we do almost every Tuesday. We now know the hostess as well as several of the servers. Josh is our regular server. When he is not there, we ask for Morgan, his girl friend. That is what we did today. Since they are familiar with us, we have brief conversations depending on how busy they are. Mike knows that we come in on Tuesday and had told Morgan to take good care of us. Near the end of the meal, she asked us if we had tried their cherry gelato. We told her we had. Then she let us know she was bringing a serving to us “on the house.” Kate and I both love desserts, and this was good gelato.

Then a couple of women we know dropped by our table to say hello. One is a member of our music club. The other is the wife of a retired Lutheran bishop who is a member of my Rotary club. We had a nice chat. Then as we walked outside we bumped into a young couple who have recently joined our church. The husband is a past president of our Rotary club. We talked briefly before getting in the car and returning to the house.

This is a rather typical mealtime experience. It wasn’t the meals we had or the gelato that made this a happy time for us. It was the engagement with other people. I can’t say that we always see people we know when we eat out although it does occur frequently. In a city the size of Knoxville, it is hard to go many places without seeing at least one person you know. Even when we don’t know other customers, we do know the servers and often the managers or owners of the restaurants.

I don’t mean to suggest that eating out is something I would necessarily recommend to other people who are living with Alzheimer’s. It isn’t practical for everyone. Kate and I both enjoy being socially active. We are both energized by being with other people. That is especially true for me. My own experience and what I have heard from others leads me to think that it is very easy for a couple in our shoes to become socially isolated. I think that when people are aware that a couple is going through a disease like this one, they tend to be unsure how to respond. This can lead toward fewer invitations out. In addition, a couple like us may accept fewer invitations to events that involve large crowds that can be intimidating to the person with dementia. I certainly see that with Kate.

Kate has faced a special problem. Since we moved to Knoxville forty-six years ago, she has had four very close friends. One of them died in an accident in the mid-1980s. Two others moved out of state. The fourth, Ellen, had a stroke two years ago this past August. Since then she has lived in an assisted living facility in Nashville where she was visiting her daughter when she had the stroke. We try to get there about once a month except for the two to three months after her stroke and another four months after she suffered a couple of seizures earlier this year. She is now in memory care in the early stages of vascular dementia. Ellen is still the only person with whom Kate has shared the news of her diagnosis. They were very close. Losing her last close friend here in Knoxville has had quite an impact on Kate.

For these reasons, the social contact we have by eating out has been very supportive for both of us. As I suggested above, the value of it has far exceeded anything I could have imagined when we began this practice. It has really enhanced the quality of our lives.

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Celebrating The Christmas Season

Last night, Kate and I attended a special Christmas dinner at Casa Bella. This is an annual event done in conjunction with Broadway Night. Christmas music makes up the entire musical program. That includes not only the musicians who entertain us, but also those who are in the audience. The formal program consisted of selected music from “The Winter Rose,” a cantata by Joseph Martin. Neither of us was familiar with the music, but we and the rest of the audience enjoyed it. Apart from the beautiful music, we sat once again with the same couple we usually sit with. They are both 93 and in great shape. We loved sharing another evening with them.

That was the second of a number of Christmas events we will be attending this week and next. I am happy that we are able to enjoy the season in this way. I only wish Kate were able to fully appreciate it. She does enjoy the specific events like last night, but her memory doesn’t permit her to retain any sense that it is the Christmas season and to reflect on how much we have enjoyed it in the past as well as the present. She doesn’t say anything about Christmas or anything about the outside decorations I have put up. Even when I showed her what I had done, she was only able to say, “That’s nice” without a lot of enthusiasm. This is another characteristic of her AD. She is simply much more even in her expression of emotions except for things that she especially likes or dislikes.

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Friday Morning At The Zurich Airport

The first thought I have about the trip is that it has been just what I had hoped for. We went to a nice variety of places (Geneva, Interlaken, Lucerne, Zurich), engaged in quite a few diverse activities from city tours, to mountain heights, to paragliding, and opera. I am aware that emotionally I have felt up most of the time but also discouraged a few times. The most negative aspect of this or any other trip we might make is the responsibility of planning and executing daily activities while at the same time caring for Kate. It is not that she has presented any serious problems. It is more like the responsibility a parent has for a child. In fact, I believe that is an excellent comparison. Like a young child, she often is confused, forgets things, loses things, spills things, is unaware of clothing that is soiled, gets hot and wants to take off her coat, gets cold in a moment and wants to put it on, etc. Some of the more discouraging moments have occurred when she gets frustrated with me. She realizes she needs my help but often resents my stepping in to help. This means I am always working to determine what I should and what I shouldn’t do.

We are ending the trip as I expected. I believe this is the last such trip we will take. We have several domestic trips between June and December. I cannot imagine my planning another international trip after that time. I continue to believe that 2015 will mark a significant change I her condition. It already has, and I suspect this will continue.

As I write this journal entry, Kate is writing an email on her iPad. She seems to be having difficulty. She believes she is online, but I doubt it. Normally This is something I would have to help her with. No matter. She can save a draft and send when she is online. We only get one free hour in the airport; so it seems wise to work offline until ready to send.

Several times she has asked me to take a picture of her with a Coke to send to her cousin in Fort Worth. She then thinks that taking it with my camera means it has been sent. Sometimes she realizes this is not the case. This is a good example of the kind of confusion that goes on regularly whether on a trip or at home.

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Thursday Morning In Zurich

It is now 10:16 a.m. We came back from breakfast about 20-25 minutes ago. Kate immediately got back into bed and appears to be asleep though she may just be resting. She was unusually groggy when I got her up for breakfast. I had gotten up at 7:35; so I was ready for breakfast. I had held on by eating some dried fruit that we bought at the train station yesterday morning before taking a city tour at 1:00. We met a family from Boca Raton, FL who were on the same tour. It was a worthwhile tour, but when the guide pointed out things along the way, it was difficult to see them, and they passed so quickly.

We came back to the hotel after the tour. We stopped off at a shoe store beside the hotel and bought a pair of shoes for Kate. The best deal we have made in Switzerland – $20. She rested a little when we got back to the hotel. Then we dressed for the opera. Neither of us had brought along anything that was dressy, but it didn’t matter. We saw all kinds of attire.

We took the tram to the stop that was nearest the opera house – 1 block away. Then we looked around for a place to eat. We found a place named Weissen Wind. It turns out that it is in a building constructed in 1434. We had a very good meal. Kate had poached salmon with mixed vegetables and rice. I had a veal and mushroom dish with rosti.

The opera house and La Traviata were wonderful. We had seats on the second row. We both agreed that this was the very best opera experience we have had.

It was a good day. I have been keeping a close eye on Kate. She has been on me about not doing so. She tells me I will never change. She has no idea how hard I work at doing so, but she is right in that I am always missing things. I am far from perfect. Yesterday I dropped my napkin on the floor at a restaurant. She pointed it out to me. I said, “you take such good care of me.” She immediately started laughing because she is always saying the same thing to me. It was one of those moments in which we both know that each of us recognizes her AD, but we don’t say anything specific about it.

Today is our last full day in Switzerland. Tomorrow we fly to London. We are taking a train to Bern to see it before returning to Zurich for dinner tonight. I can still say it has been a great trip.

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Wednesday Morning In Zurich

We caught an 11:10 train from Lucerne to Zurich. We arrived at the Bahnhof Oerlikon which is directly across the street from our hotel. We could see immediately that we had moved from the beauty of Lucerne to the big city. Quite a contrast. After a quick lunch at Burger King, we went directly to the TI office downtown and got information on several things we could do. From there we caught a boat on the river that took us to several spots on Lake Zurich. We got off at the pier where we could have caught a big boat for a longer boat ride around the lake. We chose, however, to walk to the opera house to get tickets to La Traviata tonight. Then we walked along the river and saw the Grossemunster (the exterior) and Fraumunster (inside as well as the outside). From there we looked for a place to have dinner. We saw an Italian restaurant named Contrapunto and decided to try it. Great decision. Food, service, and ambiance were terrific. This was our second great meal after the Café de Paris our first meal in Geneva.

Once again I would say that our trip is going well. I find that it places a load on me, but so long as I avoid rushing, we can simply enjoy being here. Despite the fact that Kate likes to rest in the hotel room, she is able to go long periods away from the hotel. I don’t see any signs of getting tired while we are out that are different than I would see for most other people.

She was excited about getting tickets to the opera. She also enjoys walking along the neighborhoods. She has taken an interest in seeing Reformation sites like Calvin’s church in Geneva. Both Grossemunster and Fraumunster fall in that category.

It is going to be rainy and cool today. We have overcast skies right now. I can see that the pavement outside is wet, but I don’t see anyone using an umbrella. It is 9:00 am. She has just had a shower and is dressing for breakfast. There is a walking tour of the central city at 1:00. I think we will eat and make our way downtown before then.

Just a moment again while I was writing the paragraph above, Kate said, “Do we have to go home?” I think that captures her feelings about the trip. That makes me feel good. Periodically, she has mentioned wanting to live here (Switzerland). It has been a very good trip.

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Monday Morning Lucerne

It is 8:45 a.m. We woke up shortly after 6:15. Not to much later we dressed, and went to the dining room for breakfast. We have been back in the room for almost an hour. Kate has been asleep about 35-45 minutes. She continues to enjoy resting after getting up and eating.

It is a beautiful day on what is our last full day in Lucerne. Museums are closed today; so I think we will take a combo boat, cogwheel train, and cable car trip to Pilatus, one of the mountain peaks around the city. This is the clearest day we have had; so we will try to make the most of it.

Kate seems to feel much better than she did last night. I am hoping her cold does not get worse.

I see that I did not comment on yesterday. We took a walking tour of the city yesterday morning. Our guide was the best one we have ever had. It was almost 3 hours. Then we went to lunch where we sat next to a table with a couple from New Zealand. We had a great conversation that included the waiter/proprietor (?). After lunch we walked to the old wall surrounding the city and walked up the old clock tower. We rested at the hotel for a while. Then we got some ice cream at a spot along the water front. Then walked to see the Lion Monument. Kate’s nose was giving her fits. We came back to the room where she relaxed and remained until this morning. I was full and snacked on apples and dried apricots. I went down to the terrace overlooking Lake Lucerne and then came back to the room for the night.

It was a good day in every respect except Kates catching a cold.

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Day 3 In Interlaken

I am washing clothes at a laundromat and happy to report that things are going quite well. We have had some rough edges but nothing that has put a damper on the trip. It has meant that at times I have felt frustrated. Two issues: Confusion and Rushing. Kate is unable to do or figure out so many things that I am always trying to see that she gets what she needs. For example, I gave her a ticket for our train trip to Schilthorn yesterday. It has a bar code. You stick the card in a slot, and it is scanned. I showed her where to put the card, but she did it incorrectly two times. She gave it to me and asked me to do it. This is something I should have known and handled without her asking. It seems like I am invariably assuming that she can do things that she can’t do. This frustrates both of us. The hard part is that she doesn’t want my help on most things; so I try not to give it. Then we both discover that I should have helped.

I, of course, correctly attribute this to her AD, but it does not appear that she does. I am not sure this is correct. All I know is that her frustrations in moments like this are with me and not herself.

As expected, I am having to be more careful not to lose her. There have been several instances in which she was momentarily lost. She doesn’t like for me to hold her hand. That would be one way to insure that we stick together. What I do is try to walk beside her or to look back instead of ahead.

One reason that things have gone as well as they have is that we have not been under pressure to meet deadlines. For example, when we have traveled to Jungfrau and to Schilthorn we could simply take the next train or bus rather than worrying about having to be at the station on time. We have been able to do a lot, but we have done it leisurely.

As of this moment, I would say the trip is what I had wanted it to be.