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Frustrations, Annoyance, No Way to Discuss

We just got home from lunch and running several errands. The last trip was to Lowe’s where we had an unpleasant experience that I fear may be a hint of things to come. The start of the story is that last week I took Kate to get some new clothes. We are going to more receptions that require dressy casual attire, and she has gained weight and can’t get into many of her old clothes. We spent a total of $2,200. My general style is to take great care with the things I buy. That has never been here style but it is getting worse with the Alzheimer’s. Today she put on one of the tops she had bought. After we came home from getting her hair cut this morning, I went to the office for an hour. When I got home, I found her pruning shrubs in the backyard. She was still wearing the new top. I resisted saying anything.

This afternoon we went to Lowe’s to check on delivery of compost. While I was checking, she was picking up plants. The first thing I saw was dirt from the plants on her new top. I said something to her about it and started to dust it off when she got upset. We went ahead and got in the car. On the way home, she talked about various ways she was going to be able to get new plants. She started with a taxi. Then she talked about walking to Lowe’s and bringing the plants back home in one of their “grocery carts.” Then she said she was going to buy her own car. When we got home, I tried to tell her that I didn’t intend to stop her from buying plants that I just wanted to get her blouse cleaned off. She said she just didn’t understand. I stopped trying to explain. It is just no use.

This is the second time I recall that I said something that hurt her. The first was on the New Zealand trip. We were browsing in a gift shop when she wanted to buy a small tin box with a picture of a cat on the top. This was early in the trip; so I told her she might want to think about her priorities in things she would want over the whole time we would be gone because we wouldn’t have room to carry everything that she might want. I didn’t mean at all that she couldn’t buy the box. She didn’t buy it, but she was unhappy and told me she couldn’t understand why I wouldn’t let her buy it. Not only that but she brought it up several other times in the days following. It obviously was important to her.

I find myself frustrated by things, but I can’t say anything or I will hurt her. She, on the other hand, feels annoyed with me, and feels I am controlling her life. She brings this up periodically and is proud to point out the things she knows and can do. I have always said that people with Alzheimer’s know at the beginning that they are not able to do things or remember things the way they should. I still believe this, but I think she is beginning to enter the stage where she believes she is far more capable than she is. That is hard for me to take.

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Cards Lost Again

I believe I mentioned that we have replaced Kate’s ATM card several times over the past year , three times since Jan 1, I believe. A few days ago, I gave her a leather card holder that I had used in the past to carry my business cards. I put her driver’s license, ATM card, Medicare card, and supplemental insurance card in it. Yesterday afternoon she told me that she couldn’t find it. This morning she let me know that she has gone through all her purses and looked in all the places she thought it might be without success. I looked in the car and around our bedroom and laundry room. Still no luck. I told her we would look for it later. I also told her we could use her passport when we travel to Jackson Hole on Wednesday. In addition, I suggested that we put the new cards in the glove compartment of her car and that we leave them there.

Of course, I stopped short of saying what I think is coming – that I take all her cards and hold them for her.

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Traveling in Peru and Ecuador

Kate and I have typically traveled on our own. The major exception was our trip to Tanzania. We are now at the end of a trip to South America (Peru, Manchu Pichu, the Amazon, Ecuador and the Galápagos Islands). Here are a couple of observations.

Traveling with a group requires a schedule. Overseas Adventure Travel (OAT) clearly understands this. This meant each of our days has been planned, and we are all expected to comply. That has been a challenge for Kate. She can’t remember the schedule at all and depends solely on me to get her places on time.  Since she is not naturally punctual, this has been something of a problem.

The biggest problem for me is getting ready for everything. She never wants to get packed before going to bed. That means getting up earlier than I want and being rushed to be on time for our departure. We have had numerous early departures. Tomorrow we leave hotel at 5:30. When I suggested getting back to the hotel to prepare packing for tomorrow, she didn’t want to do it. This has been a pattern throughout the trip.

The trip, by the way, has been fantastic, but I don’t plan to make any more group trips, possibly fewer international trips if at all.

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Decisions

I’ve noted before that I often wonder when is the right time to let the children know. I am now comfortable with the decision to hold off as long as we can, but can’t help wondering if the week with the family this summer in Jackson Hole might not give the children a reason to suspect. Having talked with Kate, I know that she is far from ready to mention anything to anyone.

A related issue is when do you (Kate) stop accepting certain responsibilities. She seems eager to volunteer for certain things that are hard for her. Last summer she volunteered to be the editor of our neighborhood association newsletter and directory. She was going to get an issue out last fall with pictures from a Labor Day picnic and our flag at half-staff for 9/11. She still hasn’t gotten the newsletter out.

Late Saturday afternoon when I got home from visiting Dad, she was very glad to see me. She had been working on the neighborhood association directory and was quite frustrated. She asked if I could spend Sunday afternoon helping her out. I agreed to do so. I should say that after lunch on Saturday I had created an Excel file she could use to enter any new neighbors or to update the information we have on existing ones. This was a simple matter in that I simply did a “”save as” from the original file she was given. Then I put the information in a form that she could work with more easily than the original file. I tried to ask her what she wanted me to do now, but she didn’t want to explain. This is a very, very common pattern in our relationship. It is difficult for her to explain things. The explaining part of her brain just isn’t working properly.

On Sunday afternoon we worked together to address her problem. It turns out that she needed to organize an existing hard copy of the directory. The way the directory had been assembled the names were organized by streets but neither arranged by house number nor alphabetically by names of the owners. That makes it very hard to locate a particular person. This is a very easy task akin to organizing a deck of cards, but she simply got too confused and couldn’t do it. I simply did it for her.

This raises the question of how long Kate can continue to do something like this. It is simply too difficult. She was called for jury duty by our municipal court last week and was excused because of her age. She was disappointed. She thought it would be interesting to serve. I, however, thought it would put her in an uncomfortable position since it would require asking her to comprehend arguments, remember details, and to render judgment on a person. These are all things that would have been difficult for her.

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New Year: So where are we? How is she? How am I?

I started to entitle this entry “Emotions change quickly” but thought that since it is the beginning of a new year some reflection is appropriate. Both things are intertwined.

Just yesterday I sent the following email to Tom and Carl, two email buddies whom I have kept up with since college days at TCU. Neither of them knows about Kate’s AD.

As I suggested in my previous post, each of us is approaching the stage of life with a different set of experiences and situations. I have never been a workaholic, but my job has necessarily required time apart from Kate. I used to travel a lot. I was reminded of this the other day when I noted that I have travelled only 23,000 miles this year. At one time I was travelling over 100,000 miles a year. That’s how I got to 3,000,000 with Delta. I must have flown 500,000 with US Air. Kate never complained. She actually likes alone time, and I think we were together just about as much as she wanted. Now that we have reached this stage, I just feel the need to make the most of whatever time we have left. That is why I have put as much emphasis on our 50th anniversary as I have done. I have also tried to attend as many social and cultural events as possible. We do about as much as we are comfortable doing. Sometimes it is just nice to be at home.

For me this is as much about attitude change as it is about just being together. I mean there is a difference when we are together. For example, as I finished the paragraph above, she came in to ask if I could build a fire. In the past I would have done it, but I might have thought, “Gee, we just had a fire each of the last 2 days. Do we really need another one today?” Instead I immediately started working on a fire that she will enjoy the rest of the afternoon until we go to dinner. Another way of expressing it is that I make more of an effort to make her happy than I did for a good bit of our married life. The great news is that I find that we are enjoying each other more than we did in the past. That’s saying something because we have always had a good marriage. Now it is almost like we are on a honeymoon. We don’t take each other for granted. Enough said.

Of course, this leaves a lot unsaid because I don’t want them to know just yet about Kate’s diagnosis. It also emphasizes how quickly my feelings can change. Yesterday I sensed that Kate was somewhat depressed. When I got home from visiting Dad, she was almost asleep on the sofa in the family room. We talked a little before dinner, ate at home, and went to bed. During the night she had some problems with diarrhea. This has been a chronic issue for her for some time; however it has gotten worse in the past 6-12 months. This made me think about her continuing inability to function effectively when doing a lot of tasks and what things will be like as she gets worse. It also made me think about our upcoming trip to Peru and Ecuador. I understand that almost everyone gets diarrhea on this trip. Will this be especially difficult for her? I don’t know. I hope that we will be able to take medicine that will help us. She has two doctors’ appointments coming up soon. One is with Dr. Reasoner, the other with Dr. Edwards. She also had a bad bout with acid reflux night two nights ago. I ended up calling the doctor on call at Dr. Reasoner’s office. He recommended she take Gravascon or Mylanta which we have bought subsequent to my call. My point in going through this is to say we can be up at one moment and down at another. My mood depends heavily on how I believe she is feeling.

So how is she doing? On the whole, I would say she is doing well. I think she would say the same. On the other hand, we both see signs of greater difficulty doing lots of things. I get the impression that she is sometimes just in a daze. On simple tasks like entering a new name in her contact list or an item on her calendar, she asks me to give her just one thing at a time. I can’t say, “”We are going to the Bijou on Thursday at 8:00.” That is too much information at one time. Another indication of how difficult it can be for her to do things involves her hair appointment. She missed one while we were in Tom for Christmas, and her hair dresser asked her to schedule a new appointment when we returned. I have been asking all week if she had done it, and she hadn’t. Last night I asked her if she would like me to call and make the appointment. She quickly said yes as though a load was lifted from her.

At dinner on New Year’s eve, she made a gentle reference to her AD, but we did not discuss it. It is clear, however, that she sees herself having more trouble. She does not believe her time is as short as I believe it is. She continues to talk about taking each of the grandchildren to NYC when they are 13. That would be the summer of 2014 for Heather and 2016 for the twins, and 2017 for Taylor. I am not even sure 2014 will work out. Kate certainly would be able to travel, but based on our recent trip to NYC, she requires a lot of help. (I have even thought we might consider taking Heather to NY this summer instead.) That said, I believe it is good that Kate does not believe the trips won’t work out. This would depress her.

Going to have to close now. I will deal with how I am doing in the next post.

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Special Moments Followed by Melancholy

A week ago this past Friday we went to a 5:30 movie (Anna Jesseina) and then to Casa Bella dinner. Everything was perfect. We got our usual dinner, splitting a Veal Piccata, a bottle of wine and white chocolate cheese cake for dessert. Every part of the meal was great as well as our conversation. All of this is to say that we continue to have many special moments – I suspect more than most couples.

For some reason the next day I was feeling kind of melancholy. In the car I listened to music that has been special to us. That would include a song from the movie, Same Time Next Year and another from the television series, ”Family Ties.” It was hard to keep my mind off of the fact that the special times we have together are limited and grow fewer each day. Mind you, it wasn’t that Kate did something to remind me of this; it was simply the joy of good times together that made me think of the limited time we have.

This past week we went to Lubbock to be with Kevin’s family for Christmas. This was a special time. During the trip there were reminders of Kate’s decline in memory. For example, she indicated she wanted to go to the Astrodome. I decided that the easiest way to work that into our schedule would be for us to do it on Friday morning, the day we were leaving. Each day, however, she would ask about going to the Astrodome, and I would tell her we would do it on Friday. On Thursday night, we said our good-byes to Kevin and his family after dinner at the Macaroni Grill. It was clear that the reason for doing so was that we would not see them the next morning. When she got up Friday morning, she worked on the computer for a while, and I mentioned that we would want to leave on the early side to get to the Astrodome. She took her shower, dressed, and got ready to leave; however, she hadn’t packed her things. When I mentioned this, she asked if we were leaving today. I told her yes; so despite numerous mentions of when we were returning and her writing it on her calendar, she still did not remember that this is the day we were to return.

Looking on the bright side once again, it is good that it is the short-term memories that are the biggest problem because most of our functioning depends on longer-term memory. This would not be true if she were in a position of responsibility either as a volunteer at the library or if she were still working in the school system. I am even beginning to be concerned about some of her volunteer work with PEO and our neighborhood association.

Another interesting side-effect of her Alzheimer’s is that she looks more kindly on most people. She is more complimentary of me than at any point in our marriage. She often talks about how bright I am. She says similar things about other people. I think this is because so many things are difficult for her that she is impressed when she sees others doing what she cannot do.

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Mini-Discussion

I have mentioned before that Kate and I rarely have any conversations that relate directly to her Alzheimer’s and how she is feeling. This past Wednesday, however, we had a brief discussion. Here’s how it happened. I think I have commented before that she has a harder time understanding movies than she used to. She gets confused about the plot, especially if there is anything complicated about it. On Wednesday, we went to see Anna Jesseina. It was a modern adaptation that I won’‘t even go into; however, neither of us liked it. It also had a lot of very quick “cuts” during the early part of the movie that made it hard to know who was who and what was going on. I suspected this would be hard on her, and it was. (A similar thing had gone on at Un Ballo in Maschera at The Met.)

As we drove to Hathaway’s s for dinner afterwards, we discussed the movie. When we got there, she told me that she just couldn’t get any of it. She was confused the whole time. It made it very difficult for her to remain to watch the movie. Then she said, “”You know I am getting worse.” I acknowledged that she was correct. We discussed how fortunate we are to be enjoying things while she can. She indicated she didn’t know how long that would last, but her comments made it sound like she may think it will last longer than I think. I asked her if she felt any closer to telling the children about her Alzheimer’s. She responded very quickly that she felt we were a long way from that. I, on the other hand, had been thinking that we might want to tell them either before or after our trip to Jackson Hole in June. (My reasoning is that they might notice signs that would make them wonder.) I told her I knew she didn’t like to dwell on the topic but that I wanted to be more supportive if I could. The conversation didn’t last long, but it underscored my belief that she is quite frustrated over not being able to do things or to understand movies. I think that extends to books because I hear her talk less about her books than she used to do. I think her major reason for listening to books is to help her sleep and that she is not finishing books nor remembering what she has read. She is also playing Free Cell on the computer and her iPad more. In addition, she jumps around from one task to another. I suspect that relates to frustration she has with one and tries something else.

I had a brief conversation with our pastor this week. He mentioned that a member of the staff had thought things were not quite right with Kate after our return from New York. He also felt that our children probably know or have a suspicion. This makes me think that others around the church are beginning to notice. He encouraged me to tell the children, but I think that was mostly to help me since I do not have someone to talk with now. I told him that he and our attorney were the only ones who know.

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Sweet memories but constant reminders

Wednesday night we got back from NYC. It was everything I had hoped it would be. We saw more shows than ever (5), 1 opera, a performance of Handel’s Messiah, and the new movie, Lincoln. We are treasuring the memories of such a special trip.

Back home, I see Kate dealing with the frustration of accomplishing things – mostly on the computer. Yesterday I could sense she was depressed which I took to be related to this frustration. When I got home from visiting Dad, I asked her what she would like to do for dinner. When I suggested one possibility would be to bring something in, she didn’t look excited. Then I said, “”How about going to Casa Bella?” This is one of our favorite restaurants in Knoxville? We almost always get the same thing, and it has come to be a comforting place when we are low as well as times when we are celebrating. She responded quickly saying, “”Could we?”

I told her I would like to go ahead and get my shower. She said she was ready but would continue working on the computer while I got ready. Her power cord is damaged again; so she was using mine. She has repeatedly has power cord problems because she uses the computer with the power cord plugged while lying in bed or sitting in a location where the cord is pulled. Within two months of getting the latest computer, we had to replace the piece in the computer into which you insert the plug as well as the power cord itself. We had done this on her previous computer as well. We have discussed why this is happening, and I have encouraged her not to use it that way. In addition, I bought her an iPad because I thought she could use in it instead of the computer, but she has not gravitated to the iPad. I think that is mostly because the bulk of what she does is making photo collages using Microsoft Publisher and Creative Memories, neither of which she has on the iPad.

This is all a preface to one of my failures in handling a situation last night. Just before we left and while she was working on the computer, I told her again that it was better not to use the power cord while seated on the sofa. (That is because it requires the cord’s being pulled to the side which can cause the same damage to my cord as to hers.) She said, “”I am trying to be super careful.” I answered softly but inappropriately, “If you were trying to be super careful, you wouldn’t be using the computer this way.” She then broke into tears and went to get her coat.” When she came back with her coat, we embraced and I told her I loved her. She said, “I just hate this; I can’t do anything right.”

We had a perfect evening at Casa Bella. We caught them on a very busy night, but we had good service, the veal piccata was better than usual, and we topped it off with white chocolate cheese cake. When we got home, she was tired and got into bed before I did. While I was brushing my teeth, I heard her, and asked if she were laughing or crying. She said, “”Crying.” I asked, “”Why?” She said, “”I don’t know.”

These are continuing signs that she is getting progressively worse, and she realizes what’s happening. One of the things that hurts me is that she keeps most of this to herself. I wish she were able to talk about it more, but I think it is not just to spare me but to protect herself. I suspect that she feels the more she dwells on her condition, the worse things are. She is really frightened.

Once again, events of yesterday reinforce the superficiality of social relationships. At noon yesterday, we had our Sunday school class Christmas lunch. She sat at the same table as our pastor. He has told me before that except for knowing from me that she has AD, he is unable to tell when he speaks with her. I suspect that even though they sat at the same table for more than an hour, he wouldn’t have been able to tell. On the other hand, I can see so many things that make it difficult for her to function effectively.

This makes me wonder how long we can keep this from our children. I really want them to know so that they can make the best of their relationship with her the way I have been able to do. At the same time, Kate does not want people to look at her as a patient. I will honor this desire until or unless the children begin to suspect. That could happen this summer when we spend a week together in Jackson Hole. If it doesn’t, this will be further evidence of how long someone with AD can keep it hidden from others.

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Sweet and Bitter in NYC

This is Sunday morning, and we have been in New York City since 9:15 Wednesday morning. I just got back from a nice walk around the neighborhood on the upper Eastside near Bloomingdale’s. Kate is still sleeping soundly. I am going to take a few minutes to collect my thoughts on the past few days.

The first thing to say (and the reason I put “sweet” before “bitter” in the heading for today’s post) is that we have had a marvelous time. It is everything I had hoped. This is the first of a series of things we will do to celebrate our upcoming 50th anniversary (May 31, 2013). I chose New York City because it is the place we have visited far more often than any other place, we love it, and Christmas in NYC is very special. Besides that we had our first date on December 19, 1961, got engaged on December 19, 1962 (50 years ago this month). Our first date was a performance of Handel’s Messiah. Tuesday night we will attend a performance of Messiah at St. Thomas Episcopal Church on Fifth Avenue. We both love the theater; so we have also attended My Name is Asher Lev, Newsies, The Book of Mormon, Un Ballo in Maschera at The Metropolitan Opera, and Once. We may attempt another show this afternoon; however, I am tempted to pass some time in our neighborhood. It is a wonderful area, and we have not spent sufficient time here. Of course, we don’‘t leave until late afternoon on Wednesday; so we might do that another time.

Now for the bitter. Although we have had a great time, we are both noticing Kate’s deterioration. At lunch a couple of days ago, she said, “”I would love to come back to New York with Jesse, but I don’t think I could do it again. She would have to take charge.” I said something about the wonderful memories of previous trips. It was a sad moment for both of us. In addition, at each show she asks me to explain things. It is very hard for her to follow the complexities of the stories. Yesterday at the opera, she asked me to explain what had happened after each act. She said she simply couldn’t follow things. I said it must be like there are so many stimuli coming in that she doesn’t know what to focus on. She said that was “exactly it.”

Because of her condition, for the first time I haven’t considered leaving her anyplace to browse and then meet her later. This is something we have frequently done in the past. We have both stuck close together at all times. There have been at least 2 occasions when we have gotten separated momentarily. One of those was going into Macy’s.

In addition, she gets confused on instructions. For example, last night while waiting in line to enter the theater, a theater employee asked us to move down to another line. For some reason Kate thought we were supposed to enter at a different place; so she simply went ahead of people who had been waiting in line. She also has trouble going through the turnstiles at the subway.

All these little things notwithstanding, we are having a wonderful time. It makes me glad that I decided to go all out for our 50th anniversary because things will deteriorate from here. Next year she will be less able to enjoy these things.

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Good Weekend

We had an active weekend. Friday night we went our for a nice dinner at the Parkside Grill. Saturday night I picked up something from Asia Kitchen, and enjoyed it with a glass of wine. Sunday night after coming home from Dad’s, Kate had the house decorated for Christmas with many candles lit in the family room. We had a glass of wine, and conversation with a fire in the fireplace. I had brought home sea bass from Whole Foods along with an heirloom tomato. It was a special evening even though I have a bad cold.

I make a point of these little things because we are finding that those moments are more special than we would have thought in years past. We really are making the most of the time we have left.

On the downside, this morning Kate asked me how to turn on the TV, something she has been doing without a problem up until now. I don’t mean that she hasn’t had problems with the remote. That has always been confusing. I showed her how and turned it on for her. A few minutes later, she came to ask how to change channels. She couldn’t remember. I showed her, and she remembered right away.

Two other things caught my attention over the weekend. On Saturday when I got home from Dad’s she indicated she was not in a good mood because I was coming home a little later than usual. As we discussed this over a glass of wine before dinner, she told me she likes for me to be at home. She said she has so many questions to ask me, and it frustrates her when I am not here, especially as it is growing dark outside.

The other thing involves the birthday cards that Dad received. She brought them to me yesterday afternoon and asked if I might like to take them to Dad. I said I would but thought she was going to put them in a scrapbook. She had completely forgotten that she had decided to do the scrapbook. It is getting so that she forgets many if not most things that she says she will or wants to do at a given time unless I take the responsibility of reminding her.

She spends a good bit of her time on the computer working on photo albums that she may never complete and playing Free Cell. I think she gravitates to these things because they are things she can do. She doesn’t say much, but I know she is sensing her decline and it bothers her.

I felt guilty over the weekend because she wanted to host a lunch for my staff, and I her I hated for her to have to do that. I explained that I will be stressed over it. She is planning to have a lunch for two of her close friends after we return from New York on Dec. 12.

This morning I took her car to the body shop for an estimate of the damage that occurred when she struck a support in the Belk parking lot. We should get it back soon. Kate will be happy about that.