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It’s the little things.

In an earlier post I mentioned that it’s the decline in Kate’s short-term memory that seems to be most obvious change that is occurring. That is what will finally cause her friends and family to suspect dementia. Here are several recent examples.

1. I just arrived home (10:20) from getting to the hospital at 4:00 this morning after Dad took a fall around 3:00 a.m. She was working on something for PEO and didn’t even ask about Dad. I think she remembered that he had had a fall, but I dont think it was sufficiently present in her mind to automatically ask how he was doing.

2. When I drove up to the house, I saw her glass of iced tea at the curb in front of the house near the mailbox. No doubt she had been doing some pruning around the shrubs and put her tea down. Then she finished without remembering that she had put it down.

3. Last night she said she had lost the power cord to her computer. I walked into her office where I had seen her using the computer yesterday afternoon. The power cord was right by the chair. This is an interesting symptom because it is not just forgetting where she left the cord or where she last used it, but she also has trouble focusing on things when she is looking for them. I am remembering my recent participation in a virtual dementia experience in which our eyesight was diminished with dark light and goggles. I simply didn’t see things that I would have seen otherwise.

4. On Monday of this week I did a little trimming of some shrubs that Kate had asked me to trim. As I was doing so, I found some clippers in the space between the shrubs and the house. She had no doubt been using them, put them down, and then forgot them.

5. One morning this week I left for the office while Kate was out on a walk with a neighbor. As I got close to our street, I saw Kate walking by herself in the direction of our street. Later I asked her about that. She gave me a funny look that made me think she didn’t want me to ask. (Incidentally, frequently she doesn’t want me to ask her about something and has developed a short hand way of communicating that. She says DNA (Do Not Ask.). Then she explained that she and the neighbor had finished walking and as she was returning to the house she walked by our street which is almost a half mile from where I saw her. Because she has always been geographically challenged, I fear that this is one of those things that is going to get us in trouble sometime. We have now had a number of mini-crises surrounding this. The first was in Birmingham when she and a friend had gone to a shower for niece. She has had several similar experiences when going to PEO. One of the most dramatic was when we were going to meet our son, Kevin, and his family at the airport a couple of years ago. She was supposed to meet us there. When she hadn’t arrived in a reasonably length of time, I called her. She was in downtown Knoxville and had no idea how to get to the airport. All of us packed into my car and met her so that she could follow us home.

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Our Granddaughter’s Visit

This past week our granddaughter from Tom has been with us from. It has been a great week with her. She has been an especially good companion for Kate. Throughout the week Kate has been impressed (as she has in the past) with Heather’s keen observance of things around her. She notices many things that we miss. I can’t help thinking, however, that this has been especially noticeable for Kate as her own memory declines. Two quick examples. Kate and I were looking for a picture I had taken of a Crowned Crane in Africa. It wasn’t long before Heather showed her the framed picture hanging on her wall in her office. Similarly, Kate had received a photo taken of Ken and her when they were young children. Kate commented that she already a copy of that picture but couldn’t recall what she had done with it. Not too much later, Heather showed her the picture that was displayed in our family room.

On a similar note, I was struck by a couple of things that Kate could not remember as she and Heather were preparing a special Father’s Day and birthday dinner for Dad and me. First, Kate asked me where we keep our placemats. Although we don’t eat at home much, we do get the placemats out often enough that I was surprised that she didn’t remember where they are kept. She also asked me where the spatulas are kept. A little less surprising is that she also asked where the blender was kept. This is less surprising in that I am the one most likely to use it. I use it regularly to blend soups for Dad.

We both thanked Heather for being with us and how helpful she had been. Heather commented on Kate’s forgetting things. I believe, however, that she doesn’t suspect the actual situation. She simply thinks of Kate as having a bad memory. This may be the story we see played out with the rest of the family.

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Stress, Frustration, Depression?

Kate does not talk in depth about her AD. She mentions it mostly indirectly and fleetingly. That is, she says something like, “”I just don’t know; I can’t remember anything.” Then she moves on. I have learned (mostly, anyway) not to push her to say more. She seems to want to be comfortable to recognize her AD but not to dwell on it in a discussion. She does make reference to the stress of life. She also seems down at times. I also note that there are related things that have nothing to do with memory. For example, over the past few years, she has been reading the newspaper less and less. Nowadays, she reads only infrequently. I think she is frustrated by not understanding what she is reading, but again, I don’t press her. I do sometimes joke with her about not being able to probe for more information about anything she brings up.

Another thing that has become next to impossible is operation of the DVD player or doing a number of things on the computer. I think one of the reasons she likes having me around is to be there to help her address the never-ending resolution of problems.

Yesterday she called me to say that she had forgotten another hair appointment. Neither one of us had written it down. Later she said that the message she received from her hairdresser indicated that she had forgotten to make a reminder call, something that is not routine but something she has started doing for Kate.

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Everyday Life

Earlier this week, Kate expressed her frustration over my getting home as late as I do after my daily visit with my dad. I told her I would go out a little earlier and be home earlier.

I started this new schedule yesterday. This involves a clear choice to put her over Dad in that I like to make sure Dad’s teeth are brushed and he gets his sheet and bed spread covered over him.

Today, Kate had a routine appointment with Dr. Reasoner. She couldn’t remember the doctor’s name when asked to put it in a form. She has known her doctor for years and has been seeing her every four to six months since her diagnosis. I was a little surprised that she couldn’t recall her name.

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Pain, Pain, Pain

This past Friday, Kate and I drove to Nashville where we had dinner with and old friend from Wisconsin and three of her friends. On Saturday, we got together with our daughter, Jesse, and her boys who were there for half-marathon on Sunday.

Overall it was a good weekend, but it was also a trying one for Kate After Friday night’s dinner, she commented on how people seem to ignore her and give their attention to me. She also expressed her fear that increasingly she feels uncomfortable in conversation. She has a special fear of asking things she has just asked which I have observed a few times. She says she sees herself becoming quiet the way she has seen other AD victims do.

She hasn’t wanted to talk about it, but I have noticed that she was low as we returned on Monday. She has my cold now, but I don’t believe that is the explanation. We were together for lunch, and I took her to a new ice cream shop downtown to give her a little boost. She seemed to enjoy it, but it didn’t really change things.

I should have entitled this entry (started this morning) as Pain, Pain, Pain. It is the confluence of several things at one time that makes it stressful. I am reminded of the Psalms. Many of them are written when the authors were on the mountain top. These sing praises to God and give thanks for all the blessings of life. Many others, however, are written from The Pit of despair. These focus on the challenges of life and often question where God is and appeals to God for help out of disaster. Though my own moods are usually upbeat, I have recognized in the past few years that external events can make it hard to feel optimistic. Right now is one of those times.

Over the past 3 years my business has been terrible. I have lost a lot of the money that I had made over many years. We are now down to 3 staff members. I recently sold the building to a law firm that will occupy the downstairs. We are going to lease the upstairs from them. Last week we made the move and like the new arrangement. However, in the midst of feeling good about selling the building and sensing that the new quarters suit us better, the business itself continues to decline. We just aren’t getting calls anymore. We committed to a one year lease thinking we would be safe because we have booked enough business to almost cover us for a year. It is so slow now that I am beginning to wonder if we were dreaming.

Now let’s add the events of the weekend and the following days at home. For me personally the weekend was great because we were with people we liked and enjoyed pleasant, stimulating conversation. In addition, we had the joy of being with Jesseand her boys. On the other hand, it was not as good for Kate as I pointed out above. She continues to recognize her deteriorating condition. I will SCREAM once again that for a good while AD patients know they are losing it. It is horribly depressing. I think it is especially depressing for people who value intellectual ability as Kate does. It is more than intellectual ability. It is also the ability to operate confidently in the world –, to be able to handle everyday things.

Last night we went to a movie called The Matchmaker at our local arts theater. After we left the movie, Kate said, “I didn’t understand it at all – even after you explained it.” I recognized that she wasn’t just saying that it was a confusing movie but that she was saying her condition prevented her understanding what was going on. When she says things like this, I can see the pain in her face. Then I don’t know what to say. I told her I wished I could help her and that I love her. I started to say more, and she stopped the conversation. This is a typical pattern. Things occur that lead her to say something acknowledging AD and her frustration. Then just as quickly she wants to move on as if continued conversation will only make it worse. I know the pain is greater for her, but it hurts me tremendously.

One thing that struck me and has on other occasions is similarity in my experiences with my dad. Yesterday afternoon I took my old iPhone to the ATT store and had them set it up for dad. When I tried to show him how to turn it on and make calls, he simply couldn’t do it. It was frustrating for him and for me. I had underestimated the difficulty for him. I had even set up a set of favorites to make it easy for him to dial. All he had to do after turning on the phone was to press the name of the person he wanted to call. It was next to impossible for him to do. So this experience was followed by Kate’s not being able to understand the movie that was not that complicated.

Seeing her deterioration over the past year, I can’t help wondering where we will be this time next year. We are planning to make a trip to the Galapagos in January. Will she be up to this? It was a bit of a chore getting her ready for the daily activities on the trip to Africa. Will it be impossible next year?

Yesterday morning, I saw Herman and Betty Snyder at Starbucks. Betty said she was going to call Kate and asked me if she would like to join a Care Team at church. I explored the responsibilities and told her that I thought she probably would not want to do it. When I spoke with Kate last night, she said that she might like to do it. This makes me wonder how realistic she is about things that she can undertake.

Our conversations involve references to future travel. I get the impression that she believes this is something that she will be able to do for a longer period of time than I think she will. Right now, for example, I am thinking the trip to New Zealand may need to be a cruise because it will be easier logistically.

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Multiple Signs of Decline

Kate continues to exhibit a variety of her symptoms. Without my giving an exhaustive account of each one, let me just list a few of them briefly.

1. The other night we had a good conversation in which we reflected on our marriage and some of the things we remember so fondly. The next morning when I said something about the conversation, she didn’t remember it at all.

2. After returning from her hairdressers the other day, Kate said that our daughter may know of her Alzheimer’s.  She has suspected this before, but feels more confident now.

3. This past weekend we went to Nashville to visit friends. She was quite stressed in getting ready for our trip. I told her the time we would leave . We left an hour and a half after that time.

The four of us went out to dinner with another couple whom we had not met before. We had a pretty active conversation throughout the evening, and it was hard for Kate to play an active role. She later told me that she felt very isolated. She mentioned that she could imagine her becoming quieter in social situations like this.

She also told me that she was hesitant in the conversation because she was afraid she was going to ask about something the other person had already told her.

I can’t recall another specific example, but she seems to have a harder time putting things together when we are with other people. She often doesn’t understand what people are talking about. The other day after seeing a movie she confessed that she couldn’t follow it.

My recognition that she knows exactly what is happening and is stressed by it dominates a lot of my thinking. I think this is because so many people believe that  person with dementia doesn’t understand that she has the disease.

Apart from the experiences with Kate, I had a frustrating day with Dad as I tried to teach him to use my old iPhone. He just couldn’t get it. Then tonight Kate couldn’t understand the movie. This is not the first time I have seen parallels in their situations.

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Experiencing the Consequences of Fregetfulness

I continue to feel that Kate has been feeling the pain of losing her memory. A week ago today she had a PEO meeting. I am trying to drive Kate to places that might be confusing for her. That morning I got the address and wrote out directions from our house to the home of the woman hosting the meeting. I had a meeting that morning while she would be en route; so I told her I would stay in touch with my phone for any messages. When I didn’t hear from her, I thought everything was all right.

When we spoke on the phone later that afternoon, I asked if the directions had worked. She indicated that she didn’t want to talk about it. That evening she told me that the meeting had been changed to another member’s house. She had received an email the week before letting her know of the change but had forgotten. When I asked about her getting there, she told me that she hadn’t made it. I asked what happened, and she said she didn’t want to talk about it. I honored that request; so I still know only that she didn’t make it to the meeting and assumed that she was unable to find it. It is also quite possible that she got to the original place and then couldn’t reach anyone to tell her where the meeting was.

There are other examples of her forgetfulness, but I can’t remember them at the moment. Suffice it to say that she continues to be frustrated by her inability to remember things.

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“You Told Me That”

Just a brief comment today on something I have mentioned before; however, it seems so common now that I chuckle when it occurs. Frequently when I tell her something she says, “You told me that.” Of course, it is quite possible that sometimes she is correct. It happens so often and in instances when I know that it would be impossible for me to have told her because I just learned about it. It makes me wonder if she says this because she forgets so frequently the odds are that whatever I say is something she has forgotten. Another possibility is that it is something akin to a deja vu experience.

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Everyday Problems Associated with Alzheimer’s

The past week has been a full one. We celebrated Valentine’s Day by attending a concert by the Knoxville Symphony on Saturday night, the Symphony League’s Valentine’s Ball on Sunday night, lunch at Casa Bella on Valentine’s Day, and the UT Symphony that night. These were good times for both of us and serve to remind us how much we can continue to enjoy despite Kate’s Alzheimer’s looming over us. We continue to put a special emphasis on our relationship which seems more precious to us with every passing day.

On the downside, on Tuesday morning Kate took a walk around the neighborhood with one of our neighbors, Lucy Grayson. During that walk Lucy commented on another neighbor and her husband, Barry and Mary Jane Winters. Mary Jane also has Alzheimer’s which we have been aware for 2-3 years. Lucy indicated that she felt sorry for Mary Jane and then said, “I feel especially sorry for Barry.”

These are the kind of things that occur routinely, but they have a special meaning when you also are plagued with the disease. It makes me think once again that people need to be more careful about what they say.

Kate and I had lunch together and then she left in her car to run a couple of errands before returning home. I received a phone call from her a little later. She left a voice mail as I was in a meeting or phone call at the time. The message was a bit garbled but I could tell she had had an accident of some type. I sent her a text and asked if she were all right. She answered quickly that she was; so I called to find out what had happened. She told me she was pulling into a parking space and misjudged the distance to the car on her right and had knocked out her front headlight. When I got home that night I discovered that it had not only broken the right signal light but had also damaged the front fender, the right front passenger door, the right back door which will not open, and the right rear fender.

We sat down and had a glass of wine and discussed the events of the day. That is when she told me about Lucy’s comments that morning as well as how she was feeling about the accident. We didn’t say much. It was obvious to me that she was shaken by the experience. It is just one further sign of her inability to do anything right. I try to reassure her when these things happen, but we both know her situation is getting worse and affecting lots of things besides memory.

Last night at Kate’s suggestion we built a fire, had a glass of wine, and brought in Chinese for dinner. It was a good time for conversation. We find a lot of our conversation relate to things we are thankful for. I think this is our unconscious way of counterbalancing the trauma of the Alzheimer’s. It was a very nice evening. One of the things she said when we talked was that she had lied about something and wanted to explain. She went on to say that she had indicated on Tuesday night that she had not been bothered by Lucy’s comments, but the truth was that she had been bothered by the comment that Lucy felt even sorrier for Barry than for Mary Jane. She didn’t say this, but she doesn’t want to be a burden on me.

On a slightly different note, many decisions are influenced by Kate’s condition. For example, I have been planning to buy a new car next year and thought that I might even delay a little longer. My idea was that Kate may not be able to drive much longer and that I might trade in both cars when I buy a new one. This changed this week when I have significant repair bills on my car and have decided that I should buy a new car now. Kate asked me if I were planning to pass her car along to me. I told her I was not as it had so much more mileage than hers. I got to thinking later that she might have been thinking that her station wagon was getting to be too much for her and that she might do better with my car. Now I am beginning to wonder if getting her a smaller car might be an intermediate step. At the moment, I have decided against that.

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Kate Is Discouraged

Last night Kate and I had a good but very saddening evening. When I got home from seeing Dad, I sensed that she was upset. She was working on our pictures from Vienna. She is making an album similar to the one she and her did for the her mother’s family. I asked her if she would like me to get us a glass of wine and go over what she had done so far. She accepted enthusiastically.

I got a glass of wine for each of us, and she continued working for a short time while I sat on the sofa for her to bring her computer to me. She started to express her frustration. She simply can’t remember names or events that she needs for the album. She had called me twice while I was with my dad to ask the names of two operas we had seen in Vienna. She was still having trouble with that and where we had seen them.

This led to a brief, but much a longer and honest, conversation on how she feels about her AD. She told me she wishes she would rather have cancer, a heart problem, or anything else but AD. She talked about the frustration she has about not being able to remember anything. She talked about her anger over my spending 2 hours a day with Dad when she needs me. We talked together about my spending more time with her. I told her that I had already been thinking that the change in our office arrangements might be a good time for me to spend less time at the office. She then mentioned the possibility of her coming to the office to be with me because she feels she needs to ask me so many things. She seems to feel lost when she is alone. At the same time she talked about her continuing ability to do things. She mentioned specifically that she often finally figures things out even if she struggles to do so.

I have said it before, but I now want to SHOUT it. People say that at least the person suffering from AD doesn’t know it. How wrong this is. Of course, in the much later stages that is certainly true. However, there are years before that when the person does know something is wrong even if the condition has not been officially diagnosed. In a recent conversation, she said, she wasn’t so sure now that she was glad to know.

At any rate, she can see herself declining. It is not just my own observation. Still, I don’t think many, or any, people other than I know her situation.

I continue to be sometimes feeling panic as I see that we are moving toward a time when our lives won’t be as idyllic as they have been. We still want to travel, share good times with friend, etc. I feel like that may be affected within the next year or two. I am going to have to work hard to plan things in order for us to do as much as possible. This comes at the same time that I have to worry about the future of my business and taking care of Dad.