Back to Reality

I just returned home from a fabulous Florida vacation!  My dear friend, Karen Fletcher, invited me months ago to join her and her family on this trip. When she asked me I told her I planned to go, and the only thing that might alter my decision would be a job change for me.  I know that God knew how much I needed to get away for a bit, and nothing stood in the way of my going.  I rested, read, ate wonderful seafood, soaked up too much sun, listened to the waves, parasailed and loved every single moment. I stayed in touch with home through phone calls and texts, and all was well until Thursday. 

The nursing home called me about Billy that afternoon, and he's struggling with chewing and swallowing meats.  He's been evaluated by the nursing staff, the OT and speech pathologist, and they recommend a mechanical diet where his meat is chopped very fine - not pureed but easier to chew and swallow.   He's been slightly dehydrated for about three weeks because he isn't drinking well.  He gets choked when drinking liquids (even thickened liquids), and then he won't take anymore fluids. Part of the issue is his posture which has changed drastically this summer. He cannot sit in a wheelchair anymore because he leans and falls out. He is now in a geriatric (geri) chair which supports him better, but he throws his head back and leans pretty badly. They prop him with pillows, but he doesn't stay that way for long. 

I went to feed him lunch today, and he was happy to see me when it finally registered who I was.  I have to get close to him and get his attention, and he smiles at me when he realizes who I am.  He eats pretty well, but getting him to drink is difficult. He usually falls asleep before he finishes a meal.  I believe he sleeps a great deal during the day and all night.  I was telling a friend about this today, and I shared with her that my head knows that all of this will happen, and I know the likely end of the story, but it hurts my heart to watch it.  Having been away for a week was wonderful but made the decline so much more real for me when I returned. 

I got another call late Thursday night that my mom was enroute to the hospital via ambulance.  My good friend, Rhonda, lives with Mom and me - Mom has dubbed us the Golden Girls!  Mom was able to get Rhonda's attention to let her know that she was struggling to breathe.  Mom has pneumonia that is getting better with antibiotics, possible congestive heart failure, chronic kidney disease, and as we already knew - cancer. I love that she has maintained her sense of humor through this most recent ordeal. That has carried our family through many trying times. I notice that as people age, they feel a certain freedom to express their feelings.  Mom has not hesitated to let the staff know what she does not like, and she can usually make them laugh while doing that. She hates the breathing treatments, and she thinks the respiratory therapists should go stand in the hall during her breathing treatments because their standing around gets on her nerves.  They don't allow her to shower because she's too weak, so they bring her these special body wipes that are supposed to get you just as clean as a shower.  She is not buying that either!  They suggest that she use them in the morning, and she doesn't want to do that, so she told them she would use them around mid-afternoon.  I believe she is improving and will hopefully be discharged Tuesday or Wednesday. She is questioning whether or not she will take any more chemo treatments, and I know we all support her choice - whatever it may be. 

My dad seems to be doing fairly well at the moment.  Praises for that!  Here is a sweet picture of my niece giving him a hug early today. 

Tomorrow I return to work.  I've had more time off this summer than I've had in about 15 years.  I am ready to get back to my schedule and my routine.  I love the folks I work with, and that makes it a pleasure to go each day. 

I am thankful for our blessings. I am thankful that I get to feed Billy and see his smile. I am grateful my mom is still here to make us laugh. I love that my dad can still enjoy his granddaughter's hugs.  Sometimes I get lost in the junk of life, but I know what is truly important, and I know that one day Billy will be himself again along with all of us in eternity.  

So Much Has Happened Since Last I Wrote...

My last post was April 30th, and since that time the following events have occurred:

• Billy was moved from the Memory Unit into a regular room in the nursing home in May.
• He has had another grand mal seizure and many small ones, but the last few weeks seem to have been better. 
• Dear friends from Midland visited, and he recognized them and enjoyed their visit.  
• He had a birthday!  
• He has made several short sentences that made sense, including "I love you."
• My dad seems a bit better - more alert at times and more pleasant in nature. 
• He is terribly thin but does eat.
• My mom stopped breathing on June 8th. She had been experiencing extreme swelling in her legs and feet, wheezing when she was in bed, and she had asked her doctor about it.  He told her to keep her feet up and that her lungs sounded clear.   On the night this happened, I had gone to Summer Spectacular at our church with my sister and her family.  When we got to the house, Mom was struggling to breathe and we could hear fluid rattling with each breath. We called an ambulance, and it arrived in 6 minutes - the longest 6 minutes of my life - and about a minute before they arrived, Mom lost consciousness. On the way to the hospital, she stopped breathing and was intubated. She was placed on a ventilator and admitted into ICU.  When she was given Lasix she started turning around and got off the vent in three days.  After a week in the hospital and numerous tests, we know that her kidneys are functioning at about 40-50%. She was so much better except for the extreme fatigue when she went home, but they gave her nothing to handle the fluids that were to come. Hmmmm. 
• While Mom was in the hospital her younger sister was put on Hospice. 
• I went with Mom to her oncology visit after her recent scan which showed a slight growth in her two tumors and two lymph nodes they are watching. He told her there is one more chemo drug they can try to slow the growth of the cancer. There is no cure, and he asked if we had begun talking about end of life issues. Mom told him she wanted to take a break from treatment and make the decision after we took a short trip to the beach.  He felt that was a great idea. 
• My Aunt Patricia, my mom's sister, died on June 30th.  She was diagnosed with the same cancer (ovarian) as Mom about a year and a half after Mom was.  Her system was already weakened by Parkinson's Disease, and after being declared cancer-free for a few months, the cancer returned with a vengeance. 
• Last Sunday Mom, my sister and her family and I traveled to Galveston. We rented a  condo on the beach outside of town and enjoyed a nice day on the beach on Monday. We got Mom to the beach (very slowly with many breaks!), and on Tuesday we went into town for great seafood. Mom didn't feel like going to the beach that afternoon, so she rested.  She and I shared a room with twin beds, and around 12:30 after I had gone to bed, Mom woke me up in the same distress with her breathing as before - gasping, rattling, and panic. I got my sister and brother in law, she called 911, and I prayed over Mom. When the paramedics arrived, Mom was still conscious, and they put her on a CPAP machine to help her breathe. They allowed me to ride in the front of the ambulance, and I was much more at east than the time before.  She was taken to UTMB, an excellent teaching hospital with lots of unusual people outside the ER at 1:30 in the morning!  Once again, Lasix was started, she was taken for tests and xrays, and she was admitted to a regular room around 5:30 that morning. We were so pleased with the doctors who knew immediately what happened, and she improved so much that she was discharged that night at 7:00 with prescriptions in hand for Lasix. We came home on Thursday.

When we were kids my dad would tickle us or do something equally irritating until we yelled, "Calf rope!" or "Uncle!"  The point was to see how much we could endure before giving up.  I feel the need to yell out "Calf rope!" I've reached my limit. We get past one hurdle and another appears in front of us. I've talked more about death, dying, and funerals in the last few months than all the previous years in my life. My disdain for Alzheimer's Disease and cancer remains strong.  My faith in Jesus'  runs deep, and my knowledge that He is in control is firm. 

I am scheduled to leave town on Saturday with a dear friend for a real beach in Florida!  (No offense, Galvestonians!) I am praying that my family will remain without incident while I am having another go at a vacation!  After no vacation for quite some time, I never imagined I would have two trips in one summer, but I've been blessed.  I appreciate your prayers and support for our family.

So Much Can Happen In Less Than A Month

For quite sometime I would post every few weeks or every month, and the progression of this insidious disease was fairly slow.  Recently the progression seems to have increased rapidly like an avalanche that begins with a few falling rocks then picks up speed and crashes down.  In my last post I wrote about not being able to take Billy with me anymore because he cannot get in and out of the car. Soon after that he had several falls, and his balance was unsteady. The decision was made that he needed to be in a wheelchair for his own safety. I'm all for his safety, but I hate that he has to sit all day because he loves to walk.  

He doesn't seem to know that he can move the wheelchair on his own.  At the moment, they are using a chair that belongs to the nursing home, but I've noticed a need for foot rests that he doesn't have.  Occasionally he will lift his feet ever so slightly making pushing easier, but he usually resists a bit. Pulling the chair backwards makes it easier if one can walk well going backwards.  I have enough trouble walking forward, so that presents a challenge for me.  We make it work, though.  Billy gets help from the aides, and they all love him. 

As I was getting my head wrapped around the fact that Billy doesn't walk anymore, AD threw another rock at us.  On April 14th, Billy had a grand mal seizure around 4:00 in the morning. Fortunately an aide was in his room changing his roommate and heard the noise.  She got the the nurse right away, and the seizure lasted a little over 10 minutes. His oxygen level dropped significantly, but they were able to get him stabilized.  I had heard of another Early Onset AD victim who had seizures, but I never knew of others.  It doesn't seem that the staff at the nursing home has seen this with AD patients either. The PA saw him that day after the seizure, and she requested a neurologist consult. When I fed him dinner that night, he was exhausted and his lip drooped almost like a stroke victim.  The strangest thing to me was that his voice sounded different - lower and gravelly. 

Of course I began reading about AD and seizures.  Today I went with him to a neurologist.  I really liked the doctor, and he told me the same thing that I had read.  Fewer than 10% of AD victims have seizures in the late stages of the disease, and there is some thought that it is more prevalent in Early Onset folks. Of course Billy is in that small percentage.  Of all AD victims about 5% are early onset (under age 65).  I wonder if 10% of that 5% have seizures or if that percentage is higher in this group.  Billy has been on depakote (an anti-seizure drug) for almost 18 months because it helps with the behaviors related to AD. The doctor increased the dosage to try and prevent further seizures. I don't want him to be more "drugged" feeling and acting, but I certainly don't want him to have more seizures either.  So there we have the Billy update. 

Last Friday Mom, Leslie and I met with a chaplain and put Dad on Hospice. Dad is not a whole lot worse, but the staff felt that this would be better for him, and  I agree.  In one day, they got him a better wheelchair, and he has a few more people who visit him each week.  That is so important in this journey -- human contact with people who are not suffering from dementia!  Dad is so thin now; he weighs less than 140 pounds. He has some good days, and he has many not-so-good days. Mom hangs in there with him as much as possible, but she has her own battle with cancer.  She is on maintenance chemo right now.  She has a treatment each Tuesday (if her blood counts are high enough) for two weeks. She takes a break the third week.  However sometimes during that third week, she has blood transfusions like she did today. That way she can be ready for more chemo next Tuesday - hopefully. After her next two rounds of chemo, she will have another scan to see how well the tumors are being held at bay. This is her life now. She's tired all the time, but she's here with us, and we all vote that it's worth it.  But if the day comes when she says she's had enough, I think we will all understand that, too, but we are not ready. 

In spite of the daily struggles we face, we are blessed in so many ways.  A dear friend has moved in with us, and she is preparing meals and helping in all sorts of ways. We had our extended family at our house for Easter, and that was wonderful.  I work with fabulous people every day, and that is a huge blessing. We are prayed for each day by so many, and we know that because life is bearable right now. 

The Big Decline Really Stinks

I began this post on March 18th, and then life got incredibly busy, and I got incredibly overwhelmed with everything. My heart is full, and I must write.  
3-18-2014
It's time for me to face the truth. Billy is getting worse, and he's not okay.  I've ignored the truth for a while because it's just too hard to face, but sometimes truth slaps you in the face. I have been blessed for more than two years in being able to take him with me on Saturday evenings, and that ended about two months ago. My Pollyanna side keeps thinking that when it gets warmer and stays light for longer, I can take him with me again as though warmer temperatures and lighter skies will help him know how to get into the car again.  

For a while I would take him out of the memory unit and just walk the halls of the nursing home for a change of scenery. He doesn't want to leave that secure area now. The staff told me he gets upset when they come get him to weigh him each week.  

I usually arrive at the NH between 4:30 and 5:00 to feed Billy supper. The routine for the residents is to gather them all into the dining area of the unit beginning around 4:15.  It takes a while to get everyone changed and cleaned up for dinner.  Billy is nearly always sitting at the table watching TV when I get there, but today was different.  I got there around 4:35, and Billy was still fast asleep.  The evening staff had come on duty at 2:00, and he was already asleep, so they didn't know how long he had been in bed.  It takes two staff members to get him up and changed now because he struggles with balance.  After getting him ready for dinner, the aides got on either side of him and walked/drug him to the dining area. The scenario reminded me of two parents trying to walk their toddler while his feet go in uncontrolled directions, but he's a 57 year old man. 

4-2-2014
The first few weeks of March, Billy had several falls hitting his head during most of them.  Several x-rays were done with no fractures noted, but the radiologist recommended a CT scan. The physician's assistant who sees residents each Monday at the NH noticed a significant decline in Billy's mobility and balance. Many of the big changes in Billy have taken place gradually, but this was rather sudden. He's been doing the slow shuffle for at least a year now, but he could stand on his own and walk. From what I understand he is a little more able to balance in the mornings, but as the day wears on, he cannot get out of bed alone, and he cannot stand.  Two people get him up and change him, and then they place him in a wheel chair. 

Last Friday when I got there, he was in the shower.  Our favorite aide, Lameka, was showering him.  She rarely works in the memory unit anymore, so she had not seen Billy in a few weeks. I waited on her to get him dressed, and she came out of the shower to get help standing him up.  She looked at me and said, "I had no idea he couldn't get up or stand anymore!"  I told her the change had been rather sudden to us.  The good news is that he still seems happy. He smiles often and enjoys our visits. 

I've been debating the whole CT scan event. He has to be taken to a hospital to have it done, and I can no longer transport him, so the NH could take care of that. When the doctor reviewed the orders from the PA, he questioned Billy's ability to lie still during the test. I asked the purpose of the scan, and it seems that they are looking for a cause of this big decline. They've done the usual tests - no UTI and no imbalance due to meds.  The scan would show any masses, any strokes, or anything more abnormal than the atrophy he has from the Alzheimer's Disease. The scan would also involve a large co-pay that would be difficult for me right now. I made the decision today that I will not consent to the test right now. If the test were to show something in addition to AD, what would I do? I have no desire to inflict pain or anxiety on Billy.  Just the trip to the hospital would most likely cause him anxiety.  If the scan were to show a mass, I would not choose any radical treatment for him.  A stroke? What would be done for that? More meds most likely. 

I've wondered if the medical professionals at the NH are just unfamiliar with early onset AD. I usually assume that new behaviors are just an indication of the progression of the disease. I appreciate the concern and the desire to know, but how would that change things? As I write this I hear myself sounding a bit like I don't care, and of course I care a great deal. I know that when Billy was still articulate, he made it clear how much he hated enduring all the tests and questions; and he would be more anxious and nervous than ever being taken to the hospital and being told to be still for 30 minutes which he would not understand. 

Did I make the right decision?  I feel okay about it, and I'm at peace. That may change tomorrow, and if it does, I am pretty certain we can have the scan done. 

So there you have it....I'm so sad that I can't pick him up on Saturday afternoons and take him with me. In order to take him into the courtyard, he has to be put into a wheelchair, and that involves catching 2 aides who can assist. I'm hopeful that he can come home for Easter day using a transport system, but I'm unsure of that at this point.  We trudge on. 

Stinkin' Alzheimer's!

What Keeps Us Going....and what gets us down

The  most asked question I receive is always appreciated and really difficult to answer. I'm happy that people ask about the most important person in my life, but I don't always know what to say.  The truth is that he is about the same he has been for the past few months, but in comparison to the last year, he's declined considerably. When I think about the last two years, he's gone down drastically. At times, his condition can really get me down. 

I've mentioned before how difficult it is to get Billy in the car, and about three weeks ago, he got so frustrated that I decided to stop taking him away from the nursing home for a while. I will reassess when we return to Daylight Savings Time and the weather is warmer. Those two things may not help, but he gets more confused when it's dark, and the cold hasn't helped any of us. I'm aware that I probably get more from taking him with me than he does, but I know he enjoys being with family and seeing friends. Unfortunately, if I don't take him out, he won't see most of those folks. Going to the nursing home is difficult for people, and I was one of those people for a long time. I do not criticize anyone for not going because it's not overly pleasant, and Billy communicates very little. He does love seeing family and friends, though, and we can tell that by his smile and expressions. Sometimes he will say something that we don't recognize, but he tries to communicate. 

Yesterday, he had a fall. He's fallen a few times before when he was trying to sit down and missed the chair, but this time was different. He was walking down the hall, and leaned over to pick up a "Wet Floor" sign.  He lost his balance and hit the back of his head on the hand rail that runs down the hall. As he tried to get up he fell again, and hit his head on the floor. He has no fractures, and I assumed he would not. Billy has youth on his side where falls are concerned, but the fact that he lost his footing while doing something very simple signals another decline. He may not fall again for months, or he may begin falling often. Alzheimer's progression is not always predictable, but what I notice among the residents is that when falls become the norm, the resident ends up in a wheel chair. I am not ready for him to move to a more restricted mobility. Of course, I'm sure that my lack of readiness will keep it at bay!  

Billy can do very little for himself at this point, and walking, albeit very slow, is one of his few independent activities. He needs help getting up, sitting down, eating, drinking, dressing, bathing, and toileting.  The medical world calls these daily living activities.  He is slim on independence with those activities. 

So those things really get me down, but we have some wonderful glimpses of the old Billy that get us through and keep us going. One of the last times I took Billy to church with me, he was sitting between Shelley and me. He tires pretty easily, and we stand for quite a while at the beginning of our worship service. Shelley sat down with him, and when I glanced back at them, he was leaning toward Shelley like he wanted to tell her something.  As she leaned toward him, he kissed her on her cheek. He will always love his girl, and such a small sweet gesture brought tears to her eyes. A week or so later, Shelley was helping get him in the car (the big challenge), and after she buckled him in, she kissed him and told him she loved him. He responded loud and clear with, "I love you." He doesn't say much at all anymore, and that was huge. 

When I go see him in the evenings, and he realizes I am there, he gives me a huge smile. Once in a while, he even says some little something, and I'm thrilled. Sometimes I get there early enough that he is still in bed. I don't know if I will ever get accustomed to him being in bed so much of the afternoon, but when I go in his room, he is often already awake, but they have not gotten him up. I sit down beside him, and he grabs my hand.  

The small things get us through. The smiles, the incoherent mutterings, the gentle kisses, and the touch. I will never take those for granted. 

So, how do I answer the question...how is Billy? The best I can tell is that Billy is happy. Not knowing how far his disease has progressed is a good thing for Billy. When he knew where he was headed, he was frustrated and angry. He gets frustrated at times now, but typically, he's happy. His smile gets me through, and I often tell people he's okay...not good, but he's okay. I think that most people get it.  

The Search for a Place

It's hard to believe that Billy has lived in Lexington Place for almost two years...January 24th will mark that anniversary.  I will never forget how much my heart hurt when I left him there, and he was so upset with me. I would still prefer to have him with me, but I know he is in good hands, and the care he gets is what he needs. He is so comfortable there, I have to sort of drag him out of the unit when I take him somewhere. Once a month, someone takes him to another area of the nursing home to be weighed, and the staff tells me that he is very resistant to leaving the unit. 

In the last two years, Alzheimer's has taken so much from 

Billy. The man who was NEVER at a loss for words hardly ever speaks.  He will answer Yes/No questions fairly clearly, but we often have to ask him something multiple times. It takes a while for him to process. When I arrive to visit, I have to get in his direct line of vision, so he knows I'm there. He still recognizes me and knows I am his wife...I know he does, but he never calls me by name. Some days he is happier than others and smiles readily, but not always. Today he would hardly make eye-contact and was scowling about something. He finally gave me a slight smile after I had been there for an hour. He eats well, but he has to be fed. He walks with assistance or holding onto rails. Getting out of chairs is difficult, but getting him to sit in a chair is harder. He has trouble understanding where his body is, and he's had a few falls when trying to sit down. I was visiting with a few of the aides the other day, and one of them is fairly new.  The aide who has been there almost as long as Billy was telling us that when she met Billy she thought he was a visitor because he seemed so "normal."  The decline in the last two years leaves no question about whether he is a resident or visitor. 

My dad is experiencing rapid decline also. Mom and I spent the day looking for a secure memory facility in our area of the metroplex for Dad. He is in a truly wonderful facility, but the cost is prohibitive, even with Dad's long term care insurance (thank God for that!), and Mom is not comfortable driving that far to see him.  My sister and I take Mom to see him when we can.  Three of the places with secure units in this area are full, and that includes Lexington Place which was our first choice.  We did find a place that may work because they keep the doors locked and alarmed. Patients who are an "elopement" risk (just love that term) wear an additional alarm on their ankles or on their wheel chairs. 

Dad is unable to walk after his two falls in early November. His dementia is much worse, and when he talks, he uses real words, but they make no sense. He eats well, and with some medication changes, we are told he is much calmer. He has a bad day now and then, but on most days he allows the staff to assist him. He hasn't worn shoes in a few weeks because he has cellulitis in his feet, so the therapy he is getting is not helping him walk.  Our hope has been that he can be mobile again, but we are questioning that.  

On the homefront, Mom is settling into living with us, and we love having her here. I know it's such a big change for her - going from her own large home of 30+ years to a two bedroom apartment and now living with us and our three canine family members. I'm thankful she likes dogs and tolerates ours so well - Annie likes to sleep in Mom's room sometimes. I love having Mom here, and I believe we will live together for a long time. We get along very well thankfully, and she's pretty easy going.  I'm grateful that she can be with us while going through cancer treatment. We think she has only one more chemo treatment! 

So much has happened in 2013, and who knows what might come in 2014!  My prayer is that good things happen - slowed progression of Billy's and Dad's diseases and complete healing of Mom's cancer. Whatever comes, we can handle it because God has it covered. We are prayed for often, and we know that - it's evident.  Happy New Year and God Bless you all. 

The Okay, the Ugly, and the Ironic

"Alzheimer's Disease is a progressive disease that worsens over time." Thus says the Alzheimer's Association's website. Nothing prepares you for the reality of what it looks like over the years. I am often asked how Billy is doing, and I typically say he's okay. Then I qualify my statement by saying that when I say he's okay, I mean he's not worse. I lie...maybe for myself, maybe for the person asking, but I lie. He is anything but okay. 

This past Saturday after a few weeks of bad weather and other Saturday night plans, I looked forward to picking up Billy for the evening. Our Saturday evenings for the past couple of years include worship service at 5:00 followed by dinner out, and then back to the nursing home. They are usually uneventful, and Billy talks little and smiles often. He enjoys being with family. His smile and calmness tell me he's enjoying himself. 

I got to the nursing home about 15 minutes later than usual this time, so I was feeling rushed. Billy doesn't do "rushed." In fact, he slows down the more I try to speed up. He was actually standing up and moving around when I got there. I grabbed his jacket and eventually got that on him, and we began the long walk to the door. Billy's gait is now tiny baby steps as though he is unsure of himself. We got to the secure door out of the unit, and he stopped. He rarely goes out of that door, and I had to coax pull him out. As we approached the exit, Billy saw a chair and started to sit down. Again, I redirected him to come with me. Each of the exits at the nursing home have these large fans that blow mightily overhead when you open the door. After a few years,  I'm still not certain of their purpose (either to keep out bugs or push the door closed), but I do know that they startle Billy when they hit him. The temperature was cool, and with the wind, it was cold. Billy always notices the difference and shutters if it's extreme. 

I started to the car, and Billy's nurse, Sabash, was coming back from his break, so he came over to help me get Billy in the car. Because of Billy opening the car door while I've been driving a few times recently, I put him in the back seat where I can use the child lock. It's always a challenge to get him in the car because he does not remember how. He tends to face the car seat and touch it with his hands, sort of leaning forward. We kept trying to get him to stand with his side to the seat, placing his left leg in the car and sliding in. This is where he gets stuck. He won't budge, and it is nearly impossible to move his leg for him. I decided to go to the other side while Sabash worked with getting him in the car. I reached across the seat and tried to get him into the car. After about 10 minutes of this, I looked up, and Billy had a tear rolling down his face. He was shaking and said, "It's cold." At that point, I could feel my tears welling up, and I wondered about my motive. Was this for me or for him? 

I went back around the car and told Sabash it might be best for me to get him in by myself. Sabash went inside and sent one of the aides out. She started trying to help me, and the whole situation got worse. At one point, I asked him if he wanted to go back inside, and he didn't answer me. He looked distressed, and the aide said she was going in to see if one of the other aides might get a better response from him. When she left, I opened the front door of the car, walked Billy up to the door, and he was able to place his left foot on the floor board and most of him landed on the seat. At that point, I could move him over enough to buckle him in and close the door. I held his right hand while I drove to ensure he didn't open the door.  

Once we got into church and seated, Billy was fine. I was not. I love having Billy with us, and I truly believe he enjoys being with us. However, I know that sometimes I do things more for me than for him. He may enjoy being with us, but it upsets his world to take him away from what he knows. After worship service, Shelley helped get him in the car again, so we could go to dinner. Getting him out of the car is not as big an issue, and everything was smooth sailing at the restaurant. When it was time to leave, Shelley and Andrew helped me get Billy to the car, and once again we encountered an issue. First of all, it was still cold and breezy. In addition to that, the car parked next to us was having trouble starting, and when they tried to start their car, it made a loud noise that confused Billy. He stood like a statue looking straight ahead. He didn't respond when we asked him to get in the car. I was inside the car asking him to get in, and Shelley and Andrew were at the door with him trying to get him in. In retrospect, he probably felt like we were ganging up on him, and he got upset. That made Shelley upset, and we were back to tears over getting Billy in the car. It seems like it would be so simple, and yet, it's one of the toughest things to do. Is it worth it? 

I don't go see Billy on Sundays usually because I need a day away. When I went Monday evening, he was back to his normal for now. Shelley went Tuesday and said he was in a good mood and laughing. This afternoon I attended the annual Christmas party in the memory unit. We take gifts to our loved ones, Santa and Mrs. Claus visit (Billy never acknowledges them), and we visit over some yummy desserts. Today we sat with Billy's new roommate, John, and his wife and son. I enjoy getting to know the families of the residents because I love knowing their stories. After talking for about half an hour, I told John's son that I noticed they had some fiddles (or violins) and other pictures hanging over John's bed and that I assumed he had played that instrument.  Oh, yes, he told me.  He had played in a band called the Light Crust Doughboys, and they had been really good.  I guess he didn't think I would know who the Doughboys were, but those of you who have known Billy Jack Knowles since college, know that I do know who they were. Billy's roommate is John Walden.  He is 85 now and was diagnosed with Alzheimer's Disease at age 65. What a cruel disease. So cruel that neither man can talk about a shared passion, but I am thrilled about this.  Maybe Billy and John will catch up some day in Beulah Land.