Tuesday, April 30, 2013

Continuing to Breathe

Lyn has been on oxygen support at night for over a year now.  She needs it because her blood oxygen saturation levels plummet to dangerously low levels when she sleeps.  Normally, a person would be tested for sleep apnea and be placed on a CPAP machine.  Lyn is now cooperative with this idea and has refused a doctor's request to undergo a sleep study.  As a result, she uses an oxygen condenser for breathing support.

Lyn's insurance requires an annual review of this need which means she has to have a mobile blood oximetry test performed one night without the use of the condenser.  This has happened.  They also  require that her physician perform an in-person check up to confirm the oximetry results.  This has also happened.  The test results and the physician both have documented Lyn's continuing need for the oxygen condenser.  Her insurance is currently refusing to cover her use of it.

As of Monday, the insurance is asking for the doctor's notes; not just the doctor's official report to prove that Lyn needs the condenser.  The doctor's office is confused by this, but they are releasing the notes to Mom today.  The insurance provider is refusing to accept anything that is not a part of Lyn's medical file.

The hoops the insurance company is making everyone jump through is challenging but not surprising.  If they can get away with not paying for the condenser, they will do so because the monthly cost of the condenser is more than Mom's mortgage.

Hopefully, today's activities to provide the insurance company with the ever changing documentation they want will suffice and they will continue to cover this for Lyn.

Monday, April 29, 2013

Like a Switch was Flipped


Mom writes:


She was going back to her bathroom when I heard a sound.  She came flying back into the living room.  "Who was here?  What were you doing?"  She was almost shaking.
  
I told her to settle down because "I have no idea why you are so mad.  Show me."
  
So we marched back to the bathroom and she pointed.  She wouldn't even go in.  

I burst out laughing and said "Your Uncle came by and he did use your bathroom."  

It was like I flipped a switch.  She was so sweet and changed her tune.  "Oh, ok."  You can figure out the problem.  Yes, he left to seat up.  

Nothing more was said.

Friday, April 26, 2013

Gathering of Nations 2013

Today, Lyn is going to attend the Gathering of Nations.  It is at The Pit which is the same place she goes to watch the PBR bull riders.  There will be about 100,000 people who attend some part of the three day event.  It is the largest Pow Wow in North America with members of over 500 tribes from Canada and the US attending.

A Pow Wow is a celebration and a dance competition.  There will be over 3,000 dancers performing.  The colors of the dancers' costumes will enchant Lyn.  The shawls, the beaded clothing and the feathers  from so many places are beautiful and stunning.

Lyn is so excited.  She came home from bowling completely amped up, talking loud and fast.  She sat on the edge of her seat for the PBR event.  She will be just as happy at this one even though the crowd will be larger.

Thursday, April 25, 2013

Quarterly Check Up - Spring 2013

Lyn had her quarterly check up yesterday.  She's doing OK.

A couple of times during the exam, she wanted to tell her physician something but forgot what she wanted to say and looked away each time.  The physician glanced at Mom each time and nodded, recognizing the progression of her Alzheimer's.

The check up was moved up by a week or so to accommodate documentation her insurance provider needs to continue coverage on the oxygen condenser.  They had the results of the mobile oximetry test done in Feburary but didn't have a write up of a in-person exam by the physician stating that oxygen was an on-going need.

Mom has to keep documentation on each of Lyn's appointment's and a summary of each day.  She has it organized into a couple of folders.  As a result, when the company that provides the oxygen condenser called to explain their documentation needs for the insurance company, Mom had everything at hand and was quickly able to reschedule Lyn's appointment to meet the deadline the insurance company had stated.  Mom also used to handle insurance processing for several doctors and understands how to work with insurance and care providers in depth.

Unless my sister has a medical need such as a sinus infection, it will be three months before she sees her physician again.

Wednesday, April 24, 2013

You Think You Hate Mondays

Mondays are getting harder for Lyn.

On Monday mornings, her speech therapist arrives for their weekly one-hour visit.  They practice words together by reading easy reader books in addition to a number of other activities.  The therapist always asks Lyn for an update on her week and gives my sister her undivided attention.  They have been working together for over a decade now.

Mom and I have mentioned in the past how there are times now that Lyn is surly on Monday mornings.  Her therapist has noted it and asked that Lyn eat a bowl of cereal before their session to help give her a bit more energy.

Mom makes sure that Lyn is up, dressed and fed before the therapy session.  The timing for this is neither rushed nor different from her other days when she's getting ready for day hab.  However, Lyn's behavior is completely different on Mondays than any other day.  She'd sleep until noon if Mom let her.  She's surly, slow to get dressed and often completely non-responsive now.  When her therapist arrives, she pulls within herself saying "I just like to be quiet."

This behavior is pretty new and getting worse.  If you knew Lyn or spent any significant time with her, you'd know that she doesn't just like to be quiet.  She's always been social, cheerful and chatty.

We don't know what is causing her to respond to her therapist like this now.  I suspect she doesn't like struggling with the words more than she did in the past.  I suspect she no longer enjoys the sessions and finds them very frustrating.  Yet, when Mom or her therapist ask if she wants to stop the sessions, she states "No" emphatically, saying that she enjoys them.  Her behavior suggests that she dreads them though.

It is a quandry though that casts a pall over the entire day.  Should she stop the therapy sessions she seems to no longer enjoy and get some relief from that stress?  Should she continue because it is one more mental stimulation without which she may decline faster?

Tuesday, April 23, 2013

To Jemez and Back

On Sunday, Mom and Lyn drove up to Jemez to show the beautiful red rocks to a friend visiting from Texas.  They really enjoy playing tour guide to anyone who visits.

They left early in the morning to drive up past Soda Dam, have brunch in the cafe and stop in the Jemez Pueblo visitor's center.  They've gone often enough now that the gentleman at the visitor's center recognized them.

Lyn took her car book with her to look at as they drove along.  She had added a new picture to the book as well.  It was a picture cut from the morning's paper of the new giraffe calf born at the zoo this week.  The book seemed to help her stay calm for a while.

Mom kept checking on Lyn in the rear view mirror.  When she saw Lyn starting to look anxious, she turned around and they headed for home.  They both agreed it was a good day.

Monday, April 22, 2013

An F

Lyn's SIS evaluation results have come back already.  The speed of the results from this evaluation have surprised us.

Lyn has received an F.  Previously, she received a B classification.  Lyn's results were shared with her and she was very upset at first to learn that she had an F.  It took considerable explanation from Mom and Lyn's support team to explain to her that she did not fail the test.  That the F just explained what group of services Lyn needs and that she did just fine.  She wasn't entirely sure, but she eventually accepted their explanations.

So what does this mean?  The New Mexico Support Intensity (SIS) Group Service Package Descriptions list eight different categories.  Based off the results from the SIS evaluation, the individual is groups into one of these eight, simply labelled NM SIS Group A through NM SIS Group H.

When Lyn was placed in group B, the description the state felt applied to her was as follows:

Adults in this group require more support than NM SIS Group A, but also receive intermittent rather than 24/7 paid supports.  Some time is spent alone, engaging independently in certain community activities and/or with unpaid natural supports.  Many of these individuals have mild intellectual disabilities, although broader ranges of intellectual disabilities do occur in this group.  The individual in this group require more support to meet personal needs than those in NM SIS Group A.  However their support needs are still generally minimal in a number of life areas.  This group has fewer general support needs (Home Life, Community, Health and Safety Support Needs) than 50% of the population with developmental disabilities.

Now that Lyn has been placed in group F, the state has applied this description to her:

Adults in this group include person with the most extensive/complex medical support needs that require frequent nurse intervention or management in order to minimize medical risk factors.  Maximum assistance with activities of daily living is required to meet their extensive physical support needs and personal hygiene, including lifting/transferring and positioning.  Feeding tubes, oxygen therapy or breathing treatments, suctioning and seizure management are common as well.  Many of these individuals may be medically unstable or are receiving hospice services.

It sounds pretty grim and in all honesty, it is.  To give a comparative, here is the explanation for Group E:

Adults in this group require many supports and maximum support relative to activities of daily living.  General support needs (Home Life, Commuity, Health and Safety Support Needs) exceed those of 75% of the population with developmental disabilities.  Most have at least one medical support need, which may include supports for aspiration risk, seizures, diabetes or other conditions which are chronic but relatively stable and do not require an amount of nursing intervention or oversight to meet criteria for NM SIS Group F.  Many individuals in NM SIS Group E require full physical supports.  Support Needs of those in Group E are associated with their level of intellectual disability which tends to be in the severe or profound range, although some may have mild/moderate intellectual disabilities with significant physical support needs.

So why does Lyn qualify for F and not E?  It is her Alzheimer's that makes the difference.  If it were not for her Alzheimer's, Lyn would probably be closer to a D than even an E.  However, she does have it and it is factored in now.

Alzheimer's is not a chronic condition.  It is a progressively degenerative and terminal condition.  As a result, Lyn cannot be left alone at all any longer.  She needs supports getting dressed.  She requires oxygen when she sleeps.  She needs assistance getting up from a seated position.  The supports she receives today continue to adjust to her increasing needs.  While she does not currently need assistance with feeding, that day will come.  

So, what does this mean in relation to her services?  That I do not yet know.  We have asked several questions of her case management team and are awaiting the answers.  What I can say, however, is that her services will not be reduced at this point and for that, we are thankful.

Friday, April 19, 2013

The Nest

When we lived in Virginia Beach, Lyn loved to visit a couple of places each time she visited.  One was the Virginia Marine Science Museum.

We could wander through the aquariums and watch the fish, turtles and sharks for some time before she would want to move along.  The walk through the marshes was always pleasant even when she'd make sure that we stayed together.

Along the marsh path  The museum had installed a nest you could sit in to imagine what a baby bird may feel while still in the nest.  It took us some time to convince Lyn to get into the nest.  We tried to convince her it was safe to sit in it.  She didn't believe us and thought we were crazy to suggest getting a picture of her in a nest.

Mom eventually suggested that they could get in together.  Lyn waited to make sure Mom did get in before she stepped in as well.  She squatted down and that was it.  We had to take the picture fast.



She popped out as soon as she heard the shutter go off.

Thursday, April 18, 2013

Black is Most Comfortable

The first time Mom and Lyn went shopping for new shoes, they struck out.

Neither Target nor Payless had anything.  There was no DSW closer than 6 hours drive to check either.  Lyn didn't want the elastic, spiral laces that don't need to be tied that Payless offered.

Fortunately, a friend of mine from college point out that her Grandmother wears velcro shoes for the same reason that Lyn now needs them.  Her Grandmother gets them at Walmart.

Mom had a week to mentally prepare for the trip into Walmart.  She hates the place.  It is typically overstuffed with merchandise that is poorly made and she rarely finds assistance when she needs it.  This time, she didn't need assistance.

Lyn tried on several pair.  One size was too tight so they went up a size.  It was the right size.  The store had the shoe in white and black.  Lyn tried on both.  She decided that black is the most comfortable color.

Lyn's happy with her new shoes and is able to secure them herself.

Wednesday, April 17, 2013

Photographing Dementia

Chistopher Nunn is a photographer from the UK who has spent the last four years photographing his friend and fellow artist, David Blackburn, as he lives with dementia.  He has titled this collection "Falling into the Day".  Nunn's photography is often stark and compelling.  His pictures tell a tale and are worth viewing.

I found the story on CNN and thought I'd share.

Tuesday, April 16, 2013

Boston

Lyn is aware of the tragedy in Boston.

Her biggest question was "What is a marathon?"  Mom decided to focus the conversation on the definition of a marathon.  Lyn was very confused about it.  She couldn't understand that the athletes would train all year to run many more miles than Lyn could understand yesterday.  She was unable to equate the marathon to when she used to race for Special Olympics.

She corrected Mom on her terminology.  Lyn insists she raced in the 2 feet and 4 feet races instead of the 200 and 400 meter races.  That's OK.  Mom can be wrong.  At least she remembered that she used to race.

Mom worked hard last night to keep the television turned to entertainment shows and avoid any special updates or news on the tragedy.  It would have caused more confusion and tears.

Monday, April 15, 2013

Managing Money

One of the interesting aspects of Alzheimer's is that patients will often have a near obsession with money.  They may worry about their money if they cannot see it.  They may have a delusion and believe that someone has stolen their money.  Accusations of theft are pretty common.  Even if they cannot count the money or understand what the different denominations mean, they still want to know they have it.  Just having money in a wallet or purse is often reassuring.

Each week, Mom swings by the bank and withdraws enough cash to cover Lyn's needs while she's out and about.  Before each trip out, Mom tells Lyn to go get the money she'll need for the day's activities.  Lyn ends up with a dollar or two at the end of each day.  She keeps these in her purse.  It makes her happy to know she has some money at hand anytime she might think of a use for it.

A new pattern has emerged and become routine for Lyn.  Each Saturday evening, as they leave church, Lyn starts making her bid to take Mom out to dinner.  "Now, I have something to say and I don't want you to interrupt.  I have money and I know you're tired and you don't like to cook.  We should go out to eat."  The routine includes Mom telling Lyn to keep her money because they're going home for dinner.

Lyn's not been able to handle money for a very long time.  She used to be better at it.  She used to be able to figure out that she might need two or three bills to cover a tab.  She doesn't have that understanding anymore.

After the most recent offer for going out to eat, Mom decided to check Lyn's purse to see just what she was toting around.  She waited until Lyn was asleep for the night before peeking in her purse.  It only contained six dollars.

Friday, April 12, 2013

SIS Round Two

Almost a year ago, I wrote about the evaluation the State conducted on Lyn to determine her level of need and skills.  The test that was given to Lyn was the Supports Intensity Scale.  The evaluation results indicated she was placed at a B level and should be able to live independently.

Lyn was not alone in being placed in a category which did not represent the reality of her needs.  It turns out that as 30% or more of those evaluated with the SIS scale in New Mexico were inappropriately placed in a high category with an indication that they did not require services.  The issue was so significant that the Disability Rights New Mexico organization and a number of private attorneys contested the state's findings on at least 600 individuals.

Mom contested Lyn's results on her own.

When a result was contested, that individual's services were frozen at the level before the evaluation.  They were not reduced while the state regrouped and began to conduct new SIS tests on these individuals.  Lyn's second SIS evaluation happened this week.

The first evaluation was conducted in June 2011 by an evaluator brought in from Washington, DC to evaluate and to train NM based evaluators.  The SIS evaluator this time was a lady the state brought in from Canada specifically to conduct the SIS evaluations and re-evaluations.  This raises the question: Are there no properly trained evaluators in NM?  If not, then how does the state hope to manage cases going forward?  Are they just going to continue bringing in evaluators from out of state?

The evaluation was conducted in the home.  Lyn's case managers, one of the day hab staff, Lyn and Mom were all addressed by the evaluator who asked the questions and wrote copious notes.  Mom writes, "We pointed out that now she isn't left alone whereas in the past she could have been alone all day.  Even Lyn says she can't be alone."  

It is going to be several months before the results from this test are shared with Mom and Lyn.  We all hope that it is a more accurate reflection of Lyn's current capabilities.

Wednesday, April 10, 2013

Service as Education


Earlier this year, a colleague and I were discussing our families and he shared that his daughter was volunteering at a nursing home to satisfy her high school’s service requirement for her Theology class.  As part of this requirement, the students have to write a quarterly reflection on their service experiences.  At the nursing home, my colleague’s daughter worked with dementia patients.   I asked if they were willing to share her reflections and they recently allowed me to read them.  It is with permission that I share this young woman’s thoughts today. 

She describes her reasons for choosing the nursing home as her place of service:

I chose to volunteer at (the nursing home) because some of my friends have done service there and highly recommended it. Also, a woman who goes to my church works there and I have heard good things from her as well. When I first began service I was sort of nervous and a little scared that I wouldn’t be able to have fun with the residents. As soon as I began the activities and talking to the residents all my nerves went away. I did not expect that I would have so much fun doing my service. I personally thought that doing service was going to be extremely boring but it wasn’t at all. After seeing some of the residents it made me feel sad because I never could imagine what it would be like if I lost my memory. It made me feel really bad because they can’t do anything about it and it gave me such joy to put a smile on their face.

Early on, she recognized that the residents have dynamic interactions of their own.  One relationship in particular stood out in her reflections.  About it, she writes:

In helping the elderly I have learned to always think of others before you think of yourself. I have experienced God through two people in particular. Their names are Hope and Bob. They are best friends and they are always looking out for each other. Bob always makes sure Hope is okay and they are always talking to each other and playing games with each other.  Bob has taught me to put others first because he is always thinking about Hope before himself. Through them I can hear God telling me to go and serve others and bring them joy.

In her second quarter at the nursing home, she encountered a resident who she actually knew.  The resident did not remember her due to advanced Alzheimer’s Disease.  However, the young woman continued to work with her and engaged the resident in activities.  About this she writes:

In the past quarter I served a lady named Betty. She is tall, thin, and tan and had white hair.  When I first met her she looked so familiar. I started thinking about where I had known her from and then I remembered she used to sing in the choir at my church with my dad. I remembered clearly who she was but unfortunately she has Alzhiemer’s and did not remember who I was. I played LinkSenior with her and she kept saying, “I don’t know how.”  But as soon as we started playing, she knew exactly what to do. She was a very quiet and nice lady. It was very exciting how I served someone who I had not seen in a very long time.

In her final quarter at the nursing home, she reflected upon her fears and what she has learned as a result of her service to the residents of the nursing home.

When I first began my service I was afraid that the residents would be difficult to work with and I was afraid they wouldn’t do anything interesting. My view of the elderly has completely changed.  I now view the residents as my friends, who are so nice and easy to work with. Even though they are living with dementia, it is fun talking to them and playing games with them. Some residents are actually very smart and remember during the memory games we play with them. My view of the elderly has changed and I love working with them.

By doing service at (the nursing home) I have learned how fortunate I am to have my grandparents and my great grandma in my life.  I have learned how fortunate I am to have grandparents who have not lost their memories. The grandchildren of the residents at (the nursing home) have a different relationship with their grandparents than I do with mine. I can ask my grandparents about when they were younger and about different things in the past. The grandchildren of the residents cannot do that because their grandparents have lost their memory. My relationships with my grandparents have always been strong but it has grown even stronger over the past few months. I am so thankful for my grandparents and the residents at (the nursing home).

I’m very honored that my colleague and his daughter decided to share her reflections with me and allow them to be shared here as well.  She made me recall the day I volunteered at a nursing home.  I was ill prepared for my experiences that day and never returned.  This young woman continued volunteering at her chosen nursing home for 9 months.  From what she wrote, it seems she approached her experiences with the residents with compassion and respect. 

It also appears that she gained some insights into her own relationships as well as the relationships of those she served.    Imagine how less isolated caregivers would feel if more people could have some of the same understanding that this young woman achieved as a result of her service.

Tuesday, April 9, 2013

Amyloid as a Healer?

My husband alerted me to Friday's episode of Talk of the Nation on NPR having a story about some research into amyloid proteinss being used in a therapeutic setting.

Here is the link to the story which aired:  Amyloid Proteins Help Paralyzed Mice Walk Again
Here is the article the story references:  Amyloid Fibrils Composed of Hexameric Peptides Attenuate Neuroinflammation

I apologize for not having a more in-depth blog post built around these two links today.  Unfortunately, I'm in the midst of an annual conference with over 7,000 clients of my employer.

Monday, April 8, 2013

Velcro

Lyn really cannot tie her shoes any longer.  Mom has been suggesting that shoes with velcro may be a good choice for her.  Until now, Lyn steadfastly gave Mom The Look with each suggestion.  No more.

Lyn has agreed that they can go shopping or shoes with velcro.  It will allow her to keep some independence and self pride that she can do it herself.  I'm honestly glad that Lyn's no longer fighting the suggestion for velcro closures for that reason.

Perhaps in their shopping, they'll find something she'll like.  There are more options available than just velcro.  There are slip on athletic shoes as well as the ones with the stretchy laces that don't require being tied.

Friday, April 5, 2013

What does $100Million Get You

So, what does $100Million get you?  Hopefully we'll find out now that President Obama has outlined a project to study the brain and its functions.

Modeled off the Human Genome Project, the Brain Research through Advancing Innovative Neurotechnologies, the government hopes to partner with private sector interests such as the Allen Institute for Brain Science to rapidly increase our understanding of the brain so that we can develop better treatments for brain disorders.  The National Institutes of Health is one of the major participants in this initiative.  DARPA is as well.

The $100Million is just a start.  For a good analysis and discussion on the topic, I encourage you to listen to Wednesday's Mapping the Human Brain topic on The Diane Rehm Show.


Additional Information:
Fact Sheet: BRAIN Initiative

Thursday, April 4, 2013

Helping Her Remember

One of the questions you will find is pointless is "Do you remember...?"  The chances are that the individual with dementia won't be able to remember and they may try to cover that fact.  Lyn still tries to cover even when she's not directly asked that question.  Mom writes:

"On Saturday, when I read that the nursery we frequented for a number of years had re-opened, I told her and said we would go over there.  Now, it's been 11 years since they had closed.  She agreed with everything I said but I could tell from her eyes that she had NO clue.  After a few minutes, I said "when we would buy something the lady always told us to be sure to get our "good luck" plant (a freebie)."  Her face lit up and she suddenly remembered!  As we drove down Isleta, she began to tell me where it was and she was right.  She knew where we were going.  She remembered the owner and was excited to be back there."

I find it interesting that a memory was sparked by the "good luck plant" idea.  The name of the nursery was meaningless.  

Wednesday, April 3, 2013

Between Classes

The only time my sister and I attended the same school was the time we spent in Big Timber, MT.  We were both in high school at the time.  

When we arrived, she would have been considered a sophomore and I was a junior according to our previous schools.  The school wasn't really prepared to deal with her and wanted to have her graduate the semester we arrived because of her age.  Mom fought for her to stay in school another year and that allowed us to graduate together.

Montana 1991

I don't remember why I snapped this picture though I'm glad I did.  What I can tell is is that it was taken in the high school there in Big Timber.  It was taken between classes.  The passing periods between classes was 3 minutes.  That was a bit of a transition for us.  We came from schools with 10 minutes between classes. We quickly discovered that 3 minutes was possible because the school had only about 5% of the student body we were used to.  The school is smaller than our elementary schools.

Lyn worked hard in her classes for the 18 months we were there.  Unfortunately, I am not sure that her time there gave her any additional skills.  It just bought time for her before she was out in the workforce.

Tuesday, April 2, 2013

When is She?

Mom's notes about how Lyn responded to this past weekend made me wonder where she is in her memories.  If her life is a movie that is now in rewind, where is she in that film?  Or is the question "When is she?"

When my husband's grandmother was moving deeper into her Alzheimer's the family was able to recognize different points in her life by her language abilities and the references she would make.  She was from Hungary and, at one point, believed she was 15 years old, living in Budapest.  A few years later and she was a small child who cuddled her dolls.

Lyn's behavior this weekend really made me remember how she behaved about 25 years ago when she was in her mid-teens.  She was so cheerful and willing to help.  She still can be that way as we have seen time and time again.  However, she glared a lot less back then.

My husband's grandmother had some significant life changes that marked her life and shaped her memories.  She married and had children.  The family fled Budapest before the Soviet Army arrived, relocating to the United States less than a decade later.  She was widowed.  Her children married and grandchildren were born.  All of those events, even played backward would let you note the passage of time and her age with each associated event.

Lyn doesn't have such clear life events which would allow us to recognize this backwards passage of time.  She was in school from ages 2 to 21.  She worked from 21 to about 39.  She's been in Special Olympics since she was 6.  In 1990 and 1991, we lived in Montana.  Lyn was 20 and 21 at that time.

While she has had a life of structure and consistency, her life hasn't had much in the way of those highs and lows that help us mark the time.  It may be easier to understand the personal timeline of Doctor Who than figure out her mental age today.

Monday, April 1, 2013

A Happy Easter

Mom and Lyn had a very happy, low-key Easter weekend.  It was a gift, honestly.

Mom suggested to Lyn that she stay home on Friday and Saturday to help out with the food preparations for their Easter dinner.  Their lovely neighbor would be joining them for an early dinner after church.  Lyn, surprisingly agreed.

Not only did she agree, she was helpful, cheerful and sweet the entire weekend.  She didn't give attitude, The Look or grumble about not going out each day.  She helped Mom clean, bake a peach cake, make coconut birds nests and actively participated in the dinner preparations.  If Mom asked her to do something, she was willing and engaged.  Even the task of planting a few flowers saw her committed to it for more than 2 minutes.

Lyn was excited that the Easter Man had brought her bubble gum eggs.  "They look like real eggs but they're bubble gum in a carton like real eggs!" She figures the Easter Man was very nice to Nikka because Nikka didn't bark when he visited.

When I called to speak with them on both Saturday and Sunday, Mom kept commenting on how thankful she was to have this sweet weekend with Lyn.  I am happy for them.  The happy, relaxed day like this are few and far between.  To have three together really is a gift.

On both Saturday and Sunday, she had eaten and bathed by 4:30 and was in bed as the sun was going down, tired but content.

We hope your Easter was as filled with love as theirs!