Saturday’s visit was quiet.  Sunday’s visit was overwhelmingly silent. 

On Sunday I completed the finishing touches on the Holiday decorations for Kathy’s room.  Standing on a chair to attach glittery snowflakes on the ceiling, pulling the tape from the dispenser, stepping down, moving the chair to around the room and repeating.  Despite my best efforts, it wasn’t a silent operation, to say the least.  Sitting up against her elevated bed, Kathy dozed.  Waking for a minute or two.  Looking up sleepily, her blank expression neither disapproving of the commotion, nor pleased with the festive highlights around her.  Just blank.  Nothing. 

That is nothing new.  It has been that way for longer than I can pinpoint.  So, I completed my work as quietly as possible.

Once done I sat on the stool beside her bed, and we watched a Hallmark Holiday movie. Occasionally, during the movie I would ask Kathy mundane or silly questions.  I was trying to engage.  Anything for mental stimulation, even innocuous quips to entice a smile, agreement, or a role of the eyes.  Nothing.  No response.  Sometimes Kathy would look at me, more a reaction to the sound of a voice that was not the television, but mostly she just stared out blankly, towards the window or the tv, not focusing on either.  Just quiet stares.

Her arms were crossed, like she was hugging herself, or just holding on to the sleeves of her t-shirt.  On occasion her fingers would twitch, but mostly she just sat.  I put my hand on top of hers, then just below it, on her upper arm, and patted her paper-thin skin.  Her head turned slowly, and she looked at my hand.  No expression.  She turned back to the window.  I reached up and held her fingertips.  We watched the rest of the movie, in silence.

So much of this visit was nothing new.  So much was overwhelmingly new.  The silence was deafening. 

In what still feels like recent behavior, Kathy would exhibit all the signs of echolalia.  She would repeat a snatch of speech of another person, either someone speaking within earshot, or heard from the tv or radio.  As part of her dementia, she lost her ability to control the volume and tone/inflection in her voice, so she repeated loudly and often, parroting a sentence over and over.    

As Kathy lost her ability to enunciate words, she did not lose her tendency towards echolalia.  So her parroting was often a garbled collections of grunts and yells.  These “sentences” would repeat, eventually trailing off.

This visit is filled with short stints of eye contact, me smiling, and heaps of silence. Oppressive silence. Screaming silence. Crying silence. Unnerving silence.

I’ll go back in December for a Christmas visit.  Hopefully Kathy will be more “talkative”, but I think we are in a new normal.  For a long time, her attention span has dimmed, and is now unignorably dark.  And now, communication is going painfully silent.