I posted some questions about my elderly father (82) who developed vascular dementia. About 2 months ago, he was hospitalized after a fall and confusion. A couple weeks ago, he was hospitalized again.

He would have periods where he was completely lucid, and outraged that he had been put in a rehab facility. He would demand to be allowed to go home with his live-in girlfriend (who simply wants his money). My sister as POA was conflicted about what to do. The doctors said the condition was going to get worse, and they recommended full-time nursing.

We resisted his demands and put him into rehab and then full-time nursing.

Now he is dying from the condition, unable to swallow, breathe properly, etc. --he is completely confused and out-of-it. There are no more periods of lucidity/awareness.

It took two months to go from independence to dying. Had we let him go home, the girlfriend would have robbed him blind (probably after marrying him), and left him in a dirty bedroom to die.

Vascular Dementia is really horrible, and it isn't like Alzheimer's --it happens fast, and the patient has sudden losses of function and competence.

So I'll leave this here for anyone else who has doubts or questions about this condition.

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Here is a link to a good article that describes terminal agitation:

It's called terminal agitation. I experienced the same thing with my father who lived with me for 3 years. He had some vascular dementia problems-time, forgetfulness, but he was still going to the casino (via door to door bus), heating up his own lunch, getting dressed, visiting with everyone. I was gone for a week on vacation (siblings checked on him but didn't stay) and when I came back I realized that I couldn't leave him by himself-he couldn't get the time straight, he was waking up at all hours of the night and getting dressed headed for the casino, didn't remember to eat. Within a month, we put him in assisted living where he had 24 hour care. He was still talking, eating, watching his shows. Within 1 month of going into the assisted living he had a bad fall fracturing ribs. After that the decline increased to the point where he developed what's called terminal agitation. Terminal agitation is horrible to watch, my calm, friendly Dad became a manic, aggressive person. He was on hospice by this time and they tried all kinds of sedatives and antidepressants. It was the most horrible thing I've ever experienced for both myself and my Dad. The hospice nurses kept using the term but they didn't explain it. Finally 2 days before he passed in the inpatient hospice, one nurse finally explained it and the treatments. If someone had explained it 2 weeks before he passed, I would have made different decisions regarding his care and leaving him in assisted living (although they said they were able to deal with advance care, they were not). My advice--if you don't understand the treatment prescribed or the terms that nurse or doctors are using, ask them to explain the term and treatment until you're satisfied that they are doing everything possible to make your loved one comfortable. You all made the right decision putting him in a nursing home.

My 78 yo mil was diagnosed 6 months ago, she has gone downhill in spurts, but she can still walk and feed herself, has to be directed for alot of stuff. She also has high BP, diabetes, high cholesterol, esrd and is on dialysis. She lives with us, along with my 91yo mom, and it's very difficult. They don't get along and I don't like mil. Don't know how long she'll last. I sound heartless, but my husband and I and teen (our family) is lost in this caregiving shuffle.

I agree about the Vascular Dementia being horrid and cruel. My LO went from running her own household to required AL within a few months time at age 62. She also went into a wheelchair and was fully incontinent within a few months. She is now in the end stage and on Hospice, almost 5 years later. Still, she eats good and breathing is okay. I have no idea how long she'll last. She is losing weight though, despite her healthy diet and good eating. She no longer speaks and is not oriented to place and time at all. Can't sit unassisted or feed herself. I give her all the love and care that I can, but, I no longer pray for her to continue living on this earth. I have faith that I will see her one day in another dimension.

I have read a lot online about survival rates. Most places say the average life expectancy is 4 years for Vascular dementia, but, lately I have read 5 years. The way she is now.......I can't imagine her making it another 6 months, but, I've said that before and been wrong. I just get this uneasy feeling every time the phone rings after 9:00 p.m. I was talking with the Hospice social worker today about the end, whenever that comes, and I'm not sure if I need to be in the room with her, like a vigil or not......she said that sometimes, the family member wants to remember the LO in a more positive way and not deceased, so, I'm weighing that right now. I'm not sure which is right on this.

I'm sorry your father's journey has been so dramatic and swift. I wouldn't characterize vascular dementia as fast either, my mom took around 7 years to progress from needing assistance to death. The thing with this type of dementia is it stems from problems getting sufficient blood and oxygen to the brain, and the root causes can be anything from poorly controlled diabetes to chronically high cholesterol to chronic heart or blood pressure dysfunction to TIA and stroke - how the disease progresses depends on how successfully the underlying conditions are controlled.

Thanks for sharing. My 89 yo mother has Vascular Dementia and the progression downward has been slow... she'll hit a downward spiral....then up again and back to 'normal'. It's a roller coaster ride, especially where my emotions are concerned when this happens. One day I'm grousing that she can't 'go' soon enough, then she spirals down and I'm begging God not to let her die. Crazy making at best. It's been 3 years of her living with me. I love her dearly but this whole situation seems so absurd at times.

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