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My mother has vascular dementia. I've been reading up on vascular dementia. There is so little that is certain about it. There's no timeline. It can go on for a long, long time, sometimes without any change and other times with major changes. I read that death is usually due to stroke or heart attack.


I'm fortunate my mother can still do her ADLs pretty well. The VaD leads to a huge question about what to do. Her diet is not the best and she rarely exercises. She's 89, so is it okay to let her just enjoy the food she can eat (diabetes)? Or should I encourage her to eat more healthy and get more exercise? I don't want to add a lot of stress to her life by nagging her to do things she doesn't want to do.

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Tricky balance to strike, JessieBelle, isn't it? I know you know, but just to recap: the better your mother's mobility, the better her blood supply, the less the chances of silent strokes and the more cognitive function she'll be able to maintain.

On the other hand, she already has vascular dementia, she has therefore already suffered damage to the brain, so in herself she will feel fatigued and fed up and not in the mood for positive thinking and self-motivation.

You can encourage, you can advise, you can assist her with as much activity as possible; but in the end… Do whatever gives both of you the most peace of mind you can manage. Chivvying her, or hiding her sweets, well, yes, those sorts of things are 'for her own good' but honestly? Is it really worth depriving her of any glimmer of peace and pleasure she can enjoy?

I'd cut out my mother's brandy nightcap (she was having a treble every night! And lying through her teeth, or at least wildly underestimating, to her doctor!) because it was ruining her quality of sleep; but once she got back from rehab I reinstated a more modest, occasional tipple with her supper. What on earth did I think I was achieving? I thought to myself.

By the way, on the diet, though I appreciate her diabetes makes it problematic: the brain is greedy for glycogen and uses an awful lot more calories than you'd necessarily realise. You'll know a great deal more about managing her levels than I would, but beyond that I wouldn't sweat it. Whatever makes her happy and doesn't make you feel like a Bad Daughter :)
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My cousin has VD mixed with AD. She gets good meals and snacks at the Memory Care facility, but I take her treats that she likes, usually once per week. Since dementia is terminal, I believe she should have the foods she enjoys. Its the minute by minute moments that she enjoys.

I have chosen Palliative care for her, pursuant to her wishes, and we are focused on keeping her comfortable and as content as possible, not prolonging her life. She takes pills for Type II diabetes, but that is to keep her comfortable, since prolonged high blood sugars would make her very thirsty and increase her urine considerably. Since that would make her uncomfortable, we continue with that treatment.

She gets herself around in her wheelchair which is exercise, but it's not required, since she is terminally ill. I read a lot about what professional organizations and doctors have written about those with dementia and other terminal illnesses. It confirms our choice for Palliative care. We don't do cancer screenings or have multiple tests for various possible health issues.

I guess it depends on what your goals and expectations are for your mother's health.
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