Mum is 83 and has vascular dementia. So far, it is mild, she still lives independently, but is a bit forgetful and easily confused. I am her carer and visit most days, sort her meds, order meals, arrange doctor's appointments, pay bills etc. She still has a little bit of a social life, regularly attends church, sees family and has visits from friends.

The problem is she has started bursting out crying whenever she gets confused about something. It's quite dramatic, tears, sobbing, "I'm stupid, I can't do it, I'll never be able to do it" etc. I have been very patient with her, assuring her she's doing very well and trying to calm her down.

However, I'm starting to suspect that this is in part at least, a deliberate attempt to get sympathy/get out of doing things she doesn't want to do. Eg she does it when we visit her hearing nurse - she doesn't want to try to learn to use her new hearing aid. (She often uses her deafness as an excuse for not knowing things eg she will say she didn't hear me telling her something, rather than admit she's forgotten what I said). She is also meant to do some gentle exercises each day to help her joints, but there is always an excuse why she can't do them (the doctor said she can stop them now, she did them when I wasn't there etc), when I try to get her to do them, I get the tears again.

I'm starting to feel as if the tears are fake or maybe exaggerated and I'm not sure how to deal with it. I don't want to end up being unsympathetic towards her, but I feel like I'm being manipulated (along with her nurses etc). I realise she must find her new limitations very frustrating and she does suffer from anxiety. In some ways she has dealt with things very well, but she refuses to go to the doctor to discuss her feelings - I have no idea if she would benefit from medication to help her anxiety.

Does anyone have any experience of this? Could she be trying it on with the tears? I know this is very early days, so I want to try to get things right from the start, otherwise I have no idea how I'll cope further down the line.

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Sofie, I have a totally different interpretation of your mother's inability and frustration to accomplish certain tasks.

She realizes she's losing various abilities, it frightens her, it frustrates her, and she cries out of frustration. From your description, I don't think she's doing this deliberately. Unless someone has been in a compromising situation physically and mentally, it's hard to really see what happens to someone losing life and coping skills.

Have you ever been seriously injured, couldn't walk, or couldn't take care of yourself? It's frustrating, it's frightening, and it can destabilize someone enough to be unable to even contemplate solutions.

I went through this during the later stages of my father's decline. When I first started using power mowers instead of a hand reel mower, I once had problems with the starting system, so I disassembled it and changed out a wire. Now I worry every time I have to mow that I won't even be able to start the mower.

Problem solving morphs into one in which solutions can be nebulous, if existent at all. Being faced with losing so much control, and ability, undercuts our very self esteem and self confidence.

Confidence in skills and ability has been lost; that can happen in caregiving, when there aren't that many successes, when the eventual outcome is already known, and it's not a good one.

The next time she becomes frustrated, hold her, let her express her emotions, and try to think of a way you can perform the task together, with you guiding and helping her, complimenting her along the way. Then celebrate doing something you both enjoy, even if it's just having a dish of her favorite ice cream. It will reward her for her effort.

And, BTW, I'm still trying to overcome the loss of so many coping skills, one step at a time. And I'm hoping I can overcome them; I don't want to segue into dependence at this stage of my life.
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sofieellis Jun 2018
Thank you for sharing your experience with me.

I have been very supportive and patient with her. I do hug her, tell her how well she's doing and I help her with tasks that she needs help with. I praise her lots for things she can do, especially if she does something that she sometimes struggles with.

I suppose I just wanted to know whether this is common or not and whether or not I'm doing the right thing.

Thank you again and best wishes.
Sending you a private message.
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Sofie, are you in the UK?
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sofieellis Jun 2018
yes I'm in England.
Vascular dementia was first mentioned a few years ago when she had a ministroke. I noticed her starting to get more confused about 2 years ago and persuaded her to go to the doctor. He arranged for tests, then referred her to a specialist mental health team. She had cognitive tests, scans, ECGs etc, before a formal diagnosis by a consultant.

I always go with her for all her appointments and am present when she has assessments at home as well.

We've been offered support from specialist nurses, but she doesn't want to know. I think I might have to contact them anyway though, as I feel like I'm struggling already. It's hard though, because I'm so scared of upsetting her all the time!
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Who diagnosed her with Vascular Dementia, Sofie?

You can ask for a "needs assessment" from her local Area Agency on Aging. Make sure you're there when they come to interview and assess. It will give you both a fairly objective view of what mom's needs are.

She might be able to hear a professional tell her these hard truths better.

You, of course, can make up your own mind about whether mild anti-anxiety meds might be worth a try. I found that they worked much better than my brother's bullying mom in fake "happiness" and "gratitude" that things weren't worse.
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Thank you for the replies. It's difficult to get her to see a specialist, when she point blank refuses to go to a doctor.

Yes she lives alone - I'm about a 10 minute walk away.
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One of the clues for us that something was " wrong" with mom was her constant anxiety. About everything. My brother told her to stop having a pity party.

The geriatricsychoatrist told us to take her for a neuropsych workup.

Cognitive impairments like vascular dementia and anxiety go hand in hand. Meds helped my mom get back on an even keel.

Please have her seen by a geripsych, soon.

She's living alone?
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