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So the neurologist diagnosed my dad with vascular dementia but my dad has never got strokes he has good health ...but he has schizophrenia and psychosis. Lately he doesn't want to take his meds or eat or drink water and he has memory problems and he is having hallucinations. I know psychosis and schizophrenia causes hallucinations! I'm not really sure if he got diagnosed right?

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Did he not have an MRI?
My mom had a couple of TIAs that I witnessed so she was referred to a neurologist who treated her to prevent stroke. and as far as I know she never had one. But according to her family doctor her MRI "lit up like a Christmas tree" - she had probably been having silent TIAs for years without any noticeable physical or mental effects. Try looking up multi infarct dementia.
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cwillie's question is a good one. This is something you need to discuss with the diagnosing physician, hopefully a good neuro-psych MD who did thorough testing. I think that given you know he has this underlying schizophrenia/psychosis, he is going to be very difficult to diagnose and treat; as you will know if he has had this underlying condition for some time. Drugs are iffy at best and long searches for drugs and cocktails that work are often involved. Sadly when the right cocktail is found it doesn't always last.
You are right to question this. We on Forum are the wrong ones to ask, however. We would at best be making some sort of wild guess even if we were trained professionals.
You do need to speak with the MD. If he doesn't have time to speak with the POA in health care then you need to find an MD who does have that time. I am so sorry for all you are dealing with and wish you the best.
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This forum can't substitute for a physicians diagnosis, but it can offer some insight for a caregiver. Vascular dementia is not a neurodegenerative disease like AD, LBD, or FTD. VaD has more to do with environmental causes. It is caused by a lack of blood flow to the brain depriving the brain of oxygen. A person doesn't necessarily have to have a NOTICEABLE stroke to cause damage to the arteries of the brain. Some strokes are so small they go undetected, even to the patient. But after time, these mini strokes can cause damage to the small vessels in the brain. Strokes are not the only cause of VaD. A clogged carotid artery, atherosclerosis, high BP, diabetes are other conditions that can effect blood flow to the brain. Was your dad a smoker? Smoking and obesity are significant risk factors for VaD. Whatever affects the heart, affects the brain. MRIs and carotid ultrasounds can help identify blood vessel damage and lack of blood flow to the brain. If these have been done, a diagnosis of VaD is probably pretty accurate. If they haven't been done, they should be.
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I saw my mom's diagnostic MRI that confirmed vascular dementia. (The Alzheimer's diagnosis came a few weeks later. It isn't unusual to have both conditions.) Indeed, on both hemispheres of her brain there were white areas where "silent" strokes had caused damage. Ask her doctor to see an existing MRI or request an MRI to confirm.
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My father was dx with mixed dementia - alzheimer's and vascular. We never would have known he had vascular dementia. The MRI done showed he'd had strokes in the balance center of his brain. There was no outward signs of these strokes. Finding out about his vascular dementia went a long way to explaining all his falls.
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My mother hs vascular dementia but has never had a "stroke" per se. The doctor told us she had mini strokes that we all have (I blame her bout with undiagnosed pleural effusion), and that led to her dementia.

As the others have said, a neurologist is the best one to make the diagnosis.
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Julissa, it is absolutely dotty to ask a public forum to second-guess your father's neurologist.

Think of the unfair advantages the neurologist has:
your father's complete medical and psychiatric history
access to diagnostic equipment like MRI and CT scanners
a complete record of your father's medications
AND
he's met your Dad.

So, really, the only point we have on our side is that we might agree with you and have lots of anecdotal evidence of neurologists' incompetence?

If your father has been treated long-term for schizophrenia he may be more vulnerable to degenerative brain disease, and for all I know that might well include vascular dementia.

But never mind us guessing. If you have questions about your father's diagnosis and his neurologist's rationale, there is only one person it is at all sensible to ask - go back to the neurologist. If you still don't get a satisfactory explanation you can always ask for a second opinion, only get it from a qualified practitioner.
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