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I have written several questions regarding my mother and her vascular dementia. I have so appreciated everyone's input. My mother is normally bright and articulate. One year ago she had a brief loss of reality, and now this year she is in her second month of delusion. The diagnosis then and now is the same. Yesterday, a new and better doctor confirmed the diagnosis, or at least preliminary diagnosis: Vascular Dementia, slight. Possible sleep disorder, possible vascular issues, and a psychiatric problem due to a troubled childhood. The difference is this doctor is going to do something! We wasted an entire year with the neurologist, this doctor is a geriatric specialist. He has ordered blood work, MRI, MRA, sleep study, and a neuro psychiatric exam. This all makes sense to me and a year ago I suggested she we having a breakdown due to her past. But can this be? Or are we just fooling ourselves? She's as smart and able as the next person, but not in touch with reality in many ways. All of her delusional issues deal with being afraid of men, namely her dead father. The doctor has been in practice 25 years and said he has never seen a case like this. Can anyone relate? She never had any counseling, nor did she speak of the abuse much. What I see coming out now is heartbreaking.

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Thanks Barb, and yes that's just about what the doc said, maybe all of above. I feel there's hope now to at least manage some of this. Before we were without help, answers, and no meds at all and a doctor that returned calls 4 days later.
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Michigan; you can have vascular dementia AND psychiatric issues. You can have both of those AND sleep issues. The answer may be "all of the above".

Some things, like breaks with reality, can be "over-determined". Meaning that there are several reasons that they are occurring and it's generally impossible to sort out what is causing what.

My mom has vascular dementia due to a stroke; she is also mostly aphasic, so she can't always tell us what she's thinking. From time to time, she gets utterly hysterical and miserable that:
she has leprosy
she has MRSA
that she's going to jail because she didn't pay income taxes in 1937
that she's going to H*ll because of something that happened long ago

We can't make head or tail of this stuff most of the time. The answer is sometimes that she's got a UTI, but most of the time, it is just the processing of a very broken brain dealing with the memories of a dreadful, poverty-flecked childhood, the early death of her adored father and her overburdened, unhappy mother.

The answer is usually more meds. Most of the time, she is calm and happy to see us. That's all that matters.
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