I am trying to figure out what is going on with my 82 year old father. He was recently diagnosed with vascular dementia after getting two MRIs and a EEG (along with some other tests). But his symptoms are strange:
1. He has had these episodes where he collapses into semi-consciousness, then wakes up totally confused, to the point he can't remember his own name, the date, etc. He doesn't recognize family members and is "out of it". But he then recovers to some degree, and becomes more coherent and lucid. This has happened at least twice, and the last time it landed him in the hospital for 7 days. In addition to the problems above, he was combative and uncooperative.
2. Over the last couple of years, he has become much weaker, walks very slowly, and has very poor balance (has to grip onto things to keep from falling). He has some back and shoulder problems (arthritis), but the physical symptoms have gotten much worse in the last 6 months or so. He tends to drag his right foot a bit.
3. He has memory issues, but they aren't always obvious. he will say his grandson is 10 years old, when the actual age is 16. He forgets dates, and has trouble with his finances. He can't write a check, and has to have someone else do it for him.
4. After checking him into a rehab facility after the last major "episode", he was found wandering the halls naked in the middle of the night.
5. He is depressed, anxious, and his personality seems to have changed to some degree.
What confuses me are the "ups and downs" --sometimes he is obviously impaired, and at other times he is pretty lucid (although his eyes seem glazed, almost as if he is drunk --he is on a lot of meds).
Is this normal with vascular dementia? To have these periods of lucidity followed by major cognitive episodes?
And at one point she thought she could still write. She would start a word off confidently and then lose track of where she'd got to, e.g. "thannananank youu for the..." Discreetly removing the pile of Christmas cards she'd embarked on and then abandoned was one of the sadder moments of my life.
I don't suppose it will help at all that her diagnosis was "vascular dementia, ?w/ Alzheimers involvement." She was in her late eighties and had had the classic, common or garden form of CHF for fifteen+ years.
I know we're told (alz.org is a useful source of information on all dementias, if you haven't already come across it) that vascular dementia follows a "stepped" pattern, with a loss of function, then a stable period, then a further loss of function etc. Although that's true, it didn't seem to me to take into account possible fluctuations in brain function related to poor blood supply in the actual minute, day to day; and it didn't either take into account the range of things mother would find to obsess about, or whatever impact her existing personality might have.
I wouldn't ignore the depression symptoms. Report them and don't let them be brushed aside. We found an SSRI helpful in taking the edge of the bleak, nameless misery my mother began to experience, I hope this or something else might help to nip your father's mood difficulties in the bud.
But overall, yes it's normal. It still sucks, but you're not missing anything obvious that I can see.
As for the fluctuating cognitive abilities - in the early days days my mom couldn't tell you her own name and yet other parts of her mind seemed to be perfectly intact right up to the end, it is a very confusing disease.
He was admitted into a rehab/nursing facility (technically for two weeks, but it could turn into a long-term care)
The problem is, when he is lucid, he is outraged at being in a home. He has threatened to disown his family, disinherit us, sue us, etc. --all of it is pretty extreme and paranoid.
I don't know how we could get on by himself (he lived with a girlfriend), since he has had multiple incidents of falling, hospitalization, etc.
I'm just confused at how this disorder seems to have its ups and downs.
If his brain is atrophying, I believe this is called frontotemporal dementia. People with this form of dementia can be impulsive. They lose their social filters and act out, saying outrageous, sometimes hurtful things. Then, five minutes later, they’ve forgotten they’ve said these things while we’re sitting there, upset and wondering what the he** just happened.
I would still speak with the diagnosing doctors and ask for their prognosis. They can also steer you toward support groups.
pointment with his doctor to discuss what Dad’s diagnoses and prognosis is. Share what you’re seeing regarding Dad’s behavior with the doctor and ask about what meds he’s on and what they’re for. If you have a better idea of what’s going on with your Dad, you will feel a lot less lost over what’s going on.