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My mother in law can carry on an intellectual conversation superbly. She was and is highly intelligent. She has been in the care home for about seven months minus her stays in the hospital for dehydration before being diagnosed and then a major heart attack about four months ago. She has continually the past seven months wanted to go home and been agitated about her living situation. I asked the staff if she is just sundowning when she gets agitated and wants to go home and to know why she is there. The staff said well she is unique, they can be having a stimulating intellectual conversation with her and right in the middle she will change and become argumentative and not remember the conversation they were just having. I realize short term memory is majorly affected with dementia, but the other residents there don't remember this morning, but they do remember one minute ago. On one hand it seems she is late stage dementia, because of this, but her intellectual function is not impaired. Just wondering if this type of behavior and memory loss occurs in most patients? Also she has not memory of her heart attack months ago and her memory of her early life seems to be waning. Just wondered if others have had similar experiences, and how long do demenia patients go on like this before they lose communication skills, on average? Just wondering in general what to expect because it seems there is no way to know from day to day .

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On YouTube: Anything by Teepa Snow on the Senior Helpers National channel. She has very valuable seminar videos which will help you understand the challenges and progression.
Also do a search for Jo Huey's "10 absolutes".
There is now a wealth of information to help us understand and be better caregivers via the internet.
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Vickie, they all want to go home, because they think everything will be OK if they just get back home. Anger is part of early dementia, so is anxiety, but they can be treated with medication. My MIL also has vascular dementia and difficulty maintaining balance, so she uses a walker. Her memory is good some days and pretty fractured other days. She also has the delusion that she is good enough to live on her own. We know she can't, she hated being alone, she needed people around her, and that is the biggest advantage to Assisted Living, to keep the social side alive and well as long as possible.
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Best of luck to all of you. My mother is 89. She had a stroke in September of 2013 diagnosed with vascular dimentia. It is such a roller coaster ride. Her moods actually change minute to minute. It is absolutely draining and horribly sad to see someone that you love so dearly have to be so confused, sad and angry most of the time. I feel helpless that I can't help her anymore other than just be with her and try to comfort her and redirect the mood swings which does happen on occasion. Best of luck everyone and god bless!!!
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Is she on Seroquel? It messes with your thought process. My mom, who was brilliant too, just couldn't take it. A lot of nursing homes give it to their patients.
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My brother had Parkinsons, and possibly something else going on. He could be completely lucid for a short period and then lose it. The first symptom was once when he got lost driving from one place to another, and my SIL was very worried because he had always had a great sense of direction and never got lost. He would also repeat family stories over and over again; once in a conversation it switched from fairly recent to 30 years ago. Totally different pattern than Alzeheimers, which I've seen several times.
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VickieJ, your MIL sounds very much like my LO, my cousin. My cousin had been quite happy with her assisted living facility, even crying to return after leaving for an appt., but, yesterday she claimed she wanted to go home and that she regretted she had gotten involved with that organization. She was very upset, but able to communicate with no problem. After our conversation, she came to the conclusion that she loved it there and had many friends and people who took good care of her. She did not want to leave anymore. It's a roller coaster ride. And not in a good way. I'm trying to figure it out.

They suspect that my LO has Vascular Dementia and Alzheimers, based on her MRI. She still hasn't had the neuropsychological eval, and may not. She showed signs of dementia years ago, but we didn't get it. Then the very apparent signs surfaced in April of this year. Extreme memory loss, though she had been repeating herself for years. She also has suffered many falls and sustained broken bones. It's been downhill since then.

I have read that a sudden decline is more common with Vascular and that the prognosis is not as good either. Experts have brought up palliative care to me and I'm researching that now.

I see other residents who suffer with dementia, but they have not progressed as much as my LO has from what I have seen in my visits at the facility. If it's strictly Alzheimers, it seems to progress slower than vascular.

I kept wanting my LO to stabilize, but it's one thing after the other, but physical and mental. I hope your case is different. I wish you and your family the best.
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Yes, each person is unique with dementia, and no she is not in the final stages of dementia. She will lose the ability to talk and walk in that stage. You can expect the unexpected. No one knows why or how to predict the direction of any dementia disease, so just adapt to each day and make each day the best you can. Having no memory of a heart attack is a good thing.
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It presents to everyone who it affects differently. We all share a common thread....Blessings ARE....
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my father was never diagnosed by a brain scan but was seen and we were told he had moderate to severe dementia/alzheimers. he can remember all the old stuff but not much new. my dad is a talker but there are times when he starts a sentence and also stops for about 30 seconds then continues or changes the subject. It's amazing and sad to see how just each person at a NH with these mental diseases all act differently. some are so wide awake/walking, others are sleepy/in wheelchairs or just babbling like little kids trying to talk. It just goes to show how each and every brain is individual/intricate to themselves. I wish us all good luck in our caregiver world, its definitely more than a fork in the road, its the bumpy path of life.
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Vickie: I am so sorry to hear of this with your mother in law. My mom has Alzheimer's and my father has Vascular Dementia. I want to copy or re type what my doctor told me, also both are a type of the 100 forms of Dementia.

Vascular: Cognitive abilities often seem to decline more suddenly related to an event like a stroke or a transient ischemic attack and then remain more stable. These changes are often described as step-like since in between them, brain functioning may hold steady.

My father, is like the one woman stated, he literally cannot remember the third or fourth word into his sentence. Due to a stroke, like your MIL. Everyday is a new day, each day is different. MRI's can possibly find where the damage was done on the brain and what part of the brain is affected.

Stay positive, take "me" time, and remember, one day at a time!!

Alzheimer’s: While cognition can vary somewhat in Alzheimer’s, the person’s ability to think and use his memory gradually declines over time. There is not usually a sudden change from one day to the next.

God Bless, Debbie
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I agree with all the above - vascular dementia is a response to the part(s) of the brain that were affected by the stroke. My mum's general communication skills are now quite poor but every now and then we can get a completely lucid conversation from her with words pronounced properly, in a logical sequence, and presenting a rational point of view. These are few and far between now, but the whole thing is progressive, and three years ago my mother could do much much more in communicating. Now, there are times when she doesn't remember the next few words that should follow the few she's already uttered - she may say 'I want, I want, I want ...' and just pat her stomach, I know this means she wants to go to the toilet but that she's forgotten what the rest of the sentence is and that she's forgotten that she's said she wants this because when I try to lift her she will push me away and say she's never said anything like that. Sorry, but every person is different, and you can only take what comes. It may be that the care facility hasn't got a vast range of experience.
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Vascular dementia can be totally different from Alzheimer's. It depends on which parts of the brain are damaged. My father was a very intelligent man. He kept his intelligence even when he lost his ability to walk well or sort through the normal things of life. It wasn't until after he died that we learned he had mixed dementia, predominantly vascular. He was never one to talk, and he became deaf in later life, but he would respond to things that we wrote on the white board to him. We never guessed he had significant dementia until we were told. His life followed a set schedule with little flexibility and two people tending to him. He couldn't tolerate getting out of his comfort zone. I guess it was how he was holding it all together. The only time he lost his composure is when he thought my mother was fussing at him or if he was tortured by being outside his comfort zone. Then he could go into total meltdown, which was a horrible thing to witness.
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My mom has vascular dementia and yes, the conversation turns on a dime. Yes, she can discuss the news and current events at length and in detail and then demand a mirror "because my nose is closing up". Having a geriatric psychiatrist evaluate her. There is no such thing as "just sundowning". Meds can sometimes help.
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There is no way to know from day to day.

Expect the unexpected.

Sorry.

One of my aunts would forget the beginning of her sentence before she got to the end. Literally -- no exaggeration.

Your MIL may become a little more predictable to you as you become more familiar with her behaviors -- but by then they may change.

Not all dementia patients lose communication skills. My husband did not. Some lose it fairly early in the progression.

Each of the 50+ types of dementia is different, and each patient is unique.
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