Vascular dementia what can I expect?

So… My mother has a pacemaker, she's on Clopidogrel, we've reached the end of the branch for heart meds… Where next? It's so hard to know if poor concentration/recall/processing/balance on bad days comes from fatigue or dementia (or boredom or annoyance or hearing loss or cataracts or…). What wouldn't I give for a crystal ball.

If your mother is diabetic this is also a part of of vascular dementia, you are correct about the diet and exercise, but I understand that she may be reluctant to you being the source of what exercise and what food. My mother was not receptive to my help,I took her to a day care center for the elderly for the exercise program and lunch three days a week. Maybe it was the peer pressure or not wanting to appear ill behaved with an audience but it was helpful and she participated after a few visits with enthusiasm. She eventually passed as the result of a stroke but in my opinion and that of other family members this intervention improved the quality of her life.

I think vascular dementia is an overall diagnosis that covers many types of brain damage. It might be caused by a blood clot, a hemorrhage, reduced blood flow from plaque in the blood vessels, high blood sugar from diabetes, or other illnesses. The type of damage that each person has is different because different parts of the brain are affected. Some vascular incidents are obvious, like a big stroke, but others can be silent, like little TIAs, blood sugar problems, and smaller clots or bleeds. The effect of each silent incident might be small but they add up and eventually you notice damage.

You're basically waiting to see which part of the brain gets hit next. I've been told to expect my husband to stay the same until he has another incident, which could be tomorrow or never. He could very well die of something else before the dementia gets worse, although having the dementia makes it harder to maintain his overall health.

His doctors never used the term "vascular dementia" when he was actively recovering from his strokes. It only came up when I was trying to explain why his stroke was having such a drastic impact on cognition, unlike other people I've known with strokes who had mostly language or physical impairments. It came up when I started talking to care facilities about the type of care he'll eventually need when I can't do it at home.

Because vascular dementia is caused by damage in varying places in the brain, symptoms will be different for each person. Because a later illness caused a "shower of emboli" (a quote from his neurologist), my husband has tiny bits of damage all over his brain. It's remarkable to observe how granular your brain's functions are. For example, a hit to a tiny piece of the right brain can cause trouble with "initiation" which is the ability to start doing something after you decide you need to do it. When you decide you're thirsty and need a drink, your body needs to initiate moving your arm to pick up your glass. Lucky for me, this part of his brain rewired itself during his recovery (or inflammation decreased and quit interfering with that part of his brain--no one is sure which). We haven't been so lucky with the language functions that some hits in the left brain took out. He can talk but can't think of the names, nouns, and numbers to put in those sentences. Verbs and adjectives are fine; nouns, almost none.

In my husband's case, his vascular dementia started with a huge blood clot in his right brain, which caused cognitive problems but didn't damage his memory at all. Most people couldn't tell in the hospital that he had any problem at all because he could speak and remembered everyone, and you don't usually do much higher thinking during a hospital visit. He has impulse control problems and can't follow simple instructions or learn new things, but stuff he already knew how to do, he could (mostly) still do. However, the cognitive impairments are a big problem--he can't live independently any more. and should definitely not drive anymore, although he doesn't believe it. We've had fights about that. Luckily, he's a law abiding guy. His driver's license expired while he was in rehab and he assumed he had to get a new one before driving but they wouldn't give it to him.

I found that books about Alzheimer's and other dementias are helpful when they talk about how to deal with a problem the affected person might have. For example, you can't reason with a person with a cognitive impairments when their logic circuits are broken. When they lose the ability to do things in a sequence (because of damage to a specific part of the right brain), you need to pre-sequence things by laying their clothes out in order or giving them fewer eating utensils. I've had to ask my husband many times, "Do you trust me?" when what he's trying doesn't work and no amount of explaining helps. Lucky for me, he remembers me and other people, so he knows who he can trust.

Books aren't much help when trying to guess what's going to happen to a person with vascular dementia. Everyone's dementia is different, but some dementias like Alzheimer's follow a general progression. Vascular dementia doesn't work like that. Like I said, you're just waiting for another incident, whether visible or silent. I try to get him to eat a healthy diet to prevent him from having another stroke or getting plaque buildup that partially blocks blood flow in the brain. He takes blood thinners to prevent another stroke; he's on the new generation of thinners (Pradaxa, Xarelto, and Eliquis), which are easier to manage than the old standby Coumadin/warfarin. I worry about diabetes, which he doesn't have, because he has a family history; high blood sugar can damage the brain too. I also have to keep him well hydrated, which is a chore, because dehydration makes his cognition worse.

One thing you need to be aware of is that when your loved one gets sick, has an infection, gets dehydrated, or needs surgery for some reason (like dental work), their level of function will temporarily decrease and they will be harder to care for. An example: my husband has no problems with incontinence except when he has an infection or right after dental surgery. Then he needs to wear the adult briefs for a couple of days until he gets his faculties back to his baseline. This was a big shock for me the first time it happened and I was alone in the house with him without briefs handy. And the first clue I had that he had a urinary tract infection was that he got thirsty and tried to use the soap dish (with soap in it) as a glass.

His capability for semi-independent living is very much determined by his health, hydration, and just plain old luck. For example, he likes to walk around the block a lot and a vocational therapist checked on him and said he's OK to do that alone, but someone has to remind him to drink up after a walk in the summer to keep him hydrated. He does fine with taking his meds by himself because he only takes them once a day, as long as it's the ones he's used to taking. He requires watching when his meds change. When the doctor adds a drug to treat an infection or something, my husband is confused and will either forget it (or remove it from his pill case because it's unfamiliar) or take too many of it.

He can do lots of things for himself as long as everything goes well. If our paid caregiver buys a different brand of a food he likes, he might skip lunch because he doesn't recognize it. If the phone rings when he's in the middle of something, he might forget where he is and usually skips steps or stops early. Lucky for us, he never leaves the oven on or microwaves things for too long, so he can safely make a snack for himself if I'm out.

If her memory is sharp, she is in early stages. There is no roadmap, but she should NOT be driving a car anymore, she is a danger to others. Look for signs of mini-strokes: poor balance or coordination, loss of time and place, vision or hearing declines. Later: obsessions, rummaging, hoarding, avoids the tub, unsafe with a stove. Finally: forgetting who someone is, trouble eating, speaking, sleeps a lot.

Mom had leg edema also. Doctors tried treating her for congestive heart failure, but her edema was due to her arthritis. It is pseudogout. Her rheumatologist is treating her with a long duration, low dose & diminishing prednisone. No more edema!
She suffers from vascular dementia also, and is in assisted living. I wrote a note to the doctor so she knew mom is waiting to hear she is well enough to go home. The doctor was great! She told mom that her health has improved and she is in a safe caring place. She has activities and interacts with peers. She is just where she needs to be! It has been 3 months, and mom doesn't ask when she's going "home."

My husband has vascular dementia but he is not diabetic maybe because he's on a feeding tube as a result of the tongue and tonsil cancer. He developed symptoms when he had his open heart surgery in 2002 and went downhill quickly from there. I took his drivers license away un 2009, because his driving was risky. Now he's in a nursing home and knows who and what I am to him and he knows people who come to visit if I tell them they are coming. He can't tell me what he did yesterday

My mom was diagnosed over 10 years ago with vascular dementia. I was told at the beginning that she could stay the same for 20 years or not. There is no set time frame. She started to become a hermit and more of a hoarder. With one on one careing from an outside aide. We put our heads together and started to break the traditional ways dementia people behave. Now after time. My mother is getting more confused but she goes out to family functions, she goes and gets her hair done along with her nails. Keeping involved in daily living activities and strict structure but allowance foe bad days. She can live a fulfilled life as long as she is here. Pleae look into community based programs such as CDPAP( Consumer directive personal assistance program paid by Medicaid, if she doesn't qualify for community medicaid ask them that you will open a Supplement needs pool trust account for the surplus income. And get outside help to deal with the needs she will be requiring.

Mother has leg adenoma that her PCP at times has referred to her having vascular dementia. I have no clue what his talking about. First it's 'She has the onset of Dementia', then 'She has Dementia', then it's 'Vascular Dementia'. Add that to the referred neurologist that tells her, 'You're doing fine. Keep taking your medications, socialize outside the home, watch TV, do puzzles or play games. You will get better.' ARE YOU SERIOUS? They have both told me, in private, 'She can not live independently, she need 24/7 care. And no, she will not get better with time ... only worse.' I have told them both that "You need to level with my Mother and stop blowing smoke in her (not the exact words, you understand) nether region. Being the optimist that Mother is, she needs to hear the reality from those she trusts. Hearing it from me that the 'reality' is other then her optimist view, especially when not stated by the doctors, causes a disheartening chain of events.

Mother has stated, 'I don't want to live like this. Your Grandmother (her Mother) didn't have this; why do I?' Then there are the statements Mother makes about going 'walk in traffic', 'just take me out for a ride in the country and drop me off somewhere, I can make it back.' The one that really, really upsets me is, 'just shoot me, so I can be in peace. I never wanted or expected to live (past seventy-five anyway) this long.'

Though Dr. Jack Kevorkian - aka. Dr Death- famously said, "dying is not a crime" Maybe he was onto something; letting a person choose to leave this level of the journey for the next level on their own terms. I've stated the following before, 'Boys! If I get to this point in life, just make sure I have a full tank of gas, some pocket cash, clothes and sleeping bag strapped to my motorcycle & tell me "go west ole-man.' That's the way I feel, my terms. It may seem rash, crude or whatever, but that's me.

I'm sorry for going way off topic here. It's just been one of those days. Please enjoy Thanksgiving with family and friends. Ours problems will still be here tomorrow.

Blannie, CHF seems to lead inevitably to vascular dementia if you survive with it long enough - the poor pumping action means the brain doesn't get a good enough blood supply; plus blood can pool in the left ventricle and throw off small clots that get to the brain, and goodness knows where else.

My mother's never smoked, never been overweight, always stayed fit and active - her diet wasn't great, but cholesterol always ok - and was bustling home from work back in 1996 when she collapsed in public and was admitted to hospital. First diuretics, then beta-blockers and ACE inhibitors, then the angiotensin wotsit instead of the ACE, then they tried her on spironolactone but pulled it, then the special pacemaker, then a change of diuretic, then finally this year the cardiologist snapped her file shut and said: well, that's your lot, I'm afraid.

Two strokes, two weeks apart, and here we are waiting for our appointment at the Memory Clinic. 17 extra years of good quality of life, I've no complaints about the medical profession. I just wish they could tell me what's coming next and when.

kazaa, that's the way this kind of dementia is...brain function varies from day to day and some things that are more automatic come out more appropriately, other times things are from left field... Its not you, you are just letting the uneveness of it all get to you and thorw you for a loop. And, she will recognize familiar people perfectly well even pretty far along in the course of it, to me that was the one thing very different from Alzheimer type. Many casual observers will think because they are recognized and conversed with, the peson is "sharp as a tack" but when it comes to judgement and critical thinking skills, and most short term memory things, they really need full time help. They will grasp what they can and they wil often not realize what you'd think should be obvious. Never take it personally. I have to admit when a former nursing school mate came to visit mom and chatted a while, and then told me privately, "she's very confused" it was helpful to me, because so many peole gave me the "sharp as a tack" stuff, which made me feel guilty about thinking she could never go home alone again the way she wanted to so badly, and yet, because she physically needed so much help, it turned out they did not actually think she could go back home either. It had to et to where any little infection or inflammation she had would send her off the deep end, hallucinating and hitting people with her purse, before I was finally ready to do what needed to be done...hardest thing I ever had to do was to sell that house to have funds for long term care for her, then move her to my city after my dad passed on.

And now I feel like a dingbat for not guessing leg edema from adenoma!