Prognosis for vascular dementia?

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Eve G.

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Hi--I'm new here. I've found reading the other posts on vascular dementia very helpful, as so many seem to be going through exactly what my mother is: she can no longer read (which was always her greatest pleasure) or watch TV; she has aphasia; she sleeps a lot; can talk intelligently on the phone but not in person; has no short-term memory at all.

She's 85; had a stroke at 82 and now that I look back on it I can see that she'd been slipping mentally for years in little ways. Thank goodness we found a wonderful gerontological psychiatrist, who is carefully balancing her drugs to try and at least slow the deterioration.

What I'd like to know--if anyone knows!--is, what is usually the endgame with vascular dementia? Do patients usually die from other causes, like another stroke; do they fall and break a hip and die in the hospital; does the vascular condition itself (lack of blood flow to the brain) somehow do them in?

Mom's side of the family tends to live to be about 90, and as much as I dread her dying, even more I dread her living on getting worse and worse (and, eventually, running out of money: assisted-living and private-duty nurses cost an obscene amount of money!).

Thanks, in advance, for any advice or info.
 

jenniferpa

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Jun 27, 2006
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This is just speculation on my part, you understand, because there doesn't seem to have been much research done on this. Mostly, I suppose, it's based on my own experience with my mother, who has had several strokes. Definitely, having one stroke increases your risk of having another. Furthermore, as the brain heals from the stroke damage, people often end up with epilepsy. In my mother's case, she had a grand mal seizure about 6 months post stroke, and if she hadn't been talking to a carer at the time, that probably would have killed her - she had to be resusitated. Mummy has high blood pressure and atrial fibrilation - both indicators for an increased risk of stroke. She has fallen several times with no long term ill effects (this is going to sound flippant, but as a family we have a decent amount of natural padding in the hip area - I think it can help.) It seems (anectdotally) that many of the people who break hips are on the thin side to begin with.

I suppose I expect my Mother to either have a heart attack or a massive stroke, but that may be wishful thinking on my part (if you know what I mean).

Jennifer
PS I'm in PA, but my mother is in the UK
 

Helena

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May 24, 2006
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I too was wondering what prognosis indicators there are but searching for Vascular Dementia on Google it seems much depends on the form of Vascular Dementia and age of the patient

Certainly my Mother 90 in Oct who has had High Blood Pressure for 30 yrs has detiorated very fast this year but i believe her VD is multi infarct or TIAs as while there have been events leading up to all this they have never been actual strokes

My Mother lives alone by insistance but neighbours are very worried about her extremely confused state

Her Doctors insist theres nothing they can do intervene until theres a crisis as since its not a mental illness and she is of independant mind they cant section her

My personal view is that medication simply extends the agony and if they are as determined as my Mother to avoid a NH then in all likelihood a fall or some accident with Gas cooker will be the catylist
 

Kayla

Registered User
May 14, 2006
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Kent
Treatment?

My Mum has vascular dementia and is in a NH unable to walk. I find it frustrating that nothing can be done to improve her quality of life, although I understand that she can't be cured now. I asked the nurse who came to assess her for the Registered Nursing Care contribution about physiotherapy and she just said "What's the point? She won't remember the exercises and she won't walk again." I would have thought it was a good idea to keep people moving as much as possible to improve the blood circulation.
I feel like they have written my Mum off, even though she can still hold a conversation and remember past events in a muddly kind of way. She is still my Mum and still has a sense of humour and is thoughtful about other people. At 81, with a good heart and lungs, she could have years living in her NH, and they should be as happy and fulfilling as possible. I bought her a sticker book back from holiday and she seemed to enjoy sticking in the pictures of different insects with me.
Kayla
 
E

Eve G.

Guest
Thanks for all the quick replies--I'm torn between being comforted because "so many others are going through the exact same thing," and horrified, because "so many others are going through the exact same thing!"

My mother also has high blood pressure and an irregular heartbeat; also bronchial asthma (she never smoked, but my father did). We thought one of those would carry her off, we never saw this coming!

She's still mobile, with a walker (which she uses, thank goodness), but has fallen and broken a knee and an arm in the past three years: another fall is inevitable, and we just cannot afford 24/7 private nurses. The staff at her assisted-living home is overworked and there are only six or so aides for about 80 residents. So we have a wonderful nurse with her all day, who does the work of ten people. We also found a place that let Mom keep her cat, which is a huge comfort to her.

She hasn't deteriorated mentally as quickly as we'd feared, but she's having more "spells," of panic and only being able to say, "please let me go please let me go" (which doesn't mean she wants to die--I asked her once in a lucid moment and she said, "goodness no!").

I guess y'all don't know much more about this than I do; we all had to become instant experts, didn't we? Treatment, facilities and doctors don't seem to vary much in the US or the UK, from what I've been reading here.

Thanks again!
 

jenniferpa

Registered User
Jun 27, 2006
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You lnow, even if you had 24/7 nursing care, barring strapping her to chair, there is really nothing that can be done to stop falls. Depending on where the stroke damage was, balance is going to tend to be affected. Panic - yes, I'm familiar with that manifestation. My mother forgets what has happened to her and how old she is, so sometimes, she gets in a panic because she can't understand why she is as she is. In her more lucid moments she expresses anger that this has happened to her, and frustration that she didn't die.

Jennifer
 

connie

Registered User
Mar 7, 2004
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Frinton-on-Sea
My dear Lionel's condition has always been Early Onset Alzheimer's, but more and more I am inclined to the mix with Vascular Dementia.

Indeed his CPN actuallly witnessed what could only be described as a TIA.

Where do we go from here.? He is a young (relatively) man aged just 65, mind still alert on a good day, but mobility and spatial awareness shot to pieces How do I handle this.?

Paramedics are now questioning the amount of times I call them out for falls (they think the "falls team" should be involved) "falls" are random, legs just go....... day centre phone to say they are finding it 'difficult' to cope.............excuse me I do all th.is on my own, duties they are paid to do He is so wonderful, and I know that I cannot keep him at home much longer, but HEY I was here in January of this year..............I am not ready to give in yet. Exhausted..but.
#
Love to all,
 
E

Eve G.

Guest
jenniferpa said:
You lnow, even if you had 24/7 nursing care, barring strapping her to chair, there is really nothing that can be done to stop falls.

Yep--someone at the home told me, "Even the ones who have 24/7 nurses still fall. They ALL fall sooner or later." Connie, my mother has that problem too: sometimes her legs will just unexpectedly fold up and down she goes with no warning. It's very scary and one tends to hover, which only annoys them . . .

When I talked to her today she was chatty and seemed lucid, but some things she said hinted that she thought I was my sister . . . Oh, well . . .
 

Kayla

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May 14, 2006
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Kent
Quality of life

Mum is less likely to fall, now she isn't walking, but she gets so confused and frightened sometimes. After my holiday in Cornwall, she said a woman had rung to tell her my Grandad and Dad had died. I reminded her that was 43 years and 6 years ago and she was surprised at the length of time. Then she mentioned something which wasn't true and came to the conclusion that it was all false information. It is hard to deal with all the confusion. She was convinced that she wasn't in a NH. Everyone is very kind, but it isn't an ideal place to be.
Kayla
 
E

Eve G.

Guest
It's just awful, isn't it? And even when they have a good day it depresses you, because it reminds you of what you're losing.
 

mailife49

Registered User
Oct 21, 2004
34
0
uk
i understand how you feel

Kayla said:
My Mum has vascular dementia and is in a NH unable to walk. I find it frustrating that nothing can be done to improve her quality of life, although I understand that she can't be cured now. I asked the nurse who came to assess her for the Registered Nursing Care contribution about physiotherapy and she just said "What's the point? She won't remember the exercises and she won't walk again." I would have thought it was a good idea to keep people moving as much as possible to improve the blood circulation.
I feel like they have written my Mum off, even though she can still hold a conversation and remember past events in a muddly kind of way. She is still my Mum and still has a sense of humour and is thoughtful about other people. At 81, with a good heart and lungs, she could have years living in her NH, and they should be as happy and fulfilling as possible. I bought her a sticker book back from holiday and she seemed to enjoy sticking in the pictures of different insects with me.
Kayla
Dear Kayla,
I remember you from before and I think we contacted each other once........
I also remember how much your mother seemed like mine.

My lovely mother died in May of this year ..........it was strange, she got some kind of stomach flu virus and unfortunately it was unpleasant as she was vomiting - poor thing, my mum who never had any kind of illness that I can remember........... well, it was a matter of weeks (2 I think) and I didn't know whether to go over (being in another country) or not (I didn't want to arrive and not be in time) so I thought I'd wait a bit , but I kind of regret it - as I was too late and luckily my mother was surrounded by all her nearest and dearest (my siblings) and they told her lovely stories from the past as she drifted in and out of consciousness with the morphine patches....they decided on comfort options above all , just making sure she wasn't in pain - so they spoke (my family) to her gently and even included me in that which was really nice. (at the NURSING HOME) ............AND apparently when my mother died they put up a kind of
shrine for her , i mean a couple of candles on top of some altar-like surface.
anhow she was 92 (that very month) ....... and she had visits from her great´-grandaughter (of 4 mths) and there's a photo of her with her g.grand-daugher, and she looks marvellous ´- sadly it was very close to when she got this horrible bug..............

My mother had Vascular Dementia, as far as one can tell, and she was a person who had a beautiful mind and was very good at word-games, art, poetry, witty, life and soul of the party kind of person, athletic - good golfer and a very sociable, loving person..................

It is all too sad, and sometimes i find myself just looking at some lovely photo of her on my pc and listening to some melodic music at the same time, and the tears just roll down my cheeks.............

Anyhow, I just wish you all the best and remember, what they don't remember can't do them any harm.....so maybe it's just as well they don't remember.
lol mailife49
 

Amy

Registered User
Jan 4, 2006
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Hiya mailife,
So sorry about your mother. It is early days for you still - give yourself time. It sounds as though the family were able to ensure that she was as comfortable and peaceful as possible as she reached the end of her life.
I don't know if you have noticed that we have started a new forum for people dealing with loss and bereavement, (After dementia - dealing with loss) you may find further support there - TP is still here for you.
Love Helen
 

mailife49

Registered User
Oct 21, 2004
34
0
uk
re. bereavement tp

Thanks Helen,
it was very kind of you to say these comforting words - it just happens now and then , the emotional build-up , you know .........being a mother myself i can't be like that all the time , of course.

It does get softer, the blow, and as time passes you just try and be positive,
but everyone has a bit of a cry now and then i'm sure - after all it was just a short while ago - in May.

I will go into that tp Helen,
you're a great bunch of troopers!!!
love,
mailife
 

Kayla

Registered User
May 14, 2006
621
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Kent
Dear Mailife,
I'm sorry to hear about your mother. You must miss her a lot and it will take time to get over your loss.
Even though my Mum is in the NH, she is still much the same as she's always been, which makes it harder when she says something really confusing. Now Mum has a friend, who spends a lot of time in her room. They talk to each other, but they cannot always hear properly, and often have completely different conversations together. However even though Mum is often confused, she still has the ability to make a new friend, which I find comforting.
I do envy people who are still able to go out and about with their mothers, as it seems such a long time ago, that I took Mum out in the car. I keep remembering all the things we used to do together.
I try to visit Mum as often as possible, several times a week, as I feel that there might come a time when she doesn't recognise me, or she might be unable to talk properly. I'm trying to make the most of whatever time we have left together.
Kayla
 

mailife49

Registered User
Oct 21, 2004
34
0
uk
re your mother in NH

Hi Kaila,
don't know if I spelled that right?

So sorry haven't replied until now - just saw your message and am amazed at how similar your mother seems to be to mine, although of course mine as you know is not with us "physically". I like to think there is some kind of spiritual contact though , you know you find yourself looking at the last photos taken of your mother (well not thankfully in your case) and I usually put some nice oldie music on and just gaze at the photo and reflect on the good times we had.................... It' s never easy, whether they're young or old - when you lose them you just have to try and think of the good times you had together.

You see my mum also ended up chatting with sb. and I believe the matron used to be quite amused at the pair of them as neither was really taking anything in, it was just the fun "out for a cuppa"kind of chat that went on.........

I DO hope your mum is doing ok and you are quite right - better to enjoy her while she's around and make her know she's so loved by you.

Wishing you all the best,
mailife49
 

Kayla

Registered User
May 14, 2006
621
0
Kent
Thankyou

Thankyou for for your message about your mother and it is good to know she will always be in your thoughts.
I suppose how people react when they have vascular dementia, may be connected in some way to how they were originally, but not necessarily. Mum always seems to be worried about other people and she thinks she is looking after her friend (her friend thinks she is looking after Mum!).
It was quite sad on Saturday, because Mum seemed to think that the people at Church would be cross with her, because she hasn't been able to go since she broke her hip. She couldn't remember who had visited her recently, but felt she should have been doing more. I don't always know what is real and what she has imagined.
It seems as if Mum is in a kind of dreamworld and I'm beginning to think that it is difficult to join her there, as I'm not always sure what she means. For the first time I'm making a Christmas cake, as Mum always used to do it and then we started buying one. Perhaps now is the time to create some new traditions, especially as it will be the first Christmas without my mother-in-law, who died in June.
Kayla
 

jenniferpa

Registered User
Jun 27, 2006
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I feel I should point out that this is a very old thread. I'm closing it as I don't don't want people to get confused.
 
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