We take for granted our ability to respond to change throughout our lives. When younger we can move house, do many things at once, adjust to many, many things.
Dementia changes that. For a time in the early stages the person with dementia can cope as the brain has the ability to move stuff around - up to a point. Once dementia has developed past a certain stage, changes around the patient become much more difficult to adapt to.
One of the first signs I had of my wife Jan's more serious deterioration was when we went on one of our last annual holidays, to Crete. I had paid for a luxury holiday because I knew she would not be able to enjoy such things for much longer. Jan was fine until we were in the taxi, driving from Heraklion airport, when she turned to me and said "Where are we?" During the holiday we had many fraught mealtimes as the change of scenery seemed to advance her condition. Suddenly she didn't know which piece of cutlery to use; she took ages and ages to select from the meal menu. She could never find her way to the hotel room on her own.
Because she was unsure of herself, she became less steady in her walking. You need to watch that - once, in the developing stages, I was walking with Jan in our local town on some cobbles. Although I was holding her hand, she tripped on a cobble and fell, damaging her cheekbone. Though I tried to save her, she fell too fast. After that, I always would hold on to her arm when we walked.
Molility does go quite quickly once it starts - we don't realise how much brain function, spatial awareness and motor function combine to enable us to move around.
Finally, vascular dementia moves downward in steps, unlike Alzheimers, which moves in a slow smooth downward direction. Each new episode means a new step down, and the difference is much more noticeable than with Alzheimer's.
