Moderate Vascular Dementia

[Hitheranthither]

Hello,

My mum has just been diagnosed with moderate Vascular Dementia. Thank you for hosting this helpful site and for all the comments. The learning curve has been steep! I have two questions:

1. Could anyone describe, in their experience, what prompts the transfer from living semi-independently (with carers visiting three times a day), to moving into a care/nursing home?

2. Has anyone had experience of challenging the use of general anaesthetics on the elderly without consideration/discussion with relatives, which can push them into a condition of dementia?

Thank you.

 

[PeggySmith]

Hi Hitherandthither,

As far as your first question is concerned, it was MIL's deteriorating mobility that finished us off. I'm not only not strong enough to lift her but I don't deal with incontinence issues very well either. I know for other people, wandering and personal safety can be the trigger.

As for question 2 - I haven't experienced anything around anaesthetic but would fight tooth and claw to prevent any major medical intervention and would have three years ago when she was first diagnosed. Now she's in a nursing home, I have made it clear that we don't even want her hospitalised if it's at all avoidable.

Sorry, just realised you're new to TP. Would just like to welcome you - you'll get loads of good support and sense here.

 

[Pickles53]

We had been looking at care homes because mum had become so socially isolated and was lonely and miserable stuck at home with no family anywhere nearby. But this was more to do with her declining mobility than dementia as she was afraid to go out because she might fall. In the end she had a fall at home and since then has been unable to stand or walk at all without two people supporting her, she can't get in and out of an ordinary car either or use the toilet without assistance. She has to be turned every 2 hours at night to avoid pressure sores.

So there was simply no practical alternative to moving into a care home. The sad thing is that mum can't recognise this at all. She still thinks she could manage at home and of course there is no point in trying to argue this logically.

 

[Hitheranthither]

Thank you very much for your reply; very helpful. What I meant with Q2 was that the use of a General Anaesthetic in the elderly is known to trigger Dementia. Mum's dementia was triggered after she was given a general anaesthetic when she had surgery for a hip replacement earlier this year. This issue has been highlighted in the national press, but apparently no guidelines for surgeons/anaesthetists in the UK on use of general anaesthetic on elderly....! Just wondered if anyone had any thoughts/experiences on this subject.

Hi Hitherandthither,

As far as your first question is concerned, it was MIL's deteriorating mobility that finished us off. I'm not only not strong enough to lift her but I don't deal with incontinence issues very well either. I know for other people, wandering and personal safety can be the trigger.

As for question 2 - I haven't experienced anything around anaesthetic but would fight tooth and claw to prevent any major medical intervention and would have three years ago when she was first diagnosed. Now she's in a nursing home, I have made it clear that we don't even want her hospitalised if it's at all avoidable.

Sorry, just realised you're new to TP. Would just like to welcome you - you'll get loads of good support and sense here.

 

[Owly]

My mum's dementia was extremely mild until she fell and broke her hip, and after the operation she was never quite right. She broke the other hip a year later, and so she had a 2nd dose of anaesthetic. I do think people vary in their response to drugs and so it may not be as easy as 'weigh and measure the patient and you'll know the right dose for them'. I doubt if you can mend a broken hip without a general anaesthetic.

Mum stayed at home for 3 years, until a likely stroke made her walking very difficult and she couldn't manage alone on the toilet as she couldn't stand up, and my Dad is blind and couldn't help her. She went into hospital for 8 weeks and a discharge to a nursing home was being planned. She then had a downturn, and died a week later. They said she'd had advanced vascular dementia. It progresses in sudden jumps or downturns, and usually it is some kind of crisis that will lead them into either hospital or a care home.

 

[PeggySmith]

Yes, I did sort of know about anaesthesia causing all sorts of problems. It happened to a friend's dad but wore off after a few very worrying weeks. They weren't told anything by the hospital beforehand so I wonder if surgeons are actually aware of the dangers for elderly people, especially those with dementia?

 

[Oxy]

I think that anaesthetics can trigger heart attacks and raised blood pressure in those with predeterminig conditions. Logically I guess if BP goes too high it could precipitate a stroke or heart attack. Maybe it messes with INR aswell and when too low causes a clot which if to brain causes stroke and if diminished blood flow to brain dementia starts or is exacerbated. I'm not a medic and this is just my thoughts.
As elderly get confused if unwell an anaesthetic would cause symptoms of confusion or increased dementia symptoms in same way as UTI for example. We are unable to think clearly after anaesthetic -worse for them. Doctors are usually reluctant to anaesthetise in my experience. Knees can be replaced with epidural but I don't know about hips.

 

[Polly1945]

Hi Hitheranthither

1. Could anyone describe, in their experience, what prompts the transfer from living semi-independently (with carers visiting three times a day), to moving into a care/nursing home?

My experience was that Mum had lived here with me and family (we had built a bungalow/log cabin next to our house) she was with us for nearly five years, and even though she went to the Day Care (or as she called it the Over 60s club)three days per week, she got increasingly lonely especially as she couldn't remember going out anywhere. The decision time came, when she came over to our house one evening in a snowstorm just dressed in her thin nightie We all realised that this wandering would only get worse and as we have ponds and streams on our land, the possibilities didn't bear thinking about. A vacancy had arisen in the care home where she attended during the week and I reluctantly accepted it. The Home and the carers are great, but of course Mum always wants to come back with me or more usually back to her home town of Manchester, which is very sad.

Pauline
x

 

[Spamar]

I don't think that anaesthetics cause dementia, but they can certainly make it worse. However, OH had general last February ( it was it her that or probably lose a foot). When he came out of hospital his dementia ( vas and Alzheimer's) was much worse, though dome of that was certainly because if the hospital admission rather than the anaesthesia. He is now more or less back to what he was this time last year.

 

[RedLou]

To question 1] it was perpetual falling over at home - and lying on the floor all night to avoid pressing the panic button. He's not a happy bunny about it.