vascular dementia

[Bigt]

Hi everyone I am new to the forum so I will say hello to you allI need some help with what I should do? My father is 73 and has vascular dementia and is currently in hospital getting assesed due to a number of problems that he has! He got diagnosed with dementia about 2 years ago but I knew that something was wrong with him roughly 7 years ago after he had a quadrouple heart bypass and complained of severe dizzyness and he was forgeting things that just a few days before he had no problems with remembering?? Obviously I know that vascular dementia has a great effect on the brain reciving enough blood supply and oxygen so thus causing parts of the brain to become dead and this is where I think the word dementia then becomes used??? Im lost really because he has had a number of CAT scans and these scans do not show any form of alzheimers disease or a typical vascular dementia scan picture so we do not have a actual diagnosses on his condition I really dont know how to approach the doctors and ask them what is happening or what they are going to do for my dad and I know they are now using aricept,reminyl,exelon and exiba and reporting good results for patients with vascular dementia.I owe it to my dad to do as much as I can and more asap but I just dont know who to see and what to say???? Can someone please give me some advice as he is in hospital and surely this is the best place for the treatmen to be startedThanks everyone.Tony

 

[gigi]

Hello BigT,

Welcome to TP...

I'm a bit confused by your post..sounds like you're confused too.

First...you say...

He got diagnosed with dementia about 2 years ago

..so who diagnosed this..and how ?

Second..after heart surgery..or any major surgery..it's common for a patient to be confused for some time after due to the anaesthetic and the trauma...

Third..your dad has had CAT scans and these have not shown any signs of dementia..vascular or otherwise...

Fourth..your dad is in currently in hospital for assessment..of what? You have a perfect right to ask to see your dad's consultant and ask what exactly is going on. you could ring the ward, or ask to speak to the nurse in charge next time you visit. Make it clear that you want to understand, and want to speak to the doctor who is looking after your dad. they won't come to you..you must ask.

I hope this helps..try not to expect instant solutions. It seems the first thing to sort out is dad's problems..and then look at the way forward from there.

Wishing you and your dad well.

Let us know how you get on!

Love gigi xx

 

[Skye]

Hi BigT, welcome to TP.

Your post is confusing, as gigi says, because you say your dad has been diagnosed with vascular dementia, then you say he has not had a diagnosis.

Do you mean that he has been diagnosed with dementia, but thay have not decided what kind?

You really need to make an appointment to talk to the consultant. If you talk to the ward charge nurse, he/she will be able to arrange it for you.

In the meantime, the AS factsheets will give you some information, and may suggest some questions for you to ask.

http://www.alzheimers.org.uk/factsheets

The drugs you mention are normally only prescribed for Alzheimer's, so if your dad has VAD he's unlikely to get them, though the consultant may be prepared to try one.

Please post again and let us know how you get on.

 

[CYN]

my husband also had a quadruple by pass and years later had a MRI scan as he was showing worrying symptoms ,he was found to have suffered mini strokes and his illness lasted for 5 years until pneumonia set in and he passed away. he was never given any medicines that are used for A D i was told they would not help him.

Cynthia

 

[blue sea]

Hi Tony
CAT scans often do not help in diagnosing vascular dementia. The doctor then has to base the diagnosis on the symptoms and progession of the illness. (Vascular demenetia tends to have 'step' progression and is associated with very minor strokes - TIAs). would read up on the fact sheets on this web site and then ask for a meeting with the consultant (not a junior doctor you may see on the ward) who has overall responsibility for your dad's care. Go with a list of questions about diagnosis, possible treatment/medication and care options. You may need to ask for a social services assessment too.
Good luck with it all. it is a stressful experience but you are doing your very best for your dad.
Blue sea

 

[Margarita]

Im lost really because he has had a number of CAT scans and these scans do not show any form of alzheimers disease or a typical vascular dementia scan picture so we do not have a actual diagnosses on his condition

I know what you mean it is all complicated to understand.

CAT scans often do not help in diagnosing vascular dementia

Now that sounds to me more confusing in trying to understand, so I have given up.

As My mother had a Scan in Gibraltar they told me from a brain scan that my mother has AZ.

3 years along the line I am told my mother has VD they tell me this with out doing a brain scan , but they say they can tell from the symptoms my mother having seeing my mother dietetic it must be VD . They even tell me now that mum has moderate dementia , even thought she on late stages medication for AZ which is masking the severity of her dementia.

I know they can't tell anyone if its AZ till the person dead



So how they come up with the conclusion from the brain scan in Gibraltar that she had AZ is a misery, they must of seen some form of drain damage even if it was VD , but they said it was AZ . so Blue sky made a good point when she said

base the diagnosis on the symptoms and progession of the illness.

as it must of progressed when they done CAT scan on my mother, so saw some damage , but said it was AZ


So yes ask talk to consultant about medication to slow the progression down , even if they can't see any damage yet.



It would be interesting to know that when your father was told he had a dementia 2 years ago , did they do a brain scan on him ?

Or Just do it from his symptoms ?

 

[Lynne]

Hi Tony

My sympathies on your situation with your Dad.

Like you (like most people!) before my Mum became affected by it, you could have written what I knew about Alz Disease or dementia on the back of an envelope. Suddenly you are faced with a hospital environment and a massive avalanche of medical information (lots of in a foreign language) and much of it couched in terms of "may be, could be, might be" and even "we don't really know ..." !! All very confusing and difficult to take in, given that there is bound to be emotional turmoil thrown into the mix as well.

Request a meeting with your Dad's consultant & ask for clarification of what his tests are for, and what medication is being given to him, or proposed for the future. Ask for an explanation of what individual medications DO. Do they treat or reduce symptoms which your father has, or act as a sedative, or slow down deterioration of memory? You need to simplify the avalanche of "might be" information down into what refers specifically to your Dad's condition. You need to ask the questions and, if it were me, write down what you are told (and by whom, & date) for your own review later, and for future reference.

After your Dad is discharged from hospital, have a similar meeting with Dad's GP (either with your Dad present, or with a written permission signed by Dad for the Dr. to discuss his medical welfare with you) and get yourself put in the picture about what's next. Doctors eat, sleep & use the loo just like all the rest of us. Their job title doesn't mean we can't talk to them about the health & welfare of family members, more especially if we are to be closely involved with their on-going care (either hands-on, or by arranging the necessary care to come in).

I would also recommend getting in touch with your local Alzheimer's Society group, (Alzheimer's Society Teesside Branch, First Floor,55-57 Albert Road, Middlesbrough 01642-655688) meet with someone from there. No, they will not be able to answer all your questions & queries, but they will be able to discuss practical difficulties in a feet-on-the-ground conversation. These people are often former family carers themselves, living with their loved one affected by the various forms of dementia, not seeing them in a 'professional capacity' for 10 minutes a week (or 3 months, or 6 months).

Best wishes, & please come back again whenever you feel this site can be helpful. Even if it's only letting off steam and expressing the frustration, most of us will completely understand the pressures you are under, & may be able to offer helpful suggestions gained from experience. The AS Factsheets contain a lot of useful information too. I'll try to add a link if I can remember how! http://www.alzheimers.org.uk/factsheets

 

[Bigt]

Thanks and sorry for the confussion

Hi everyone and thanks for your kind advice.I have so much going on in my head at the moment I dont know if I should stand up or sit down??? Right my dad had a heart bypass some years ago and as soon as he woke up he said straight away that he was confussed and rather dizzy so that led me to ask the nurses if this was normal and they said yes of course and that it would settle down very quickly.It didnt and my dad went from a very outgoing very self depandant man to being slightly lost and confused over the next 3 years.He then seemed to be fine and seemed to level off to a point where he did look a little bit unwell but seemed to be ok but did worry about anything and everything ( but dads do this Then it was the car insurance is due the mot is due and the tax is due! I promptly done the jobs that were required but only to be told that the car tax etc etc were due again.So the alarm bells started to ring and asap I got him to the doctors because he developed a tremmor in on of his arms and the obvious memory loss.I was then told we would be going to so a neurologist and he diagnosed some form of dementia but my dad would have to have a ct scan then come back to see him for the diagnosis.We got the letter very quick and the day of the meeting I was praying for it not to be a tumour or something like that and after the specialist done a score test where my dad had to draw a clock it became very apparent what the specialist was saying to us(it was unplesant but we felt a big weight was lifted) He got a good score of 16/20 and was a bit depressed that he got some of the numbers wrong on the clock and the specialist reassured him not to worryAnyway he told us that becuase of the onset of heart disease that it was probabaly sub cortical dementia at a vascular level but also that the scans showed no evidence that his brain has been effected but he said the damage would most certainly be in the brain stem in the form of small clots.My dad them went in to a assesment unit in feburary this year and he was fine apart from he had a problem dressing because he has become so stiff but the staff there discovered that my dad did have signs of parkinsons because of his tremor in his arm My gp then started him on some tablets co/careldopa which he showed signs of improvement in tremors and body movement and going to the toilet also most important his speech was better but them without me knowing my dad was taken off the tablets as the doctor said there was no marked improvement in 3 weeks????? Now come on I know tablets can take a damn site more than 3 weeks to work and the fact that I seen the marked improvement tells me that he should still be on them evne thought the diagnosis was scvd and not parkinsons? Im getting confussed again but honestly this is what has been going on over the past year or so and things have got worse with my dad.I have a appointment tommorrow and will be taking all your kind help in there with me.I just want to know what my dad has wrong with him and what they intend to do? I know that alzheimers therepys are being used with great results for Vascula dementia and I would like him to be tried on something new or atleast be put back on to the co/careldopa.I will let everyone know tomorrow what they have said and thanks again everyone.

 

[Lynne]

Hi Tony

Thanks for filling in some of the gaps re. your Dad's illness & what led up to the present day situation. When we first come onto TP & pour our hearts out to a bunch of (im)perfect strangers, it's difficult to know how much to include & where to stop, isn't it.

Now that you've had a meeting with the medics, are you any further forward? Were any medications offered, & is Dad's progress to be monitored by anyone? Is he still in hospital, or back home now?

Mum & I are very lucky in that our GP is very supportive and will answer my questions & discuss things with us; unfortunately not all doctors are the same. However, your Dad is owed a Duty of Care (remember that phrase, 'official-ese' & applies to Social Services etc. as well.) and his family - as his carers - are entitled to be kept informed of changes, or proposed changes, to his care plan.

Have you given any thought to suggesting to Dad that giving you (& mum) Power of Attorney might be a good idea. You would be able to deal with (on his behalf) anything that might come up while he's in hospital. You will know best how to approach it, after reading up on it & explaining it to Mum.

Anyway, I hope you'll feel able to let us know how things are going next time you come on board.
It's not just that we're nosey (actually most of us have enough at home to worry about - just joking!) but replies here, taken with what other carers put up, provide the real hands-on knowledge from which we can all learn.
In my opinion, there is more information & actual experience on this board to learn from than any of us will ever get from talking to medics, even the helpful ones.

Best wishes