Vascular Dementia

[jay6]

As all dementia's are different. Even with Vascular, each case is different. So I thought I'd start a chat on Vascular dementia in particular to try and find what things you find are affected. I realise some things will overlap with the different forms of dementia's but trying to get a better insight into Vascular in particular. Thank you

So I've found - Lack of empathy for others
Very me, me, me,
Verbally aggressive but only to me as carer.
Never their fault
Can put on a show as 'normal' for others

 

[Sarasa]

Both my mum and mother in law had vascular dementia. I think it highlighted their underlying personality. For instance my mum was one tough, assertive woman but she could get her way with charm. In her job she often had to sack people and I'm sure if she had done so to you, you would have thought she was doing you a favour. When the dementia took hold, charm went straight out the window and she was downright aggressive. MiL was always a much kinder, empathetic person. However she became very nervous when she didn't understand things, unlike mum who'd make you feel it was all her fault.
I think the fact that memory loss isn't necessarily an early symptom can confuse medical professionals.

 

[jay6]

Thanks for replying @Sarasa I was wondering if their underlying personality was highlighted. My OH was always quite self cantered and could be nasty if things didn't go his way and that's certainly escalated now. I do remember the consultant saying sometimes the bad parts of the personality come to the forefront with Vascular. I'm just wondering if it slows down after a period. He always thought he was always right but I could at least argue my point, but now there's no chance. He's right and that's it. If I dare disagree, there's no end to the verbal abuse I get. So I try to just walk away but it's not easy and I must admit I do bite sometimes.

 

[jennifer1967]

Thanks for replying @Sarasa I was wondering if their underlying personality was highlighted. My OH was always quite self cantered and could be nasty if things didn't go his way and that's certainly escalated now. I do remember the consultant saying sometimes the bad parts of the personality come to the forefront with Vascular. I'm just wondering if it slows down after a period. He always thought he was always right but I could at least argue my point, but now there's no chance. He's right and that's it. If I dare disagree, there's no end to the verbal abuse I get. So I try to just walk away but it's not easy and I must admit I do bite sometimes.

there isnt much value in arguing the point. it just makes things worse. it does exaggerate their worst traits and there is no meds recommended for vascular but just to treat the symptoms. i used to tell him but he really didnt understand, it was like a little boy lost. pick your battles.

 

[jay6]

there isnt much value in arguing the point. it just makes things worse. it does exaggerate their worst traits and there is no meds recommended for vascular but just to treat the symptoms. i used to tell him but he really didnt understand, it was like a little boy lost. pick your battles.

Totally agree, no point in arguing but much easier said than done. I know it makes it worse but sometimes I just can't just let it go. I am trying though and think I'm doing a lot better than a couple of months ago.
Mines like a little boy with temper tantrums 'cos you taken his toys away 😆

 

[sdmhred]

We have vascular dementia here and I would agree with @Sarasa that with us mum’s existing personality has been exaggerated. She was a kind, caring person and this has remained. She is now concerned as to whether she is ‘doing the right thing’ when she is confused.

In order the progressioh has so far been.

We have the non stroke version of VD - blood vessel damage probably due to u treated high ish blood pressure thru middle age, but also v v similar presentation to my Granny - but starting a few years earlier in late 70’s….

apathy, withdrawal from activities, mild forgetfulness 2018/19

avoidance of difficult tasks - eg cooking, financial stuff , mildly argumentative when challenged 2020

confabulation, mild delirium when physically unwell denial of difficulties 2021 - diagnosis New Year’s Eve 2021

confusion, confusion, confusion and more confabulation and now sleeping 12hrs each day 2022

Feb 2023 - urinary incontinence
struggling with remembering how to get in and out of car etc
becoming Much more accepting something is wrong.
unable to hold a conversation

july 2023 onwards - heightened anxiety & agitation when stressed

september 2023 - forgetting how to walk when tired or stressed, struggling to articulate herself even for simplest of things .

what fun reading, but I have to say her personality is so far still here 💜

 

[canary]

Vascular dementia doesnt follow one particular path - it is very very variable depending on which part of the brain has been affected.

@jay6 - it definitely sounds to me that the area of the brain which has been affected in your OH is the frontal lobes, which gives changes to emotional control, decision making and the personality. These symptoms are very similar to FTD - for the reason that its the same part of the brain affected.

My MILs original problems were her memory, but also some visual problems - she had a lot of trouble interpreting what she was seeing and originally it was thought to be LBD, or PCA, but it turned out to be vascular dementia.

A friend of mines mum was affected very early on in the area that controls movement and became bed bound well before she lost other abilities. I remember visiting her and she could still hold a lucid conversation and play simple card games. I now realise that hostess mode was probably playing a part, but nevertheless, her relative who was the main carer agreed that movement was one of her earliest symptoms

The one thing that links all presentations of Vas Dem is that it typically progresses in "steps". It stays the same for a while (possibly a long time) and then suddenly declines in a step down (sometimes quite a steep step), or sometimes a series of steps.

 

[Sarasa]

Both the manager of mum's first care home and I thought that mum's Frontal Temporal lobes had been damaged, as her behaviour became very reckless both before and after she moved into care. Of course in the end all dementias end up the same way.
I also think people can sometime find a new pathway in the brain, so that things appear to improve a little. That was certainly the case with my MiL, who would take a dip, recover a bit and then carry on on that level for quite a long while, sometime appearing to improve even more. It might have something to do with how many neural pathways are available to the person with dementia. Both mum and MiL were very intelligent women, but mum had very little formal education whereas Mil was an academic. I always felt MiL was using all the reasoning she had to try and overcome her problems, until that was no longer possible. The same wasn't really true of mum.

 

[jay6]

We have vascular dementia here and I would agree with @Sarasa that with us mum’s existing personality has been exaggerated. She was a kind, caring person and this has remained. She is now concerned as to whether she is ‘doing the right thing’ when she is confused.

In order the progressioh has so far been.

We have the non stroke version of VD - blood vessel damage probably due to u treated high ish blood pressure thru middle age, but also v v similar presentation to my Granny - but starting a few years earlier in late 70’s….

apathy, withdrawal from activities, mild forgetfulness 2018/19

avoidance of difficult tasks - eg cooking, financial stuff , mildly argumentative when challenged 2020

confabulation, mild delirium when physically unwell denial of difficulties 2021 - diagnosis New Year’s Eve 2021

confusion, confusion, confusion and more confabulation and now sleeping 12hrs each day 2022

Feb 2023 - urinary incontinence
struggling with remembering how to get in and out of car etc
becoming Much more accepting something is wrong.
unable to hold a conversation

july 2023 onwards - heightened anxiety & agitation when stressed

september 2023 - forgetting how to walk when tired or stressed, struggling to articulate herself even for simplest of things .

what fun reading, but I have to say her personality is so far still here 💜

Thanks for replying @sdmhred . Although Vascular is always different in every case its good to get an idea of what's happening to others to compare.
My OH was stroke related but seems to be simular progress to your mums. My OH rough dates
2015/6 apathy, withdrawal from activities, mild forgetfulness, total disinterest in property
2017 couldn't do financial stuff , argumentative when challenged, gas lighting
2018 mild delirium, odd occasions of violent (hair pulling, punched in back etc.) and more verbally aggressive. becoming more me, me, me. No interest in anyone else
2019 sleeping a lot more, still odd violence, verbally more aggressive, when things not going his way
blaming everyone else for anything that goes wrong (eg ME, doctor, physio etc)
2020 Violence stopped but verbal increase 100% Nothing ever his fault. Nasty towards me but fine with everyone else. (can put on a show to make it look as if it is just me)
2021 Mobility beginning to suffer, spending more time sat in front of TV on sofa
2022 No interest in anything. Starting to feel like walking on eggshells.
2023 Odd bed wetting, struggling more with mobility, can't hold conversation. Asleep most of time

 

[jay6]

Vascular dementia doesnt follow one particular path - it is very very variable depending on which part of the brain has been affected.

@jay6 - it definitely sounds to me that the area of the brain which has been affected in your OH is the frontal lobes, which gives changes to emotional control, decision making and the personality. These symptoms are very similar to FTD - for the reason that its the same part of the brain affected.

My MILs original problems were her memory, but also some visual problems - she had a lot of trouble interpreting what she was seeing and originally it was thought to be LBD, or PCA, but it turned out to be vascular dementia.

A friend of mines mum was affected very early on in the area that controls movement and became bed bound well before she lost other abilities. I remember visiting her and she could still hold a lucid conversation and play simple card games. I now realise that hostess mode was probably playing a part, but nevertheless, her relative who was the main carer agreed that movement was one of her earliest symptoms

The one thing that links all presentations of Vas Dem is that it typically progresses in "steps". It stays the same for a while (possibly a long time) and then suddenly declines in a step down (sometimes quite a steep step), or sometimes a series of steps.

Thanks for repliying @canary, Yes I do understand how Vascular dementia doesnt follow one particular path as I said in first bit. But just trying to get an understanding at what may be similar.

You are right it is the frontal lobes so very much about emotional control, decision making and the personality. I’ll have to read up more on FTD

I really don’t understand this hostess mode they can do. It’s like a switch when they are back home.

I understand how it progresses into steps which is why I’m trying to gauge what is happening. I’m sure my OH has taken a ‘step’ down. I just can’t get how far this is as it’s hard when things are going on all the time.

I’m accused of being argumentative and miserable ever since he’s known me. He totally forgets just how much I’ve looked after him, especially when he had a really nasty stroke back in 2014 which left him partly paralysed on one side. He was bed bound when he returned home and I spent 3 years almost full time, taking him to a gym, Physio etc. to get him walking totally unaided and managing stairs. We used to argue due to his selfishness but the, me, me, me, now has really escalated. I feel I’m walking on eggshells. Nothing is ever his fault. He has blamed just about everyone including doctors rather than take any responsibility. Mind you I don’t think he was ever good at taking responsibility for things that went wrong. He even tried to blame the doctor for his stroke. He’d been having problems with itching so doctor changed blood pressure meds to see if it helped and he suffered stroke within weeks, so to him, that was to blame. Nothing to do with the fact he had high blood pressure or what was going on at the time.

 

[jay6]

Both the manager of mum's first care home and I thought that mum's Frontal Temporal lobes had been damaged, as her behaviour became very reckless both before and after she moved into care. Of course in the end all dementias end up the same way.
I also think people can sometime find a new pathway in the brain, so that things appear to improve a little. That was certainly the case with my MiL, who would take a dip, recover a bit and then carry on on that level for quite a long while, sometime appearing to improve even more. It might have something to do with how many neural pathways are available to the person with dementia. Both mum and MiL were very intelligent women, but mum had very little formal education whereas Mil was an academic. I always felt MiL was using all the reasoning she had to try and overcome her problems, until that was no longer possible. The same wasn't really true of mum.

Thanks Srasa, My OH is also frontal lobe from very bad bleed stroke. He had to have opp. to drain blood and almost didn't make it (1 in 4 chance) I definitely think the bad points of their personality are really heightened with frontal lobe.

 

[canary]

2015/6 apathy, withdrawal from activities, mild forgetfulness, total disinterest in property
2017 couldn't do financial stuff , argumentative when challenged, gas lighting
2018 mild delirium, odd occasions of violent (hair pulling, punched in back etc.) and more verbally aggressive. becoming more me, me, me. No interest in anyone else
2019 sleeping a lot more, still odd violence, verbally more aggressive, when things not going his way
blaming everyone else for anything that goes wrong (eg ME, doctor, physio etc)
2020 Violence stopped but verbal increase 100% Nothing ever his fault. Nasty towards me but fine with everyone else. (can put on a show to make it look as if it is just me)
2021 Mobility beginning to suffer, spending more time sat in front of TV on sofa
2022 No interest in anything. Starting to feel like walking on eggshells.

This sounds very much like my OH used to be (apart from the dates, of course). He is now beyond it but can still get very angry if it is suggested that he cant do things. We dont have a diagnosis, but his neuropsychology tests show "anterior brain dysfunction" (ie the frontal and temporal lobes) and for a few years he had a diagnosis of FTD (now withdrawn).

The majority of his behaviour problems were because he had/has anosognosia - a symptom of dementia (and other neurological conditions) that means that they are unable to comprehend that they have changed. They are aware that things are different and when they try and do things it goes wrong, but they are totally unaware that it is they themselves that have changed, so they blame things and people around them.

I remember (very early on) OH telling people that he didnt do things because I was preventing him from doing them. I was working at the time and said to him that if he thought I was stopping him, why didnt he do things when I was at work? He had a sudden moment of insight and said "Its me! Im stopping myself!!" I tried to get him to hold onto this insight but it was like watching sand slipping through his fingers and after 30 mins he was saying "no, thats what you think, not me"

On another occasion he told me that there was a blockage in his emotions and it felt like everyone around had become cold and uncaring (although, to me it seemed the other way around). After half an hour, of course, it became that we (and particularly me) really were cold and uncaring. The "blockage" has meant that he has lost empathy, of course, but it also seems to work the other way too, so that he feels others have lost empathy for him.

I always felt that these two things explained why he always thought it was me that was to blame and confabulated all sorts of horrible things that I was supposedly doing. It was the only thing that made sense in his damaged mind. Im not saying it was easy to accept. After so many things he has said and done I have lost the love I once had for him - and he was originally such a lovely man - and I still get angry with him at times, but at least I feel I can understand why these things have happened

 

[jay6]

@canary From what I read, I can relate to what you've written in posts quite a bit so thanks for joining in this topic.
I suspected dementia about 6-9 months after his stroke but after continuous battles with 'It's just his stroke' I finally got diagnosis in April this year. Vascular with frontal lobe affected.

I think like yours my OH couldn't accept there was anything wrong, still doesn't. So everything that goes wrong is somehow my fault for being stupid, argumentative, miserable etc. Taken me months to bottle my temper, even now we have episodes where I react, but then realise how pointless it was.

He has told others I prevent him from doing things like yours. He still has odd moments when I get an apology but they are become a lot less now.

Mine also says same about people not caring about him. Apparently I've never cared. But yes it's all about the Apathy thing.

I'm trying to understand by reading what others say, I tell myself it's the illness and he doesn't understand, but it's so hard as he was never an easy person to get on with anyway. It's so hard not to loose all feeling or sympathy, when you are faced with this continuous nastiness.

As I say he still has moments when I can try talking to him. In fact I did it earlier today. He actually listened, or seemed to listen to what I was saying and apologised and to me but it's only a matter of time before he forgets again and it will all be my fault again.
The roundabout continues.

I have learnt a lot, like getting pads and kylies ready so thanks for that. Now looking into a carpet cleaner for the future. I did read up on the one you spoke about but it says for hard floors?

 

[canary]

This is the one my daughter has

VAX SpotWash Home Pet-Design

Our best cleaning companion for effortlessly removing spills, stains and pet messes with complete home versatility. Plus expert cleaning tools for a reassuring, deep clean, killing over 99% of bacteria‡‡. + Free Stain Removal Kit Worth £30

www.vax.co.uk

Its not cheap, but my word its good.
It has a scrubber attachment (for ground in nastiness) as well as a hard floor attachment and one for upholstery. Its intended for small areas, not a whole floor. I cant see me using the hard floor attachment unless its particularly unpleasant as Ive already got a basic steam mop which will get rid of all sorts from hard floors.

 

[jennifer1967]

This is the one my daughter has

VAX SpotWash Home Pet-Design

Our best cleaning companion for effortlessly removing spills, stains and pet messes with complete home versatility. Plus expert cleaning tools for a reassuring, deep clean, killing over 99% of bacteria‡‡. + Free Stain Removal Kit Worth £30

www.vax.co.uk

Its not cheap, but my word its good.
It has a scrubber attachment (for ground in nastiness) as well as a hard floor attachment and one for upholstery. Its intended for small areas, not a whole floor. I cant see me using the hard floor attachment unless its particularly unpleasant as Ive already got a basic steam mop which will get rid of all sorts from hard floors.

ive just bought one as we do have carpets in the bedroom that he could chuck/spill things on and its smaller than the ordinary one which is important. we do have a steam mop for hard floors but i couldnt carry it upstairs. and it does the upholstery which is brilliant.

 

[Mojomel72]

Thanks for replying @Sarasa I was wondering if their underlying personality was highlighted. My OH was always quite self cantered and could be nasty if things didn't go his way and that's certainly escalated now. I do remember the consultant saying sometimes the bad parts of the personality come to the forefront with Vascular. I'm just wondering if it slows down after a period. He always thought he was always right but I could at least argue my point, but now there's no chance. He's right and that's it. If I dare disagree, there's no end to the verbal abuse I get. So I try to just walk away but it's not easy and I must admit I do bite sometimes.

As all dementia's are different. Even with Vascular, each case is different. So I thought I'd start a chat on Vascular dementia in particular to try and find what things you find are affected. I realise some things will overlap with the different forms of dementia's but trying to get a better insight into Vascular in particular. Thank you

So I've found - Lack of empathy for others
Very me, me, me,
Verbally aggressive but only to me as carer.
Never their fault
Can put on a show as 'normal' for others

My husband has recently been diagnosed with vascular dementia, I started noticing change’s approximately 2 years ago, little things to begin with, but I’m now finding he has a good phase then a dip. We recently went away to see our new granddaughter, we stayed in a cottage and it’s been really hard, I think because he’s out of his routine and “safe place” the first day we had a blazing argument, it was my fault in that I should of just bit my tongue but for some reason (I’m shattered) I bit, it was short lived and I managed to get him back to what is his now baseline. My husband is normally extremely placid and calm, he was the one that sorted out our finances etc, he can’t do any of that now, he struggles to talk on the phone even to family members.
There is so much more I could write but I don’t know where to start.

 

[jennifer1967]

mine doesnt like talking on the phone even with family. today, he used his mobile but didnt know how to hang up and i had to do it. the other day, he didnt know how to call someone by pressing the buttons to call.

 

[Mojomel72]

Other times he seems to turn it round on me, I’m the one that’s wrong and doesn’t remember stuff, it’s a wild ride for sure

 

[jay6]

@Mojomel72 Glad he is still placid and calm most times. Mine is really hard work, turns everything round to being my fault when things don't go right. His is frontal lobe affected which is a nightmare dealing with.

and @jennifer1967 Strange how they forget to use simple things, they've used so many times.

 

[JaxG]

@jay6 as we have discussed before, my experience has been very similar to yours. Although my OH is classed as having mixed Alzheimer's/Vascular dementia, his symptoms seem mostly vascular. Scans in 2020 did show a small stroke, but he had been showing symptoms since about 2016/17, and it would seem many of the changes are in the frontal temporal lobe. His behaviour was definitely an extreme version of behaviours he had always had. The loss of executive function was probably the first thing to go - he couldn't manage money, appointments, was struggling to run his business, make decisions, keep to time schedules etc. By 2019 he was getting lost in familiar place and was becoming very rude to people and losing any empathy. He became increasingly aggressive - every time he failed or found something difficult, it was my fault. He was extremely verbally abusive and aggressive - told me I was worthless, and had contributed nothing to our marriage. He had never been an easy man, was always quite selfish, but this behaviour was something else. In 2021 he then became physically aggressive, he would argue over anything and everything I said, he threw me on the floor, rammed a door into my back, barged me out of the way and threatened to punch me. The police were called, SS involved but it took another 18 months in 2023 to get any real help.
Until 6 months ago I would say the decline was quite gradual. About 3 months ago he woke up one day and did not know how to get out of our home, or how to get to the local shop 100m away. The decline now is almost daily - he can still dress himself but needs prompting with what to wear. He can feed himself but can't remember to eat or how the food goes together - for example a sandwich or wrap. He gets confused about whether it is morning or evening, what day or month it is - everything is confusing to him. He can't follow conversations or films, but can still talk and this makes people believe he is more capable than he is. He is now calmer on the anti psychotic medication. I have no love or like for this stranger, it has been the most brutal process and I want it over.