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Ugh. Took my Mother to her Dr's appt yesterday. She had a CT as well some memory testing done. Finally! She was dx with early to medium stage for Vascular Dementia. The Dr has prescribed one medication that I can not recall the name of it to help with the dementia and Lexapro for depression. He refuses to sign the POA's at this point, not that it matters because I still can't find the one about the financial one. My mother cried at hearing the news. I have no idea what to say to her. Her mother had dementia as well! So I am assuming she may have some idea what this means. Or not?


My mother in the past has stated that if she gets dementia that she might take her own life because she would not want to burden me & and become a shell of a person. I don't think she will because of her Catholic background.


Now that she has been dx; what do I do?


Any and all advice or opinions would be greatly appreciated! Thank you!!

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Shell, vascular dementia is a very different kettle of fish from Alzheimer's Disease.

So #1, find out what kind of dementia your grandmother had. If your mother's memories are of a descent into Alzheimer's you can reassure her - that's not what she's got.

I notice your mother has heart disease. Vascular dementia is likely to be a consequence of this after a long time. The heart disease affects blood supply to the brain (to everything, but the brain needs it most!) and eventually the brain becomes damaged, tiny bit by tiny bit, until the damage becomes clear.

The best thing to do is go to alz.org and look up this page in particular: https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia

On that site you will find lots of useful and practical and positive ideas to share with your mother about looking after herself *now*. It's very important that she doesn't think she's "going crazy". But her brain does need all the t.l.c. she can manage.

You don't have to tell her this: it is not possible to reverse the damage that's already happened. But you can do quite a bit to make the most of what's there.

I know you've got a lot to take in and adjust to so I'll stop here. But lots of hugs and reassurance and comfort to both of you. No pretending it's good news, of course :( but it is always better to know your enemy.
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Shell, this doesn't necessarily help as such, but I used to spend quite a lot of time trying to figure out what was going on in mother's head. If anything... it felt like at times.

The thing is. With "complex co-morbidities" such as your mother has, the bad news is that it can be incredibly difficult to work out what is causing which particular problem, but the good (good-er, anyway) news is that in terms of her overall wellbeing every little helps every little thing. Anything you can encourage her to do in the way of activities, diet, interests, participation is good for all of her.

So take your mother's short term memory. Memory is such a tricky process. When you break it down, it involves information in, information processed, information stored, information retrieved, information out.

But your mother is really fatigued - and that's partly the vascular dementia, especially if she is having TIAs or micro-strokes, but it's probably *mainly* her heart disease. And if she's knackered and depressed and fed up, then how hard is she going to be concentrating on anything you tell her? Grasping any item of communication involves effort, even if it's usually unconscious. When you're as tired as she is, it may well be far too much effort most of the time. So she never gets as far as the information in, not properly.

So the upshot of that is that it's not so much her short term memory as her input function. And the solution, if there's ever a battle that really needs picking, is to make the input pleasant and digestible and attractive - then it's worth her trouble. (Or do it for her!)

It is really good that you're ahead of the curve on her depression. The depression that develops with vascular dementia is harrowing, both to watch and - it must be - to experience. Being there is about all you can do, but at least you are doing that.

There is also a phase called 'flat affect' - I wonder if you've noticed this? The person shows no normal emotional response, good or bad, to anything much - not to everyday pleasures or chores, not to anything you can suggest in the way of activities or conversation. I found it extremely weird! It came across as stony disapproval of absolutely everything I said or did, but of course it wasn't any such thing - it was just that part of the brain being out of order for a time. I can't remember how long it went on but I was glad when it passed.
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Shell38314 Nov 2018
Thank you for your reply. My problem is I understand the function of the brain. I understand the disease. But I guess, I am having a hard time understanding her or learning to live with it. I don't know if that makes any sense!

If someone came to me and said, "my mom is lying when she use to never lie. She is acting out like a 3 yr old. She is being forgetful. She is being very mean & disheartened. She was never like that. Oh by the way she is 75 yrs old". I would tell them that on my short list would be: dementia, infections, medication changes, bump to the head!

So, why am I having a hard time understanding that most of what she does is not her but the disease? Prehaps because I am living with it!

Yes, I have notice a "flat affect". It is very weird.

I do wonder if she even understands what I say to her, I mean there are times when I know it went over her head; however, most times I walk away wondering how much of what I said did she get.

Thank you for taking me back to the basics!

I just don't know how to communicate to her!

Thank you again!
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Even though your mom has been diagnosed, she is probably still legally competent. The doctor will probably give you a Statement of Competency since they won't activate your POA. As long as she can understand what she is signing, you can bring her to a lawyer and get a POA that starts immediately.

My dad had vascular dementia. My Step MIL has Alzheimer's . They are not really the same disease from my experience. Dementia is a big umbrella. Maybe her future won't go exactly as her mother's did.

If she is a woman of faith, maybe she would be comforted by a conversation with her priest or deacon.

And once you have POA , change her over to a more compassionate doctor.
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Oh Shell, that is a double sided coin to be sure.

One of the ways that I got my dad to sign Durable POA for general, health and mental health was to explain that, God forbid, if something happens and he is unable to answer or tell anyone his wants and desires, it gives me the authority to make sure that his wishes are carried out. He was mad and said he was signing his life over. I told him if he didn't trust me, pick whomever he does trust or when he ends up in the hospital his life will be in the hands of the doctors and last time the hospitalist put a DNR in his chart and I could not change it. I, also told him that if he doesn't sign for some one then I would not be present to help, having the responsibility with no authority aged me 10 years and I wasn't doing it again because he wants it all his way. That's what his way looked like. Needless to say, he signed the paperwork. I will only use it for medical emergencies or if he asks me to handle business for him.

I think that our parents fear that we will treat them the way they treated us. My situation would be so different if that was my plan, I would just not be around to know what was going on. I had good teachers in walking away when it no longer suits you, they can't even see I'm not like them in the least. Something to do with the , I am not to be trusted therefore I can't trust anyone syndrome.

I know it is hard to reassure your mum but if she runs the I'm crazy, poor me please for your sanity try. I would also tell her that truly crazy people never admit or even think they are crazy, so she has provided her own proof.

One day at a time sister. You got this! You are doing and will continue doing a great job.

Ya know, if it gets to hard you could put her to work herding cats!

Hugs!
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Shell38314 Nov 2018
You are right when you say, "I am not to be trusted, therefore, I can't trust anyone syndrome". That is her!

My mother has signed her POA's but her Dr has to sign them and write the reason for it.

There are 3 different kinds of POAs. And like I said, "she has hid the financial one", which you would think it would be easy to find in a house!

I love to put her to work herding cats, but shes to busy working the remote control!

Thank you for your encouraging words and for always making me laugh sis. You are to funny!

Hugs!
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Thank you Country mouse. I have been on alz.org and did some research on vascular dementia. My mother is having problems with her short term memory! I thought with vascular dementia does not effect the short term memory ( didn't see it on the list of symptoms).

I did explain to my mother what she had and it was because her brain was not getting the blood supply it needed. She than said, "ok". However, still cried! And no, I don't blame her.

I think her mother had dementia with a mental illness.

Thank you again!
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Was she possibly prescribed Aricept? This should slow the progress. You could reassure her of that. Part of the disease may be that she will not remember all aspects of facing it. That is the situation with my mother who has been on this medication for a year.
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I'd work with an attorney getting the proper paperwork signed. Durable POA, Healthcare POA, Advance Healthcare Directive, etc. If she becomes incompetent, she won't be able to sign them.

Thank goodness, my LO had signed everything years earlier and told me where I could find them. So, I was able to step in and handle all her affairs, get medical treatment, pay bills, have her admitted to AL, etc. It was so valuable.

I'm not so sure that it helps to dwell on it with them. I mean, it's sad and depressing and what is to be gained by discussing it. As long as proper documents and safe guards are in place, I'd focus on trying to make her happy. Talking about the good times, sharing pictures, favorite foods, seeing family members, etc. Because, eventually, she won't want to do it, she'll not remember who people are or her past. It's sad, but, I'd try to not discuss that. Even if you do, it won't matter, because, she will eventually forget what you talked about. I'm so sorry that you got this news. It's important to get help and support though.
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Thank you all for answering my post.

My mother does have all of her paperwork in order. However, as I have stated she has signed and I have signed her POA's. But she has hid the financial one. Also, her Dr has to sign them. I have read them at her lawyer's office.

I just wanted some ideals or advice to be able to help my Mother and what next step I should be taking! I feel as though I am walking in the dark not knowing where I should be going.

Again thank you for your time & may God bless you.
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