Well, there isn't a huge difference between the two - the hallmark symptoms of forgetfulness, cognitive and functional decline, and impaired judgement and disinhibition are generally the same. However, vascular dementia progresses more in a step-wise fashion than alzheimer's dementia. You may notice that your dad changes little until he has a stroke and his function declines with each successive stroke. The literature (and personal experience) has shown that people with VD are more likely to be functionally impaired (strokes cause weakness, problems with walking, speaking, swallowing, and other functions more readily than the gradual plaque buildup of AD) while their cognition stays comparatively intact longer. This presents a particular difficulty with VD- your dad can be in denial of his functional decline, and while he may become unable to care for himself due to instability, injury or weakness, he can seem very "with it" and adamantly deny that anything is wrong. Some people with VD are able to be more aware of their disease in the early stages, (cognitive -vs- functional decline) but that really has to do more with their constitution and ability to cope than with the disease. So, it has also been my experience that people with VD tend to suffer more 'psychiatric' symptoms than AD. Your parents may likely experience depression, hallucinations, delusions, erratic behavior, wandering, or aggressive behavior at some point. Not everyone with the disease gets these symptoms, but they're possibilities to be discussed. Um, I would say that if you google "vascular dementia" you'd get a ton of pretty good info. http://www.helpguide.org/elder/vascular_dementia.htm had good info and good links. So, it's good that they have a living will, but know that when it comes down to it, a lot of families have big trouble agreeing on a plan of care, especially if not everyone is in the same area. Keeping your mind and communication open is really important. The decision to move them out of their home is a really difficult one. There are cases to be argued for both quality of life & happiness *and* for safety and quantity of life. Moving out may cause some depression and speed his decline, but he could also easily leave the stove on and burn the house down with both of them in it. And, contrary to popular belief, moving won't actually kill him. The death of your mom is much much more likely to affect his health than moving. If he is able to keep busy and keep doing the things he likes to do, an assisted living facility or other long-term care could be very good for both of them and give them years of meaningful, happy life. If your mom is more amenable to moving, she may be able to get your dad to see the light. You may also be able to give some control back to him and negotiate the terms of moving out - he can set the date, they can choose a place together. The Alzheimer's association has good info on housing options and tips to help preserve function. Also, I don't know how they are being medically managed, but there's good evidence for blood pressure medication and low-dose aspirin or coumadin in preventing further strokes and TIAs. Let me know if you have any questions, between H and I we can get you more info. As far as your dad's CT and MRI scans being "clear"... Doctors are notorious for not explaining everything. It's easy to assume that this has already been explained, you're just adding on, when often patients didn't get very basic information in the first place. It sounds like your dad is pretty stubborn, so this may be simply a problem of denial, but still, it could be ignorance. So, having a good discussion with him about what they were looking for on the scans, and that while he did not sustain any major damage in his falls, that doesn't explain away the reason he fell in the first place. Give him fact sheets, things to read. He will probably still put up a good fight, (wouldn't you?) but I'm glad you and your siblings are all in agreement about this. In my opinion, it's better to move them too soon than too late. I don't envy you this, especially given your family history, I gather. ((hugs))
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So, it has also been my experience that people with VD tend to suffer more 'psychiatric' symptoms than AD. Your parents may likely experience depression, hallucinations, delusions, erratic behavior, wandering, or aggressive behavior at some point. Not everyone with the disease gets these symptoms, but they're possibilities to be discussed.
Um, I would say that if you google "vascular dementia" you'd get a ton of pretty good info.
http://www.helpguide.org/elder/vascular_dementia.htm
had good info and good links.
So, it's good that they have a living will, but know that when it comes down to it, a lot of families have big trouble agreeing on a plan of care, especially if not everyone is in the same area. Keeping your mind and communication open is really important.
The decision to move them out of their home is a really difficult one. There are cases to be argued for both quality of life & happiness *and* for safety and quantity of life. Moving out may cause some depression and speed his decline, but he could also easily leave the stove on and burn the house down with both of them in it. And, contrary to popular belief, moving won't actually kill him. The death of your mom is much much more likely to affect his health than moving. If he is able to keep busy and keep doing the things he likes to do, an assisted living facility or other long-term care could be very good for both of them and give them years of meaningful, happy life. If your mom is more amenable to moving, she may be able to get your dad to see the light. You may also be able to give some control back to him and negotiate the terms of moving out - he can set the date, they can choose a place together.
The Alzheimer's association has good info on housing options and tips to help preserve function. Also, I don't know how they are being medically managed, but there's good evidence for blood pressure medication and low-dose aspirin or coumadin in preventing further strokes and TIAs.
Let me know if you have any questions, between H and I we can get you more info.
As far as your dad's CT and MRI scans being "clear"... Doctors are notorious for not explaining everything. It's easy to assume that this has already been explained, you're just adding on, when often patients didn't get very basic information in the first place. It sounds like your dad is pretty stubborn, so this may be simply a problem of denial, but still, it could be ignorance. So, having a good discussion with him about what they were looking for on the scans, and that while he did not sustain any major damage in his falls, that doesn't explain away the reason he fell in the first place. Give him fact sheets, things to read. He will probably still put up a good fight, (wouldn't you?) but I'm glad you and your siblings are all in agreement about this. In my opinion, it's better to move them too soon than too late.
I don't envy you this, especially given your family history, I gather.
((hugs))