How To Support Someone With Vascular Dementia

Get A Carer’s Assessment

If you care for someone, you can have an assessment to see what might help make your life easier. This is called a carer’s assessment.

A carer’s assessment might recommend things like:

• someone to take over caring so you can take a break
• training in how to lift safely
• help with housework and shopping
• putting you in touch with local support groups so you have people to talk to

A carer’s assessment is free and anyone over 18 can ask for one.

Tips For Caregivers: Taking Care Of Yourself

Being a caregiver can be extremely rewarding, but it can also be overwhelming. Caring for a person with Alzheimer’s or a related dementia takes time and effort. It can feel lonely and frustrating. You might even feel angry, which could be a sign you are trying to take on too much. It is important to find time to take care of yourself. Here are some tips that may offer some relief:

• Ask for help when you need it. This could mean asking family members and friends to help or reaching out to for additional care needs.
• Eat nutritious foods, which can help keep you healthy and active for longer.
• Join a caregiver’s support group online or in person. Meeting other caregivers will give you a chance to share stories and ideas and can help keep you from feeling isolated.
• Take breaks each day. Try making a cup of tea or calling a friend.
• Spend time with friends and keep up with hobbies.
• Get exercise as often as you can. Try doing yoga or going for a walk.
• Try practicing meditation. Research suggests that practicing meditation may reduce blood pressure, anxiety and depression, and insomnia.
• Consider seeking help from mental health professionals to help you cope with stress and anxiety. Talk with your doctor about finding treatment.

What Are The Symptoms Of Vascular Dementia

The symptoms of vascular dementia depend on the location and amount of brain tissue involved. Vascular dementia symptoms may appear suddenly after a stroke, or gradually over time. Symptoms may get worse after another stroke, a heart attack, or major surgery. These are signs and symptoms of vascular dementia

• Increased trouble carrying out normal daily activities because of problems with concentration, communication, or inability to carry out instructions
• Memory problems, although short-term memory may not be affected
• Confusion, which may increase at night
• Stroke symptoms, such as sudden weakness and trouble with speech
• Personality changes
• Mood changes, such as depression or irritability
• Stride changes when walking too fast, shuffling steps
• Problems with movement and/or balance
• Urinary problems, such as urgency or incontinence
• Tremors

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Make Everyday Tasks Easier

This “memory bench” is used by a person living with dementia to organize the things she needs for each day.

Many people with early-stage dementia continue to manage their everyday activities. But its important to look ahead to a time when performing daily tasks will be harder. The sooner you adopt new strategies to help you cope with changes, the more time you will have to adjust to them. Here are some tips:

For more suggestions on living independently, see Aging in Place: Growing Older at Home.

My Mum Suffers From Dementia And Excessive Sleep She Sleeps During The Day And Sleeps Very Little At Night Is It Ok To Let Her Sleep All Day

If possible we recommend encouraging her to take fewer and shorter day time naps, at the same time and place if possible . Keeping to a routine full of activities can help keep her awake during the day, and work some way towards night-time sleep problems. Try regularly getting her up for short walks and maximise daylight in rooms. Sensitively wake her up if she does fall asleep outside of a routine nap time.

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Key Points About Vascular Dementia

• Vascular dementia is a disorder characterized by damaged brain tissue due to a lack of blood flow. Causes can include blood clots, ruptured blood vessels, or narrowing or hardening of blood vessels that supply the brain.
• Symptoms can include problems with memory and concentration, confusion, changes in personality and behavior, loss of speech and language skills, and sometimes physical symptoms such as weakness or tremors.
• Vascular dementia tends to progress over time. Treatments cant cure the disease, but lifestyle changes and medicines to treat underlying causes might help slow its progress.
• Surgical procedures to improve blood flow to the brain can also be helpful. Other medicines might slow the progression of dementia or help with some of the symptoms it can cause.
• A person with vascular dementia may eventually need full-time nursing care or to stay in a long-term care facility.

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Things Not To Say To Someone With Dementia

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Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.

For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.

1. Youre wrong

For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.

Instead, change the subject.

Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.

2. Do you remember?

Instead, say: I remember

3. They passed away.

Instead

4. I told you

Instead, repeat what you said.

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Help Them Stay Organized But Without Doing Everything For Them

Having a nighttime routine also helps with sleep problems that some seniors with dementia encounter. Doctors suggest non-drug options to manage sleep issues in those with dementia-related sleeping issues. The right room temperature, comfortable bedding, nightwear, and a soft light that isnt too dark can help. So can reading or listening to music to wind down instead of television or a drink which can act as a stimulant and disrupt sleep.9

A person with dementia may need help with their daily tasks and life which theyd managed alone until now. Having a set routine can help. Dont do everything for them though it might make them feel unwanted or useless. Instead, have them do things with you or assist with little jobs around the house. If tasks seem daunting, break it down into simpler steps for them. You could even use notes or little posters at critical locations to help them remember what to do or how to do something.10

Resources For Dementia Caregivers

There are many resources available to caregivers of a person diagnosed with dementia. The Alzheimer’s Association will refer you to your local chapter for information, resources, and their hands-on caregiver training workshops.

“I’ve been to our local association’s caregiver workshops and to their monthly support groups, too. Every time, when I leave, I’ve learned something — techniques, strategies, things like that — and that I’m not alone in this,” says George Robby who is caring for his wife with Alzheimer’s in their Chagrin Falls, Ohio, home.

Other good sources of information, assistance, and support include your local Area Agency on Aging and, for those caring for veterans, the Veterans Administration’s Caregiver Support Program . Some senior care companies, including Silverado Senior Living and Home Instead Senior Care, offer programs and skill-building workshops at their facilities.

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Check Their Advance Care Plan

You should find out if the person has an advance care plan. This document may record their preferences about the care theyd like to receive, including what they want to happen, what they dont want to happen and who they want to speak on their behalf. It may include an advance statement or an advance decision. We have information on planning ahead for patients and their families, which you might find useful.

How Is Vascular Dementia Treated

Vascular dementia can’t be cured. The main goal is to treat the underlying conditions that affect the blood flow to the brain. This can help cut the risk of further damage to brain tissue.

Such treatments may include:

• Medicines to manage blood pressure, cholesterol, triglycerides, diabetes, and problems with blood clotting
• Lifestyle changes, such as following a healthy diet, getting physical activity, quitting smoking, and quitting or decreasing alcohol consumption
• Procedures to improve blood flow to the brain, such as carotid endarterectomy, angioplasty, and stenting the carotid arteries are located in the neck and provide blood flow from the heart to the brain
• Medicines, such as cholinesterase inhibitors to treat the symptoms of dementia or antidepressants to help with depression or other symptoms

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Symptoms And Disease Course

Symptoms differ depending on what part and how much of the brain is affected, and can overlap with those of other types of dementia. Symptoms are likely to be more gradual and less dramatic in multi-infarct than in post-stroke dementia. For example, in multi-infarct dementia a gradual decline in some aspects of speech and language may be noticed, whereas immediately following a stroke there can be a sudden change in speech.

Vascular dementia does generally progress, but the speed and pattern of cognitive decline, motor skills slowing, and mood changes can vary. Some individuals may experience memory loss, whereas others may exhibit changes primarily in mood and behavior.

Like all dementias, individuals in later stages will show overall cognitive changes and will depend on others for care. Symptoms common in both post-stroke and multi-infarct type dementia can include:

• confusion and difficulty problem-solving
• changes in mood including loss of interest in regular activities
• trouble finding the right word
• motor symptoms including clumsiness and slow or unsteady gait disturbance.

Family caregivers may find it difficult to know how to provide help when symptoms are so variable. Getting a definitive diagnosis will make it easier to provide care now and in the future.

Tips For Home Safety For People With Dementia

As a caregiver or family member to a person with Alzheimers or related dementias, you can take steps to make the home a safer place. Removing hazards and adding safety features around the home can help give the person more freedom to move around independently and safely. Try these tips:

• If you have stairs, make sure there is at least one handrail. Put carpet or safety grip strips on stairs, or mark the edges of steps with brightly colored tape so they are more visible.
• Insert safety plugs into unused electrical outlets and consider safety latches on cabinet doors.
• Clear away unused items and remove small rugs, electrical cords, and other items the person may trip over.
• Make sure all rooms and outdoor areas the person visits have good lighting.
• Remove curtains and rugs with busy patterns that may confuse the person.
• Remove or lock up cleaning and household products, such as paint thinner and matches.

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Employment And Support Allowance And Universal Credit

What is it?

ESA is a UK government benefit paid to people whose illness or disability affects their ability to work. It is being replaced by a benefit called Universal Credit.

Am I eligible?

• not in receipt of Statutory Sick Pay or Statutory Maternity Pay
• not in receipt of Jobseekers Allowance

You might be transferred from Incapacity Benefit to ESA and wont be expected to return to work.

How much is it?

Youll get a pre-assessment rate of between £58.90 and £74.35 when you first claim. Then, after 13 weeks, you can receive up to £113.55 a week.

How do I claim?

Find out more at gov.uk/employment-support-allowance

ESA is being replaced by a benefit called Universal Credit. Universal Credit is being introduced in stages throughout the UK. To find out if you are eligible to claim Universal Credit or ESA, please visit gov.uk/universal-credit

Communicate Patiently Slowly And Clearly

Use physical touch to help communicate. For instance, if a person with dementia is having a hallucination, a gentle pat from you might draw them back to reality and out of their frightening hallucination.4 Sometimes holding hands, touching, hugging, and praise will get the person to respond when all else fails.

Communication or more specifically failed communication can be the crux of problems for many caregivers. Weve whittled it down to some of the key aspects that you could focus on to make it easy for you and the person with dementia:5

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Are They Starving Or Dehydrating To Death

It may seem that the person is being starved or dehydrated to death, but they are not. In the end stages of dementia , the persons food and fluid intake tends to decrease slowly over time. The body adjusts to this slowing down process and the reduced intake. It is thought that by this stage the hunger and thirst part of the brain has now stopped functioning for most people.

The person may be immobile and so does not need the same amount of calories to sustain their energy levels. Having reduced food and fluid intake and decreased interest in this can be thought of as a natural part of end of life and dying.

Giving increased food and fluids artificially can be helpful for some other health conditions, but it is usually not considered to be helpful at the end of life in dementia as a way of managing reduced oral intake.

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Take A Break From Caring

Taking regular breaks can help you to look after yourself and better support you in caring for someone with dementia.

Family and friends may be able to provide short breaks for you to have time “just for you”.

Other options include:

• day centres social services or your local carers’ centre should provide details of these in your area
• respite care this can be provided in your own home or for a short break in a care home

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Fca Fact And Tip Sheets

A listing of all FCA fact and tip sheets is available online at www.caregiver.org/fact-sheets.

The National Stroke Association provides education, information and referral, and research on stroke for families, health care professionals, and others interested in or affected by stroke.

American Stroke AssociationThe American Stroke Association offers information and sponsors programs and support groups throughout the nation for stroke survivors and family members.

American Heart AssociationThe American Heart Association provides public health education to community members, healthcare professionals, and to lawmakers and policymakers.

National Institute of Neurological Disorders and Strokewww.ninds.nih.govThe National Institute of Neurological Disorders and Stroke supports and performs basic, translational, and clinical neuroscience research through grants-in-aid, contracts, scientific meetings, and through research in its own laboratories, and clinics.

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Actions For This Page

• Dementia is the word used to describe the symptoms of illnesses that affect the brain.
• The most common dementias are Alzheimers disease and cardio-vascular dementia.
• The National Dementia Helpline is an Australia-wide, confidential telephone information and support service that helps people with dementia, and their partners, carers and friends.
• The Cognitive Dementia and Memory Service is a specialist multidisciplinary diagnostic, referral and education service that helps people with memory loss, or changes to their thinking, and those who support them.
• Other services can support people with dementia to remain living at home, such as the Home and Community Care or Home Care programs.
• If you are caring for someone with dementia, you can get free counselling, support and advice from Alzheimers Australia Vic and Carers Victoria.
• Caring for someone with dementia can be challenging. If you need or want to take a break from your care role, there are respite and support services and programs you can use.

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Support Groups For Carers Of People With Dementia

There are formal and informal support groups and networks for people with dementia and for their partners, carers and friends. You might find you feel reassured by catching up with others and getting help from people who share similar experiences.

Carer support groups bring together partners, carers and friends of people with dementia, sometimes with a group facilitator. To find the location of your nearest support group, contact the National Dementia Helpline on 1800 100 500, between 9.00am and 5.00pm Monday to Friday.

Alma And Silvias Story

Alma had been forgetful for years, but even after her family knew that Alzheimers disease was the cause of her forgetfulness, they never talked about what the future would bring. As time passed and the disease eroded Almas memory and ability to think and speak, she became less and less able to share her concerns and wishes with those close to her.

This made it hard for her daughter Silvia to know what Alma needed or wanted. When the doctors asked about feeding tubes or antibiotics to treat pneumonia, Silvia didnt know how to best reflect her mothers wishes. Her decisions had to be based on what she knew about her moms values, rather than on what Alma actually said she wanted.

Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimers disease.

However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimers. They may believe that the persons quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.

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