Caring for someone with vascular dementia

That shape is what makes vascular dementia hard to plan around. A stretch can last months or years, and there is no way to know from the outside how long the one you are on will last. It also means a drop is worth treating as an event rather than as the condition catching up: a new weakness, a new difficulty with speech or a step change in confusion is something to tell a doctor about.

Where the damage is in the smallest vessels deep in the brain, the Alzheimer's Society describes the change as slow and gradual rather than stepped, so a gradual decline does not rule the diagnosis out. Signs that dementia is getting worse covers what a change looks like when it is the condition rather than something new.

Memory and language are on the NHS list too, so memory problems are part of vascular dementia rather than absent from it. They are less likely to be the thing that brings a family to the GP. The different types of dementia sets the main four side by side if the diagnosis is still being worked out, and Lewy body dementia, where alertness swings within a single day is the other type whose day-to-day pattern sets it apart.

Having more than one type of dementia at once can be the answer when the picture does not fit neatly. The NHS says some people with vascular dementia also have brain damage caused by Alzheimer's disease, and that this is known as mixed dementia. The Alzheimer's Society describes the two diseases combining to make symptoms worse than either would on its own, so a family may see a memory that fades in the way they expected alongside the slowed thinking and the steps. It changes little about the care, and nothing about the value of treating the blood supply risk below.

If the diagnosis followed a stroke, our stroke recovery care pages apply directly. The first weeks home after a stroke is the one to read first if a discharge is coming, because the house, the routine and everybody's confidence have to be rebuilt at once. Transfers with one-sided weakness covers getting somebody safely between a bed, a chair and a toilet, which becomes the daily job when one side is weaker. Aphasia and communication is for when the words are the problem rather than the thinking behind them.

Rehabilitation still matters after a diagnosis of dementia. The Alzheimer's Society lists physiotherapy for movement problems, occupational therapy for staying independent at home, and speech and language therapy where swallowing or speaking is difficult. Ask the GP for a referral rather than waiting.

Two of these are worth saying more about. The NHS names atrial fibrillation, an irregular heartbeat, as a risk factor, and says treating it is meant to lower the risk of complications including blood clots and stroke. It often has no symptoms and is found at a routine check, so it is reasonable to ask whether your relative's heart rhythm has been checked recently. The NHS also states that the medicines given for Alzheimer's disease, such as donepezil, galantamine, rivastigmine and memantine, are not used to treat vascular dementia. If you expected a prescription at the memory clinic and did not get one, that is why, and it is not a sign that your relative has been given up on.

The ordinary week is where a family or a paid carer does the work: tablets taken at the same time each day, repeat prescriptions ordered before they run out, blood tests and annual reviews attended, and somebody who notices when eating or drinking has changed. None of it is dramatic, and it is what turns a treatment plan into treatment. Medication administration at home covers what a carer can and cannot do with medicines, mobility and falls care covers walking and balance, which becomes a risk of its own once falls start, and making the home dementia-friendly covers the light, contrast and flooring that make a house easier to read and to move around.

UTIs and sudden confusion goes through the infection question in full. A short note of the date and time of anything you notice is the most useful thing you can hand a doctor, because a step down is easier to recognise from two or three dated entries than from a description of how things have been lately.

The steady part of the job is the routine described above: the tablets, the meals, the appointments and the walk. What needs dementia experience is everything around slowed thinking, which means giving somebody time to answer and breaking a task into one step at a time. Where mood is low, company at a set hour each day does more than another phone call.

When your relative has dropped a step and needs more help than last month, you can search for carers near you and compare their rates, experience and availability without paying anything or booking anybody. Carers on PrimeCarers are self-employed, and PrimeCarers is an introductory service rather than a care provider or an agency. Before a carer appears, they have an online interview, and their identity, their right to work and an enhanced DBS on the Update Service are checked. They are insured while they work. What training and experience they have is their own account on their profile, so ask each carer about their dementia and stroke experience yourself.

Tell whoever you speak to what has already happened, in full. The client contract requires the client to give full and accurate information in advance and on an ongoing basis about known risks, and it names cognitive impairment among them. A carer who knows there has been a stroke and that the anticoagulant cannot be missed can plan around both.

If the help needed has grown past what visits can cover, live-in care for dementia explains how one carer in the house works, and the cost of care for dementia sets the arrangements against each other with the funding routes. If you are wondering whether home is still the right place, at what point should someone with dementia go into care is written for that decision.