You all know that Mom has ALZ and Dad has what is more than likely Vascular Dementia. He has never been properly diagnosed. He was originally labeled with ALZ by his GP. I just know the pattern of his dementia is not that of ALZ.
My question is for those of you familiar with vascular or other dementias other than ALZ.
One of the first abilities that Mom lost was her ability for abstract thinking. In particular manipulating numbers. One of the first indications we had that she was slipping was her inability to keep a check book register. She could not subtract the numbers. She also lost the ability to think rationally and logically.
My Dad is in probably his 9th year of dementia. We were sitting in the apartment today and he was looking at a scrap book which has many of the certificates he has received over the years. He stated that he received one certificate in 1969. He ask me what years it was. I told him 2009. He thought maybe half a minute if that much and said... that was 40 years ago. He had managed to subtract the number in his head. Yet a few minutes later I ask him about it and he had no memory of having done it. Didn't even know what year it was. So I checked to see if it was a fluke. He managed to subtract two more number in his head.
The other difference between him and ALZ is his temperment. He reacts with more reasoning and logic then Mom. His temperment and mood is better and has not had the personality shift that Mom has had. His has been a slow progression with step downs rather than a gradual decline and each step down had occured in relation to a heart issue. It just makes me wonder...
Any ideas here? I'm still thinking vascular dementia and I intend to ask his new doctor his thoughts when I take him next week.
Mom had been diagnosed with dementia but my Dad came home one day with her and say 'the doctor said your mother has Alz'. Only she didn't seem to exhibit any symptoms to us and Mom was always very high-strung and sneaky
by hiding money and things.
We started to notice her decline in the mid-90's. It was most evident when they came from their Pennsylvania home to the NJ home they had lived in the longest. It just seemed like Mom couldn't remember what cabinet to open or drawer to open to get what she wanted. But that slip was usually only 24 hours long. And he would say the same thing would happen to her when he went back to Pennsy. Then he started to say "why don't you stay with the girls, and I'll go back to pennsy. I'll be back in a few weeks again, and you can visit with them" but Mom insisted on being with him and going back and forth with him -- now I know why he tried to get her to stay in NJ. Each trip over the 7 years they were out there, she was more confused for longer times than normal.
After Dad died and we moved her back to NJ full-time, she drove and was living 'fine?' but our doctor said that its probably just that she's living on her long-term memory not short-term. But during this time she'd pick up my daughter from school and drive her to the next town for gymnastics. Then my kids started saying things like Grandma drove the wrong way down a street or grandma turned on a red light when she wasn't suppose to.
When she had the hit and run, I took the driving priveledge away totally.
A year or so later, when sister made an attempt to work after losing her job, Mom started having panic attacks real bad. I'd come home from work and find her sitting in the dark dining room crying real bad because my sister was not home for either working or shopping for groceries. I told sister she needed to start 'planning' things so that someone was home with her while sister went out. But she never planned, she just think "Oh, I need x, and take off in the car thinking my mother would be fine for an hour or two".
One big thing everyone picked up on was that Mom started to forget to sign the cards she gave out. There would be a name at the top and some sentence on how much she loves us and then Love (blank) nothing. We'd all laugh.
And then Mom started forgetting words in sentences as she was talking. And then she had difficulty in actually writing totally. And then the day came when she started becoming more quiet and not talking at all -- she started making moan sound upon breathing in and out but then even that left after a few months of annoyance to anyone in the same room as her. She wasn't aware of it.
Then came the constant hand pounding, foot stomping when sitting, and yelling 'no no no' and her grabbing at her head and holding it. This was the longest time and the most aggravating.
After that came the food hiding, purposeful food spilling, throwing or whatever, Sister kept saying it was because she knew the medicine was in it.
Then we all know the last step was she was taking very long to eat, sister had to start to feed her and then she wasn't able to swallow, dehydrated, fell and was put in the hospital, tranferred to NH and died 2-3 weeks later
So that's it with Mom. Hope the info helps. Since my cousin had a Dad who has Alz diagnosed at 55 and was dead at 57, I think Alz patients go much, much faster than Dementia patients do. My girlfriends x-husband just died from Alz and it was pretty much the same, diagnosed 2 years ago and died last week and he even had a heart transplant 15 years ago!
Last edited by caringsister54; 04-09-2009 at 05:37 AM.
Deb, I guess there can be more than one form of vascular dementia. Your father's condition seems to be slowly progressive. My mom has vascular dementia and had a rapid decline. A little over 6 months ago she was doing everything for herself, paying bills, cooking, mowing the lawn and driving, using a debit card, balanicing her account and now here she is in a Nursing Home. She couldn't remember from one day to the next, was confused, and had little memory about her past? In fact 95% of the time she had no memory of her past, although it has improved a little lately.. I don't know for sure why the difference between her and your dad, but I have to wonder if your dad is dealing more with an old age senility where some of the memory is lost naturally. How many other symptoms does he display of dementia that would make his doctor diagnose him with it. He does have A/fibs, so does my mom. Perhaps when the heart is in this state there is a lack of oxygen to the brain causing the death of brain cells?. However when mom was taken to the Heart Specialist last and after running mulitiple tests on her heart, he said that she has a strong heart, only problem it was beating too fast A/Fibs so he put her on digoxin and they also lowered her metoprolol by half and I believe they added another heart pill to control her high blood pressure.. This has helped where she isn't as confused and is able to remember some things that normally she couldn't. She still gets confused, forgetful and has her days. One thing is clear, she no longer can be left on her own because she is so unpredictable. Your dad seems to have the ability to think and formulate, you would think that would be missing in someone that has had dementia for 9 years, maybe I'm wrong. Maybe ask his doctor, I wish my mom could think like that, lol we would send her home.
Caringsister, when you wrote of your mom it brought tears to my eyes because there are so many similarities to my mom such as pounding on the table, cursing and accusing people of poisoning her with meds. Maybe she is right, maybe they are. Maybe it's the meds doing it.?
You stated "Your dad seems to have the ability to think and formulate, you would think that would be missing in someone that has had dementia for 9 years, maybe I'm wrong. Maybe ask his doctor, I wish my mom could think like that, lol we would send her home."
and "Maybe she is right, maybe they are. Maybe it's the meds doing it.?"
First off, honey you do realize that reality was that even if she was to be more cognisant, you would not be able to have her sent home right? and also that the meds could be doing it.
While I do think that the Namenda should be taken off the market and not used by anyone because so many had adverse affects, I do believe that the medicine wasn't making things worse, only because we lived daily with the day to day changes that were occurring.
Yes some medicine may have adverse affects, when seen, you should call the doctor and make adjustments necessary.
But in reality -- I do believe that as one ages, the oxygen levels to the brain isn't as high. I also believe that -- it may be the cause of the loss of function as brain cells do die. That is why in a stroke, they die but with therapy some of the unused brain cells can get re-trained to pick up the slack.
Dorri -- we all have walked through the horrible paths of this disease. And while we all looked for the last vestigages of who these people are, we also have to know reality that they are losing capabilities faster than we can put in place the stuff needed to accommodate them. One thing for sure, anyone with this disease has no right to be at home and the burden put on the family for the 24 hours care that is required for the last year or few months. It never gets better.
I'm definiely listening. It has been 9 years or more for Dad. He has no current memory at all. He does have hallucinations now (since the afib and introduction of the digoxin). That has lead to his wandering which he never did before. He has had 5 bypasses, two stints in his leg arteries, and a couple of stints in his heart. He also has PAD. He had an MRI and it showed no infarctions (indications of stroke). Yet I watched him subtract number in his head. He assesses a situation and comes up with logical explainations. I do know he has decreased oxygen, especially when active (even walking), As I said, he has never been properly diagnosed. He was labeled with ALZ but we know that is not the case (after 9 years). Then it was vascular dementia. Now I wonder what is going on. He has an appointment Thursday and I will talk to the new doctor.
As for Mom, her memory is no better since she stopped the aricept/Namenda. After an 8 point drop in her mini mental over 18 months it was evident that it was not "helping". What is better is her emotional state. Even with the move I have seen more smiles from her in the last week than I have seen in the last two years. I do not have overblown expectations. I know cognatively she is not going to get better. I know that I will still get calls that Dad is packing and ready to go home when in reality it was only books and laundry that she had put on the bed and forgotten she had done it. But I have what I wanted. Instead of getting totally distraught about it, she was much more calm about it She even told me tonight that her new place was an ok place to be. That is all I wanted....
Caringsister I was joking when I said we would send her home. I do agree that it's an around the clock job and yes she does require more care then any family member can give her. When I start to get my doubts all I have to do is think back with her being here for Christmas and remember how hard that was.
Although I do find it interesting that cutting back on her heart pill DID improve her confusion and her memory. While this may not be entirely responsible, this side effect may have contributed to her overall condition.
Deb, you put a smile on my face when you say that your mom is better emotionally and is happy in her new place. My mom is very unhappy in a hospital setting awaiting NH placement, in other words she is down right miserable, so I was already starting to question if a Nursing Home would be any different? I hope so. Mom needs a place she can call home. She always had a bleak outlook and a negative attitude long before her illness, so that came with her into the dementia and may follow her wherever she goes. Oh, it would give me great peace if only she could become at peace with herself and her living arrangements.
Please tell the doctor about your dad's ability to assess and subtract in his head. Have you just started to notice this in him or was it there all along, sitting dormant, lol has he been put on any new meds that may have activated brain cells that were asleep?
It will be interesting to hear what the doctor has to say about this? Keep us posted.
What I found with FTD/Pick's is that each person loses different abilities at different stages. I guess it just depends on which part of the brain is shutting down. But, Betsy did seem to have her long-term memory right up to the end, but had no awareness of "today". Her speech left over a year ago, so it was hard to know exactly what was going on in there. but while she could still talk, she could remember something from her childhood, but couldn't figure out the word for "dresser". The planet Dementia is a strange and alien world. Hope to never visit again.
Dorri... I think it has always been there. I have just noticed it more lately. Today his wallet was not in his pocket. He looked in and around the chair he sat in, he looked in the pants pocket of the pants he took off yesterday, he also looked in his coat pocket. All logical places that it might be. At the same time Mom was looking in the strangest places. She checked her jewlery box and went through a bag of pens and pencils. She also looked through the laundry we had just folded. The difference was striking.
Cute part of this was that I had my niece purchase a new wallet (Dad would not stop looking). I met her at the door, took a few copies of his important information (I have the originals) and cut them out and put them in the wallet. Then I put in a new $20. Most of you know that Dad has to have his $20. My niece gave him the new wallet and contents. He checked for his military ID and was happy with the copy and then checked for his $20. He was happy both were there and the situation was over.... until the old wallet was found, where mom had put it. Now he's excited that he has TWO $20's. lol. I could hear him, while on the phone with Mom, telling her that he now had $46. Two $20's, one in each wallet, a $5 and a $1 in his pocket. He can add too. Yet he had no clue we had switched wallets on him even when the first one was found. He also has no idea that he went to supper, let alone what he ate. His is just so different.... and then we deal with the paranoia and hallucinations which have no pattern. Saturday night was the first time in weeks and he's been fine since.....
Deb, you're such a good daughter that you have taken the time and have the interest to observe your parents. I have to get a chuckle when you said "until the old wallet was found where mom had put it"..lol, now if mom would have kept her hands off dad's wallet then poor dad wouldn't have had to go through this in the first place. (I'm joking) well, mom is the one that hides her things in odd places, dad seems to be a little more organized with his stuff.
It's interesting with the differences between your parent's behavior. Take away dad's forgetfulness, would he still fall into the categorey of dementia. I believe some doctors are quick to diagnose without ruling out all the other possibilities. Mom's family doctor immediately diagnosed her with it, and when we insisted for a referral to a Geriatric Specialist I think he was a little put off because he said why put her through all those tests?. Anyways after mom ended up in ER in a different Regional hospital, they did one test after another and eventually came up with pretty much the same diagnosis as the first doctor who didn't take any tests other then her heart? Hmm..maybe the first Dr. had enough experience to spot Dementia without all those tests, I don't know? How do they differ dementia from normal senility forgetfulness?
Oh, the many faces of dementia.
I wish I knew Dorri.... So much is rolling around in my head these days. I don't want to leave any stone unturned for Mom or Dad. I am a firm believer in observations and investigation and learing all you can about whatever you are facing. Yes, there are many many diffrent faces of dementia. As many faces are there are those that suffer from it. The medical profession puts neat little groupings and labels but each is an individual and needs to be treated as such.
I've been wanting to add my two cents here but just got the chance to do so. Here goes deb..........I've seen big differences in my Grandparents illness, Alz, and Moms, vascular dementia. Grandparents decline was erratic and much more devastating when the declines happened. Does that make sense? Moms declines have been slow and seem to go hand in hand with her declining health. When she started having A-fib heart problems and a small stroke..........of course things got worse. Her short term memory continues to slide downward but Gram and Gramp had almost no memory of anything except their childhood. Therefore they ask constantly for their Mom and Dad. Gram seemed to know us at times but Gramp didn't at all after a short while with Alz. He wandered terribly and his sundowning was severe. Grams wasn't. She was in excellent health.....until her death. Sounds like I'm making a joke but I'm not, honestly. Gram could not swallow food or water so we had to call in hospice. She had perfect blood presure, her heart was great. Never one medication her entire life. Didn't need a thing. Her geratric Dr. said she could have lived to be 110 if not for the Alz. So Gram passed at 97. Gramp could not pour milk from the container.........but he played a mean game of poker until the day before he passed away. He loved poker. Bless his heart. He won too. My husband was shocked.
Moms Dr. told me if Moms survives long enough with dementia that it will not be that different from Alzheimers. Its like the two will be indistinguishable from each other. Then he said every patient is different and Mom may not have the decline that my Grandparents had in the end. So in the end its a waiting game. Maybe I'm hoping for the impossible but I pray that Moms declining health takes her before she doesn't know me. I'm not sure how I could handle that one. I suppose I could, I've handled everything else !!!!!
Anyway, I'm rambling again. Your story about Dads wallet was a good one. Put a smile on my face for sure. So sweet. Mom wants two 5's one 10 and 10 one dollar bills in her wallet and she's happy. It must stay the same or she worries that she doesn't have enough money. Money for what?? Whatever I want, she says. Makes me smile. They're something else aren't they? I love their little quirks......once you get them straight.
Chris, my mom's physical health is also good. Strong heart, good blood pressure...her only problem is her anemia that she is treated for bi weekly.. so I understand wishing her physical health fails before she forgets who I am....but unfortunately (strange choice of words!) she is as healthy as a horse.
I can't imagine what that must be like for my mother to not know me. If they don't recognize us then are we a new stranger to them everyday or would we be the same stranger? Odd questions.
But if her mind does go then I have told her blood doctor that we would then talk about halting all further treatments. I won't keep her heart beating to keep her in Alz. limbo.
Gram didn't remember our names, her grandchildren, but when we came into her room she knew that we were different from her caregivers. She would want a kiss and hold on to our hands and say, "Love you". So in her soul she knew us..........just not our names. I know how you feel about your Mom being so healthy. It was a worry for us when Gram was suffering with Alz. we knew she would last a long time because of her excellent health. To say "unfortunately her health is good" in this instance, is very understandable.
My Grandparents eventually forgot my father, their only child, he passed away about 4 years before Gramp did. They would ask "Who is that fellow"? pointing to Dads picture. When I told Gram that was her son she would remember that he was gone and she would cry. I took his pictures down and she never spoke of him again. She loved him dearly and suddenly he was gone and not spoken of any more? Maybe it was too painful? I suppose it depends on which part of the brain is being affected at different stages? I don't think anyone knows for sure. I would like to think that Mom will always know me........but I know better. I just try to enjoy her right now. Your a good daughter and you enjoy and love your Mother. Thats what is most important at this point in our lives. We can't change whats going to happen. I try not to be a "worry wart" but I am........
In my Mom's case there were occasional lights in the darkness. Since she lived in NY, I only got to see her every 3 months or so. Each time I had to explain who I was, but then she 'knew' me for a couple of days. On our last visit my daughter and her husband were with me. Mom knew J all her life, and her husband too, since she was at their wedding. She had been at their house , knew their first son, but wasn't sure about the 2nd one, she kept forgetting that they had 2 sons.
Anyway after visiting her a few days in a row, we were about to leave one day when she looked my son in law in the eye, called him by name and said "D, I almost forgot you!" That was one of those rare moments. I was so glad that breakthrough happened while we were all there.
Mom was on a do not resuscitate order, and when she got some kind of cold or virus or bronchitis or whatever it was, they did not give her life savings drugs. She slipped away. She was 99 years old. I was glad that we had had her that long, but it would have been cruel to 'cure' her of the illness only to have her hang on for more months with no real joy in life. She had stopped eating, stopped processing food and medicine, and was slowly slowly dying. It was a blessing an illness took her. So I understand perfectly how you feel. And I pray often that my body will not outlive my mind.
You have to laugh at their quirks and each one is definitely different. I'm not seeing a pattern here anywhere, except that there is no consistency. I had to smile today. Mom was upset, made a phone call to Sister 4 and then the coordinator put Mom on the phone with me. I had her calmed down enough to talk to me when Dad ask who she was talking to. Mom told him it was me and I said I had it all under control. His response was.... and she probably does since she is the one with common sense. Mom had to giggle at that one. From that point the melt down was over
The botched attempt to move Dad out of the room with Mom is stuck in Mom's mind. She's constantly worried that Dad is going to be separated from her. I have to remind her over and over that they are where they are going to stay and nobody is moving Dad anywhere. She doesn't remember the move and at times thinks she is where she was. WHen she knows she is not where she was she likes it there.... if she can get past the fear of being separated from Dad. Dad on the other hand is fine. Except the one night, he has been his normal happy self Since Mom's meltdowns are less frequent and less instense he is more patient with her. I am still astonished at how well they are doing.
Martha, Mom does have those occassional lights in the darkness. She wrote down a phone number, read it back to me, and then managed to make the call last night. Today she had no clue how to make the same phone call. She remembered to tell me that she saw a hummingbird (I put a feeder outside of their window) but she doesn't remember the move.
Chris, I think you are right that it all depends on what part of the brain is affected at what time. There is a standard pattern identified for ALZ but that's just a norm and not true with everybody. Other dementias can affect other brain areas and you get a different reaction to the dementia. I truly believe that is the answer You are also right on another point. I do try to enjoy my parents, no matter what level they are on. I can't change what is happening to them and I do expect that the time will come when they don't know me. I will enjoy what time I have that they do remember me and I will love them right through the times they don't remember me. We can't change what is going to happen... just live with what is and enjoy the moment. The future will unfold itself in time and we will deal with that too!!