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sonofvasc 12-18-2012 02:44 PM

My 87-year-old dad has recently been diagnosed with vascular dementia.
He currently lives alone and still drives. DMV is checking him out soon and I hope he loses his license. He doesn't want to move, doesn't want to live with anyone else, and most importantly, doesn't see that he has any big problem--just that he forgets things. Like driving to an appointment hours early--or in the middle of the night, or a few days early. He also gets lost driving further away from home. And has had delusions or hallucinations like having just returned from a second "vacation" home that looks just like his current one with the same neighbors and all.
He "might" consider moving to a 'retirement' community, one with a receptionist and meals, but he doesn't seem to understand that he needs more--(how can I tell if he takes his medication daily if he doesn't seem to know day from night?). How do I tell him he needs "assisted living" or worse, a "locked" memory center? Can he live in an 'assisted living' facility or does he need an actual memory unit? I'm just beginning to research this, have conversations with his doctor, and telling him what I think he needs, without using words like "dementia" or even "assisted living."
I would love to hear any advice from others who have gone through this.

Gabriel 12-18-2012 07:59 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Sonof... sorry you are having to deal with this but glad you found us here. I have been where you are now and I truly understand. My Dad had Vascular Dementia.

Everything you explained in your post is exactly the way it is. He doesn't realized there is something truly wrong with him. The brain is an amazing place. When there are holes in his memory he just makes the pieces fit. His reality is what he believes and nothing you say or do is going to convince him differently. If he tried to convince you that you were the one with cognitive problems (which he just might do) you would not accept his word... and he is not going to accept yours.

I am glad you are getting him evaluated for driving. That is so very important. He is probably going to fight you tooth and toe nail to keep his driving privileges so beware. But letting him drive is asking for disaster.... and with his diagnosis, if he gets in an accident, then there is grounds for negligence. He can probably drive just fine if you only take into account the physical driving. He can turn on the car, press the gas, and go. But the cognitive part of driving, which is the most important part of driving, has been impaired. Anything out of the ordinary will throw him off... not to mention getting lost and driving aimlessly.

You are the one that needs to decide which placement he needs. He is not capable of being rational about this... he has dementia! Then you need to present it in a way that it might be ok with him. Take your cues from him. If he likes the idea of that vacation place then call it that. Emphasize that they will cook and clean for him. He just needs to enjoy life. Whatever he might want it to be, make it just that.

From what you have said here he will not do well in independent living. They are not set up to take care of his needs and he needs more than they have to offer. Depending on his level he might work in Assisted Living if you can find a place that has a wander guard system and staffing for adequate cuing and assistance. Locked unit have more staffing and as the name says, they are locked for the residents who are elopement risk. It is also a smaller community which is better for those with dementia. Some communities have two levels of locked units. One for the high functioning elopement risk residents and one for the lower acuity residents.

If I were you I would look for an assisted living with a locked unit on site. They can do a proper assessment and tell you which of the two he would be best suited for. It might be worth trying him in the Assisted Living section to see how he adjust. If he does well there then you can leave him there. If he needs a smaller more secure placement then he will not have to move to a new location.

As for picking a facility, do your homework. Ask for information and see what each facility in your area has to offer. You will want to know their pricing schedule, room availability, and other such details. Then check online, especially with your state department that regulates care facility, to find out what their rating is and if they have any deficiencies. You can narrow your search before you ever go into a facility. Ask friends and family if they have any experience with a facility they might recommend. Then go to each facility and take a look for yourself. Don't listen to the hype of the sale person. Watch the residents and how they interact with the care staff. Is the care staff patient and involved with the residents? As about the staffing levels and the staff retention rate. Ask to see the license which has to be posted. There will probably be a rating there as well. Narrow the search down to a couple and do a second visit at a different time of the day. You will quickly get a good or bad feeling about the place. The last step is to hang out in the parking lot and talk to family members. Out of ear shot of the facility staff you can find out the best information! If you can talk to at least three you can get a good sense of what is going on. You can even talk to care staff coming and going. Their attitudes will tell you a lot. If they are enthusiastic then it is a good thing. If they are disgruntled then that might be a warning flag.

Be honest with the facility about your Dad's abilities and inabilities. They need to know. You need to give them all the information possible so they will know what your Dad needs.

Hang in there. When it is all new, all that needs to be done seems totally overwhelming. Start making list and checking it off one step at a time. The more you do the more you will know and the better off you will be. Know that I will be around if you need to vent or assistance. You have done the hard part... you have his diagnosis and know what you are dealing with. Now it is on to the next step of finding the right placement... and getting him off the road :)

Love, deb

sonofvasc 12-19-2012 09:55 AM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Thanks very much for your reply. I am in the middle of much of the researching. I am hoping he gets into an assisted living situation because most of the 'memory' support places are filled with people who appear to have little or no ability to carry on a conversation. I know he may end up there, but for now, I think he can use the stimulation of people he can talk to. It is great to be able to vent here. I appreciate your help.

Momento 12-19-2012 01:42 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Hi Randy:

You are not alone and I support all that you are doing with your father. We are struggling with you. Excellent advice from Deb! Always remember to be present and to be connected with your strength and instincts. Sounds like you are finding your support and creating your own coping structure.


Gabriel 12-20-2012 12:24 AM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Randy, do not rule out the dementia units. As I said there are facilities that have two levels. One for the more high functioning and one for the higher acuity. Especially if Dad is an elopement risk, that is the best place for him. We have all levels in Mom's unit. We have one gentleman and a lady that are very high functioning but an elopement risk. From there we have all levels down to those that are non communicative, non ambulatory, and need assistance with all activities of daily living. For the most part they all get alone very well.

If you had seen my Mom and Dad at the time I moved them into the dementia unit you would have probably said they didn't need it either. But they had been in AL and it didn't work for them. They self isolated because they could not keep up with the more cognitively aware individuals in AL. Dad eloped twice. AL was too big and too overwhelming and confused them more. It was only after they moved to the smaller dementia unit, where they could not get out, and there was more one on one help from the staff, that they both settled down. I found with myself.... it was ME that was not ready to admit that Mom and Dad needed the dementia unit. They were past ready :)

Each is different and you have to get a good assessment of Dad's abilities to make an informed decision. Hope your search goes well :) As for venting, vent away. It is what keeps us sane!!!

Love, deb

sonofvasc 12-21-2012 08:49 AM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Thank you for your support. It is great to read that so many have gone through similar experiences. I took my dad to a place I really like that has a set of 'memory support' groupings that aren't in their locked memory unit. They tested him and indicated he can fit into one of those groups. Now I just have to get his doctor to fill out the state forms as quickly as possible to get him in. Not that easy at this season. I was amazed that my dad liked this place. Later last night, he called to ask me how to get there. He was ready to move in.
I am wondering about simply driving his car away. I told him he shouldn't drive, he might get lost, he might hit someone, etc, and he seems to agree, but not completely. I'm not sure how his potential anger or lack of trust may occur if I take the car. (I suppose I can try to talk him into it). Any thoughts?

Luau 12-21-2012 12:37 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
A simple solution to the car issue is for you to simply yank out one of the spark plug wires without him knowing. That way you know he wouldn't be driving it. Later, you can say you will get car towed to a shop to see what is wrong with it.

Gabriel 12-21-2012 09:06 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Luau made a good suggestion :) We took Mom and Dad's care away but left Dad with the car keys. They seemed to be of comfort even though he didn't have a car to put them in. He did ask about his van and we just told him that it was being repaired. AC needed work, it needed inspections, had to have new tires, needed a tune up, .... repeat :) He would forget the last reason and had no time frame so no idea it was gone for years. When he fussed about hoe long the repair was taking we agreed and promised to check into it... over and over again. In the mean time he went on outings with the facility on their bus. There were times he was anxious but we just gave him a repeat excuse, acknowledged his frustration, and promised to do something about it... tomorrow!

I am glad Dad seems willing to move in. Know that his emotions are fluid and depending on the moment. So do not be surprised if he changes his mind. Just stay positive about the facility and keep moving forward. Hope the doctor will get that paper filled out sooner rather than later. I am happy that you have found a place you like while will accept your Dad :)

Love, deb

sonofvasc 12-22-2012 01:43 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
I appreciate your ideas, but I'm not really comfortable with them. Sabotaging his car (possibly in front of neighbors), seems infeasible. And he might call auto club. I have always built my relationship with my dad with complete honesty and I don't want to start making up stories and deceptions now. I hope to just tell him how strongly I feel about the danger of his driving, how scared he will be when he is lost, how likely that is to happen, and most importantly, how if he hits/injures/kills someone, I could be liable because I knew he wasn't a safe driver. I plan to demand his keys, if only temporarily (until he goes to the DMV to potentially prove that he is a safe driver), and give him other options, taxi coupons, care workers, and my repeated trips, to drive him wherever he needs to go.
I also plan on putting a big note on his front door to tell him his car hasn't been stolen, but that he gave it to me to use for a couple of weeks.

This kind of reverse father-son relationship is new to me but I have been slowly moving in that direction over the past year and now it moves to a new level.

Gabriel 12-22-2012 07:03 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
.....This kind of reverse father-son relationship is new to me but I have been slowly moving in that direction over the past year and now it moves to a new level.....

Yes, I can tell you are new to this. It takes a while to grasp just what you are dealing with. This disease is unlike anything else you will ever experience and it will turn everything you believe upside down. We all start out just where you are now but eventually learn that with this disease, life changes dramatically. Those long held beliefs go right out the window in favor of what needs to be done to make life easier for all involved.

You are going to talk to your Dad like he is a rational thinking adult with his cognitive abilities intact. You are going to convince and demand. Sounds wonder in theory but in reality... because of the brain damage caused by the Vascular Dementia... he is unable to understand, comprehend, appreciate, or remember. I have been exactly where you are. My Dad was my hero. No way I was going to tell him anything but the truth, the whole true. But the fiftieth time he berates me because I was the evil person who would not let him drive, I told him that the car is in the shop. When he yell at me the hundredth time and threatens to throw me out of the will and throw me out of his house if I don't give him the keys, I gave in to not being so logical and rational with him. At some point you will understand that what he needs is validation of his feelings and hope for the future... not the car back. You will get that he is angry because his world is turning upside down and there is nothing either of you can do about it. You will realize that giving him a little hope, no matter how unrealistic it is, is better than dashing his hopes repeatedly. That is what you will do every time you say he can't drive. He will have at best a vague memory of the last conversation but for the most part the realization that you are taking his independence (driving) away from him is going to be crushing. Why repeat that over and over and over.

Most of us try that rational approach. We are brought up to be honest with our parents. We believe that is the only way to be. Yet when we are faced with the repetitive illogical thinking of someone with dementia we realize that is not possible. It does more harm than good. Back in the l980's there was a line of though labeled "reality orientation" that told us we needed to do just this with our loved ones with cognitive loss. Over the last 30 years this has changed dramatically. Now there are validation therapies that work much better. We given them back what they need. This takes understanding of the person they are, where they are in the disease, and how their brain is working. It is about THEM and not about what we think is right for us to do.

I remember telling my Dad that he could not drive any more. WOW! Talk about the roof blowing off the house. How dare one of his children tell him what he could not do. He was perfectly capable of driving and I was not going to tell him any different. I was crazy if I though he was going to listen to me. Despite my pleading and interventions there were times that he just got in the car and drove off. I spent months trying to get to the drivers side first. I listened to him berate me repeatedly. I still have voice mails of him yelling, disowning me, and throwing me out of the will. How dare I not let him drive. He wore me down. So finally the van went to the shop. In reality it was actually parked at my sister's house but he was told the AC needed repair. He accepted that. He complained that it was taking so long but he dropped his anger at me. I would commiserate with him about how long it was taking. I would validate his feelings of frustration at not being able to drive. But he had that little bit of hope that the van would return. This was done successfully for 2.5 years. He still had the keys in his pocket when he died and I left them in his suit pocket for that final trip to heaven. But he never got his van back... just hope that one day it would be ok. That is all you can give your Dad now... Validation of his feelings and a little hope in a hopeless disease.

You can take this as you want. There is no right or wrong, just trying to find out what works. I give you this from my experience, validated by success and current therapy. You can try it your way if that is what you need to do. :) Either way, I wish you luck because this is not easy on either of you.

Love, deb

ninamarc 12-23-2012 06:39 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
I would like to say that you should not worry about playing tricks on Dad. I can see that you are not comfortable. Lying to him or "stall" his car. I understand this. You either worry that you are not respecting him or that he will find out and get upset. This makes sense if dad is very alert and is not confused. Now you have a problem trying to make sure he is safe. Playing tricks will only work if he forgets a lot. It is your call: if he forgets a lot, your stalling his car is nothing bad or immoral. On the contrary, this is part of caregiving: make sure he is safe. I think this is also moral to help him to be safe. A locked unit is the same thing; the demented person has no idea he was confined in an area where he may like very much. Lots of memory units look like an AL with a locked pad. That is all.
Good luck!


sonofvasc 12-23-2012 11:15 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
I appreciate your answers. Deb, I especially realize that you have gone through the process and kind of know what's coming. My dad is more or less alert a good part of the time. Independent of all that, I have to go through the experience and 'learn what I already know is likely to happen.' So I did go to my dad's with my wife and adult daughter (for support and agreement) and a well-reasoned written page of cause and effect and worries and liabilities and emotions. And he read it and understood my concerns and tried to use his logic to counter it....and when push came to shove (not literally), he wasn't going to give up his keys. And said he still might drive down the street to the bank or the grocery store and he wasn't giving up his car. And I wrote two notes on his front door, one with the phone number for a taxi service and the other saying that if he is thinking of driving to call me. Yes, I realize these may do absolutely nothing and he probably will drive to the store and/or the bank before I come back in a few days and very likely nothing will happen.
And in 11 days he has an appointment with the Department of Motor Vehicles to take whatever tests they demand, and hopefully fail.
I'm not happy with this, but I'm not ready to do more yet.


Gabriel 12-24-2012 12:21 AM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Randy, none of this makes anybody happy but it is what we were given to do. First you have to accept someone you love has this dsease, with all it's negative indications. Then you have to take away their independence, many times their home, and the disease takes away their ability to understand why you are doing what you are doing. This is one evil diesease.

I am not surprised that you got exactly what you got from your Dad. The part of his brain that would allow him to understand and remember has been damaged. His judgement is impaired and his ability to predict outcome. A blessing or a curse, he has no clue that what his mind tells him is not right. If he thinks he is ok, nothing you can say will change that. He will probably ignore the signs, forget to call you, and be off in the car tomorrow. He may get lost just going to the store, wandering around for hours trying to find his way home. But that will be forgotten and you will be oblivious. Or, like my Dad, he can hit a car and drive off. Dad had a hit and run warrant out. It was only vehicular damage so insurance information took care of that... after a lot of explanation. Never did figure out what he backed into that dented the back bumper. The next 11 days can not past quick enough.

A heads up, Just because he has a letter from the Driving Licenses Bureau or his license are taken away, don't expect him to willingly comply. They will be crazy and he will be convinced it is a mistake and he can still drive. Been through that one too. I also remember the panic when he drive off, got lost, and didn't come home for hours. When he did finally return he gave us a rambling tale that made no sense. Actually I have dealt with this twice because we went through it again with Mom and her Alzheimer's. The experience was the same.

You just need to be aware of the possibilities. I will tell you what somebody told me long ago. We do what needs to be done when WE are ready. Our loved ones with this disease are past ready when we get there. It is our acceptance of the situation that drive what we do.... not where our loved one is in the disease. I can tell that you are still struggling with what lays before you. Taking control of our parents lives is a HUGE undertaking. As I said, it turns everything we believe and hold true upside down. We are responsible for the very person who has always watched out for us. We are forced, because of the nature of the disease, to do things that we never thought we would ever do. It's difficult, but necessary. You will get there :)

You are here :) and know that we are here as well. We are all traveling this same bath together even though it may be at different stages. One thing I might suggest is to find your local Alzheimer's Association Support Group. They are usually listed on the organization web site or you can find them by calling the Alzheimer's Association Hotline. There you will find a trained facilitator and other care givers that are going through what you are. It is beneficial to sit down with a group of like minded individuals and vent, share experiences, and find out what is around the corner. I was hesitant at first but it is now my favorite night of the month :) Hang in there and keep moving forward :)

Love, deb

jagsmu 12-24-2012 01:07 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Hello randy, glad you have found us, all of us on here have a common thread connecting us together, our love and concern for our loved ones. I have been where you are and you have just started on a long road. Most of us have a really hard time moving our loved one into some place that is safe. Your father seems to favor the move, I would jump as fast as I could to make it happen. There will come a time where dad will not want to move as his security of where he is now will outway anything in his mind over anything you can say and then the move will be really hard on everyone. Most of us waited too long to move them, a lot of us waited until something happened. An accident, a call from the neighbors or many other things that took the choice out of our hands and then we were in a panic to find the right placement. If you are worried about his meds talk to his dr. Or your dad about putting his meds in blister packs. This takes the guess work out of the equation for both of you. Dad will know what to take when and you will know if dad is taking them. It is really easly done, the drugs store will put his meds is a pack that is divided into moorning noon or night or what ever he needs and all he has to do is pop out the right one and take all in that packet. Have you got some one coming in with food, we had what they call meals on wheels that brings dinner everyday. Is your dad a veteran, ther are a lot of programs available to vets.
I realize that telling untruths to our parents goes against everything you have been taught, but remember dad is changing right in front of your eyes and you need to help dad help himself and stay safe. Perhaps the car can go in for a turn up for a couple of days and see how dad handles being without a car. Now here is a really hard part, do you have POA, is something in place so that you or someone can help dad with his bills, you sure don,t want his owner shut off or his phone because he forgot to pay them, or he thought he did and he didn't,t, Make this easy, while on a visit tell dad you are going out to pay some bill and does he want to come along to pay any of his!! At this stage dad needs to feel like he has some control, as I am sure he is worried and will not say anything, make dad feel like he is doing what needs to be done all the while watch how he is handling it. Make a joke about someone trying to sell you some silly insurance thing and ask if it has happened to him, listen to his answer, if he has invested in something that seems not quit right you need to investigate and make sure no one is trying to scam him. So many out there will and do take advantage of them, especially telemarketers.....
I know that this is all so new to you and you probably think we are over cautious and that your dad is not at this stage and he is still doing okay, but in truth what you see when visiting is your dad on his best behavior, look for burnt pots in the cupboards, or rotton food in the fridge. Maybe things are not where they should be, lettuce in the freezer or food in the cloths cupboard. Perhaps he is using paper towel in the bathroom instead of tissue paper. Does he wear the same cloths all the time!! We have to turn ourselves into detectives to make sure our loved ones are truly okay or is it just a facade that they are presenting.

I don,t mean to be so negative, you should. BE commended for stepping up and being concerned about dad. You are a wonderfully son to be so concerned. Stay with us here and post often, as they say the door is always open...


sonofvasc 12-24-2012 04:00 PM

Re: My 87-year-old dad has recently been diagnosed with vascular dementia.
Hi Judy,
Thank you so much for posting. I am so glad I found this site, even though I am learning of lots of rude awakenings yet to come.
Dad really is interested in moving sooner rather than later, but I really picked a bad time of year to get this started. Doctor has to fill out forms, and is out of the office half the time these weeks. I have tried the blister packs with my dad but he said he doesn't need to use them--he remembers what to take when. (I took him to cardiologist last week and everything looked fine on EKG). One more place I cross my fingers and hope he is in no immediate danger.
Dad has plenty of food in the freezer but I don't know how much he eats when I'm not there. I bring over lots of fruit and it slowly disappears. (But there is some very old food in the fridge sometimes.) I plan to start going over more often and check what he eats then. Maybe I'll try getting in touch with Meals on Wheels.
I have met his attorney before and have sent an email, asking about power of attorney. Dad also wants to talk to her so I plan on getting there soon. I already pay his bills. For awhile now I have had access to his bank accounts and am keeping him up to date. (Once in awhile a bill goes missing--he has lost it or filed it someplace else). Usually I find all kinds of mail on his table, throw most of it away (solicitations) and he doesn't seem to mind. He signs the checks that I fill out. (While he has given to many charitable causes before, it hasn't ever been any outlandish amount--luckily, he has never given money or credit card numbers over the phone and perhaps out of habit, I can depend on him keeping it that way until he moves.
In general I am watching him more closely now. If I look at him today compared to a couple of months ago, it seems like the rate of deterioration has increased. It just occurred to me to wonder if he puts his trash out.
Thanks to your input, I plan on checking a number of things when I go back over there.

Much appreciation to you all,


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