Does anyone have experience dealing with a younger person (mid 50s) with vascular dementia and nursing homes?

The man's needs are more than can be provided in HIS own home (unless a team of 24 hr carers are provided & being managed adequately).

Any suggestion that a relative takes on the care of a person with needs this high into their OWN home (without such a team of 24 hour carers) is just la-la-fantasy fluff. It is a sugar coated ball of cotton-candy that 'home' is better for everyone without any basis in real world common sense or logistics.

Not every nursing home is dire.

Not every home environment is safe. Or meets the care needs.

This one song is getting very old indeed. There are so many songs in many styles & cultures.

I'd look for a different nursing home. Or better still, not a nursing home as such but a specialist memory care facility with a good track record in younger residents - possibly people with brain injury legacies, for example.

It isn't just the stroke, though, is it - that's quite a list of conditions your brother is dealing with, and he's young for all of them. Before the stroke and before you were really involved in supporting him, what was going on with his health? I'm wondering how he got to where he is now, and whether there might be any brighter prospect for him if you can only get someone to pay attention to him holistically.

I would explore the possibility of some type of group home. Nursing homes are primarily dealing with older people in the last years of life and/or with high physical needs whereas there are many kinds of group homes that help those with cognitive deficits, hopefully you can find something that gives him the possibility of companionship and perhaps even a meaningful occupation.

cwillie took the words right from my fingertips.
A Group home or even Assisted Living where the residents are more active might be a better option than a Skilled Nursing Facility.
The one thing I would make sure of is that in an Assisted Living he would not be able to leave by himself.
Living with you is a great option IF you can handle it. Can you do it yourself or will you have to have caregivers that help you. (I can say right now you can not care for someone 24/7/365 without help. ) And he will continue to decline. He will need more and more help not less. He will need more and more supervision.

I am so sorry you and your brother are going through this. He is very lucky to have you as his friend and advocate. He is also very young to be in the environment of the average SNF; most of their long term residents average age in about 82. Totally different interests and activity level. I remember having to refused admission to two residents to the facility I work at because we could "not meet their needs" in terms of appropriate activities and socialization; they were 17 and 25 respectively and our average occupant age was 80 and our activities were geared to that age group. We were the closest facility to the families involved and had a ton of staff but I knew these two young men would become withdrawn and depressed if we had admitted them.

I don't think the nursing facility he is in is willy-nilly putting him on drugs (only the facility doctors can add meds) but those doctors may be used to treating older people. He may need a new work up by outside doctors including those specializing in neurological issues in the young and in stroke victims. Can you possibly request this long distance? I know your brother is not a senior yet but possibly a call to his states dept. of health or Office on Aging could give you some helpful resources to investigate.

I personally would counsel you not to bring him to your home at this time unless you can find no other solution after some research. Unless medicine comes up with a new treatment soon, his dementia will probably get worse and it will cause a major impact in your life as well as that of your family (can they all deal with it?) even if you can get some outside assistance. Is it possible to find a facility (anywhere at this point but start closer to your home just to make it easier) that deals with a younger clientele? I would concentrate on facilities that deal with persons who have had sports injuries (yes, I'm thinking of Christopher Reeves) and/or resulting dementia diagnoses. You might want to add teaching hospitals and universities to your list of places to search - check out the big schools/hospitals who always seem to be into something Sandford, Harvard, New York Hospital, Columbia Presbyterian, Penn Medicine, Mayo Clinic, etc . I know there is a young person stoke program at Stanford (https://stanfordhealthcare.org/medical-clinics/stroke-center/programs-services/young-stroke-program.html). This type of group may be able to recommend someone that has dealt with stroke and resulting dementia dx in the young. Even if they say they can't help you always ask if you can leave your name and phone number. That's how I was able to find a good situation for one of the patients I mentioned in the first paragraph of my answer; got a call from a stranger 5 weeks after I'd told them the situation and left my name! A new program with new (if needed) meds and a living situation with a slightly younger population might see a bit of a rebound for both of you.

I wish you luck and grace (and a large cup of coffee because you could be on the phone and the computer a lot) on this journey. You are doing all that can be humanely done so be proud of yourself.
Peace.

"Nursing facilities" do not hand out medications willy nilly; a doctor has to prescribe them first, and then the facility will hand them out as written. You would be much better off being an advocate for your brother in the SNF than taking him home with you, in my opinion. Dementia is a VERY difficult condition to deal with and for a family to cope with, especially since it progresses. Are you POA for your brother? If so, you can have a meeting with his doctor and discuss the medications he's taking and see what you think. If you feel that he's overmedicated, speak up! Let the doctor know you think he's becoming more depressed and withdrawn, and ask his opinion on the matter. Go from there.

Perhaps you can make arrangements to visit him frequently and bring over small gifts, magazines, treats, things like that when you go. Are you able to take him out for a car ride or out to lunch? My mother lives in a Memory Care ALF and things have opened up recently, so we're able to go visit her in person now & give her a hug. I know that many residents of long term care have had a hard time of things the past year with the virus ruining everything; it has been depressing and isolating for them.

If you have no experience caring for a person with dementia, it can be very very difficult to do so at home unless you can afford a lot of caregivers to come in and help you. You won't be able to leave him home alone, so you'd have to take that into consideration, and how that would affect your life; if you work, have children, etc. There are just a TON of things to consider before making such a decision and how it would impact you and the rest of the household. Is he incontinent? Are you willing to change adult briefs and linens on a daily basis? How about helping him shower, since you mention hygiene being an issue? As dementia progresses, they normally HATE showering and adult briefs and can become very aggressive about refusing both. He'll need 3 hot meals a day cooked, 3 healthy snacks, activities and exercise, and you'll need to make sure the chemicals are locked up and out of his reach. Locks will have to be installed high up on the outside doors to make sure he cannot get outside at night while everyone is sleeping and wander away, as often happens with dementia as it progresses. Safety in the home is of utmost importance and has to be considered. There are a ton of other things to consider, too numerous to mention here in a comment.

Not to scare you, but just spend time here on the site reading about what goes on with loved ones trying to care for a parent or spouse with dementia at home. It's very educational and eye opening. If you decide to make such a change, please do so with your eyes wide open.

Best of luck, whatever you choose to do.

I met a middle aged lady with mild Down Syndrome & mild memory issues starting (expected to worsen). Her room was in the Memory Care section but she attended many activities in other areas.

They had a great pastoral care approach of finding what gave each resident joy & doing what they could towards that. They had the usual church, bingo, balloon games but also groups for flower arranging, a discussion group for current affairs, choir & classical music groups. A short walks group (for the more mobile) off the property.

What does this person like to do most? Would having a personal Aide come in to facilitate that help? Having a special interest is something we all enjoy.

From your profile, I can't tell if you still live far away from him, or if he is in a facility closer to you.

I applaud the love you have for your brother but I strongly urge you to NOT take him into your house unless he has the monetary resources to afford in home care.
Your life will change drastically. A full night's sleep will become impossible. You won't be able to go on trips, have a social life outside your home, unless you have someone reliable THAT YOUR BROTHER ACCEPTS stay with him to keep him from wandering off, turning all the burners on the stove on, leaving the water running, using a carving knife to open a bottle of wine, or using a metal skewer to fish a piece of toast put of the toaster. All of these things happened in my house while either my sister were present. You truly cannot let him put of your sight.
A Memory Care facility close to you will be the best. You can visit with him, but go home and live your life.
Sending you a huge virtual hug.

I am a certified nursing assistant with 22 years of experience with the bulk of it being with alzheimer's and dementia in the elderly but I have worked with a lady in her 50s with early alzheimer's who was very advanced in her symptoms. The only way to get anything done with her was to play Pat Benatar music on my cell phone which she would automatically calm down for and sing along. She couldn't speak full sentences but could sing every word of "We Belong" by her favorite artist, Pat Benatar. I was named the only CNA or staff member who could help this lady for which I was honored and I shared my tactics with the others especially when I knew I was leaving the company. She is on my mind daily and I left there 3 years ago.

If you placed him in a facility, you realized that you can not care for him at home. The dementia will not get better and probably not any physical issues related to the stroke. Please keep conversations going with staff, his primary care doctor, and his neurologist. He will do best with a consistent routine, more interaction with others (very hard to do with COVID pandemic), frequent visits (phone calls, video phone calls, and in person visits) from family and friends. AND psychoactive medications that are either under control of his neurologist or a geriatric psychiatrist. It does take awhile for psych medications to become effective and each person will need adjusted doses and medications to find just the regimen that works.

Your job is tough - be his advocate and be his encourager.