Hello I’m struggling with making the right decision of long term care or home when I go visit him in a SNF and he’s having a good day. I know that can change on a dime. Is dementia and vascular any different and if so how souls I look at it? Do the pass from another stroke or eventually have full blown dementia?
According to Google.. most people with VD pass from stroke, or heart failure.
The step-down description that Grandma'54 provided is excellent. This slow, stepped decline is what I have seen.
I compared Alzheimer's decline like walking down a long ramp. Sort of a steady decline.
Vascular dementia is more like going down stairs. Picture stairs with landings. the landings can be large or small. there is a decline then the person hits a landing and stays pretty static for a time then goes down a stair or a few stairs then hits another landing.
My Husband want from walking one day to not being able to walk literally over night. there were other things that he could do one day and not the next.
Oddly with my Husband I could tell almost exactly when he would have a big decline. He fell 8 times and within the next 12 hours or so he would have a marked decline.
I do think my husband was having small strokes with each of the declines he had and while I can not prove it I do think that it was a stroke that ended his existence (I can not say it was a "life" at that point)
The questions you have to answer for yourself are:
Can I SAFELY care for him at home? (you do not want to injure him while caring for him and you do not want to get hurt yourself)
Is my/our house set up to be a safe place for my husband? (wide halls, barrier free shower, no carpeting, no stairs...)
Am I prepared to hire caregivers that will come in and help me? (you can not do all the caregiving all the time you need a break. Minimum I would say 2 or 3 days a week for at least 6 or 7 hours)
Is he getting good care where he is? Can he remain there? and Can you provide the same level of care at home?
My late husband was diagnosed with vascular dementia in July 2018(though he showed signs a good year or so before)and he died Sept. 2020.
With vascular dementia the person usually starts with more of the physical symptoms like the unsteady gait, incontinence and loss of comprehension of the spoken word, before you notice the mental decline, That usually comes a little later. But it does come.
And with my husband, he developed aspiration pneumonia(and almost died)in Nov. 2018 when his brain was forgetting to tell his throat to close thus allowing food and drink to get into his lungs. After that he remained under hospice care in our home completely bedridden for the last 22 months of his life.
So know that your loved one won't linger on like some do with the other dementias like Alzheimer's, so just enjoy whatever time you may have left with them.
Stroke is a brain injury. It causes damage inside the brain which can effect speech, mobility, emotion regulating, personality.
Dementia is an umbrella term, covering many types of diseases or conditions - causing progressive damage to the brain. Alzheimer's Disease being the most well known with symptoms of memory loss. Some specific types of dementia have known causes, due to alcohol misuse or repeated concussions but many have no known cause.
Vascula Dementia is the term for dementia caused by vascular problems. May be the cumulative effect of many smaller strokes (TIAs), one large stroke, narrowed blood vessels, anything causing lack of oxygen in the blood supply to the brain.
Not everyone stroke survivor will go on to develop Vascular Dementia. Strokes vary - from very mild to severe. Recoveries vary widely too.
Hopefully your LO will move through acute care to rehab.
In rehab, hopefully there will an allied health team (Physiotherapy, Occupational Therapy, Speech Therapy) to assess & start along a recovery path.
It will be too early to decide where that path ends yet - home, home with supports, AL or SNF.
Wait & see.