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Posted: November 08, 2004

Practical Caregiving

Getting a Clearer Picture of a Cloudy Mind

My sister had a very hard time accepting the idea that Mom had Alzheimer's disease, preferring instead to think it was another common form of dementia, vascular dementia.

We knew that Mom had suffered a decreased blood flow to her brain which doctors couldn't treat. Later she developed TIA's (tiny strokes). Both those conditions contributed to her brain not receiving enough oxygen. After the TIA's started, she had problems being able to say the words she wanted to say, but according to everything we read that didn't mean Alzheimer's disease. She had short periods when she couldn't remember very well, and then she would improve.

But then she started going downhill much faster. Her ability to think and reason got worse and didn't improve. That's when the doctors said she had Alzheimer's disease. We didn't know what they know now about all forms of dementia. My sister did some research and found that what happened to Mom sounded like vascular dementia, and she kept telling us that it was not Alzheimer's.

I wasn't concerned about the exact diagnosis. Both appeared similar, and I needed to take care of her and get the medicines she needed. The Alzheimer's diagnosis made that possible.

Now researchers know more of the differences among the various types of dementia. Alzheimer's is one type of dementia. The next most common type is vascular dementia, which we all thought was Mom's problem. Since researching this and the next two weeks of columns, I realize Mom probably had both.

In this column I will discuss vascular dementia. Next week's column will be about Alzheimer's disease and the differences between AD and vascular dementia. In the third column, I'll cover what a caregiver should know and do when taking care of someone with these diseases.

Vascular dementia occurs when there is not enough oxygen getting to the brain through the vascular system (a network of blood vessels). Because of this lack of oxygen, cells in the brain die, leading to the symptoms of dementia.

Several diseases or conditions can be responsible for this lack of oxygen, and quite often it can be prevented with proper medicine, diet and exercise. That's why it's so important to see a doctor as soon as the signs appear. It's also possible the symptoms may be caused by an infection or other problem that needs immediate care.

High blood pressure (hypertension), uncontrolled cholesterol, heart disease, diabetes, elevated levels of fats in the blood, smoking and an unhealthy lifestyle are some of the factors contributing to problems with the blood flow to the brain.

A stroke is one of the most common causes. Dad had several strokes, and each time the effects were worse and lasted longer. I was afraid that the major stroke he had while we were in Texas was going to cause him to be a vegetable the rest of his life, but he did improve. It just took longer. He was in the hospital 2-3 weeks, and when I drove him home to the trailer, he made this comment, ?That's a nice team or horses you have up front. Where are mine?? I had learned not to argue with Mom when she ?saw ?things, so I just told Dad they were at ?his place.? I didn't know if his place would be the home when he was a child or as a young adult, but he accepted my comment and didn't talk about it any longer. Later, when his thinking improved, I mentioned it to him. He remembered my taking him home in a horse drawn carriage and we laughed about it.

TIA's (transient ischemic attacks) are another common cause. If these are not stopped, they will cause damage over a long period, each time making the effects worse. Mom had more TIA's than Dad. She would feel dizzy, weak or faint. Once she was completely paralyzed for a 15-20 minutes. She seemed to recover, but over a period of a few days we could see small signs of damage. A series of small strokes like this can cause multi-infarct dementia. This is a term that means oxygen is deprived in the brain for a short period many times rather than for one longer period.

Vascular disease, lung cancer, brain tumors and many other diseases can cause the blood flow to be interrupted or decreased en route to the brain. Be sure to see a doctor if you think there are problems.

Symptoms of vascular dementia vary with each person, but there are some generally common symptoms.

?  Quite often certain parts of the brain are affected instead of the whole brain. Some abilities will remain unaffected.

?  Sometimes the symptoms will remain the same, then things will gradually improve.

?  People will understand what is happening to them during these incidents.

Symptoms may include the following, but not everyone will have every symptom:

?  Difficulty speaking

?  Difficulty remembering

?  Slurred speech

?  Unusual behavior or mannerisms

?  Inability to concentrate

?  Rapid and/or shuffling steps when walking

?  Wandering or even getting lost at home

?  Inability to follow directions

?  Sudden laughing or crying

?  Loss of bladder and/or bowel control

Mom and Dad had the above symptoms at various times, but Mom's happened over a longer period. Mom and I would talk about how frustrating it was for her to not remember some things. She seemed to relax when we talked about it.

The doctors were able to stop the TIA's for Mom, and she continued to function several more years. Later she was diagnosed with Alzheimer's disease. Next week I'll cover Alzheimer's and how it differs from vascular dementia.

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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