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My dad was seeing things having hallucinations and we decided to take him to a neurologist. He had had a heart valve replacement 2 months prior, home next day, another hospital stay a week after for pancreatitis and his mental started going down. We went to the neurologist appt and he had an “episode” that mimicked a stroke. But he didn’t have a stroke. He had old strokes. Admitted him to the hospital and from Thursday to Monday he went downhill and is a different person. Diagnoses is vascular dementia. This was all so sudden. I thought dementia developed over time. They said the chronic strokes combined with traumatic events (heart valve surgery, pancreatic hospital stay, going to the Neuro doc) caused him to “step down” mentally. I need this to make sense because it does not. In don’t see my father living much longer this way.

My Husband was diagnosed with Alzheimer's
I suspect he also had Vascular dementia.
I compare Alzheimer's to walking down a long ramp. A somewhat slow and steady decline.
My Husband's decline was slow and steady then he would take a step down all of a sudden, level off and continue the slow decline.
He would be able to do something one day and literally overnight he would be unable to do the same task the next day.
Since he was on Hospice I kept track of each decline and if I called 911 for a Lift Assist I would write that on a white board I kept.
Looking back at the calls for a Lift Assist each one of them coincided with major decline. I do not have any proof but I suspect that each of the episodes was probably related to a mini stroke.

Your dad would probably qualify for Hospice. I know that is a scary word for many people but it does NOT mean end of life. and it does not necessarily mean that he has only 6 months. What it does mean is that he has a life limiting, untreatable condition that at some point will take his life. As long as he meets the guidelines that Medicare has established for recertifying someone he can remain on Hospice. (my Husband was on Hospice for almost 3 years)
What you will get is support, a Nurse that will come see him at least 1 time a week the nurse will check his health, order medications, and any medical equipment that you need. And a CNA that will come 2 times a week to give a bath or shower and order all the personal items that will be needed. Briefs, wipes, gloves, ointments, absorbent pads. You will have a Social Worker, Chaplain as part of the Team assigned to him. You can also request a Volunteer to come stay with him for a bit once a week. Medicare also covers Respite Stay each year so that you can get a real break.

((hugs))
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mywadofclay Nov 19, 2024
Excellent information, thank you so much!
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Glad you updated your post. Hallucinations often go hand and hand with Lewy Body dementia and not vascular dementia, but it's possible that your dad may have both as having multiple dementias is very common.
Being in the hospital for any length of time can also cause what is called hospital delirium too.
Because there are so many different dementias and doctors still have a lot to learn about them all, loved ones often get misdiagnosed.
But if in fact your dad now has vascular dementia which is the most aggressive of all the dementias with a life expectancy of just 5 years, his decline will be much more noticeable than say someone with Alzheimer's which is the slowest progressing of all the dementias. And to me that can be a blessing as we don't have to watch our loved one suffer quite as long.
My late husband was diagnosed with vascular dementia in July 2018, after showing signs a good year prior, and he died in Sept. 2020, and I am grateful that my husband didn't have to suffer any longer than he did.
So I will just say to enjoy whatever time you may have left with your dad, and make sure that you leave nothing left unsaid.
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mywadofclay Nov 19, 2024
Thank you so much for the information 😊
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I should add that some of the "typical" signs you would see in a person that is having a stroke can EASILY be missed in a person with dementia.
The speech of a person with dementia is not always easy to understand so if they are slurring their words or if the words come out "garbled" you may think that is "normal" for them.
Trouble walking, talking, understanding, facial weakness, balance, trouble swallowing and many others. are signs you might look for if someone is having a stroke but are par for the course in a person with dementia.
So if you "miss" the signs of a stroke don't blame yourself it is dementia that is dealing another bad hand. in a sucky game of life!
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I haven’t experienced this in a family member but have heard plenty of people relate of times one event precipitated a huge change in an elder. Seems we don’t fully realize the impact of hospitalization on many seniors. In my dad, a few days in the hospital equaled his days and nights becoming confused, his walking ability diminishing to a lower ability level, and his energy taking a hit. He’d always return to a new, but slightly lower level of function. Strokes can cause far more damage than is readily seen. I’m sorry you’re going through this with your dad, it’s devastating, hope he will have peace soon
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mywadofclay Nov 19, 2024
Thank you so much ☺️
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"Old stroke" =

Post-stroke recrudescence (PSR)

This is when someone experiences a brief recurrence of stroke symptoms they've previously recovered from. It's fairly common, affecting about 10% of people who seek medical attention for transient neurological issues. Symptoms are usually mild and last less than a day. 

Ischemic stroke recrudescence

This is a rare condition where someone redevelops symptoms of an ischemic stroke they've previously recovered from. Symptoms usually develop about four years after the initial stroke.

source: AI browser search

Was he ever tested for a UTI? Besides a stroke, a UTI can "suddenly" create dementia-like symptoms.
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mywadofclay: His neurological function may have weakened if had 'mini strokes,' known as T.I.A.s (Transient Ischemic Attacks). Bear in mind that hospital delirium may be a factor also.
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II can start off by saying I don't have any answers for you I'm so sorry. But I can say that yes, I am dealing with that right now with my 86-year-old father. We've known that he's had memory issues for years probably 10 years. Starting off very very mild of course. Worsening in the last couple months. He lives alone now my mom passed away 10 years ago he just lives in senior housing but there's no care provided. Still drives but he is quite combative and has turned all of his anger on me and I am his only child left. Very very difficult to deal with him because in essence he hates me. I do not have POA of his finances, just Medical. On November 1st it was brought to my attention by his landlord that he was talking and not making sense and my adult sons talk to him on the phone and said something was terribly wrong and to call 911 so I did. He just ended a 18-day hospital stay. Physically, he is years younger than his age but mentally they have diagnosed him officially now with vascular dementia. I can't believe how fast it happened. 2 weeks prior to his Hospital entry, he was pushing his great-granddaughter around in a stroller at an apple orchard picking apples and playing games! And driving he's always been driving. Fast forward to November 1st when he couldn't say who was president or what year it was basically nothing. The hospital because they found nothing wrong with him physically, forced him out yesterday. There is no war for him to go other than back to his apartment where he lives alone. So yes I am shocked at the difference and the fact that he believes that people on the TV and in photographs are real people that are looking at him and talking to him. Our situation is compounded by a very poor caseworker in the hospital that told us he made too much Social Security to qualify for Medicaid and therefore since he has no other funds, there was no placing him anywhere. That's a story for another time but I do understand how quickly vascular dementia moves. I'm about to go find out how his first night alone went and I am terrified. Luckily his vehicle has been taken but since he's in such great shape I would imagine he will head out on foot and get lost immediately. I I'm sorry this was made more about my issue than yours but I just want to say I totally understand fast acceleration of dementia
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CaringWifeAZ Nov 19, 2024
Thank you, Pleasehelp, for sharing your story.
I think everyone's story helps us as we might find a similarity in our life that we can relate to.
I'm surprised the social worker gave you no options other than returning your father home to live alone!
The next time he is hospitalized, refuse to pick him up. The hospital won't want to keep him indefinitely, so they should find a skilled nursing rehab or long term care to transfer him to. Medicare will pay for 20 days inpatient skilled nursing rehab, and up to 100 days with a co-pay, but only under certain conditions.

Try contacting the county social services department directly and help your father apply for medical assistance (Medicaid).

Perhaps he does have enough in Social Security income to pay for a skilled nursing facility. Check around. Ask what the cost is at different facilities, and when you tell them he doesn't have enough income, they may be able to direct you to some other options.

He might be able to afford an in-home aide to check on him and spend a few hours with him during his most vulnerable time of day.
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May I offer my experience. My Dad had by pass heart surgery at about 82. It was traumatic as cardiologist said they “lost” him 3 times before surgery completed. Following this surgery the dementia developed. Two heart specialists informed us that about 45% of individuals coming out of heart surgery can develop vascular dementia. It seems reasonabe to assume age and other health concerns may be involved. I found being”his best friend” helped us care for him. He lived with me until he passed about 6 years later. My prayers are with you and your family.
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Our experiences are similar. My wife had a stroke about 3 years ago and suffered speech and memory issues, but not that most would notice. She was recently diagnosed with breast cancer, and after the anesthesia (and angst) for her surgery, her symptoms came on very quickly. An MRI was prescribed a few months later and a sedative was needed to keep her calm, resulting in added vascular demensia symptoms. We see almost daily changes.
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I feel your pain, my mom had a 1 stroke and developed vascular dementia and she went downhill at an alarming rate. Now we are pretty much at the stage where everything has to be told to her several times, speech is very hard to understand. She doesn’t remember certain dates or her whereabouts. She has even wandered around last winter. She has had so many tests but they can’t tell us much other than she has vascular dementia. Unfortunately. this is something we may never understand and it sucks. None of makes sense but know you’re not alone in this.
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