Caring for someone with vascular dementia: how can live-in care help?
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Live-in care
Vascular dementia is the second most common type of dementia in the UK, and those living with the condition will likely need increasing levels of support as their symptoms progress. In this article, we’ll look at the kind of support a person may need at the different stages of dementia, as well as how live-in carers can help individuals and their families navigate what can sometimes be a difficult or overwhelming time.
If you or a loved one has received a diagnosis of vascular dementia, you may have noticed that some daily activities are becoming harder to manage. Memory problems can make it difficult for older people to carry out basic tasks when it comes to staying independent at home, such as managing appointments, preparing meals safely, or running errands and paying for shopping or utilities.
What causes Vascular Dementia?
Vascular dementia can be caused by a number of things, but in the simplest terms, the disease results from reduced blood flow and damage to the brain. The varying types of vascular dementia have some symptoms in common, including memory loss, difficulty in problem-solving, communication and language issues, a deterioration in spatial awareness and difficulties in decision-making. It’s important to understand that every experience of dementia is unique, so certain symptoms may be more pronounced in some cases of vascular dementia than others. However, in almost all cases, they will have some impact on an older person’s quality of life.
Stroke-related dementia
A stroke happens when the blood supply to the brain is suddenly cut off – often by a blood clot blocking a blood vessel. How severe the damage is can depend on which vessel is blocked and how long for. A stroke can lead to the onset of vascular dementia over time.
Post-stroke dementia
Not everyone who has a stroke will go on to develop vascular dementia in later life. The Alzheimer’s Society estimates that around 20 percent of stroke survivors will develop post-stroke dementia within six months.
Single-infarct and multi-infarct dementia
This is dementia caused by one or more smaller strokes. The stroke may be so small that the person doesn’t realise they are happening, or symptoms may only last a few minutes because the blockage is able to clear on its own. When symptoms last less than 24 hours, these are commonly known as a ‘mini – strokes’ or transient ischaemic attack (TIA).
Did you know
- It’s estimated that 180,000 people in the UK have vascular dementia.(NHS)
- Having a stroke can more than double your risk of developing dementia. ( Alzheimer Society of Canada)
Caring for early-stage vascular dementia at home
It can be difficult to know what to do in the early stages of vascular dementia – whether you’re living with the condition yourself, or supporting a loved one. The Stroke Association recommends taking the time to do the following after a diagnosis of dementia.
Talk
Talking about a progressive condition is rarely easy, and there’s no playbook for how you should handle it. Be prepared for lots of different emotions. Create a comfortable environment that’s welcoming of all thoughts and feelings – free of judgement. If you’re not the person who’s been diagnosed, make sure you understand their wishes for the future, so that you can feel confident advocating for them in the months and years to come.
Sometimes it’s easier to speak to a stranger – especially if you’ll be the one taking care of a loved one with vascular dementia, as the physical and emotional impact can be huge. Using online forums or local support groups to talk to other families that are dealing with dementia could be helpful. You may also wish to speak to your GP about support groups or mental health therapy or find a private counsellor.
Learn
The more you understand about vascular dementia symptoms and progression, the better you’ll be able to prepare. Talk to the doctor treating you or your loved one and make sure you understand the stage of the condition and how it’s likely to change. Speak to your council about support you can get such as funding and benefits you can claim, or free adaptations to make your home safer. If you’re currently working, you may want to speak to your employer if you’re comfortable doing so to see if you can adjust your hours, or put special arrangements in place to make things easier.
In the early stages, you may also begin to notice some new symptoms too. While this can be worrying, there are things you can do to make day-to-day life easier and protect independence for as long as possible.
Slowness in thinking and thought – a person with vascular dementia may need extra time to consider and answer questions. They may respond better to simpler ‘yes, no’ questions.
Memory problems – They may need help managing appointments, a designated place to keep important items like keys, and reminders to take medications.
Feeling disorientated or confused – they may need doors, rooms, and cupboards labelled, and help keeping things organised around the home. They may need someone around to ensure they don’t wander in the middle of the night or to reassure them if they become confused about the time of day.
Problems with making decisions or understanding – They may need someone who knows them well and recognises the best time to approach decision making, and can make regular checks that their hearing aid is working, or they have their glasses on.
Speech and language problems – a person with vascular dementia may find it difficult to find the right words or follow a conversation. They’ll likely need someone patient to speak clearly with plenty of eye contact and to prompt them if needed. They should also be encouraged to join in conversations with others where possible.
Problems with perceiving objects and visuospatial skills – they may struggle to judge distances and find it harder to do things like walk up stairs, or park a car. They’ll often need someone to help them remain confident, ensure their environment is well-lit and free of clutter, and help them to do the things they enjoy. For example, if they’re a big reader but now struggle to focus on books or a kindle, try audiobooks instead.
Problems with mood – They may experience depression and anxiety, and changes in their behaviour. Having someone around to support them can help manage these instances in a gentle, calm way, and raise the alarm with the right health care provider if they need additional medical treatment. Interactions with other people or taking part in activities that provide a sense of purpose or achievement can help too.
Caring for mid to late-stage dementia at home
In the mid to late stages these symptoms can get worse. A person may need additional help with communication – using visual aids like pictures. They may need signs around the home to help them find the bathroom, or forget the names and faces of people they know. Some of the later symptoms of dementia can be quite overwhelming or upsetting if you’re not prepared for them, or if you’re unsure how to manage them.
Hallucinations or delusions – when someone sees or experiences things that aren’t there can be distressing for everyone that is present. A person with dementia will often need someone to offer reassurance, remind them they’re safe, and offer a distraction.
Sleep disturbances or over sleeping – People with dementia may struggle with a range of sleep disorders. They may be unable to sleep at night (insomnia), wake a lot during the night, or sleep a lot during the day. Over time this can cause exhaustion which can lead to mood and behaviour problems, and put a lot of pressure on the family. Over the counter or prescribed sleep medication is rarely recommended to people with dementia, so sleep disturbances in people with vascular dementia requires a lot of specialist care. A person may need someone to keep a diary of their sleep patterns and night time activity to help their GP understand the best course of action. They may need a professional night carer who can be nearby and offer support so that others in the home can get some rest.
Poorer movement – physical activities can get difficult as vascular dementia progresses, causing problems with balance and coordination. A person may need someone to help them get around the house or outdoors safely. They may be advised to make changes to how they do things by an occupational therapist or need help making adaptations or using a walking aid.
Tips for supporting a person with vascular dementia at home
- Try to keep a routine, such as getting up and eating at the same time each day.
- Help the person write down to-do lists, appointments, and events.
- Schedule things that they enjoy doing at the same time each day.
- Consider a system or reminders for medication, such as a pill box with a lock and alarm.
- When doing intimate tasks like dressing or bathing, allow the person to do as much as possible themselves. If you do need to support them, tell them what you are going to do, step by step, while you help.
- Buy easy-to-use clothing, such as clothes with elastic waistbands, fabric fasteners, or large zipper pulls, or take your favourite items to a tailor to be adjusted
- Serve meals in the same place and give the person enough time to eat.
How live-in care can help
People with dementia may wish to remain in their own homes, and in fact, a familiar environment can be beneficial to someone with declining cognitive function – as it can help minimise confusion.
With a live-in care package from a provider such as Elder, you or your loved one can receive specialist dementia care. A live-in carer will not only help you or your loved one with day-to-day tasks such as cooking, cleaning and staying mobile, but they’ll also be able to assist with those personal care tasks which may have become a struggle, including getting to the toilet, getting dressed and bathing.
They’ll also be able to take them to and from various medical appointments and social events, provide peace of mind and ease pressure on family caregivers. A professional carer with experience in vascular dementia will ensure the person they’re caring for receives the highest standards of care and benefits from meaningful interaction with the outside world.
Learn more about live-in care
Take a look at more Elder guides on the benefits of live-in care.
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