Coping Strategies for Vascular Dementia Caregivers
- Jun 23, 2011
Vascular dementia (VaD) is one of the most common types of dementia in older adults. It causes a subtle, progressive decline of memory and other brain function, such as thinking, learning, remembering, organization skills and complex visual processing, and is caused by reduced blood flow in the brain.
VaD may be caused by a stroke, in which the blood supply to the brain becomes blocked, resulting in permanent brain damage. When caused by a single stroke, it’s called single-infarct dementia. When caused by a series of small, often unnoticeable strokes, it’s called multi-infarct dementia.
As a caregiver for someone suffering from vascular dementia (VaD), you may face difficult challenges as you try to provide care and understand the behavior changes of the person you are caring for. Understanding the behavior of a person with VaD can help lessen these difficulties.
People with VaD may exhibit the following behavior:
- Problems with thinking, walking and performing everyday activities are the most prominent symptoms. Many people with VaD also suffer from depression, which can result in less motivation to perform their usual activities or a lack of interest in the world around them.
- Extreme anxiety about daily life, which may be exhibited by asking questions and repeating information about once familiar events and/ or people, preparing for appointments/day care well ahead of time and using notes and reminders endlessly.
- Apathy or a lack of initiative about tasks that used to be routine, though now feel overwhelming. For example, the person who always enjoyed puzzles but no longer does them because they are too overwhelming and require skills he/she no longer possesses.
- Frequent agitation may occur as people become less able to interpret their environment and control or express their feelings. For example, a person with VaD may strike out at their caregiver.
Coping and support
Caring for a person with vascular dementia can be very stressful for both you and your loved one. You can make the situation easier by providing a stable and supportive environment.
A stable environment starts with a stable, healthy you. It’s easy to lose sight of your own needs when your loved one is dealing with dementia. But taking care of yourself isn’t optional. Stress and burnout are common in caregivers - and that isn’t a good thing for you or the person you’re caring for. Nurturing and protecting your own emotional and physical health isn’t selfish. It’s the best thing you can do for the person you love.
Tips for caring for a loved one with vascular dementia
- Avoid changing things up. Your loved one will feel more comfortable and less frightened or agitated when he or she is on a regular routine and in familiar surroundings.
- Use calendars and clocks. Place large calendars and clocks around your loved one’s living area. They can help people with dementia reorient if they’ve forgotten the date or time.
- Keep your loved one busy. Encourage your loved one to continue physical and social activities as long as possible. Whether it’s going for a walk or spending time at the local senior center, it’s important that he or she has regular activities to participate in.
- Provide plenty of stimulation. Make sure your loved one’s room is colorful and inviting. Do they have a nice view outside? If not, you can bring the outdoors in with some flowers or a plant. Also make sure they have a TV, radio, or other things to look at and do.
- Tell your loved one what you’re doing, and why. If it’s time for dinner, say so. Don’t just lead them into the kitchen without explaining what’s going on. Be sure to communicate, even if you’re not sure your loved one understands. Even if he or she doesn’t understand your words, your tone of voice and body language can provide reassurance.
The following strategies may help you cope with caring for someone with VaD:
Have realistic and attainable goals. Often, caregivers try to make everything all right and strive for unrealistic goals, though end up exhausted and frustrated. Perhaps your goal is to be sure that your patient is clean, comfortable and well fed. However, accepting that success may be only 80 percent will allow you to enjoy time you might have otherwise spent fretting about not reaching these goals. Although difficult, try being comfortable with a less than perfectly groomed spouse or perfectly organized home.
Control vascular risk factors. While there is no current treatment to change the effects of VaD, preventing risk for additional vascular damage, particularly stroke, can be an effective way to lower someone’s risk of worsening dementia. This can be done by encouraging exercise, abstaining from smoking, drinking alcohol in moderation and possibly changing diet to reduce salts and saturated fats. It is also important that people with VaD have their blood pressure checked and their blood fat levels measured at least once a year. In addition, some risk factors for stroke, such as High Blood Pressure, heart disease, diabetes and High cholesterol can be controlled with drugs. Don’t hesitate to discuss these options with your doctor. If vascular risk factors are not attended to properly, recurring strokes and worsening dementia symptoms may occur.
Anticipate misinterpretation by your patient. A person with VaD may no longer be able to accurately interpret verbal or non-verbal cues, which can cause anxiety and frustration in both you and your patient. Try to be clear and concise in your communications - repeating things as needed using the same words or message. Reduce extraneous noise and distractions when trying to communicate. Do not use confusing pronouns, such as he, she or it, but rather names and specific titles.
Remember that all behavior has a purpose. Many experts believe that some of the behavioral symptoms that people with VaD exhibit, such as shouting or striking out, are meaningful. Although the person does not generally intend to disrupt things or to hurt someone, they do intend to be noticed and perhaps communicate a need that is not being met. In addition, it is important to remember that while these behaviors are meaningful, they are not intentional and the person is not doing this “on purpose,” but more likely trying to convey a message that they can longer explain in words. Slowing down, trying to see the world through their eyes and trying to respond to the “feeling” behind the behavior, rather than the behavior itself, may prevent an emotional crisis.
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