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I am curious if anyone can educate me on symptoms of late -stage vascular dementia. What type of behavior do you or did you see when vascular dementia progressed to near the end of life?

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This is a tough one to answer since it really depends on which areas of the brain are not getting a good blood supply. Symptoms coincide with degree of brain injury to the area of brain affected. A better person to ask is the neurologist who is managing the care of the loved one with vascular dementia.
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My husband recently passed away after seven years with vascular dementia. Symptoms quickly progressed at the beginning of this year. He did not want to shower regularly, did not want to take his medications (improved after crushing and mixing with applesauce), and no longer knew our children or me.

He was a sweet man, but his moods reflected my moods. If I was angry with him, he would "dig his heels in" and not do anything I asked. If I stayed calm even, though my head was exploding, he would cooperate. During the last week of his life, he was unable to swallow or walk.

He was a wonderful husband, father, and grandfather. I miss him every day and very much regret the times I was angry with him. Just remember this is your loved one and the person you knew is pretty much gone. There are still good days, but they are different. Remeber the good days, forget the ones that were not.

Take care of yourself. Get some help if you can. This is a wonderful forum to vent and get advice from others in the same place as you. ((((( Hugs to you)))).
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I too would like to hear more about what late stage vascular dementia is like. My wife has vascular dementia as the result of a severe stroke over 2 years ago and I am taking care of her. She is unable to walk or talk and is on a feeding tube but seems medically stable at the moment.
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Msblcb: My DD's father in law suffered from vascular dementia. He was getting help via a hyperbaric chamber when he had a massive seven centimeter hemorrhagic stroke, which unfortunately ended his life well before age 70.
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My mom has vascular dementia/small vessel disease. Pretty sure this was brought on by overall health in her younger years, and, let's be honest, genetics.
Right now mom is stable, she knows who we are, what day it is, and how to order me around. The last part is on me to handle.

But what I notice is, making a plan. She has all these ideas and starts sentences with, "I gotta..." and says it, but it goes nowhere. I used to think that was bait for me to say "ok mom I'll get that done," and years ago it was and I would drop it all to do it. But if the "I gotta--" doesn't end with an emergency or a health care thing, it has to go into the ether.

I suspect we are approaching the end stage of it. Sometimes hygiene and basic self care are either resisted or too much trouble. I will ask a very simple question and I'm looked at like I just set the house on fire. Sometimes it is, "not worth it to eat for just one person," and I'm finding tons of leftovers in the fridge that our angel given caregivers have prepared for her. "I don't want it."

As others have said, my mom no longer has that old southern dry wit one liner sense of humor she used to have. She has no humor. Sometimes if we joke with her she takes it as an insult. We had to quit.

Long story even longer as I've made it - hygiene basic self care, knowing you need to eat but do not, in our case alcoholism, not caring about what's around you, not caring about yourself innately, and of course, general safety and falls that they would otherwise hopefully look out for. My mom left a burner on the stove on one night, ALL night. She was mortified when she realized it, but even more mortified at that fact that, realistically, she didn't.

Good luck to us all.
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My mom is 93, has vascular dementia, and still insists on living alone in her home. Her doctor told me that every time a crisis occurs, there is a corresponding nosedive in cognition . Mom has taken a few hits over the last two years: a fall resulting in a broken arm; the sudden death of my brother (mom’s firstborn;) and then a car crash where she walked away but her car was totaled. Each incident brought noticeable significant decline. The doctor said she is medically frail. All it will take, he said, is another fall, a UTI, even just a head cold, and she won’t be able to live on her own anymore.
My understanding is that this is a progression that will conclude in inability to eat and walk, and pretty much a total loss of recognition and memory. From what I have read, it happens faster with vascular dementia than it does with other forms of dementia.
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My mother has VD she has been fairly stable for the last three years. Her current status has reached a a pseudo stable point. She had one lapse of forgetfulness where she nearly burned down her apartment. We took action at that point. As it stands what we have noticed is her word recall is not as quick as it once was, and she is hyper sensitive to sound and temperature.
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To all those that are dealing with dementia and/or grief. My two cents: My loved one passed away February 2022 after dealing with LBD for about four years. She broke her hip about three months before she passed. Last residence was in hospice in a NH. She tested positive for COVID twice in the last two months. Death certificate said "Alzheimers." Never previously diagnosed with Alzheimers. I say COVID took its toll and she eventually succumbed to it. My hats off to all those who are dealing with these dementias and who are grieving or will grieve. I still cherish the sharing on this forum. It helps put my experiences into perspective. We're all in the same boat and doing the best we can. Wishing all of you the best.
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My mother had vascular dementia for seven years. What got to me was the loss of her emotions. She had a fantastic sense of humor and was a great crier at movies and music that moved her. All of that disappeared almost overnight.

Her decline was fairly steady throughout those years. When there was a crisis -- medical or my dad's death -- she took a deep dive and never quite came back cognitively to where she'd been before. The isolation during Covid did a huge number on her as far as knowing me, my brother, or the grandchildren, and I don't think she ever did know quite who I was from that point on. It didn't help that she couldn't see either, so my visits to her window were largely for my benefit, not hers.

She was in the hospital for two weeks in December 2020 and went on hospice care on January 1, 2021. She never ate solid food again -- she had no interest, not swallowing issues -- and her cognition continued to decline steadily. She had an imaginary husband who moved into her brain immediately after my dad's death, and even he slowly faded away.

She died peacefully in her sleep seven months after going on hospice. The official cause was dementia, but I think it was heart failure.
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ML4444 Jul 2023
Im sorry for your loss.

The final cause of death will always be some type of organ failure. Alzheimers would be an underlying cause.
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Ms, we were told survival was generally 5 years tops. It was prescient.

When she had her wits about her, mom quite explicitly said she never wanted to live with dementia. So I did not do anything to prolong her life.

My brother insisted on asking mom if she wanted a pacemaker to which she said yes to. Couldn't fight that.
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My mom had VaD. She declined over the course of 4 1/2 years.

I went on a vacation for two weeks and came back. She had clearly declined. I pointed this out to my brother. He said, no, she was fine. I held my peace.

A few days later he called and said, I see what you mean...

A day after that, her aide was assisting her in the bathroom, gave her the same instructions as always, to hold on. But mom didn't hold on to the bar this time.

Catastrophic fall. We put her on hospice and she died a few days later.
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Msblcb Jul 2023
So sorry for your loss. Thank you for the feedback. Vascular sounds more like rapid declines rather than slow methodical declines. Perhaps that is what happened to my mom, I second guess myself that I could have responded differently. I felt I reacted rather than being proactive. Hope this makes sense,
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As the declines happen they may happen more often.
In all probability the person with Vascular dementia will most likely have a major stroke that will cause their death.
I think my Husband had both Alzheimer's and Vascular Dementias.
He would literally go from being able to do something one day to not being able to do it the next day. I could almost pinpoint each big decline he had as he would have a fall just before the decline. (never hit his head they were controlled "falls")
I think each of these were strokes.
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My mom actually passed in November of last year. I have been a bit tortured over her decline.
6 weeks before her death she walked with a walker, ate pretty good, knew my name but she started to refuse meds.
5 weeks or so she started getting very agitated and suspicious of everyone.
4 weeks she got “asymptomatic covid”.
3 weeks she started to refuse food. It was difficult to get her to eat anything. 2 weeks she was diagnosed as “failure to thrive” and did not know my name, 1 weeks she was still walking to the bathroom with a walker.
3 days she was in bed and could not get up.
She took her meds the day before she died.
The day she died she had terminal agitation. Very hard day.

She did have congestive heart failure. The death certificate reflected vascular dementia.

I guess I am rehearsing the info and trying to answer something that is impossible to answer. She did not decline with the typical dementia symptoms. I know vascular can be abrupt and in steps.

Perhaps I need to call my counselor again. Trying to figure this quick decline out is driving me crazy.

No question here, just curious.
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Beatty Jul 2023
So sorry for your loss.
I am not a Doctor, have no medical training & didn't know your Mom. But I'd blame Covid. Asymptomatic or not. No symptoms like runny nose, sore throat, fever - but - what havoc was being caused internally? Inflamation? Brain? Lungs?

I've seen Covid cause delerium time & time again (just as it does with UTI, pneumonia & other infections). Delerium causing confusion, disrupted sleep, disrupted or refusal to eat, agitation, memory deficits. That's how your weeks 5,4,3,2 read to me. Delerium. Weeks 2-1 could be the disease itself turning more severe.

I have three elderly relatives severely effected by Covid. Two never cognitively the same after Covid, now worsened memory. Another required all heart values replaced.

For sure speak to a councellor if it helps. Sadly, we don't always find answers to all our questions.

Passing 'with Covid' as one of the factors is a natural death in my book. I hope you can find peace going forward.
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My late husband who had vascular dementia had swallowing issues the last couple years of his life and almost died from aspiration pneumonia(and developed sepsis and septic shock from almost dying), and I had to puree all his food for a while until he slowly graduated to just soft foods.
He also became completely bedridden where he remained in our home under hospice care for the last 22 months of his life.
His comprehension also got way worse.
I hope that by now you have brought hospice on board as they can better tell you what to expect at end of life as everyone is different. And with vascular dementia being the most aggressive of all the dementias with a life expectancy of only 5 years, it doesn't hurt to bring them on board sooner than later.
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You have a few really good answers here, and likely will get more. You will also get a wealth of information online if you type into your favorite search engine the words "end stage vacular dementia symptoms".

I would also discuss with doctor if you have a good one and are POA.
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My 100-yr old Aunt was still semi-mobile (with assistance). She said awful things and was delusional and negative and insulting (opposite what she was pre-dementia). Screamed for her sister whenever she left her sight. She was healthy but would forget she couldn't walk without assistance, so had a few falls that resulted in broken bones. Finally one night escaped the barriers we had in place to keep her safe, she fell and broke her hip, which we chose to not have the partial surgical repair. She was about to go into LTC when she passed away (probably from a clot). She had dementia for about 15 years. Her sister just turned 104 with no dementia. Everyone's dementia journey can be different. There's lots of variables that can happen so it's difficult to predict any "end of life" scenarios.
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Swallowing difficulty so needing a pureed diet, total incontinence, non ambulatory, mostly non verbal, sleeping 20+ hours a day, obvious frailty. My mom had periods of lucidity right up to the end of her life. If they are physically stable this can go on indefinitely, my mom was in NH 18 months before she succumbed to aspiration pneumonia but there were people like her there when she arrived that were still there when she left.
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