How do I know I have Vascular Dementia?

I wonder if clouds ever look down on us and say, 

“Hey, that one’s shaped like an idiot”

How do I KNOW I have dementia?

“Sometimes I question my sanity, but the hippopotamus in my kitchen 

told me I’m fine.”

Diagnosis & Tests

If you or someone you care for is having problems with memory, language, and decision-making that seem to be getting worse, schedule an appointment with a healthcare professional, preferably a geriatrician. A geriatrician is a physician who has advanced training in caring for older adults.

If you’re having these problems, it’s best to bring a relative or close friend with you when you see a healthcare professional. I became very dependent on my sister, Cathy Vrba, and her husband, Pat Vrba. They accompanied me to doctor’s appointments, visited me in the nursing home and hospital, and Cathy became my power of attorney. It was very hard to relinquish control over making decisions for myself, but I knew I had to have help and the Vrbas’ are very intelligent people! The amount of work it takes to file for Medicaid ( I am not 65 years of age, so I cannot receive Medicare and I became uninsured when I could no longer afford to make the payments). 

If someone you know is having these problems, its best if you or another relative or close friend go with them to the appointment. 

To determine whether an older adult might have dementia, a healthcare professional will:

• Ask about the person’s medical history.

• Review the prescription and over-the-counter medications, supplements, and herbal remedies the person is taking. These might be causing changes in mental ability, mood, and behavior. (Bring or make a list of all medications, vitamin supplements, and herbal remedies to show the healthcare provider).

• Check for signs of depression and other mental and physical health problems that can cause dementia-like symptoms.

• Ask questions about any noticeable changes in the person’s physical and mental abilities, mood, personality, decision-making, or behavior.

• Ask about possible delusions or hallucinations the person may have had.

• Do tests of mental abilities including attention, memory, thinking, language, and decision-making skills.

• Do a complete physical exam that includes blood and other lab tests to check for underlying problems and reversible causes, such as infections, vitamin B12 deficiency, and thyroid problems. I underwent MRIs, CAT scans, X-Rays, psychiatric evaluations, etc. and doctors were able to give me an accurate diagnosis. 

• Possibly recommend brain scans to look for abnormalities such as brain tumors, and for evidence of strokes and other changes linked to dementia.

“Dementia diagnosis and tests”, Health in Aging 2017. https://www.healthinaging.org/aging-and-health-a-to-z/topic:dementia/info:diagnosis-and-tests/ . Accessed December 2018. 

When the doctors at the hospital finally finished all the testing and analysis, two of them came in to speak to me one afternoon. “We have a pamphlet for you to read. It’s about progressive vascular dementia. Your tests indicate that is what you have.”

“A pamphlet? Dementia? How the hell did THAT happen?? I’m a smart guy that has had his fair share of medical stuff in the past, but dementia? Isn’t that an old person’s disease? Yes, I forget stuff from time to time, but…. dementia? Progressive?? What does that mean? I thought progressive meant continuous improvement in a positive direction or an automobile insurance company. Vascular? I knew that had something to do with blood flow or lack of it. I don’t want a pamphlet, I want someone to sit with me and answer some questions.” That is when the doctors said I would have to undergo a session with the hospital psychiatrist. “Am I sick or am I crazy?”

Their drop the bomb explanation started my intense need for answers to my questions. The hard part was: my mind was already slipping, and I wasn’t sure what questions to ask. 

People forget things all the time. It is a normal part of the aging process. “Where are my car keys? Why did I come into this room? What am I supposed to be working on?” These things may get worse over time, but they are not part of dementia. 

However,

Memory problems that aren’t part of normal aging include:

1. Forgetting things more often than you used to. I would often forget my name, where I was at, what I was supposed to do that day. I made checklists, in the beginning, to remind me to shut the refrigerator door, turn off the stove, shut off the lights, put away food on the counter in the kitchen. Then I made checklists to remind me what I needed to do for the week, in full detail. When to pay bills, when to get ready to go to work, when I should start to make dinner and lunch for the next day. 

2. Forgetting how to do things you’ve done many times before.I am pretty sure Satan created remote controls for people with dementia! I eventually gave away my television and DVD player because I forgot how to use them. 

3. Trouble learning new things.

4. Repeating phrases or stories in the same conversation.

5. Trouble making choices or handling money.

6. Not being able to keep track of what happens each day.

Time and place. People who have dementia may get lost on their own street. They may forget how they got to a certain place or how to get back home.

Being absent-minded. Everyone gets distracted at times. People who have dementia can forget simple things. Examples are not putting on a coat before going outside or not using an umbrella when it rains.

Problems with abstract thinking. Anyone could have trouble balancing a checkbook. People who have dementia may forget what the numbers are and what to do with them.

Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious, fearful, or depressed.

Changes in mood. Everyone is moody at times, but people who have dementia can have sudden mood swings. They may go from calm to tears to anger in a few minutes.

Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people.

A memory problem is serious when it affects your daily life. If you forget names sometimes, you’re probably okay. Another difference is that normal memory loss doesn’t get much worse over time. Dementia worsens a lot over several months or years.

“Dementia”, Family Doctor, 2017, https://familydoctor.org/condition/dementia/?adfree=true, Accessed January 2019.