Supporting someone through the 3 stages of vascular dementia

If you care for someone with vascular dementia you might feel anxious and uncertain about the future.

Taking time to plan how you will look after them, and your own needs, can help your loved one to live better with the condition and help you maintain a more positive relationship.

Early stage 

Dealing with the diagnosis

Everyone’s response to a dementia diagnosis will be different. Some will feel anger, fear, or grief. Others will be in denial and not want to talk about it.

Ask them what support they might need. Let them know you’ll be led by them.

While difficult, it can be helpful for family members to discuss the diagnosis and agree on approaches to cope.

You can gently encourage the person with dementia to speak about it, if they feel able to. Ask them openly what support they might need and let them know you’ll be led by them.

Informing yourself

Learn as much as you can about vascular dementia and how to manage the symptoms from a reliable source.

Informing yourself early on means you’ll be better able to cope with future challenges. 

Planning for the future 

Discussing a person’s preferences can help them to feel a sense of control and make decisions about the future easier for the family.

The person with dementia can think about a ‘lasting power of attorney’, which is a legal document that lets them appoint one person or more to take decisions on their behalf.

They can cover care, property and finances. But it must be done while the person still has the mental capacity to make their own decisions. 

A dementia diagnosis can open up government financial benefits.

Less formally, it can be helpful to discuss how they’d like to be looked after as the condition progresses. For example, they might want to stay in their own home as long as possible. 

This could be written down and regularly reviewed – Dementia UK has a useful 'Advance Care Plan’ template.

A dementia diagnosis can open up government financial benefits including Attendance Allowance and council tax discounts, so it’s worth also checking on the UK Government website.

Focus on what they can do now

It can be easy to feel overwhelmed if you’re anxious about the future. But try to make room for the here and now. 

Help the person with dementia to continue to do the things that they love. 

Restarting a previously loved hobby can boost a person’s mood and memory.

A loss of confidence following a diagnosis can sometimes stop people going out. You could encourage them to keep up with friends or find new ones through a local support group. You could offer to give them a lift to their get-togethers if that’s helpful.

If work was an important part of their life and they’ve had to give it up, perhaps they could look into volunteering or restarting a previously loved hobby like crafting, painting, doing puzzles, dancing or spending time with animals. These can all boost a person’s mood and memory.

Having a healthy lifestyle together

Vascular dementia is caused by problems with the blood supply to the brain.

Healthy lifestyle changes that can help to slow the condition’s progression include:

• eating less saturated fat, salt and sugar
• being physically active
• keeping to a healthy weight
• giving up smoking
• cutting back on alcohol.

It may be easier to make these changes together. For example, go for regular walks, or garden together, or switch to zero alcohol drinks.

It is important to keep high blood pressure, cholesterol and diabetes under control. If the person with dementia is struggling to keep up with their medicine, see if their GP or pharmacist can help.

Middle stage 

Staying independent

As daily tasks become more difficult for the person with dementia, families can sometimes rush to take over. It’s better if you can help them to stay as independent as possible.

Simple changes to their home can help. For example, picture labels on cupboards and doors could show where spoons are kept, or where the bathroom is.

Ask their GP for a referral for an occupational therapist to do an assessment and suggest changes. 

Assistive technology, such as fall detectors and plugs that automatically open if taps are left running, can also help keep the person safe at home.

If you’re worried about them getting lost, a tracker in their bag or on their phone can help them to continue to go out on their own.

Getting support

Your local authority’s social services can do a ‘needs assessment’ if someone is struggling. This can take a few months. They will then create a care plan, which might mean daily visits from a care agency, a dementia day care centre, or respite care.

Sharing the load will allow you to feel less tired and frustrated and able to keep supporting them.

You may want to look to other sources of support. Some families create a rota or WhatsApp group on their phone so that friends and family can work together to provide support. 

If someone offers help, try to accept it. Sharing the load will allow you to feel less tired and frustrated and able to keep supporting them.

Dementia cafes, dementia gardening or walking clubs can be good ways to meet others with the condition. It’s also a chance for loved ones to meet others in a caring role.

Online forums, such as those run by the Alzheimer’s Society, can be a useful place to share experiences and tips.

Recording memories

Looking at old photos and videos, listening to music that was meaningful in their past, or even favourite scents, can be therapeutic for someone with dementia. It can also be a chance for their family to learn more about what is important to them.

You can think about capturing some of these memories by writing them down in a book or saving mementos in a box. This can be a source of comfort for the person with dementia to return to later. It can also help outside carers, who did not know the person before, to understand who they are and form a connection. 

Later stage

Easing communication problems 

Communication can become challenging. It is important to use simple language, speak slowly, and use non-verbal cues like eye contact and touch.

Avoid open-ended questions. Instead ask a simple ‘yes-no’ question and give the person plenty of time to respond. Using flashcards or pictures can help some people.

We often talk about ‘compassionate communication’. This means focusing on the emotions behind what they’re saying, as much as what they’re saying. 

Put yourself in their shoes. For example, if someone says they want to “go home to mum”, instead of saying “your mum has been dead for 20 years”, think this is a sign they need comfort and reassurance. If you are constantly correcting someone, it can make them angry or withdrawn.

Try to anticipate their basic needs, as they might not be able to say what's wrong. Imagine if you were hot, cold, hungry, tired or just needed to go to the loo but you were not able to say that. 

Often, agitation and anger can be due to these simple things.

Eating, drinking and incontinence

Keeping people with dementia hydrated and fed can be difficult in the condition’s later stages. Families can support their loved ones by offering finger foods and providing high-calorie meals if weight loss is a concern. 

Make drinks easily accessible by leaving brightly coloured, easy-to-hold cups around the house and offer fluid-filled foods such as cucumbers, soups and ice lollies. 

If they have swallowing difficulties, you can get a referral through their GP to a speech and language therapist who will assess their eating and drinking needs.

Be kind to yourself and recognise that it’s okay to feel frustrated at times.

If incontinence is an issue, families can access support from their local continence team through a GP referral. These teams provide assessments and recommend products like pads or pull-up pants.

Prompt the person to use the toilet regularly and address any underlying health issues, such as urinary tract infections. 

Looking after your own wellbeing

Caring for someone with dementia can be physically and emotionally draining. Be kind to yourself and recognise that it’s okay to feel frustrated at times. 

It’s not possible to do it on your own, all day, every day. Help from friends, family, or professional carers can provide a much-needed break.

Whether you use that to read, listen to the radio, go for a walk, meet friends or even just catch up on sleep, you’ll return to your caring responsibilities in a better mood, which will be better for the person you are caring for.

Families sometimes feel guilty about handing over care to agencies or a day centre, or if the person with dementia needs to move into a care home. 

But having someone else take over the practical tasks like washing or dressing can allow you to step back into your role of husband, wife, son or daughter, for example. 

Even in the very late stages, it is possible to enjoy time with each other, whether it’s sitting holding hands, listening to their favourite music, or simply watching the TV together.

Get more information and support

• Dementia UK’s Helpline is staffed by dementia specialist Admiral Nurses. Call for free on 0800 888 6678 (9am to 9pm, weekdays, or 9am to 5pm at the weekend) or email [email protected].
• You can book a free video or phone call with a Dementia UK Admiral Nurse. 
• Go to Alzheimer’s Society dementia support forum for an online community of people in a similar situation.
• The Age UK website has advice on paying for care.
• Together in Dementia Everyday has information for people caring for loved ones with dementia.

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