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We are meeting with neurologist on 3/3, but primary care dr thinks she has vascular dementia, and so do I.
I see a lot of correlation on the internet between strokes and VaD.
Do they HAVE to go hand in hand?
I have not seen evidence of any strokes, or smaller TIA's...

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I intend to follow this link as I'm interested also. I've had at least one TIA due to all the stress of caring for a AD mother.
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Yes, my dad has had TIAs and now has cognitive impairment brought on by vascular ischemia.
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This information is of great interest to me as well, due to what I saw in my Grandfather and now I am seeing in my mother.
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Actually that is wrong there are several ways for vascular dementia to come on and one reason is mismanagement of medication. like for instance blood pressure and high cholesterol meds can do this. yet it has been seen that once they get their meds straight it can cause it to do a reversal. there are many forms and many reasons yet make certain you have everything in order when you get a diagnoses as such because both of my parents were diagnosed with it and it is false. more so because they are trying to say they are incompetent and they are not.
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I do not have a background or expertise in the medical field, but I do know that my father had vascular dementia but did not have any strokes. His only medication once he no longer took Namenda & Aricept was tylenol and/or antiinflammatory meds for arthritic hips.

Keeping someone informed of daily activities and directed helps them as they progress in dementia (though not always easy as many of us on AC know!).
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My husband developed vascular dementia about 8 months after a massive stroke. After speech, physical and occupational therapies he overcame the aphasia (not remembering the names of objects) and apraxia (unable to say the words correctly), we thought we had won the battle against all odds - he even could walk again with a cane. Practically overnight he regressed. His neurologist told us that we are now dealing with vascular dementia due to the massive damage from the stroke. He also was diabetic, had heart problems (heart attack, 2 heart surgeries, and a cardiac defibrillator implant). I believe all those health issues were just too much for his body to handle. We always thought that one day his heart would just give up - the nightmare of dementia never crossed our minds.
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my understanding is that vascular dementia is brought on by a micro stroke in the brain, or a series of micro strokes, that the brain does not recover from. micro strokes are common in all of us, but a healthy brain recovers from these. this is the type of stroke that has no outward physical manifestation, except that each time a person with vascular dementia has another micro stroke that they don't recover from, you will see a drop in their abilities. keep the brain healthy with high doses of omega 3s, healthy fats and supplements specific to brain health. i have heard about a book written by Dr. Perlmutter called Grain Brain that is supposed to be really informative.
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Yes Vascular Dementia is caused by a series of mini strokes and the result of these strokes causes death of brain tissues. Strokes can occur at anytime and depending on which part of the brain has been affected it may cause changes in their memory or personality.
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Yeah, vascular dementia can develop with the strokes being small and less obvious over time, and some sources indicate that long standing diabetes will cause encephalopathy (brain problems) due to its effects on the microvasculature (tiniest arteries/capillaries) even if you never block off a bigger vessel. That works the same as when you can have sores that won't heal even right next to a good pulse in a foot or toe.

My mom had this, and the degree of atrophy on her MRI was suprisingly severe; later on she had more definite large vessel stokes, mostly posterior circulation and had vision loss and aphasia from it. We had her on anti-platelet agents but she had some resistance to them, they felt it was too dangerous to use warfarin (Coumadin) and she absolutely would not take a healthier diet. We got a little better control of her diabetes but eventually nothing helped unclog things in her brain or her heart any more and we lost her a few years ago now. But, with this type of dementia rather than Alzheimer's, as bad as it was, she always recognized us and had long term memories to draw on...wish this was not happening to you, and I wish you a better time of it than we had!
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Yes my mum has diabetes (which she has NEVER controlled?) Now "vascular dementia" she will be having a series of ministrokes especially when she "hypos" her geriatrician said diet and excercise are paramount to whether she declines quickly or not. She refuses to excercise eats what she wants and is now not taking her meds shes dropping them all over the house gets aggressive if i try and take control.

I myself have had a ministroke and had zero sympthoms which is scary to think i had it unknown to me. they found 3 spots on the brain. This is from the stress of looking after mum and i am very worried that i may develope this "dementia" when im older.
Yes all the omegas lots of fresh air,give up smoking eat lots of antistroke foods,Blueberrys,oranges basically the same old same old eat healthy and get lots of oxigen to the brain.
I am know considering getting mum a "shrink" as she wont do as shes told and i cant do this anymore she wont listen to me and does what she likes? Im drained and can see this ending in her dying of a massive stroke or heart attack and soon as she does nothing to help herself. Diet and excercise can slow down the progression of this dementia but thats not going to happen thats why she would live longer in a NH where she would be monitored better than I can do.
Dementia and diabetes is incredibly dangerous i have to make sure shes taking the correct dosage of insulin if she takes it when im not here as she forgets it could kill her.
I am taking Krill Oil which i am finding quite good they also say virgin coconut oil a couple of tablespoons a day can stimulate brain cells.
What i fear the most is genetics both sides of my family have heart and strok ae issues BUT als or dementia is a first here with my mum as that is mainly down to her badly controlled diabetes so sad that this could have been avoided?
I still hope that its not too late for me have stopped smoking and eat all these foods that are good for the brain etc... but as my doc said you can do all this but stress can still cause a stroke? I need to find a solution now to mums care as the stress of looking after her could cause another stroke and i have to now think of my own health.
My mum had been on meds all her life which i find frightening her health issues could have easily been controlled with a good diet and excercise but she would never listen. Part of me is sad for her but another part is angry with her to have all this at 76yrs is just so sad when it could all have been avoided.
I am confused to this dementia as some people say they dont completly lose thier memory while others say they do? My mums short term is going but her longterm is better than mine?
Does anyone know just how this dementia progresses or is everyone different? My mums geriatrician said of all the dementias this one is the better one to get???
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That's why the mini strokes are called "silent". Blood supply to the brain has been cut off temporarily or for longer periods of time, and the result is a vascular dementia. However, a person can have Alzheimer's dementia as well as a vascular dementia at the same time. Wait and see what the neurologist says on 3/3 and my best to your mother and you. Read about vascular and Alzheimer's dementia on WebMD.com.
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Kazaa, I guess you got your wake up call like I did mine. Looking at my mom was like looking down the barrel of a loaded gun, given we have so much the same genetically. You have it right about the memory issue, you don't have so much loss of long term memory with vascular as you do with Alzheimer dementia, so the person loses judgement and other intellectual capability and eventually short term memory rather than forgetting who familiar people and loved ones are. I guess that's "better" in some ways, but it still sucks and it also sometimes makes people think their loved one is "sharp as a tack" and doing maladaptive things competently and on purpose!

My mom was actually IN the Nurses' Health Study that showed those lifestyle habits we almost take for granted today can make a difference. And yes, they can. Now I've got long-term care insurance for myself going in case everything I do isn't enough and I end up needing it, but I lost weight, got reasonably fit, and have held type II diabetes at bay for myself going on 6 years now. I move more and eat less as much as I can, and what I do eat is good stuff almost always. My mom's generation just did not believe in physical activity for ladies and thought butter, cheese, ice cream, and steak were health foods. I feel angry too that Mom was never able to learn or think differently and change her health habits, which would have added years to her life and life to our years...and when I get those Omaha Steaks offers in the mail with her name or mine on them, I make a little ceremony out of tearing them up into little bitty bits and dropping them in the recycling bin.
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Mother has vascular dementia as well. No stroke - ever. She does however also have Alz, Bipolar and Borderline Personality Disorder. Her short term memory is all but gone, she never remembers that I have visited and yells at me for "never" coming to visit her although I do it approx. 3X/week. It is frustrating but I get it. We still keep plugging away with visits. Started writing it down on her calendar when we have been there. Good Luck and hugs on your journey!
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The threat to a caregiver's health from stress is only too real. I spent a life time avoiding my NM and cared for her for four years (out of duty) until she went into a nursing home in November 2012 but there was no peace - constant phone calls, demands and screaming tantrums, along with abuse to staff and fellow residents.

I was constantly on edge, strung out, stomach churning and my hair was falling out. Two weeks ago I had what I suspect was a TIA and stroke runs in the family so it terrified me. I've changed my phone number, made it unpublished and the NH has strict instructions not to give it out. As the NH calls me for every little thing I also take it off the hook overnight and also during the day if I nap.

For the past two weeks, apart from basic chores, I've done very little, always tired and sleep a lot. I've only visited once and that was awful, however my mother's dementia is just about full blown and she won't remember if I was there yesterday, last week or last month. It will take a while to recover from the years of stress but I have to take care of myself before I'm really ill..
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Yes Ashlynne no matter how much sleep i get im always tired! My doc suggests a holiday but a short term solution to a long term problem i need to get my life back together before its too late.
I cant understand why the NH feels the need to annoy you all the time that cant be right? Surely they should only call you in an emergency?
Can you tell her doc that you need the NH to stop calling you unless its urgent? thats not fair.
I hope youre getting better. I feel like doing nothing lately thankgod i have a cleaner that comes in for 3hrs a wk id be lost without her she just whizzes around and cleans the whole house and does ironing of course my mum thinks we dont need her????
This week im just so drained and fed up. First my cat got a bad attack from another cat and his poor little head has a bald patch break your heart when they get hurt.
then the toilet broke (yep mum again 200 euros)
the washing machine broke down then (yep mum again putting her washing in with rings,diapers you name it a call out now and maybe a new machine?)
I cleaned the bathrooms then mum decided to poo all over them a friend called for coffee? I didnt open the door and pretended i wasnt home?
Im not getting out of bed tomorrow unless there is some good news to get up to??
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From Alz Association in the UK. It's not necessarily only from a stroke.

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=161

How does vascular dementia develop?

To be healthy and function properly, brain cells need a good supply of blood. Blood is delivered through a network of blood vessels called the vascular system. If the vascular system within the brain becomes damaged and blood cannot reach the brain cells, the cells will eventually die. This can lead to the onset of vascular dementia.

A number of conditions can cause or increase damage to the vascular system. These include high blood pressure, heart problems, high cholesterol and diabetes. This means it is important that these conditions are identified and treated at the earliest opportunity. Effective treatment of these conditions may significantly delay or stop the development of vascular dementia.
Types of vascular dementia

There are different types of vascular dementia. The difference between these types depends on what has caused the damage in the brain, and which part of the brain has been damaged.
Stroke-related dementia

A stroke occurs when the blood supply to part of the brain is cut off. This interruption in blood supply causes permanent damage to the brain. A stroke is usually the result of a burst blood vessel (known as haemorrhagic stroke) or a blood clot (known as an ischemic stroke).

The symptoms that a person experiences as a result of a stroke depend on which area of the brain has been damaged. For example, if the area affected is responsible for movement of an arm or leg, paralysis might occur. If it is responsible for speech, the person might have problems communicating. Equally, damage to particular areas in the brain can cause the symptoms of dementia.

The most common type of vascular dementia is called multi-infarct dementia, which is caused by a series of small strokes. These can be so tiny that the person might not notice any symptoms, or the symptoms may only be temporary.

When vascular dementia develops after an obvious stroke, it is sometimes called post-stroke dementia (or 'single-infarct dementia').
Sub-cortical vascular dementia (small vessel disease or Binswanger's disease)

Sub-cortical vascular dementia is sometimes referred to as small vessel disease. There is also a specific form of sub-cortical vascular dementia called Binswanger's disease. Sub-cortical vascular dementia is caused by damage to the tiny blood vessels that lie deep within the brain. Symptoms may include difficulties walking, clumsiness, lack of facial expression and speech difficulties. Loss of bladder control early on in the disease is also common. These symptoms, however, are not always present and may come and go. Some people may experience sub-cortical vascular dementia as well as stroke.
Mixed dementia (vascular dementia and Alzheimer's disease)

About 10 per cent of people with dementia have a type known as mixed dementia. A diagnosis of mixed dementia means that Alzheimer's disease, as well as stroke or small vessel disease, may have caused damage to the brain. The symptoms of mixed dementia may be similar to either Alzheimer's disease or vascular dementia, or may be a combination of the two.
Factors that can increase the risk of vascular dementia

Many of the factors that increase the risk of vascular dementia are the same as those that increase the risk of cardiovascular disease (for example, smoking). This is because the cardiovascular system (made up of the heart and blood vessels) is responsible for delivering blood to the brain.

Factors that can increase a person's risk of developing vascular dementia include:

a medical history of stroke, high blood pressure, high cholesterol, diabetes (particularly type II), heart problems or sleep apnoea (where breathing stops for a few seconds or minutes during sleep)
a lack of physical activity, drinking more than recommended levels of alcohol, smoking, eating a fatty diet, or leaving conditions such as high blood pressure or diabetes untreated
a family history of stroke or cardiovascular disease
an Indian, Bangladeshi, Pakistani or Sri Lankan ethnic background - differences in vascular risk factors (such as heart disease) in these communities may contribute to the increased risk
an African-Caribbean ethnic background - more research is needed to know why African-Caribbean people have an increased risk of vascular dementia.
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Kazzaa a holiday won't help because you'll spend it filled with the dread of having to go back. Maybe it's time for a nursing home for your mother? You've gone above and beyond for her and what you're going through is inhuman and it has to end before you have a stroke or heart attack. Can you contact local social services and see what might be available? In a nursing home your mother will have structure, skilled staff 24/7 and be safe.

You can't stay awake or sleep with one ear open in case she gets into trouble. My paternal grandmother used to have all four stove burners on high with nothing on them and get up at 3 a.m. so she didn't miss the milkman. From what I've read here some dementia/Alzheimers folks leave the house and wander the streets in their night clothes, other wander the house at night. Thankfully during the years I cared for her my mother never did those things, though she did some really bizarre stuff at home.

I so know how you feel about your cat. I have 4 plus 2 dogs, Sue and Ashley - that's Ash, from rescue last spring, in my avatar - and a big old goldfish called Ralph and without them I'd probably be in the looney bin or worse by now :)

Re the calls from the NH it's their policy. Last week she got out of her wheelchair and they found her on the floor, no harm done. Christmas eve night I had 4 calls. 1) she tried to get out of bed, found on the floor with a cut finger which they bandaged; 2) it wouldn't stop bleeding so they send her to the hospital 4km away; 3) would I come take her? Nope, I can't lift her, call transport; 4) they can't get transport, should they call an ambulance and I pay for it? Frankly I don't care if you send her by helicopter or flying carpet, just do it! Now you know why the phone goes off the hook a lot. In fact it's 5.30 p.m. and I'm about to feed my critturs and get my own supper so off the hook it's going until tomorrow.

Please let us know how you're doing and if you can make some plans to end your nightmare and take your life back. I'm so worried about you. God Bless.
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Yes blannie mum has "multi-infarct" a series of mini strokes i think i know when shes had one as her moods get worse and her bloods are all over the place she will rarely but sometimes complain about a headache and i notice shes in foul mood for a few days after.
This particular type means that they can change day to day she can be "competent" one day then "mad" the next which is why they can manipulate family as they seem totally normal to them but then she will throw her depends out the window?? its a very subtle "dementia" but spend enough time around them and you can see the illness better BUT my family never spend enough time to see the "crap" that i get. The horrific mood swings,the aggression,the way she speaks to me like a "slave" the clutter,the money hoarding,the hygiene issues,the mess everywhere and then some!!
Mum has all of the other posts health issues. HBP,HC and diabetes and heart "stents". I am in utter shock that shes still alive ive looked after her now for 4 yrs and ive had a TIA?? just goes to show how stressful this is to deal with. A surgeon once called mum "cat oh nine lives" but as we all know her ninth life is almost up noone can be that lucky with thier health but then mum has outlived most of her family as they all passed away in thier "60s"? so sad and so young. My fathers side are the opposite they lived well into thier "80s" oh god whos genes have i got?
I think all we can do is eat well and excercise and "refuse to get stressed" LOL
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It's good to hear I'm not the only one exhausted. The phone rang this morning (well, at noon) and it was mom asking, "Why haven't you called me?" "I'm very bored..." "You should make sure I'm all right..."
I swear I have had chest pains for a week now.
Needless to say, we got in the car and went shopping....that made her feel better...for now.
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A good neurologist will image the brain, and you should ask to see the pictures. Sometimes the images make it all to clear to you what has been happening. Vascular dementia is mini-strokes that accumulate damage over many years. Often we don't notice when a person stops reading novels or cancels the daily paper. We dismiss minor forgetful moments. Years later they stop paying bills or they stop bathing and suddenly we realize there is damage.
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Nikki dont ever take chest pains lightly. I know i had them before the stroke i dont know if you smoke but get your chest sorted out just in case. So many people take chest pains lightly its a warning OR youve got bad indigestion which i doubt. I had them and just put them down to stress i casually told my doc and she was furious i didnt go to ER. Anyway just advice no matter how stressed i thought i was with mum i still cant believe i had a TIA at my age you can think youre stressed then find out that its actually "chronic stress" which is serious my TIA was brought on by chronic stress. Im trying to learn to let things go but its hard.
Ashlynne my mum needs a NH but hell will freeze over before shell go into one i spoke to her doc and he said she cant go if she dosnt want to???? like alot of us "We wait until she falls or worse" this is insane but if you try and tackle the professionals this is what you will hear if she wont go theres nothing i can do she also refuses to sign POA so i give up its not worth the stress on me. I know i will have to leave soon when this money comes through sometimes i really think FATE has trapped me here i feel mum wont be here much longer and maybe thats why my life has put me here now IF i get the money to leave soon then ill know i was meant to leave.
Its a desperate situation but when you have no more cards left to play all you can do is pray and hope.
I dont know why your mum is falling out of bed all the time?? do they not have her in a secure bed with side handles? sorry im just shocked that shes falling out of bed ALOT?
Mum asked me tonight why was she paying for TV?? its my TV why am i paying for it?
Shes getting more and more confused and asking some pretty scary questions its just heart breaking to watch i just answer her then run to the kitchen and cry what a horrible cruel illness i am prepared for this to get worse i dread the day i would have to leave her in a NH but for some strange reason i dont think she will survive that long its wierd but i just have a very strong feeling. I always had this feeling along time ago that my dad would die around xmas and he did so my gut feelings are usually right or maybe i just want her to go before she ends up in a home?
Please God there will be a cure soon for this awful disease soon and we never have to witness it again EVER!
I can recall years ago maybe 20yrs i met a guy who was looking after his mum with ALs i remember thinking what a great guy to do this then thinking how lucky i was that "mum" would never get anything like that?? Its still hard to believe she has it as there are days when she is so alert and "sharp as a tack".

Ive let my cat out and its late and now i want him in again i just let him out to toilet as he dosnt like to go inside (little pet) i am so tired and hope he comes in soon.
I have taken myself off Stilnoct (sleeping tablets) four days now but have realised who am i kidding? i aint sleeping i suppose ive become an addict i will try again tonight and if i dont sleep quickly ill be down at dawn banging on my docs door for another months supply? well at least i tried?
When i was a baby i was the best sleeper slept all night and more before my accident ive gone from 10 hour a night sleeps to 4 hours so had to take something now i cant sleep without them.
Has anyone ever come off these i wonder how long it takes i know that they are addictive but we need sleep have tried KALMS they were crap.
If i dont take a tab for sleep I just worry and think about mum and whats going to happen to her. Even in sleep we are stressed!
Cats in and not happy but its for his own good! if only i had same control over mum!!! LOL
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I was driving with her yesterday; she seemed to be "back to normal" from being tired last week, and I asked her to count backwards by 5's from 40. You know, like 35, 30, 25, 20..... I started it for her, and she looked at me and remarked, "oh my brain doesn't do all that!" and started laughing..... I laughed too, but I wondered. CAN SHE?
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Kazaa, smoked for 25 years... Just quit last Halloween. I do the e-cig now. (I have to do something) also started drinking maybe 2-3 years back... too much... seems I would pour one after a phone call with mom or after a fight with bf... at 1:00pm and while they were little cups, I would refill them a good part of the day. Often think I became a functioning alcoholic. I'm sure I have. Funny thing; if there is nothing to drink in the house I'm fine with iced tea and iced coffee. I don't need it... so to speak. I don't get shakes, it doesn't consume me; the thought of it. Still, I'm smart enough to know that if I continued on the path, I would definitely BECOME a functioning alcoholic, if I hadn't already... so I have slowed it down. As I type this I am drinking a vodka and cranberry, lol.... it's just hard. Between the stresses at home with the kids and bills, and mom since 2010, bless her heart... it's hard. I do worry for myself; if something happened to me, what would become of mom, or my two teenagers? I have to decompress and think positive every single day.
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It also is very difficult because I AM my mother's POA. Over finances, health, all of it. And if I don't give her enough attention she threatens to move. And if I say "you're not going to move..." she retorts with, "I am the boss of me! And if you try to do anything you are out of the will." I mean I am making her sound like a disney villian here, but she isn't. She's a scared old lady who was scared even before she got old. She lost her go-to guy, her husband/my dad, in 2009, and has been lost ever since. And I don't want to push the envelope, and who knows what she would do.... maybe write me out of the will. Not saying it's about the money but I am literally living paycheck to paycheck (child support only) and when that runs out, I am F*****. I really am. I have no retirement, no savings, I am trying to keep a 3-bedroom 2 car garage mortgage paid and all the other bills without doing without so the kids don't do without... and so I can live across the street from mom and take care of her.
The stress of worry about my future consumes me. THAT is what consumes me. I gave up my career when Dominic, my 17 yr old, was THREE. That means I have no career. I have nothing. When she dies, yeah sure. I'll have the inheritance. If it isn't gone to ALF or Memory Care. She will hang on, let me tell you. She has grandpa's genes, and he lived to be 99, God bless him. I worry every day about tomorrow.
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Does hardening of the arteries also cause vascular dementia? We just did a CT scan and they said she showed hardening of the arteries and a loss of brain cells.
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HolyCow good question.... next week on 3/3 when I see the neurologist we will get our money's worth lol... I will ask him these questions (on behalf of the community here) if he will allow me the time...
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Holycow,hardening of the arteries blocks blood flowing to the brain so yes this will effect brain cells. thats why its important to keep an eye on cholestrol levels mine is high 7.2 i need to get it down to around 5ish they say when you go over 7 its quite hard to get it down but i am not taking statins id rather starve!
Nikki good for you for stopping smoking im struggling its very hard when mum stresses me out i was doing ok having maybe one or two a day then i overheard her on the phone to my sister when i came home and she said in gaelic "oh here comes bigs ears i cant talk to you now". so she and my sis were bitching about me i was so mad i went and bought a pkt of cigs???
I dont care what mum says about me but my sister listens and believes everything she says as shes quite stupid and dosnt really understand dementia and cant be bothered to inform herself.
My mum also threatens me with the "taking you out of my will crap" dont listen i told my brother and he said that if she did that he would make sure i get my share?
We get all the abuse and thats just what comes with this illness they need someone to bitch at my mum was never like this so i know its the illness but shes getting worse if you disagree with anything she turns into monster and will hurl abuse i just learn to walk away then she sucks up to me by asking me if i need money??
I tell you this illness should come with an "idiots guide to caring" handbook thankgod for these sites as not one professional has ever given me any advice since she was diagnosed last September!
Nikki vodka and cranberry is my fav drink!!! vodka bad for liver cranberry good for liver WIN WIN!!!
I have to say i dont drink much now since stroke maybe just a few glasses of red wine which is suppose to be good for blood thins it apparently. My fags were my best friend!!! good for you to give them up when youre under so much stress thats shows that you can get through anything.
Ive seen a nice blouse and skinny jeans (in baby blue for spring) if i dont smoke i can afford them im going to treat myself every week? Pray that i get to stop smoking as its very hard even if youve had a stroke they say its easier to give up heroine??
Roll on easter when mums away just to have to do nothing for 12 days but ive been here before and when mum did go into respite i would just sleep and watch TV all day even that was a treat!!!!
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Also Nikki how are you feeling with e-cig? do you feel healthier? my brother has been puffing this for 4years surely thats not good? i suppose its better than a ciggy but i want to give up the drug itself nicotine i know cold turkey is hard but ive seen people becoming hooked on these e-cigs my doc said you should only be on them for six months?
Off for a coffee now and a choco bar would kill for a smoke!!!!!! LOL
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Kazzaa it's been two weeks since I backed away, changed my phone number and so on and, apart from necessary chores and caring for my animals, I've been resting and sleeping a lot. It will take time and, as someone said, it's PTSD for life, but I'm starting to feel much better already. It's 10.30 a.m. and I'm still in my PJs :)
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I do feel better with the e-cig. God knows I smell better. When I smoked traditional cigs, I had a dull pain in my back, by my shoulder blade (lung?) Then I went to Dr. It was clear thank GOD. But it came with almost every cigarette. I quit, now I smoke e-cigs. NO MORE PAIN IN BACK. So that is something. Do I think it's as healthy as nothing? No.
And now since I have smoked these, I have chest pain, which I don't know its cause... is it stress ? (I think so) or the e-cigs? Regardless, I am weaning myself off them completely.
The chest pains feel like anxiety. My money situation is AWFUL right now due to having to live here in a house bigger than what I can afford, because it's across the street from mom's.
The money situation is going to get $1200/month worse very soon when that payment stops, and it is due to stop within a few months.

Can I get a job? Nope.
Mom says it's because of the kids. But it's not. The kids are 13 and 17 and are fine on their own here. It's her. I can't "tell" her that, but of course she's the reason.
I tried to get a part-time job a couple of years ago. She called asking when I was coming home. The job lasted two days.
I'm just very tired, feeling trapped, guilty, awful. I want out. God forgive me but it's too much... and we are not even at the point yet where she needs me for hygiene or anything.
I cook for her, get her pills out, ENTERTAIN HER every day, and basically just spend time with her. Right now that's all she needs.
When it gets worse, I will be forced to make a decision for ALF which will actually free me to sell the home and get a job.
It's really a lose-lose... there is no easy answer.
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