Brother with VD, diagnosed in July '23

ANNdrd

Hi. I am new to this. My first post. My brother is newly diagnosed with VD, but a neurologist just said he is in mid stage. She said to keep his brain active but I'm struggling with finding an option. He hates puzzles and solitaire and is not computer savvy. He used to do wood working but we need to keep him away from power tools. He likes to read.

Two weeks ago he said he had a new book and read 30 pages. He has not read it since. He says he is waiting until he gets his new glasses, yet he reads the newspaper. How does one determine if the LO is truthful or hiding something? After much thought I believe perhaps he can't remember what he has read from one day to the next so is using the glasses as an excuse???

How do I find something for him to do? He just sits and watches TV and gets upset at the news. He is 79.

harshedbuzz

@ANNdrd

Hi and welcome. I am sorry for your reason to be here but pleased that you found this place.

When a person is diagnosed with one of the dementias, especially in the middle stages, medicine has precious little to offer in the way of effective intervention. Many doctors will suggest the best practices-- a Mediterranean or DASH diet, moderate exercise, sufficient quality sleep, social engagement and mental stimulation. Unfortunately, the losses and behaviors associated with dementia can make engaging a PWD in any of this a challenge. This can be an exercise in frustration for both caregiver and PWD for so many reasons-- PWD crave sweet and easy-to-eat prepared foods, many don't want to move around, their sleep become fragmented, friends pull away and they lack the cognition to initiate and engage in mental challenges. As a result, the caregiver is either feeling as though they're not doing all they can or wondering if their efforts are upsetting their LO. It becomes an additional burden on the caregiver.

The brain is not a muscle one can flex. My uncle clearly suspected my aunt had early-stage dementia (in her case VD) and used to encourage her to do the NYT crossword and would often use this skill as proof that she was OK. A few years after he died suddenly, her sister found her sitting in a cold dark house wondering when the cable would be fixed. After she went to MC, we cleaned out her compound-- house, workshop, 2 cottages, 4 bay-garage, shed and a boathouse-- I found a 12' long closet filled floor to ceiling with sacks of cut-out puzzles and many more under her bed. The bottom bags had completed puzzles but over time they weren't even attempted and the top bags were just grids without clues.

To your question about your brother-- I saw exactly this with my dad. I think you are spot-on regarding the memory piece. Dad's only real hobbies were philandering, golf, drinking and reading. In his 80s, blind in one eye and on androgen deprivation therapy he wasn't able to participate in the first two, he wasn't supposed to engage in the third and his working memory precluded any enjoyment of the last. The onset of this loss as it relates to reading was kind of subtle over a couple of years. Both short term and working memory are needed to comprehend something like a book. Initially, he'd get a new novel from one of his favorite spy or thriller author and complain it wasn't as good a read and the man's early work. A year or two later he'd say he really couldn't get into the books I sent at Christmas of his birthday. Dad was a history teacher by training and loved the genre. DH and DS would suggest really interesting stuff they'd read-- they were great choices but in retrospect he couldn't hold onto the gist of one chapter for the time it took to read the next and he lacked the executive function to draw the conclusions presented.

Like your brother "blaming" the glasses, the problem for dad wasn't him it was my poor choices. I think this is more a function of anosognosia-- where they can't recognize their own deficits-- than ascribing blame.

Eventually dad took to re-reading favorites from his past. I don't think he was getting much out of it-- it was like he was acting like he was reading to prove he still could. He reread the first chapter of Hunt for Red October daily for about 6 weeks until it went missing. Because dad could read-- decode-- written English we found the newspaper and magazines a better choice for him as there were multisensory (picture and words) and short. Dad liked The Week, a news weekly, and sometimes I'd bring a sports magazine or something to do with cars. Perhaps this would help.

One of the problems is that PWD can't really entertain themselves because they can't initiate activities, so someone else often needs to set the task up and support the PWD with prompts and encouragement which means him entertaining himself doesn't give you a chance to do something else. In this stage, many families like day programs a few days a week to give the PWD some social interaction and activity as well as a break for themselves.

HB

M1

HB has said it perfectly. If he's content watching tv I'd let well enough alone, although you may want to block the news channels and see if he'll be content with oldies. My partner loved Mayberry marathons.

ANNdrd

Thank you both. Very good insight and much appreciated.

I will look into magazines. My brother wants to unsubscribe from the newspaper because it is always late. This makes him get agitated. But he likes reading it so we'll continue it.

It would be good to subscribe to other newspapers, but most are digital. He doesn't like technology...computers/tablets, etc. Just likes to hold a paper.

thanks again!!!

Iris L.

Read about failure-free activities for PWDs. Example: raking leaves.

Iris