You're Not Who You Used to Be

Abstract

Heart failure and vascular dementia have similar underlying pathologies, so it is not uncommon for one condition to exist in the presence of the other. In-home management of each condition is challenging for patients and their family caregivers, but when both conditions are present, those challenges are amplified. The purpose of this case report is to describe one family's experience managing heart failure and vascular dementia at home. A mixed method of semistructured interviews and short surveys was used to examine the health status and well-being of the patient and family caregiver. Data were derived from individual interviews and standardized measures. Survey results revealed the patient had worsening dementia, poor heart failure-related quality of life, poor spiritual well-being, depression, and diminished self-care. The caregiver reported poor physical and mental health. Interview data revealed frustration dealing with worsening symptoms, inadequate information about disease progression, and fear of an unknown future. Additionally, the patient suggested strategies to deal with challenges. Families managing heart failure and vascular dementia need easy-to-understand education from healthcare providers, on-going assessments, and early referrals to support services including those provided by social workers and chaplains.

Family Caregiving of Patients With Heart Failure and Vascular Dementia in Rural Appalachia: A Mixed-Methods Study

“…48,49 A unique finding in this study was that caregivers described their loss of companionship due to the decline in patients’ health and grieved for what had been. 46,50 Caregivers reported fear of future care demands and their anticipatory grief about losing their loved one, indicating their need for home palliative care guidance. Caregivers’ worry is related to the declining health and progressive stages of dementia in patients.…”

Does Transcranial Direct Current Stimulation Affect Potential P300-Related Events in Vascular Dementia? Considerations from a Pilot Study

“…Vascular dementia encompasses a range of cognitive disorders, ranging from mild cognitive deficits to severe dementia manifestations [ 15 , 16 ]. This clinical complexity significantly impacts the quality of life for affected individuals and their families [ 17 , 18 , 19 ].…”