Brief Answer:
I do not think you would have prevented dementia if you sent her straight to A&E

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and understand your concern if you could have prevented the development of dementia.

Vascular dementia is a condition that happens in patients that have diabetes or hypertension and is generally due to several strokes. Vascular dementia happens after a long time of suffering from diabetes or hypertension.
I understand that due to love and care for your mother you may be struggling with the feeling of guilt if this could be prevented or not. On the other hand, I do not think you lost time or that vascular dementia would be prevented by going straight to A&E.

In my opinion, you have taken good care of your mother, seeking medical assistance when she developed symptoms and following the advice of the doctor when it comes to referring her to the A&E.

To conclude:
- I am sorry for what your mother is going through and for the struggles you are having in your thoughts if you could have prevented all this
- In my opinion, you did not waste time but sent your mother for medical assistance right when symptoms started
- vascular dementia is not something that develops at one point in time. It is the consequence of the effect of diabetes or hypertension on the blood vessels of the brain over a long period of time and going straight to A&E would not have prevented it.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
I do not think you would have prevented dementia if you sent her straight to A&E

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and understand your concern if you could have prevented the development of dementia.

Vascular dementia is a condition that happens in patients that have diabetes or hypertension and is generally due to several strokes. Vascular dementia happens after a long time of suffering from diabetes or hypertension.
I understand that due to love and care for your mother you may be struggling with the feeling of guilt if this could be prevented or not. On the other hand, I do not think you lost time or that vascular dementia would be prevented by going straight to A&E.

In my opinion, you have taken good care of your mother, seeking medical assistance when she developed symptoms and following the advice of the doctor when it comes to referring her to the A&E.

To conclude:
- I am sorry for what your mother is going through and for the struggles you are having in your thoughts if you could have prevented all this
- In my opinion, you did not waste time but sent your mother for medical assistance right when symptoms started
- vascular dementia is not something that develops at one point in time. It is the consequence of the effect of diabetes or hypertension on the blood vessels of the brain over a long period of time and going straight to A&E would not have prevented it.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
Diabetes causes vascular dementia over time- it would have not been prevented by sending her earlier in A&E

Detailed Answer:
Hello and welcome back,

I understand you feel you could have done more. Vascular dementia is a condition that develops in a long time of diabetes affecting the brain vessels.

Even though seeing her earlier and sending her to the A&E earlier would feel like you would have done the right thing, it would not have prevented the damage the diabetes causes in 35 years. Unfortunately, many times it is impossible to prevent vascular dementia, even with the best of care.

The feeling of guilt will not change the situation but may drain your energy, capacity, and XXXXXXX It is important to focus on the present and how you can be of a blessing to her now. Guilt just puts us in chains that limit us.

If you are struggling with these thoughts and you find it difficult to cope with them, you may need some counseling as well to help you deal with these thoughts.

I hope my answer gave you some comfort and reassurance. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Diabetes causes vascular dementia over time- it would have not been prevented by sending her earlier in A&E

Detailed Answer:
Hello and welcome back,

I understand you feel you could have done more. Vascular dementia is a condition that develops in a long time of diabetes affecting the brain vessels.

Even though seeing her earlier and sending her to the A&E earlier would feel like you would have done the right thing, it would not have prevented the damage the diabetes causes in 35 years. Unfortunately, many times it is impossible to prevent vascular dementia, even with the best of care.

The feeling of guilt will not change the situation but may drain your energy, capacity, and XXXXXXX It is important to focus on the present and how you can be of a blessing to her now. Guilt just puts us in chains that limit us.

If you are struggling with these thoughts and you find it difficult to cope with them, you may need some counseling as well to help you deal with these thoughts.

I hope my answer gave you some comfort and reassurance. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Vascular dementia is not prevented in a day, it is a more complex complication

Detailed Answer:
Hello and welcome back,

It is very common that after a sad situation, we look bad and identify things we could have done differently. On the other hand, we are not all-knowing and we have our limitations when it comes to understanding the gravity of certain situations. It is important for us to understand these limitations and give ourselves grace. I believe the most important thing is the motives. You did not do this because you wanted to hurt your mom or you wanted to be negligent.

Furthermore, as I explained previously, vascular dementia is not something that depends on the decisions of a certain moment or decisions of a few days. It is a complication that happens after many years of damage in the brain's blood vessels. So, even if you sent her to the A&E immediately, it would have not prevented dementia.

If you are having it difficult to cope with these thoughts, a counselor would be of great help to assist you in this and I would strongly recommend this to you.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Vascular dementia is not prevented in a day, it is a more complex complication

Detailed Answer:
Hello and welcome back,

It is very common that after a sad situation, we look bad and identify things we could have done differently. On the other hand, we are not all-knowing and we have our limitations when it comes to understanding the gravity of certain situations. It is important for us to understand these limitations and give ourselves grace. I believe the most important thing is the motives. You did not do this because you wanted to hurt your mom or you wanted to be negligent.

Furthermore, as I explained previously, vascular dementia is not something that depends on the decisions of a certain moment or decisions of a few days. It is a complication that happens after many years of damage in the brain's blood vessels. So, even if you sent her to the A&E immediately, it would have not prevented dementia.

If you are having it difficult to cope with these thoughts, a counselor would be of great help to assist you in this and I would strongly recommend this to you.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
It is important to address feelings of guilt and try to look forward

Detailed Answer:
Hello and welcome back.

I understand you feeling guilty. This shows that you love your mother and care for her health and want the best for her.

It is important to look forward from now and on to see how you can help her and care for her now and on. Guilt may prevent you from coping with your needs or hers.

It is a decision you need to make to not focus in the past so you can do your best at the present.

If it is difficult for you to cope with the feelings of guilt, I am pretty sure psychotherapy will be of help to you.

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
It is important to address feelings of guilt and try to look forward

Detailed Answer:
Hello and welcome back.

I understand you feeling guilty. This shows that you love your mother and care for her health and want the best for her.

It is important to look forward from now and on to see how you can help her and care for her now and on. Guilt may prevent you from coping with your needs or hers.

It is a decision you need to make to not focus in the past so you can do your best at the present.

If it is difficult for you to cope with the feelings of guilt, I am pretty sure psychotherapy will be of help to you.

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Life expectancy in vascular dementia varies but is around 5 years generally

Detailed Answer:
Hello and welcome back,

Unfortunately, there is no cure for vascular dementia and once it starts it progresses over time. Some patients progress slower than others and having proper care may contribute to a longer life expectancy. Life expectancy in vascular dementia is around 5 years but this differs from patient to patient.

At the beginning of the disease, the patients can be cared for at home. With the advancement of the symptoms (mental and physical) more specialized care is needed and in this case, it is at the best interest of your mother, that if possible, she receives specialist care in the centers assigned to assist such patients.

I understand the hesitation of your mother as many elderly prefer to be treated in a home environment and close to the loved ones.

On the other hand, the specialists that come to take care of her at home will tell you for sure if it is best to do this at home or in the specialized centers.

There is a need for a good balance between her needs and her desires and definitely, involving the caring staff in this decision and in discussion with your mother will be beneficial.

One last note, due to the risk of mental decline, your mother needs to decide on her life wish, advanced directive, power of attorney, etc (the medical staff caring of her can further guide you in this).

I hope this answers your query.
I remain at your disposal for further medical assistance.


Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Life expectancy in vascular dementia varies but is around 5 years generally

Detailed Answer:
Hello and welcome back,

Unfortunately, there is no cure for vascular dementia and once it starts it progresses over time. Some patients progress slower than others and having proper care may contribute to a longer life expectancy. Life expectancy in vascular dementia is around 5 years but this differs from patient to patient.

At the beginning of the disease, the patients can be cared for at home. With the advancement of the symptoms (mental and physical) more specialized care is needed and in this case, it is at the best interest of your mother, that if possible, she receives specialist care in the centers assigned to assist such patients.

I understand the hesitation of your mother as many elderly prefer to be treated in a home environment and close to the loved ones.

On the other hand, the specialists that come to take care of her at home will tell you for sure if it is best to do this at home or in the specialized centers.

There is a need for a good balance between her needs and her desires and definitely, involving the caring staff in this decision and in discussion with your mother will be beneficial.

One last note, due to the risk of mental decline, your mother needs to decide on her life wish, advanced directive, power of attorney, etc (the medical staff caring of her can further guide you in this).

I hope this answers your query.
I remain at your disposal for further medical assistance.


Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

I understand that when caring for a loved one, sometimes, emotions may go high and guilt easily may take place. Also, having a good balance between her needs and desires is not easy.
It is important to clarify with the staff that works with her if moving her to the specialized center is just a good idea or this is the best care in her case. Moving the care away from a familiar desired place should be based on more legitimate reasons.

If the care providers think that they can not offer her as good care at home as in the specialized center and this may affect the health of your mother, then there is no reason to feel guilty of transferring her to such a center.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

I understand that when caring for a loved one, sometimes, emotions may go high and guilt easily may take place. Also, having a good balance between her needs and desires is not easy.
It is important to clarify with the staff that works with her if moving her to the specialized center is just a good idea or this is the best care in her case. Moving the care away from a familiar desired place should be based on more legitimate reasons.

If the care providers think that they can not offer her as good care at home as in the specialized center and this may affect the health of your mother, then there is no reason to feel guilty of transferring her to such a center.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
This is a very difficult decision to take

Detailed Answer:
Hello and welcome back,

This can be a very difficult decision as it can really drain you financially. The care in a care home can be quite expensive and I understand that even them coming to see her home is not cheap either.

I am sorry you have to make such a difficult decision. This is a decision that you will have to take with your brother and your mother if she is mentally capable. Pros and cons should be balanced well, which means the benefits and the cost and disadvantages of each option.
You may also need to explore if there is any support that you can get from the government or any subsidy that will cover some of her medical expenses. The social worker should be some guidance on this.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

---

Brief Answer:
This is a very difficult decision to take

Detailed Answer:
Hello and welcome back,

This can be a very difficult decision as it can really drain you financially. The care in a care home can be quite expensive and I understand that even them coming to see her home is not cheap either.

I am sorry you have to make such a difficult decision. This is a decision that you will have to take with your brother and your mother if she is mentally capable. Pros and cons should be balanced well, which means the benefits and the cost and disadvantages of each option.
You may also need to explore if there is any support that you can get from the government or any subsidy that will cover some of her medical expenses. The social worker should be some guidance on this.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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