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Has anyone dealt with Binswanger's Disease?

I am currently very frustrated because my dad is wanting to have his own condo with 24/7 support so he doesn't have to live in an assisted living facility where nobody talks to him. It seems that the folks in the Manor where he lives are not fully functional so they don't interact. So he gets bored and upset. Does anyone out there have experience with dealing with the mental and mood swings associated with this disease? Hell! Has anyone out there HEARD of this disease? Seems like nobody has. Sigh. I feel very alone in dealing with this given that even the medical staff (nurses/doctors) don't know of the disease.
Status: Open    May 16, 2015 - 11:45 AM

Dementia, Senior Health & Nutrition

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Jun 29, 2016 - 08:20 AM

First, I am truly sorry about you father’s condition and your frustration as a caregiver. You both face difficulties ahead and having more information would certainly help.

Binswanger’s disease is a rare form of dementia characterized by loss of memory and intellectual function and by changes in mood. It is a progressive neurological disorder resulting from white brain matter atrophy. Sadly, as of today, it has no cure.

Check with your father’s doctor about his plan of care. In most cases, treatment plans include medications to control mood swings and depression as well as blood pressure, seizures, and rhythm irregularities in the heart. Treatment is designed to reduce the adverse effects of these associated, underlying conditions. The Alzheimer’s medication, donepezil, may also help Binswanger’s patients.

As the disease progresses, mental ability and mobility will decline. Your father will likely require a nurturing environment that provides for medical care and safety. That’s probably why he’s in an assisted living facility today – but do note that more support will likely be required as the disease progresses.

Your feeling alone as a caregiver with this particular, rare disease is understandable. Perhaps you might find some good advice, shared experiences and perhaps a little comfort in a dementia support group.

Answers

May 21, 2015 - 07:47 AM

Binswanger's Disease is considered a rare disease by the National Organization of Rare Diseases.

Binswanger's disease (BD), also called subcortical vascular dementia, is a type of dementia caused by widespread, microscopic areas of damage to the deep layers of white matter in the brain. The damage is the result of the thickening and narrowing (atherosclerosis) of arteries that feed the subcortical (below the cerebral cortex)areas of the brain. Atherosclerosis (commonly known as "hardening of the arteries") is a systemic process that affects blood vessels throughout the body. As the arteries become more and more narrowed, the blood supplied by those arteries decreases and brain tissue dies.

The symptoms associated with BD are related to the disruption of subcortical neural circuits that control what neuroscientists call executive cognitive functioning: short-term memory, organization, mood, the regulation of attention, the ability to act or make decisions, and appropriate behavior. The most characteristic feature of BD is psychomotor slowness - an increase in the length of time it takes, for example, for the fingers to turn the thought of a letter into the shape of a letter on a piece of paper. Other symptoms include forgetfulness (but not as severe as the forgetfulness of Alzheimer's disease), changes in speech, an unsteady gait, clumsiness or frequent falls, changes in personality or mood (most likely in the form of apathy, irritability, and depression), and urinary symptoms that aren't caused by urological disease.

There is no specific course of treatment for BD, other than treatment for symptoms. People with depression or anxiety may require antidepressant medications. BD is a progressive disease; there is no cure. Changes may be sudden or gradual and then progress in a stepwise manner.

I have not worked with anyone diagnosed with BD. But I recommend Dementia and or Alzheimer's support groups in your community or to be found through your local Alzheimer's Association.

I will offer that in home 24/7 paid assistance is the most costly option. Being in his home with one caregiver 24/7 doesn't give him as much socialization as he could get in an Assisted Living Facility with a good activities program and who also has memory care assistance. Physicians who should be familiar with this disease would be primarily neurologist who treat strokes and vascular dementia.

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