My wife (80) has vascular dementia in the late stages.The evenings are a nightmare for me, she is very nasty and aggressive. Advice?

She's sundowning - it is not an attitude per se, and ought not to be taken personally. Some medication approaches may ease this a little; have you mentioned it to her doctor? The sleep-wake cycle getting turned around is not uncommon and again, adjusting meds plus having help to keep her alert and occupied during the day if she's worn you out with care needs all night can help too.

It is unusual for one person to be able to meet the needs of someone with dementia through all the stages. By late stages most people need to be in a care home setting, or at the very least to have additional help for the caregiver.

If you have kept your beloved wife home with you through early and moderate stages, I congratulate you! Well done! It is not a failing on your part, and it is certainly not her fault, that her disease requires that she have more care.

Have you been considering more Day Care for her? Or perhaps a nursing home? You may actually be able to have a more loving relationship with her if you do less of the hands-on care.

That link above has a lot of good information. I agree that reading a lot about the disease can help you cope better.

Sometimes medication can help a dementia patient feel more content and less anxious. It can also help them sleep better. I would discuss this with her doctor to see about the options. Some people get amazing results with medication.

Medication does not always help and sometimes the patient is still quite challenging to handle and care for. Some patients will continue to be resistant and aggressive. When someone is in the late stage and resistant, it's almost impossible to handle them by yourself in the home. I would read a lot about what the progression is like and what is in store. That way you can explore the options.

Have you thought about having help come into the home? Placement in memory care is also an option. The staff there are trained to handle dementia patients. Your energy can then be more focused on just spending time with her and not being so exhausted.

Do you have family members who can help you? I would explore the options and discuss with your family to see what will work for her continued care.

If she is getting a full bath twice a week, I wouldn't worry too much as long as she is not suffering or having infections. Ask her doctor about it. I don't think I could give you any advice on how to keep an incontinent person with dementia clean around the clock by myself. It's a huge job. Maybe others here who do this can provide you some tips. God bless you.

Franke, sorry you hear that your wife is on that dementia journey. Here is a link to some good articles on what to do regarding Dementia/Alzheimer's... click on the link and scroll down to the articles.

https://www.agingcare.com/Alzheimers-Dementia