I know I've come to the right place when I ask.....has anyone else experienced this?

Vascular dementia is a reduction of blood flow to the brain, which can be seen on a scan while other dementia types are found on autopsy, so maybe that is the driver behind the change in diagnosis. But I agree it's really a best-guess situation.

Many times, different types of dementias exist in the same person. It's called MIXED DEMENTIA. Risperidone is an antipsychotic used in this case, to control her agitation. Her thought disorder will continue unabated and her cognitive disorder may even get worse from the Risperidone. There is point in trying to reason with her. The only way to make a dementia diagnosis 100% accurate is by autopsy and after examining the brain tissue with a microscope. The classification into various types is more academic than anything else. All dementias are incurable and will kill the patient eventually.

How did your mom go from LBD to vascular dementia, I wonder? Oftentimes I don't think these doctors know WHAT they're even talking about when it comes to dementia and diseases of the mind! How long has your mom been suffering from dementia? Because VD is the quickest of all of them; it has a 5 year life expectancy to it. My mother was dx'ed in Dec of 2016 and she was just accepted in hospice on 12/21. She's deteriorated VERY quickly over the past 5 years to the point where she too is talking continuously of her dead siblings and parents, as if they are alive but just ignoring/abandoning her, and making up other outrageous stories as well, although nothing like your mom's.

I wonder if the meds are making your mom worse? I know my mother can't handle most meds at ALL; they make her mind function MUCH worse! When she was on Cymbalta for instance, she got SO bad SO fast, that she was incoherent and falling down w/o realizing she was on the floor! So for me, whenever I see a decline, I first think is she on a new medicine? If not, then I wonder if she's had a TIA or a stroke? I can't get that confirmed b/c a trip to the ER is a huge waste of time these days; if an elder doesn't have Covid, they're given the bum's rush in our experience. Mom was sent to the ER earlier in Dec for chest pain, given an EKG in the ambulance (which was normal), so the ER doc gave her a blood test and sent her on her way. In reality, I believe she has a pulmonary embolism b/c her oxygen levels are dipping down into the 60s which the ER doc ignored.

So, the other answer for new and off the rails behavior could be a UTI. Or she could have just taken another step down, cognitively, which is how VD works. They go along at a certain cognitive level for quite a while and then BOOM, they take a step down. That's what you may be witnessing now with your mother.

Each time my mother was hospitalized, it took quite a while for her to get back to her baseline normal also; it takes a lot out of them to BE hospitalized, so there's that factor to consider too. They get very disoriented when in the hospital, and take a cognitive hit, so that could be why your mom is delusional right now. Mine was delirious when in the hospital and then rehab, for the entire time! It was awful.

But who knows WHAT is happening to her, really, in the absence of tests for UTIs, strokes, etc? Can you ask her PCP for a hospice evaluation? S/he may have something of value to add to this mess you're in; I sure hope so.

I'm so sorry you are going thru such a terrible experience with your mom. I know how this feels and it's a 24/7 stomach ache. Sending you a big hug and a prayer for peace in the midst of the chaos.

This is all such an inexact science. When my brother was diagnosed with probable early Lewy's we were told he was being diagnosed solely by his symptoms (which were quite classic for Lewy's.) He died of sepsis, but at the time that was one and one half years after diagnosis and he had done nothing but IMPROVE after he went to ALF (go figure) and I handled all his finances in and out. He relaxed and was better and they said that wasn't unusual. You are looking at two different diagnoses, and looking at medications as well, and it is almost impossible to tell what is causing what. When I got cancer and asked about one treatment versus another my oncologist leaned back, put his feet on his desk and said "Ohhhhhhhhh, I don't know. It's anything but an exact science. And I can tell you that because you are a nurse; I can't tell other patients that because they are sick and they want answers". Ha! Little did he know. I was a nurse. But I was sick and I wanted answers.
I think part of the charm of agingcare is that we are all struggling for the "answers", and eventually we all end up knowing that what may be an answer for another isn't for us, or what is for us isn't for another.
I am so sad to hear about all that is going on for you and for your Mom. I am assuming she is in care now? Is that going OK for all of you?
And yes, let us all hope for a New Year as happy as it can be.