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You mentioned your mom has vascular dementia. Honestly, sometimes I think the doctors are clueless with the elderly. I can relate to how well they can appear at doctor visits; but act totally different in their own environment.
Do you think your mother has depression, or some other form of mental illness that would explain the highs and lows, energy, no energy. My mother goes from one extreme to another as well; but has diagnosed mental problems; but can be savvy enough at the doctor to come across normal. It is hard to explain; MIL was like this as well.
If you are getting ulcers from this, then that is your body telling you to get some help. I would love to help you in any way I can. I'm not an only child, but in this alone - my brother is deceased and sister lives 3,000 miles away and wants no involvement. I highly recommend Elder Services in your town - just for coping strategies and understanding of your plight.
Please write to me anytime - my mother has 9 lives and if I could figure out her behaviour I would be a brain surgeon. Blessings to you and hugs.
I don't know much about vascular dementia. I know that great fluctuations are a hallmark of the kind of dementia my husband has, Lewy Body Dementia. Perhaps you could talk to her doctor about what to expect with vascular dementia.
Since she is possibly in the final stage of her life (I only say possibly) perhaps you all would benefit from hospice services. Would her doctor approve that?
Hugs to you in this challenging situation.