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They get through the hospitalization, and you're relieved. But when they come home, things aren't quite the same. They're more forgetful, less steady on their feet, or suddenly need help with things they used to manage on their own. And just as you're adjusting, something else changes.
In this episode of Navigating Dementia, Carlyn shares her grandmother's story and explores vascular dementia, including how changes in blood flow to the brain can affect thinking, movement, mood, and everyday abilities.
While memory changes are often associated with Alzheimer's disease, vascular dementia may also show up as slower thinking, difficulty getting started, trouble organizing tasks, or changes in walking and balance. Sometimes changes appear suddenly after a stroke. Other times, they develop gradually, making them harder to recognize.
Drawing on 25 years as a physical therapist and her family's experience, Carlyn explains why vascular dementia doesn't look the same for everyone, how symptoms may progress, what families might notice at home, and how understanding those changes can help you offer more meaningful support.
In this episode, you'll learn:
One Thing to Try This Week
Choose one everyday task that's become more difficult. Notice where the person gets stuck.
Do they need help getting started? More time to process what you're asking? Fewer instructions? A change in the environment?
Sometimes a small adjustment can make a meaningful difference.
And remember, your needs matter, too. If everyday routines are taking longer or the person now needs more supervision, that's important information to share with the healthcare team.
Coming Next Week
Next week, we're talking about mixed dementia, when more than one disease process contributes to changes in thinking and everyday function.
We'll explore why symptoms can overlap, what that means for families, and how to focus on what the person needs, even when the diagnosis isn't straightforward.
Free Doctor Visit Guide
Use this free guide to organize your observations and questions before the next appointment. You don’t need a diagnosis to use it.
Download the Doctor Visit Guide
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way in Dementia Care → https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep14_shownotes
Website → https://www.abetterwaydementiacaresolutions.com
Facebook → https://www.facebook.com/profile.php?id=61562478140551
Instagram → https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn → https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest → https://www.pinterest.com/carlyn0832/
YouTube → https://www.youtube.com/@NavigatingDementia
If this episode helped you understand a difficult moment, share it with someone who could use that same support.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual’s needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
What if someone remembers appointments, conversations, and what they had for dinner last night, but their behavior, judgment, or personality seems completely different?
Would dementia even cross your mind?
In this episode, Carlyn explores frontotemporal dementia (FTD), a group of brain disorders that can affect behavior, decision-making, emotional responses, and language long before memory problems become noticeable.
She shares a story from a conference about a mother whose son began showing subtle personality changes in his thirties, followed by a serious incident at work that eventually led to an FTD diagnosis. It’s a reminder of how difficult these changes can be to recognize when families are living through them one day at a time.
As part of the Know the Waters series within The Signal Guide Navigation System™, Carlyn explains:
W ether you’re noticing unexplained changes in someone close to you or already supporting a person diagnosed with FTD, this conversation offers a clearer understanding of what may be happening and where to turn for help.
Free Doctor Visit Guide
Use this free guide to organize your observations and questions before the next appointment. You don’t need a diagnosis to use it.
Download the Doctor Visit Guide
Additional FTD Resources
The Association for Frontotemporal Degeneration (AFTD)
Information, education, and support for people living with FTD and their families.
https://www.theaftd.org/
National Institute on Aging
Information about frontotemporal disorders, symptoms, diagnosis, and care.
https://www.nia.nih.gov/health/frontotemporal-disorders
Coming Next Week
Next week, we’ll explore vascular dementia and mixed dementia, including how changes in blood flow to the brain can affect everyday function, why symptoms may look different from one person to another, and what happens when more than one type of dementia is present.
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way in Dementia Care → https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep13_shownotes
Website → https://www.abetterwaydementiacaresolutions.com
Facebook → https://www.facebook.com/profile.php?id=61562478140551
Instagram → https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn → https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest → https://www.pinterest.com/carlyn0832/
YouTube → https://www.youtube.com/@NavigatingDementia
If this episode helped you understand a difficult moment, share it with someone who could use that same support.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual’s needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
What happens when something has clearly changed, but forgetting isn’t the first thing a family notices?
With Lewy body dementia, someone may follow a conversation over breakfast and need much more help getting dressed a little later. Add disrupted sleep, changes in movement, or seeing things that aren’t there, and families can be left wondering what’s happening and how to respond.
In Episode 12 of Navigating Dementia, Carlyn Lenfestey explores Lewy body dementia through Know the Waters, the first step in The Signal Guide Navigation System™. We follow an imagined morning to understand how the diagnosis can affect everyday life, what support might help, and what to bring up with the healthcare team, even if you’re still seeking a diagnosis.
In this episode, we talk about:
A question to carry into your week:
“What part of the day do we most need help with?”
Start with one example. Maybe getting dressed has become harder, sleep is interfering with meals, or you’re awake much of the night. Write down what’s happening and how it’s affecting both of you. You don’t need the right medical words to ask for help.
Free Doctor Visit Guide
Use this free guide to organize your observations and questions before the next appointment. You don’t need a diagnosis to use it.
Download the Doctor Visit Guide
Next week, we’ll explore frontotemporal dementia, or FTD, including why changes in behavior, judgment, personality, or language may appear before memory becomes the main concern.
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep12_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
If this episode helped you understand a difficult moment, share it with someone who could use that same support.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
How can someone with Alzheimer’s remember an old song but forget a conversation from five minutes ago?
That difference can be confusing, especially when you’re answering the same question again or trying to help with an appointment they don’t remember discussing.
In Episode 11 of Navigating Dementia, Carlyn Lenfestey explores Alzheimer’s disease through Know the Waters, the first step in The Signal Guide Navigation System™. We look at what the diagnosis can tell us about everyday challenges and how to offer support that fits the abilities available right now.
In this episode, we talk about:
A question to carry into your week:
“How can I make this easier to do with the abilities that are available right now?”
Try noticing one moment that asks the person to remember something. Could you offer the information when it’s needed, show the next step, or use a reminder they can understand?
Next week, we’ll explore Lewy body dementia, including changes in attention, alertness, movement, and visual experience.
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep11_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
If this episode helped you understand a difficult moment, share it with someone who could use that same support.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
How can someone with Alzheimer’s remember an old song but forget a conversation from five minutes ago?
That difference can be confusing, especially when you’re answering the same question again or trying to help with an appointment they don’t remember discussing.
In Episode 11 of Navigating Dementia, Carlyn Lenfestey explores Alzheimer’s disease through Know the Waters, the first step in The Signal Guide Navigation System™. We look at what the diagnosis can tell us about everyday challenges and how to offer support that fits the abilities available right now.
In this episode, we talk about:
A question to carry into your week:
“How can I make this easier to do with the abilities that are available right now?”
Try noticing one moment that asks the person to remember something. Could you offer the information when it’s needed, show the next step, or use a reminder they can understand?
Next week, we’ll explore Lewy body dementia, including changes in attention, alertness, movement, and visual experience.
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep11_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
If this episode helped you understand a difficult moment, share it with someone who could use that same support.
When something changes in dementia care, it is easy to focus on the part we can see. Someone refuses help, becomes upset, or repeatedly says, “I need to go home.” Our first instinct may be to correct the words or stop the behavior.
But before we decide what the signal means or how to respond, we need some context.
In this episode, Carlyn introduces the first part of The Signal Guide Navigation System™: Know the Waters. She shares why it helps to look at three things together: the diagnosis, the person, and what is happening in this particular moment.
A diagnosis can give us a useful place to start, but it cannot tell us everything about the person in front of us. Their history, routines, roles, preferences, and the conditions around them all shape what they may need. When we widen the frame, we have a better chance of offering support that actually fits.
In this episode, we talk about:
The three questions to carry with you
You will not always have complete answers. This is not a test you have to pass before you can help someone. It is a way to use what you know, notice what you do not know, and stay open to what the person is showing you.
Connect with Carlyn FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep10_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
Before you focus on getting a behavior to stop, ask the question that actually changes things: what is it trying to tell you?
In this episode, Carlyn picks up a thread from the woman and the playlist story from last week, then widens it into something bigger. Someone keeps standing up during a meal. You sit them back down, remind them it's time to eat, move the chair in, and a minute later they're up again. If we only look at what we can see, the goal quietly becomes keeping them in the chair. But the standing up might be a full bladder, a sore hip, a too loud room, food they don't recognize, or someone across the room they're trying to follow. The person may not have the words to explain any of that, so their response becomes the explanation instead.
The problem was never just about making a behavior stop. Carlyn makes the case that behavior, and its absence, is information, and that safety always comes first when there's real danger, but once that danger has passed, the real work is asking what changed, not just how to make it stop. She also introduces something new: The Signal Guide™ navigation system, six words that sit around the Wheel of Function™ for the moments when a tip doesn't work and you need a way to think it through instead.
In This Episode
Connect with Carlyn FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep9_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
The wheel is only half the picture. Follow the show, because next week we start knowing the waters, the first step in actually using it.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
Before you decide someone "can't do that anymore," ask the question that actually changes things: did anything change in them, or just around them?
In this episode, Carlyn tells the story of a woman in an adult day program whose mornings kept falling apart. The moment staff approached to help her wash and dress, she'd become agitated and shut down, and once that happened, there was no bringing her back into the task. An occupational therapist could have focused on the task itself, a different cue, a different way of laying out the clothes. Instead, she looked at what was happening before the task even started. She found the music this woman loved, built it into a calm, familiar playlist, and had staff turn it on twenty to thirty minutes before they ever approached her. By the time they did, she was calmer, more open, and able to do far more of the washing and dressing herself.
That story opens the fifth and final spoke of the Wheel of Function™: the environment. The problem was never just the room, the noise, or the lighting. Carlyn walks through why the same person can feed herself just fine at her kitchen table but struggle in a busy dining room, why a dim bathroom or a dark mat can quietly work against someone, and why a drawer with twelve shirt choices can feel like less independence, not more. She also makes the case that care partners are part of the environment too, our voice, our pace, our touch, even how rushed we feel, and that with all five spokes now on the table, the wheel is finally whole.
In This Episode
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep6_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
All five spokes of the Wheel of Function™ are on the table now, sensory, emotional, physical, cognitive, and environmental. Follow the show, because next week is where we start putting them to work.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
Before you break another task into five careful steps, ask the question that actually changes things: is breaking it down helping her brain, or asking it to do more?
In this episode, Carlyn goes back to a story from the adult day program, a woman who could not get out of her chair. Standing in front of her and walking through it step by step, "scoot forward, bring your feet back, lean forward, push, stand," made her more stuck with every instruction. But walking over, holding out a hand, and saying "come with me" gave her a much better chance of standing. Same woman, same chair, same legs. What changed was the demand on her brain, and that is where this episode opens up the third spoke of the Wheel of Function™: cognition, the spoke Carlyn calls the driver of function.
The problem was never just about memory. Cognition is what lets us pay attention long enough to act, understand what is being asked, start a task and stay with it, know what comes next, and notice when something is not working. Carlyn walks through how much of that happens automatically when you get dressed in the morning, and how differently it can look once that process starts to change. Sometimes the shirt can't be found against a bedspread of the same color, that's sensory. Sometimes embarrassment about needing help gets in the way, that's emotion. Sometimes a sore shoulder makes the sleeve painful, that's physical. And sometimes the person can dress beautifully once you hand her the shirt, she just couldn't start on her own, that's cognition. She makes the case for asking "what part is getting in the way?" instead of only "can she do it?", and for changing the task to fit the brain in front of you instead of expecting that brain to adapt to everything around it.
In This Episode
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep6_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
Before you decide someone "just can't do this anymore," ask the question that actually changes things: what's different about this moment, not this person?
In this episode, Carlyn tells the story of a woman at an adult day program who had the hardest time getting out of a chair. Staff would walk her through it step by step, scoot forward, feet back, lean forward, push, stand, and the more instructions she got, the more stuck she became. But if Carlyn simply held out her hand and said "come with me," she had a much better chance of standing up on her own. Same woman. Same chair. Same legs. What changed wasn't her strength, it was what her brain was being asked to do with the information coming at her. That's the doorway into the third spoke of the Wheel of Function™: physical function, and why it is so much more than a question of "is she strong enough."
The problem was never just about the chair, or the six-step instruction, or the sweater that didn't get finished. Carlyn walks through why "he did it this morning" doesn't mean "he can do it tonight," why a couch can be a harder physical task than a dining chair even for the exact same person, why unexplained pain often hides behind "he doesn't want to," and why more help isn't always better help. She makes the case that physical function fluctuates the same way it does in any of us, and that the real question is never "can they or can't they," it's "what do they need to be successful right now."
In This Episode
Connect with Carlyn
FREE Weekly Newsletter, Finding Our Way In Dementia Care -> https://abetterwaydementiacaresolutions.com/page/weekly-sign-up-1?utm_source=podcast&utm_medium=shownotes&utm_campaign=ep6_shownotes
Website -> https://www.abetterwaydementiacaresolutions.com
Facebook -> https://www.facebook.com/profile.php?id=61562478140551
Instagram -> https://www.instagram.com/abetterwaydementiacaresolution/
LinkedIn -> https://www.linkedin.com/in/carlyn-lenfestey-abetterwaydementiacaresolutions
Pinterest -> https://www.pinterest.com/carlyn0832/
YouTube -> https://www.youtube.com/@NavigatingDementia
If this one changed how you'll look at "he can't do this anymore," follow the show so you catch what's next: the cognitive spoke, and the story that's been waiting for it since this episode's opening scene.
DISCLAIMER
The information provided in this episode is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual's needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
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