My 89 yr old father was diagnosed with vascular dementia last year. Is he being stubborn or is it dementia?

Oh, BLESS you and the situation you're dealing with.
My BIL moved in with Mom (my MIL) after his diagnosis, and didn't allow anyone to clean his room for MONTHS. He was hospitalized this week, and I went in and cleaned up.
IF he comes back to Mom's home, there will be a clear understanding that he will be responsible for sweeping/vacuuming, changing linens WEEKLY and that once a month I'm going in to damp mop and "deep dust". Our fervent hope is that he will relocated to a care facility that can help him live as independently as possible in a safe and controlled environment, as he should not be driving and has gotten lost a time or two already.
Put your foot down and inform your father that as a condition of independence and as an agreement of *minimal* interference, you insist he allow you or a cleaning service to come as often as necessary (weekly? bi-weekly?) and that he will bathe and change his clothes on an agreed upon schedule. Maybe every other day, or Monday, Wednesday and Friday or something. Oh and clean underwear daily or more often as required. Set up laundry baskets for darks, lights and towels and you'll be able to track how he's doing with this independence. If he can't handle as scheduled, explain that you will be sitting right there until he does it.
It's for his health and safety and will help alleviate _________ from worry. Fill in the blank; if he's angry at you, ya can't use yourself but pick somebody he cares for or use his doctor, even -- and you'll have to tell his doctor if he doesn't comply.
You could even try a reward system; I've known some elderly folks who would do anything for a soft-serve ice cream cone from the drive-thru.
See if his doctor will medically revoke his drivers license?
All the best to you!

It could be a little of both, you know what he was like before and we don't.
Now is the time to get all your ducks in a row so that when you need to act you are ready: figure out all you need to know about transportation services, meals on wheels, agency home care, assisted living/memory care/nursing homes in your area, and investigate financial planning such as care contracts and medicaid eligibility considerations - I hope he already has his POAs in place? If he shouldn't drive then the car has to go.

The answer to your question is really only important as far as it relates to your father’s safety, comfort, and overall welfare.

You’ve taken his guns, and if the doctor says that he’s not capable of driving safely, and you have responsibility for him (POA?), you need to remove his car.

If he won’t bathe or change his clothes, you will have to inform him that he’s smells (if he does), and people who like/love him can’t tolerate his odor, so he won’t be included as part of family activities or other social events. His choice- .

He is, and will continue to be angry with you, but if your most important responsibility is caring for him, you have to take the anger (and the outbursts) in stride.

No matter what else he is still able to do, vascular dementia is impacting on EVERY ACTIVITY he undertakes. Your supervision won’t be pleasant or comfortable for either of you, but you’ll have to do what your conscience dictates.

Most of us encounter this kind of situation somewhere in caring for someone with dementia. Be sure to establish a sense of healthy balance between caring for him and caring for yourself and other family members who love you and depend upon you.

One of the challenges of dementia is its subtleties. You are still interacting with your "pre-dementia" father because your relationship is so ingrained over decades. There is cognitive dissonance when he behaves in irrational ways: we tell ourselves he is stubborn, lazy, controlling, in denial. What he is, is in dementia. His brain is broken and is continuing to break. We can't see it like a cut or bruise or a broken arm. It's in increments and changes come and we can't see it until we experience it through an interaction or observable behavior. Daily I have to remind myself not to argue with my mom when she's having a confused thought. Yesterday she was going to the grocery store to buy dinner fixings and she said she didn't know if she could get the meat (chicken) because it might not be in season. !! So, people with dementia can not only NOT learn new things or follow new routines, they are actively losing what was existing in their minds.

Teepa Snow has some very good videos on dementia on YouTube. I really recommend watching a few so that you don't burn energy unnecessarily struggling with your father and his dementia. There are enough challenges already. May you gain wisdom and peace in your heart.

"Wont admit for ANYthing that he needs help at all"

He just won't know.
His ability to reason he needs any help or needs to wash will probably fluctuate. Flicker off & on like a faulty lightglobe.

Arguing, trying to reason with him will probably just infuriate you both.

Is he living alone? Supervision will become necessary sooner, later or maybe now?

Lack of proper food & fluid intake causes problems: dehydration, dizziness, & falls. Diminishing kitchen skills can cause accidents: leaving the stove on, misuse of microwave oven, burns. Leaving taps running, heater on high, doors unlocked, it goes on.

Sorry if this sounds scary. Despite their anger, sometimes you have to make unpopular choices.

I am so sorry you are in the middle of this. I had to convince myself that my dad’s safety (and safety of others while driving!), nutrition, medication management and my sanity were the most important things during this very stressful time. My dad had Lewy Body Dementia and his reasoning skills fluctuated. The reasoning fluctuations were so unpredictable! I decided his general safety was what mattered. What that ends up being might look different for you, but I moved him to an caring assisted living facility. I wish you the very best of getting him help.

All pretty much in line with dementia. It is hard and frustrating, but if you can avoid arguing with him, it will lower your BP! You can't argue with dementia, or rather you can't win the argument.

My mother, even in the early stages, was adamant that she was "fine, independent and could cook." Answer was none of the above, but it was pointless trying to convince her otherwise. Her response to being forgetful? I'm old, I'm entitled to forget sometimes. Problem is it wasn't sometimes!

Driving is a HUGE issue. Others will argue with us and say it's their car and their decision. Yes, it is their care, but it should NOT be their decision. My response to others who chastise those of us who take the car away is that I would rather deal with any legal issues about taking and selling the car (all money received went into her account for her care/use) than all the repercussions of dealing with an accident where she or others could get injured or killed.

While some (few) might accept a doctor telling them not to drive or letters from the DMV, most either don't believe it or forget it and will attempt to drive anyway. YB did all the talking (I was there) and took her key. She looked like a 5yo who had been caught in the cookie jar. On the way out, I told him I think she has another key, and suggested he disable the car. He pulled the battery cable. That might work for many, but too often men are car-monkeys and can figure that out. The very next day, who gets the nasty call demanding the key back? Me. I told her I never touched it and she asked who did then. I replied you're so smart, you figure it out and hung up. Rude, but she was SO nasty about it I couldn't help it! Day 2, another nasty call, demanding I get down there right away and fix whatever I did to her car. So, despite dementia, she managed to locate that other key and attempted to go drive! While there are so many skills lacking, it can be perplexing how they manage what they often do!

The best thing you can do about driving is move the car to a place he can't find it (selling it is even better, if you have POA.) If not, then you need to disable it somehow, either use The Club or have a kill switch installed. Hiding his keys might work for a while, but never underestimate what someone with dementia is capable of! You may have to disable your own car(s) if you live with him. If he snags your keys, he will be off like a rocket!

Others have made suggestions about bathing, here and in other threads. I didn't have to deal with that myself, but it was clear my mother was wearing the same clothes multiple times (we had cameras at the door and I would see her in the same ones, once 6 days in a row! Given that she had enough clothes to open a store, this was definitely out of character.) Once when OB was visiting, he pointed out food stains on her clothes. She looked at them and laughed!

Assumption is you are living with him. Does he change into night wear? If so, after he's asleep, take the clothes away and leave clean ones out for him. No discussion, just put them out.

If all else fails, perhaps trying some medication can help. Some anti-anxiety meds can make a person a little more compliant. But again, approach it as a choice he makes, not a demand. Although they are not children, sometimes we have to use similar tactics to get them to make the decisions.

Hard as it is, try not to let his anger get under your skin. Unless this is how he was before, it is just how the dementia is affecting him. Avoid confrontations. Provide him with choices rather than presenting a wall that he will try to knock down! He is right - a little dirt won't hurt anyone, but messes will need to be cleaned up. I wouldn't count on him doing it, so just take a deep breath and clean up.

It sounds like there are at least 2 of you living with him. Even with 2, this will become more and more difficult to manage and you will need help. Now is the time to do some research, to find out what is available.

You can call your local DMV and report to them he is unable to drive safely anymore

https://manchestermanorch.com/protect-unsafe-elderly-driver-close/

You have to tell him he stinks like a skunk and needs to bathe. Do it at a scheduled basis. You have to set limits.

Your doctor can prescribe psychotropic medications, but the flipside are side effects including worsening balance and higher risk for falls.

Does he live with you? My SIL lived with my MIL and required ER care. In comes social services because MIl stunk, nails long and dirty, hair a mess. As she spilled out how MIl won't ...... Social services let it be known if you are caring for someone in your home it is your responsibility or you can be charged with elderly neglect. So there you have it. They did not charge her as MIL ultimately died after being admitted, however, she was scared to death-dealing with a strong-minded mother who could have caused her to go to jail. I've shared this story with many a caregiver. I remind my own Mother. If you don't stay clean and fight me then you are more than I can handle and arrangements will have to be made to move her to a nursing home and I have POA. She has no problem keeping clean.

Have said this before, but although I am not a "group" kind of person I did find the local chapter of the Alzheimer's Assn (it can be for any kind of dementia) had a specific group for adult children and it was beneficial. Unfortunately we were a great group with a sense of humor, had a great facilitator and she opted to resign after many years due to a change in how the organization was going to operate. Once she left things took a turn and one by one people stopped showing up and the staff or volunteers attempting to lead the meeting were just not meeting the bar so to speak. I tried to keep going but lost patience with the leadership. May try again. There are some in-home services maybe provided through his city of residence to help on a sliding scale to do cleaning or provide some care assistance, but he sounds like stubborn one. Do NOT let these issues get to you, do NOT burn yourself out with care or worry. Maybe check into Meals on Wheels. Can he cook a frozen meal? I have tried to do much for my parents who supported me all these years, but it wound up nearly taking my life...literally. So I am a one-woman campaign to warn others not to take the same path. You need to take care of you too!

Guns are out of the house.
Measy won't hurt him.
Maybe you can hire a maid to come in once a week.

Let him start eating microwaveable meals that are easy to cook and no clean up.
Eany food to snack on like apples, grapes, nuts, apple sauce, yogurt, breakfast bars and drinks.

As far as the driving goes. It depends on his dementia.

He might just have short term memory and still be able to drive short distances.

Sone times Dr's will agree with the person helping the loved ones when really they don't know how the patient is really doing seeing that they are checking to see his blood pressure, ect and sees you like 10 minutes a year.

Go for a short drive with your Dad, see if he knows to stop at stop signs and red lights and go for green light and not get lost going to and from the store.

Prayers

Depends. Vascular dementia is "stroke related. Symptoms depend on which area of the brain is not getting enough blood. Talk to his doctor for more insight.

If it is the dementia or stubbornness, try to do mini wash-ups and mini clean-ups throughout the day and week. If cleaning becomes more of the routine, eventually he will stop being so angry about it.

Your dad is regressing. You or someone you employ will need to help him get bathed and dressed before going out now. He is not going to admit to anything because his mind is not the same as it was. In some ways you are dealing with a child and you would not allow a child to drive - the doctor is right. You would not want a child having access to firearms either. Dont argue with him or try to make him admit to the changes hes going through because he isnt able to comprehend what his mind is going through. Enjoy each day with him, dementia and all. People with dementia are still a joy to be around. I work with people who have it. They can be a handful and you will most likely need help but take the rest of your time with your dad a day at a time and hold on to something good each day.

Imho, this was the epitome of my daughter's FIL, who suffered from vascular dementia. He, too, was stubborn, refused to bathe, demanded to wear dirty clothing, made messes with food and drink products, et al. A hemorrhagic stroke ended his life. Please see that your father's specialist monitors his brain function routinely.

Dementia.
The thing that has helped me is getting him to laugh and smile. I use the things I know he likes to make him happy. Eventually he is ok with getting his bath. (I'm not sure if your dad gets in the shower himself, but won't now, than this is the point where he need home care and sponge bathed.) And usually I put the polka on and dance and sing for him while doing his bath and he laughs at me. Patience. There are times when he gets mean but I stay positive and never give up and eventually he comes around. We have to remember that these are not their normal thoughts and actions. This is the end of their lives and need love compassion caring and fun! Lol. If at some point they are not able to be cared for at home or you feel you can no longer do it( as some do become combative) then it is time to move them. This is in no way your fault. It is ok to ask for help. Never feel guilty over this. You loved and did all you could. Hugs to you!
O ya. Mine is still asking everyday where his car is and thinks he still drives. He is 87. It's been 2 yrs since he drove and he actually owned a company that has been closed for about 10 years and still thinks he is in business. Everyday he needs to get to work...i ask him why.,he say he has so much to do it's unbelievable. We all have to find some humor in it or we will all go crazy. It's ok.

When my Papa had the same issues, he had a younger (than him) buddy willing to help. I gave him two choices for a shower: me or his friend - of course he took his male friend. Maybe put it to him that way - give him two options and put your foot down (maybe you or an aide). My Papa was as bullheaded as they come, that was the only way to get through. That way he still thought he had some control, even though he really didn’t.

As far as his clothes, any time he took them off, I gathered them up and put them in the car for laundry day - oops sorry Papa!

All of that is normal and predictable, especially for his age and diagnoses.
He’s 89!
He is going to be grizzly and stubborn.
One day you might be too.
How many elderly humans”, go out,” smiling with joy and gratitude?
Play nostalgic music, and try a sponge bath in between actual showers.
My step father (decades ago) punched me, as I tried to help with a shower, so I get it.
They can’t help these awful symptoms, so try to remember that.
Its not personal it’s a disease.
Get someone in between to help you out, because not doing that, will suck the life out of you-
“Remember, we’re all just walking each other home.” 💜😇☮️