Mixed Dementia Can Be Confusing
Throughout Dementia Action Week, we’ve explored the major types of dementia and how they intersect with NHS Continuing Healthcare (CHC) funding. We’ve covered Alzheimer’s, Vascular Dementia, Frontotemporal Dementia, and Lewy Body Dementia. In this final blog of the series, we’re shining a light on a lesser-known but incredibly important condition - Mixed Dementia.
For expert CHC advice call 0113 320 5000
At Winston Solicitors, we frequently support families whose loved ones are living with more than one type of dementia. These families who often feel confused by the diagnosis, unsure about prognosis, and worried about the cost of care. This article aims to explain what Mixed Dementia is, how it progresses, and when CHC may be available to help with care needs.
What Is Mixed Dementia?
Mixed Dementia is a term used when someone has two or more types of dementia at the same time. The most common combination is Alzheimer’s disease and Vascular Dementia, but it can also include Lewy Body Dementia or, more rarely, Frontotemporal Dementia.
Historically, Mixed Dementia was thought to be rare. However, advances in brain imaging and post-mortem studies have shown that it may be much more common than previously believed. Particularly in people over 75. In fact, research suggests that over 50% of older adults with dementia may have mixed pathology.
Because symptoms often overlap and develop at different rates, diagnosing Mixed Dementia can be complex. The challenges of managing it, however, are all too real.
Why Mixed Dementia Is Different
Each type of dementia affects the brain differently. In Mixed Dementia, multiple parts of the brain are under attack at the same time, which can lead to:
- A broader range of symptoms
- A faster or more unpredictable progression
- Greater complexity in diagnosis and care planning
For example, someone with Alzheimer’s and Vascular Dementia may have both memory issues and problems with reasoning, planning, or physical coordination.
A person with Alzheimer’s and Lewy Body Dementia may experience hallucinations, movement problems, and sudden changes in alertness alongside memory loss.
This overlap can make symptoms more severe or harder to manage than with one type of dementia alone.
Common Symptoms of Mixed Dementia
Because Mixed Dementia involves multiple disease processes, symptoms will depend on the combination present. Some commonly observed issues include:
- Memory loss (often short-term)
- Confusion or disorientation
- Difficulty with language or understanding
- Changes in behaviour or personality
- Depression or apathy
- Hallucinations or delusions
- Physical symptoms like poor balance, tremors, or muscle stiffness
- Fluctuations in alertness and attention
These symptoms may not appear all at once. Instead, families often notice a slow layering of difficulties over time, with new challenges emerging as the condition progresses.
Diagnosing Mixed Dementia
Diagnosis can be tricky. Often, a person will be diagnosed with Alzheimer’s or Vascular Dementia first, and only later will doctors suspect there’s more going on. It’s not uncommon for Mixed Dementia to be confirmed only through a brain scan or in post-mortem studies.
That said, it is possible to make a working diagnosis of Mixed Dementia based on:
- Clinical history
- Cognitive testing
- Brain scans (MRI or CT)
- The presence of overlapping symptoms
Early and accurate diagnosis is important for care planning, medication management, and financial or legal decision-making. If you suspect your loved one’s symptoms don’t fit neatly into one box, it’s worth raising the possibility of Mixed Dementia with their clinician.
For expert CHC advice call 0113 320 5000
Progression and Prognosis
Mixed Dementia is progressive, meaning symptoms worsen over time. The rate of progression varies depending on the specific combination of dementias involved and the individual’s overall health.
In general, people with Mixed Dementia may:
- Decline more rapidly than those with Alzheimer’s alone
- Develop complex care needs earlier
- Experience more unpredictable symptoms day to day
Eventually, individuals may require full-time care, assistance with personal tasks, and support for both mental and physical symptoms.
Caring for Someone with Mixed Dementia
Caring for a person with Mixed Dementia can be demanding. Families often face a moving target of symptoms that don’t respond predictably to medication or intervention.
Common care challenges include:
- Managing confusion, agitation, or aggression
- Ensuring safety during episodes of disorientation or hallucinations
- Supporting mobility and preventing falls
- Communicating effectively when language skills decline
- Helping with personal care, eating, medication, and daily routines
Because the condition affects so many aspects of brain function, a multi-disciplinary team approach is often required. Carers may need support from GPs, dementia nurses, physiotherapists, occupational therapists, and social workers.
This level of complexity often means that NHS Continuing Healthcare should be explored.
What Is NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare (CHC) is a fully funded package of care provided by the NHS for individuals with significant health needs. It can be delivered in a care home, hospice, or even in a person’s own home.
CHC is not means-tested, which means eligibility depends entirely on the person’s health needs. Not their income or savings.
For people with Mixed Dementia, CHC may be especially appropriate where:
- Symptoms are severe or highly variable
- Behavioural and physical needs are both present
- Frequent nursing interventions are required
- The person needs 24/7 supervision or care
Yet many families are unaware of CHC or assume they won’t qualify. At Winston Solicitors, we believe it’s always worth seeking professional guidance to see whether an application is worth pursuing.
Why Mixed Dementia Shouldn’t Be Overlooked in CHC Assessments
One of the challenges with Mixed Dementia is that symptoms can appear "moderate" when assessed individually, but the combined effect creates high levels of need. CHC assessors sometimes fail to recognise this cumulative impact.
This is why a detailed understanding of the person’s daily care requirements, risks, and complexity is essential. CHC should be considered particularly where:
- The person is highly dependent on carers for personal care and mobility
- Behavioural symptoms (such as aggression or wandering) pose barriers to care
- Health interventions (e.g. skin care, continence care, or medication administration) require skilled oversight
- Fluctuating needs make care planning unpredictable
It’s also important to document how symptoms interact. For example, a person might fall due to poor balance (vascular damage) but be unable to explain what happened due to memory loss (Alzheimer’s). This kind of interplay is often misunderstood by assessors.
The Role of Legal Planning
Legal planning is a vital part of supporting someone with Mixed Dementia. As well as our CHC team, we have a dedicated Private Client Team who can help you with planning ahead.
We recommend:
- Lasting Powers of Attorney (LPAs) for health and financial decisions for those who still have capacity
- Deputyships for health and financial decisions for those who now lack capacity
- Wills to ensure assets are passed on according to their wishes
Early action is key. Once capacity is lost, families may face delays or barriers in managing finances or making health decisions on their loved one’s behalf.
How Winston Solicitors Can Help
We understand how overwhelming it can be to support someone with a complex diagnosis like Mixed Dementia. That’s why our team is here to offer clear, compassionate guidance every step of the way.
We can help you:
- Understand whether CHC may be appropriate
- Navigate the application or appeals process
- Prepare supporting documentation for assessments
- Connect with trusted local care and support services
In addition, our Private Client team can give you clear advice on putting in place LPAs and Wills. You don’t have to face this journey alone.
Final Thoughts for Dementia Action Week
Mixed Dementia might not be a household term, but it affects thousands of families every year. The overlap of different conditions makes it harder to diagnose and even harder to manage. But help is available.
If you’re supporting a loved one with a complex dementia diagnosis, or if their care needs are starting to feel unmanageable, it may be time to explore your options for funding and legal planning.
Contact Winston Solicitors today for expert advice on Mixed Dementia and Continuing Healthcare. We’re here to help you get the support you need.
