The neurologist emphasized that with vascular dementia, the person has much difficulty with going from step 1, to 2, to 3, to reach 4. So, I purposefully give direction in short sentences, in order. Structure and fewer choices are important. I pick the shirt, hand it to him so the armhole is lined up with the correct arm, he does the rest. I do the top button, he does the rest. I put out the right shoes, he puts them on, etc. He is no longer able to tie laces, so I just bought slip-ons, keeping positive- "These are so comfy." He is no longer able to make sense of a menu, I cheerily say, "I know your favorites!" and say that to the server too- we all laugh.
I think it's very important to be calm and cheerful, as hard as it may be. I believe the person with vascular dementia observes and picks up the caregiver's emotions very quickly and mirrors them and may start to spiral if the emotions are those of upset or worry.