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You may be concerned or frustrated if you or someone you care about starts having some memory or thinking issues. There can be many reasons for this, and it is best to start by speaking with a doctor and care team. Some underlying causes are treatable, and there is support to help you or someone you care about live a more fulfilling and safe life if it is dementia or a mild cognitive impairment (MCI).
What is Mild Cognitive Impairment (MCI)?
People living with mild cognitive impairment (MCI) may have some trouble with memory, thinking, understanding, and speaking that is not related to aging. While the person may not reach a level where they are considered to have dementia, slight changes could be a reason for concern, and the person should meet with their doctor. If it’s reversible (like a treatable infection), the doctor may help treat the underlying cause. If the cause is unknown or the person is diagnosed with mild cognitive impairment (MCI), you will want to take steps to ensure safety in the home and so the person remains healthy and independent as long as possible.
What are the Signs of Mild Cognitive Impairment (MCI)?
It is important to remember that the signs below are only warning signs if they are different from what the person can usually do in their normal environment. For example, if someone has always been anxious, anxiety isn’t necessarily a sign of mild cognitive impairment. Also, if someone has different work tasks or more work, they may have difficulty completing it.
- Forgetting important things: we all forget where our keys or phone are from time to time, but misplacing checkbooks, credit cards, medication, and other important documents or forgetting things more than occasionally can be a warning sign. Also, forgetting to go to important places, like a doctor’s appointment, may be a sign.
- Difficulty speaking: People may not be able to find the word they want to use when talking.
- Trouble with complex tasks: Difficulty with planning an event, driving, handling finances, or difficulty with work duties may be a sign that mental capabilities are changing.
- Taking longer to complete tasks: Requiring extra time NOT due to physical changes, may mean someone is requiring more time to think about the task or make decisions a be a sign of cognitive changes.
- Mood Changes: People who have trouble understanding can easily become frustrated, anxious, and agitated. People may also completely withdraw or give up on completing the task if it is too hard.
- Poor judgment: People may make decisions that seem unsafe or bad because they are having trouble understanding the consequences of the decision. They may not be able to understand alternative options or be overwhelmed with the decision-making process in general.
What are some causes of Mild Cognitive Impairment (MCI)?
Many people first ask why someone is forgetting more or having increased difficulty understanding things they used to be able to. There are many reasons this may occur:
- Stress
- Poor Nutrition
- Medication Side Effects
- Medical Issues (infections, neurological disorders and other medical conditions)
- Sensory Issues: poor eyesight or hearing many also affect comprehension and should be examined as a possible cause for confusion or misunderstanding
The condition may also be a chronic condition or something that is temporary (like temporary stress or a treatable urinary tract infection).
**The first step is to consult the person’s primary care doctor to further understand why this is happening and make a plan.**
Signs of a Mild Cognitive Impairment
- Forgetting important things: we all forget where our keys or phone are from time to time, but misplacing checkbooks, credit cards, medication and other important documents or forgetting things more than occasionally can be a warning sign.
- Trouble with complex tasks: Difficulty with planning an event, driving, handling finances or difficulty with work duties may be sign that mental capabilities are changing.
- Taking longer to complete tasks: Requiring extra time NOT due to physical changes, may mean someone is requiring more time to think about the task or make decisions.
- Mood Changes: When people have trouble understanding, they can become frustrated, anxious and agitated easily. People may also completely withdraw or give up on completing the task if it is too hard.
- Poor judgement: People may make bad or unsafe decision.
What can be done?
How a mild cognitive impairment is addressed depends on the cause. If the doctor rules out medical conditions that can be corrected or medication side effects and determines the cognitive impairment will be ongoing or progressive, ask for a referral to a psychologist, occupational therapist, speech language pathologist or certified dementia practitioner. These professionals will be able to give you more specific recommendations based on unique needs and the level of the cognitive impairment. Some general ideas include:
- Getting a monitoring system or medical alert system to allow someone to get help if needed (granted the person is at a level where they can recall to use the alert system.) Improving technology such as wearable technology can also be useful to make calls and detect emergencies.
- Support the person by offering assistance. Make sure you do not patronize the person or take away their role. Offer to do it with the person to monitor for safety. I frequently recommend that anyone with cognitive impairments, lots of medicine or really anyone have someone else there when they are filling up their pill box. I typically say something like, “It’s hard to set them up perfect every-time when you have lots of medications. But, it’s one of those things that if you make a small mistake or miss a does, it can have big consequences, so it is always good to have 2 sets of eyes when you are filling up your medication box, just to double check.” Try not to make the person feel unable to do anything, just give support for safety. This could also be done with things like managing finances. Read 3 ways to Improve Communication and Relationships for additional tips! Also help them stay on top of home maintenance with this Home Maintenace Checklist with special considerations for seniors.
- Hire a companion or caregiver. Sometimes people will need help, but be more reluctant to receive help from their family as they feel like a burden or try to “hide” the extent of their issue from their family.
- Use technology. There are Smart clocks for orientation to the date and time, automatic pill dispensers to help with medication management, automatic pet feeders so the pet does not go hungry and more devices are always coming out as technology advances! Smart technology is also continuously improving and is already part of our everyday lives. Stoves and curling irons that turn off automatically after a set period of time to decrease the risk of fires and programmable thermostats are a few examples. See this guide for more ideas to keep someone safer at home.
Ensure to continuously monitor for worsening cognitive changes as a more support or a higher level of care may be needed. Striking a balance is key. While you want to try to support safe independence, knowing warning signs and being proactive to prevent mishaps is important. See the following related resources for more details:
5 Powerful Ways to Adapt to Roles
Professionals and Free Resources to Help with Aging in Place
Interactions of the Person, Environment and Occupation or Task
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