First sign of forgetfulness and we become deeply concerned.  Unfortunately dementia is a major part of our world these days.  Makes us all pay closer attention to our lack of perfection(s) while wondering if we just might have mild cognitive impairment.

But are forgotten names, appointments, or important dates a significant sign of dementia?  Happy answer.  No it is not. 

MCI defined 

If not dementia, then what?  It could be Mild Cognitive Impairment (MCI).  What is the difference between the two?  According to “The Lancet‘s” online article, “cognitive decline [is] greater than expected for an individual’s age and education level but that does not interfere notably with activities of daily life.”

Indicators of MCI may be present if:

1.  You’re forgetting things more often.  
2.  Events such as appointments or social engagements are forgotten..  
3.  Train of thought or the thread of conversations, books, or movies gets lost.  
4.  Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task, or interpreting instructions.  
5.  Have trouble finding your way around familiar environments.  
6.  Becoming more impulsive or show increasingly poor judgment. 
7.  Your family and friends notice these changes.

If you’re getting nervous thinking you too may have dementia because you can check off most if not all of these, stop and take a deep breath.  MCI is not yet dementia and may never become so.  

Reasons it’s MCI

MCI can actually be a result of other problems like malnutrition, dehydration, UTI or other infections, depression, stress, or poor medication interaction.

The good news here is that all of these can be reversed leaving you back at your baseline again.  We all have forgetful moments like, “What’s that actor’s name that played Batman in the first movie?” you ask as you suddenly draw a blank.  Or, “Oh dang!  Where did I put my keys and checkbook?  I’ve searched everywhere and still can’t find them!”

These are not necessarily signs of dementia.  In fact, I was once told that if you worry you have dementia, you most likely do not.  People with dementia find it very difficult to connect linearly to ideas like that.

Ruling out other possibilities

Dementia may be the cause.  To gain a better idea of its possibility, answer these three “ruling out” questions:

1. Could malnutrition, dehydration, UTI or other infections, depression, stress, or poor medication interaction be the cause? 
2. Has the cognitive decline become extremely disruptive to their daily lives?  Are they at risk of harming themselves or others?  Getting lost in familiar places?  Confused about their medications?
3. Have you noticed logic is no longer a motivating factor in their decision-making process?

If you answered “no” to the first question and “yes” to the last two, it may be time to suspect dementia.  Get a professional involved regarding diagnosis.  Start putting a healthcare plan in place.  Transition from independent care to accepting some guidance and help is difficult. Unwanted behaviors can easily become a problem.  

Tweaking your normal thought patterns

This is the time you will need:

• To really understand the importance of meeting their psychosocial needs. (Please read “Attachment Theory” and “Psychosocial Interaction” to learn more about the value of psychosocial needs.)
• Go to their reality and not force them to yours (Please read “Opposing Realities, Part I and Opposing Realities, Part II” to learn more).
• Become “that one that will cause them to survive,” (Please read “What is Psychosocial Model of Care?” to learn more).

This is the loved one’s most sensitive time within the decline process.   They know they are beginning to need assistance.  Prefer they not need that assistance. Are now beginning to question their ability to survive.  Triggering of many knee jerk reactions and unwanted behaviors begin to be seen.  In short, they are heading into survival mode.  

Intuitively they begin asking themselves, “Is there someone who is vested in my survival?  Who is that one who will help me to thrive and enjoy life?”  These are the unspoken questions, fears, and concerns for newborn infants and now once again for your loved one.  

Pairing infants and loved ones together; first the infant

It turns out Infants are born with an instinctive desire to survive.  They leave the security of the womb to adjust to the newness of the world that now envelopes them.  

They can’t speak the language.  Have no idea how to get food or any of their basic needs met.  Can’t identify their body’s urges.  Intuitively are able to sense something is not right at times.  

They have no safety awareness and no experience to draw from because they have neither short term nor long term memory.

Now regarding the loved one

In like manner loved one’s with dementia struggle for the same reasons.  They too are having difficulty with communication skills.  Struggle with not understanding many of their body urges.  Equally show no safety awareness, risking harm to themselves or others.  Exhibit absence of short-term memory.  Long-term memory is slipping away.  Intuitively they now return to using those very same survival tools they once used as an infant. 

Surprisingly, a deeper knowing that things should somehow be different lingers within.  This added tidbit of knowledge wants to put the loved one over the edge.  

We can take those struggles away replacing them instead with a sense of calm, safety, and high quality of life.  Use of dementia-wise interaction while meeting their psychosocial needs calms the inner being; just as it did when they were an infant.  

Psychosocial Encouragement

• Become “that one that will cause them to survive” caregiver.
• Remind them of their daily successes.
• Validate their feelings, not the content of their statements.
• Use nonclinical touch as often as possible.
• If struggling, join a support group.
• If you want to share your problem-solving ideas with others, join a support group.