The Family Caregiver Alliance estimates that more than 16 million people in the US are living with cognitive impairment. This is challenging for them as well as for the financial advisers who strive to act in their best interests. Here are some guidelines and suggestions intended to help clients and their advisers as well as family members.
What is mild cognitive impairment?
Mild cognitive impairment is a cluster of symptoms that describes changes in how you think and process information. It is not an illness.
Someone struggling with cognitive impairment may have difficulty remembering, concentrating, learning new things and, in general, making decisions that affect their life. You may recognize that you’re having trouble, but you are still able to carry on most of your usual daily activities while living independently.
Some of these difficulties may relate to health issues: dietary deficiencies; medication side effects; metabolic imbalances (abnormalities in a person’s blood chemistry;) hormonal imbalances (like thyroid;) psychiatric disorders including clinical depression, anxiety, and paranoia; neural physical damage from strokes and other traumas; and substance abuse.
What are common signs of cognitive impairment?
Increasing memory lapses or memory loss. You forget things more often, including important appointments and social engagements.
Frequently asking the same questions over and over again.
Losing your train of thought following conversations, reading a book, or watching a movie.
Not recognizing familiar people and places. You begin to have trouble finding your way around familiar environments. You may become confused about time, people, and places.
Difficulty planning and carrying out tasks. You feel increasingly overwhelmed having to make decisions or working out steps to accomplish a task. As a result, you may put off making decisions that need to be made in a timely fashion.
Being victimized in financial scams. This is an increasingly serious problem that is significantly underreported as the victims are ashamed of what has occurred. You do not have to be impaired to be a victim of financial fraud.
Your family and friends notice “out of character” changes in your moods or behavior. These could include depression, irritability, anxiety, or apathy. Sudden outbursts of anger, damaging impulsive behavior, atypical (for you) risk taking, and other behaviors suggesting questionable judgment may be increasing in frequency.
How can I tell the difference between normal aging and mild cognitive impairment?
On your own, without an objective external point of reference, you probably can’t tell the difference. Here are some examples of “normal” aging:
Occasionally forgetting an appointment that is not high on your importance list.
Forgetting where you left your glasses or car keys, or where you parked.
Walking into a room and forgetting why you entered the room.
Driving somewhere you don’t regularly go and requiring a minute to remind yourself of how to get there.
Running into someone you have not seen in a long time and not being able to quickly recall their name.
If I, my friends or my family, suspect I may be suffering from the beginnings of mild cognitive impairment, what should I do?
First, strongly resist the urge to do nothing. On the positive side, roughly half of people who are diagnosed with MCI do not experience further decline. But if you are destined to be in the other half, it is better to know that now than later.
Second, go to your primary physician and discuss your concerns. Do not be misled into thinking you can determine, on your own, whether you are suffering from MCI. Like gradual hearing loss, we are generally unaware of small changes over time.
There is no single, specific test to definitively indicate the presence of MCI. A thorough evaluation would include a review of medical history and all current prescriptions, a physical examination, lab tests, neuropsychological and memory tests, and input from close friends and family members.
A referral to a specialist such as an eldercare consultant, if needed, can be provided, for follow-up. If you are determined to be at risk for progression to dementia, a far more serious form of cognitive impairment, it will allow the family time to assess how to plan for that future.