Living alone with Mild Cognitive Impairment

Some of our patients with MCI live alone, perhaps with just occasional “check-ins” from family members. For many people, this is not a problem and they continue to manage well independently despite short-term memory loss. However, we would like to recommend that if you live alone and have been diagnosed with MCI that you consider putting some “safety nets” in place, just in case you need more support. Here are some tips from us here at the HABIT Healthy Action to Benefit Independence & Thinking® team.

1. Inform a group of people you trust of your diagnosis.

This can be a small group of family members, such as adult children or siblings, or even trusted friends and neighbors. For many people with MCI, their friends and family may not even notice the short term memory changes at first. So, informing them of your diagnosis can start you off in building your support team safety net. In other cases, close friends and family may have noticed some short term memory changes, and you informing them of your diagnosis may come as a relief to those who care about you that you are being proactive about your health and care. This also can open the door to helping them feel comfortable asking you if they can support you in some way. Maybe you don’t need more support now, but you can have people who care about you helping to maximize your independence and ready to step in and support you if you do need help down the road.

1. Consider a plan for driving supervision.

Many patients with MCI continue driving and can do so safely. However, driving safety is often a concern in MCI and certainly a concern if MCI progresses. We encourage you to empower a trusted loved one or friend to give you feedback about driving and possibly help you stop driving if there are safety concerns. Then consider how you might get around if you cannot drive--Do you live somewhere that you can use public transportation? Perhaps begin looking into ride services or determining if your church or other faith community has a volunteer ride service available.

1. Consider a plan for financial supervision.

Managing finances, from routine household bills to complex investment or estate trust plans, can be complicated. People with MCI often make good decisions about finances, but short term memory loss can sometimes interfere with implementation. Therefore, we encourage you to consider enlisting professional help with financial management and/or involve a trusted family member in your financial matters. You may not need their help in making financial decisions at this time, but they can be a “safety net” for helping be sure you’ve gotten that utility bill paid on time (and not double paid), helping you talk through larger financial decisions, and serve as a memory back-up for implementing a decided upon investment strategy.

1. Consider a plan for medication supervision.

Many patients with MCI use supportive tools, such as a pillbox, to help ensure medication accuracy. If you are not yet using one, we strongly encourage you to start. There are a number of models on the market that include multiple times per day dosing if needed. In addition, however, we would encourage you to enlist a trusted friend or family member to occasionally check in on your medications or perhaps oversee when you fill your pillbox to ensure accuracy.

1. Consider joining MCI support or engagement groups.

Living alone can be isolating for any of us. Unfortunately we often see our patients with MCI withdrawing from their social networks. We’d encourage you to fight against this tendency (perhaps by letting some trusted social connections know of your memory loss so that you don’t have to worry about having a memory slip with them). In addition, many local Alzheimer’s Association chapters have social groups or support groups for those with MCI (sometimes called early stage support groups or social groups). Take a look to see what is available in your area, as being able to connect with others also experiencing memory loss may help you stay socially connected and engaged in addition to helping you find a source of encouragement along the way.

1. Plan for your future.

It is important for all of us, with or without memory impairment, that we’ve made decisions and communicated our wishes including medical treatment wishes, financial planning, and end-of–life care. However, a diagnosis of MCI, with the possibility of progression of cognitive impairment, increases the urgency of these decisions. If you have already established a power of attorney for health care and a power of attorney for finances, do those individuals know your wishes?  Do you need to update them on any changes?  Do you need to revise any your advanced directives or living will? Do you need to revise anything related to your estate planning? Now is the time to make any changes and be sure to inform those who care about you of your wishes. You can seek out an elder law attorney in your area for help with these issues. Again the Alzheimer’s Association can also help guide how to handle some of the above planning issues.

The above topics are those we see coming up most often in our patients with Mild Cognitive Impairment. We’re hoping to encourage you to make some plans now, not because you need help right now, but so that there is a plan in place.  We want to see you live as independently as possible, but also have a safety net should your short term memory loss cause some bumps in the road. For many, MCI progresses, but we don’t know how soon or how fast. So we encourage you to make plans now, before you need them.

Your local Area Agency on Aging and the Alzheimer’s Association have additional resources related to living your best life as you age and additional considerations for living alone if MCI progresses to dementia. We would encourage you to also view these resources. Our goal is to help you live a full life as independently as possible by pre-planning for common challenges in MCI.  We would like to see you in the driver’s seat about decisions for how you might accept additional help if it is needed, rather than one day possibly having it dictated for you.