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Thu, Mar 5 4:13pm · The Role of Social Work in Mild Cognitive Impairment in Living with Mild Cognitive Impairment (MCI)

At Mayo Clinic a person can ask their outpatient physician provider about social work services. We have social workers that work under the case management department and provide outpatient services to some of our specialty practices, and we have licensed clinical social workers who provide psychotherapy services through the department of psychology. Outside of Mayo Clinic it is best that patients contact their physician to see what services are available. If psychotherapy services are needed a person can contact their insurance company for a list of community providers.

Tue, Mar 3 8:00am · The Role of Social Work in Mild Cognitive Impairment in Living with Mild Cognitive Impairment (MCI)


This week, the HABIT Directors have asked me, with my background as a licensed clinical social worker (LCSW), to comment on the range of services social workers could offer in working with individuals living with Mild Cognitive Impairment (MCI) and their families. There are many ways social workers may be a helpful resource for those living with MCI.  I hope this brief post helps you understand what social workers do, and potentially ask for social work help if you think it may be right for you.

As an LCSW, I am a member of the HABIT team and provide the memory support system training as well as lead patient or partner support groups. Outside of HABIT, I also see a variety of medical patients for brief psychotherapy (up to 10 sessions). In addition to what I do, social workers work in a variety of settings and offer various services depending on their specialty, service area, and license. Social workers can provide services in a hospitals, care centers, state and community organizations, medical out-patient practices, and in private psychotherapy practice.

When working as part of the case management/care management team in a medical setting, the social worker’s role is to assess patient needs and offer services based on the patient’s individual medical, physical, and emotional health.

Example of services may include:

  1. Education on short and long term care services that are available both in the community and in your home. Examples could include information on home health care vs. personal care services, assisted living options vs. nursing homes vs. skilled nursing facilities.
  2. Helping connect you with the appropriate services. Examples may include finding specific resources to help you get services like medication assistance programs, programs for providing meals, information on senior centers in the community, options for adult day healthcare centers, and community support groups.
  3. Education and assistance in completing medical advanced directives. Legal resources can be offered for more complex issues and/or estate planning and financial power of attorney documents.
  4. Brief solution focused therapy.
  5. Caregiver support.
  6. Discuss what resources are covered and are not covered by your medical insurance.

Social workers also provide ongoing psychotherapy services if they are licensed as an LCSW (licensed clinical social worker) by the state in which the service is being provided.  In MCI, a therapy goal may be to help the person with MCI, and/or their care partner, better cope with the emotional stress of MCI.  LCSW’s can teach people therapy skills that can help them better cope with their stressful thoughts, emotions, and behavioral responses as a result of MCI.  Some have also been trained to teach cognitive compensatory techniques to help with memory.

I hope that you’ll look for the social work resource where you receive your medical care! Feel free to comment below on ways a social worker may have helped you in your care.



Jul 10, 2019 · Feeling overwhelmed? Try these communication tips. in Living with Mild Cognitive Impairment (MCI)


Have you ever felt overwhelmed when people have long conversations with you or offer you too much information? Many of our patients with Mild Cognitive Impairment (MCI) tell us they feel this way–too much information coming at them too fast.  In the HABIT program we work with couples where one partner has MCI and the other doesn’t. We often work on communication tips to improve communication in these wonderful, loving partnerships. Here are a few of our most frequent communication recommendations and some examples of how to apply them. If you are living with MCI and feel you struggle to keep up in a conversation, we would encourage you to try some of these tips with your loved ones.

Short and sweet.

A main recommendation is keeping the message short and sweet. Ask your loved one to communicate with you by using fewer words. Ask them to use short direct sentences that are brief, and in a gentle and soft voice. Due to MCI, you may experience attention and concentration difficulties because the brain has difficulty processing information.  Keeping sentences short, with one idea or thought per sentence, may make it easier to understand.  Longer complex sentences may be too much for the brain to process resulting in feeling overwhelmed, switching the brain off, or getting frustrated or angry.

Use Pauses.

We also encourage your loved one to pause between those short sentences so you have time to write down what you’d like to keep track of. Ask for that pause if you need your loved one to stop and give you a minute to catch up. Shorter sentences and pauses help separate thoughts which can help you absorb and process information better. Pauses also give you the opportunity to ask questions, if you have any.

Putting it together–some examples

Example 1:  Going out for dinner with friends.

Don’t say:  We are going out for dinner with the Smiths tonight at 6pm at Spagettios, and they are looking forward to seeing us.  We haven’t seen them in how long?

Do say:  We have dinner tonight with the Smiths at 6pm. *pause*  We are going to Spagettios.  *pause* How long has it been since we’ve seen them?!


Example 2:  Can’t remember the name of a person.

Don’t say:  You know, his wife’s name is Mary and we went out to dinner with them about a month ago and he talked about golf. He ordered the steak and wore his purple shirt….His name starts with a J.

Do say:  His name is John.


Example 3:  You’re repeating a question, for example, a question about the date of an upcoming trip.

Don’t say:  Don’t you remember, we already talked about this? If you just think about it a little longer you’ll remember.  Remember we talked about it last night with the kids and grandkids they are excited about going.  You used to go there as a kid and really enjoyed it!

Do say:  We leave for Disney on June 12. Can I help you write that in your calendar so you’ll have that information?


Example 4 (for those using a Memory Support System or Dayplanner/DayTimer organizational system):  Going to a doctor’s appointment.

Don’t say:  We are going to see Dr. Stevens at 2pm and I want to make sure we remember to discuss your chronic pain, sleep, and memory issues since it’s really been affecting your mood lately.

Do say:  We are going to see Dr. Stevens today at 2pm. *pause*  Let’s write this down in your planner.  *pause while getting out the planner*. 2pm Dr. Stevens.  *pause* Please make a note *pause* Discuss chronic pain *pause* sleep *pause* memory *pause* mood. Is there anything you can think to add to this visit?

It can be difficult for your loved ones to pause or to shorten their sentences. Feel free to ask them to pause or tell you just one piece of information at a time. For example, you might ask them to tell you the date of some upcoming plans but then wait until you open your calendar to that date. Then ask them the time, then the details of the plans you may wish to record. You can work together with your loved one to help them get into this habit to help maximize the information you take away from your conversations!  Do you have any other communication tips you’d recommend for your family and friends?  We’d love to hear from those of you living with MCI what communication tips you find most helpful.

Mar 19, 2019 · Practicing self-kindness: Part 2 in Living with Mild Cognitive Impairment (MCI)



Last week we started the conversation about self-kindness or self-compassion and challenged you to a few concrete self-kindness activities you could try for a week. In this week’s post, we’d like to address how you might more broadly and in a life-style change sort of way, live a life of self-kindness. Specifically, we’d like to help you continually monitor your self-critic and pay kind attention to yourself.

Monitoring your self-critic

How would you respond if you heard a friend saying critical things about themselves? You’d probably jump in to support them and show then kindness, even if they are not perfect. We’d like you to talk to yourself like you would that dear friend.

It’s easy to be kind to ourselves when we think we deserve it, but past and current experiences and emotional mood states can make it difficult for us to accept kindness from ourselves.  Despite that you may not always believe it, you deserve to be treated with patience, love, tenderness, compassion, and grace.  Self-kindness is an important “practice.”  It may not come naturally to all of us so we actually have to practice being kind to ourselves.  This involves generating feelings of caring and kindness towards yourself, instead of being critical and judgmental. Speak and treat yourself in a nurturing way. Have the courage to be imperfect and believe that you are enough just as you are. Validate and embrace the vulnerability that may emerge from this.

Self-kindness exercises to nurture your inner voice


  1. Practice kindness with yourself:

Say three nice things to yourself, about yourself, each day.

Example: I’m a good friend/spouse.  I have a good sense of humor.  I have these strengths and abilities: (list strengths and abilities). I’m perfectly imperfect.


  1. Tell yourself “I love you”:

Put your hand on your heart and take a breath and say “Good morning (state your name).”

Do this for 1-2 weeks.

Placing your hand on your heart as you do this also releases oxytocin (a “love hormone”) which is good for you.


Advanced practice:

Put your hand on your heart and say, “Good morning, I love you (state your name).”

Allow yourself to receive this kind attention and self-love.

We may not always believe it each day, but give it to yourself anyway.


  1. Kind attention:

Mindfulness is intentionally paying attention with kindness. Notice when you are becoming self-critical and/or judgmental and pay kind attention to your responses and compassionately respond to yourself again.


Negative/critical attention: I always mess things up.

Kind attention: I made a mistake, mistakes happen.  I can learn from this.


Advanced practice:

Cultivate kind attention to what may seem like an unforgiveable part of yourself.  You are so much more than your past actions.  You can change and choose differently now.


  1. Check your perfectionistic talk:

Perfectionism is a thought pattern with unrealistically high standards.  Do you judge yourself in a harsher manner than others would judge you?

Notice when you “should” yourself.  (Ex. I should have done “X.”  I should have known “Y.”) Change “should” to “could.”  (Ex. I could have done “X.”) It turns regrets about the past into a strategy for the future.


  1. Ask yourself “what do I need now?” and give it to yourself:

Every “now” is a different “now” so you will answer this question differently each time.

Notice if you need:




Cool/warm shower or bath

Activity with rest breaks (pace yourself)

Physical touch

Space and time to yourself

A friend to talk to


Some of these may feel awkward when you first start the exercises, but the longer you do them intentionally, the more often you will be able to act with self-kindness in time of challenge or stress. “Self-compassion is nurturing yourself with all the kindness and love you would shower on someone you cherish.” (Debra Reble, PhD). We cherish our loved ones even with all of their mistakes and imperfections. Let’s cherish ourselves as much as we do those loved ones!


Mar 12, 2019 · Practicing self-kindness: Part 1 in Living with Mild Cognitive Impairment (MCI)


Random acts of kindness

Have you ever engaged in a random act of kindness? We hear those delightful stories all the time–the kind customer who bought coffee for the person behind them in line or a surprise batch of cookies for a lonely next-door-neighbor. And there is simple kindness toward others–compliments, a smile, praise, or just saying hello! The writer Barbara de Angelis said, ”Love and kindness are never wasted. They always make a difference. They bless the one who receives them, and they bless you, the giver.”

I think we can all agree that kindness is powerful and to be kind to one another is valued. But what about self-kindness?  Today, we’d like to suggest some ways that you can be both the giver and the receiver of kindness by practicing self-kindness–get that double blessing! None of us are perfect—we all make mistakes and have flaws. But when we add stress to the mix, such as a challenging diagnosis like Mild Cognitive Impairment, acts of self-kindness can help. Self-kindness can help both you and your loved ones cope with your own internal experiences (your thoughts and emotions) as well as day to day outside stress with more resiliency. Mild Cognitive Impairment is, unfortunately, one of those stressors we just can’t change. It is what it is. And when you can’t change that external stressor, you CAN change your response to it.

Deliberate acts of self-kindness

Here are some recommendations for practicing self-kindness. This week, I’d like to challenge you to randomly pick an activity from the list below each day for the next week. Give that activity a try and see what happens!

  1. Do something nice for yourself (flowers, a movie, meet up with a friend, splurge on a fancy coffee).
  2. Praise yourself! Find one thing to compliment yourself about. Write that on your mirror in dry erase marker.
  3.  Watch your self-critic. If you hear a discouraging voice in your head–tell yourself something positive. What would you tell a friend if you heard them saying such discouraging words to him or herself?
  4. Spend 30 minutes doing something you love.
  5. Ask your partner or a friend or loved one to join you for lunch.
  6. Write a list of 5 things you are grateful for.
  7. Send yourself a thank you note–there is always something you can thank yourself for!
  8. Give yourself permission to say no. Say no to doing things that make you unhappy and yes to things you’d rather do instead.
  9. Set your own pace. Allow yourself to complete a task at a pace comfortable to you, even if that is slower than in the past.
  10. Walk tall and smile!  You will feel better and so will those you smile with!

Let us know how it goes!  Or  tell us what is your favorite random act of self-kindness? Next week, we’ll aim to go a little more in depth into more broad concepts of practicing self-kindness in an ongoing manner in your approach to yourself and life.

Sep 25, 2018 · Habits of Calm: The Body Scan in Living with Mild Cognitive Impairment (MCI)

Thank you! One of my favorite sayings is, "sometimes you have to go slow to go fast." Slowing it down and being more present and intentional in our moments is definitely an ongoing practice.

Sep 25, 2018 · Habits of Calm: The Body Scan in Living with Mild Cognitive Impairment (MCI)


How do you notice stress?

Symptoms of stress can vary from person to person. Every person’s body sends out a different set of red flags. Some common examples of stress body signals are:  increased heart rate, increased blood pressure, breathing changes (fast or shallow breathing), stomach and digestive problems, dizziness, sweating, lightheadedness, tremors, fatigue, pain (ex. headaches), tension in various muscles in your body etc.

How the body scan can help

The body scan is a mindfulness exercise that can help you reduce stress in your body by bringing awareness and identifying parts of the body that hold both physical and emotional stress tension.  It increases kind attention and awareness, and acceptance of things as they are.  It also helps us practice being in the “being” mode instead of the “doing” mode.  Cultivating internal peace not only helps us feel better in our mind and body, but this calmness can help guide our interactions with daily stressors.  We can’t always fix a stressor, but we can change our response to it.

Consider trying the body scan meditation by Jon Kabat-Zinn to practice mindful awareness of thoughts and body sensations.  Notice how this awareness can affect your body, as well as your moment by moment experiences in your daily living.

Doing vs. Being

“Doing mode” is goal-oriented, narrowly focused, “get it done” way of thinking and behaving.  It also tries to close the discrepancy between how things are and how we would like them to be.  Doing mode involves thinking about the past, present, and future.  Doing mode works well for strategizing how to solve problems and achieve goals that we can do, but it doesn’t work well for things that we can’t do or we can’t fix.

“Being mode” is accepting and allowing what is happening without any immediate pressure to change it.  There is no goal or desired state to achieve, and there is no problem to solve.  Being mode focuses on the present moment and dropping into it and experiencing it as it is, rather than viewing it through past experiences or future predictions.  Awareness is focused on the experience of the moment so it can be processed in all of its fullness, rather than comparing moments.

Acceptance isn’t resignation

Acceptance of something is allowing it to be as it is, not because you like it or want it that way, but because it is that way …for right now anyway.  Letting go of our desire to want things to be different than they are, and making space to allow things to be exactly as they are, can help us struggle less with the moment.  Instead of constantly trying to fix or change the moment, we learn to live and even thrive within it.

What are the ways you handle stress and take care of yourself?

Apr 17, 2018 · “I Already Told You That”- When Memory Affects Communication in Living with Mild Cognitive Impairment (MCI)

I Already Told You

For those living with MCI, it’s a common issue to repeat questions or stories due to your short term memory problem. At times you may be aware that you are repeating yourself, but since you can’t recall the answer, you ask the question again. Other times you may not be aware that you’ve asked the question before, but you sense the frustration in your loved one based on his/her response: “I already told you that!”

Here are some tips for you and your loved one to consider in tackling this difficult problem for both of you.

Your loved one may not always understand MCI, or may lack patience with your memory loss. Some people get frustrated when they are asked the same question again because they may assume that the person they responded to was not listening or paying attention to their response. This is not the necessarily the case with MCI.

Since memory problems are mild in MCI, and you may still be very independent, your partner may on occasion forget that you have a short term memory problem. However, it’s not a  “selective hearing” problem, or you’re “trying to be difficult” problem, it’s a memory problem.  If you believe they get frustrated or angry with you when they remind you that you’ve already asked the question, you may have hurt feelings.  Or, you may feel embarrassed, sad, frustrated, anxious, depressed, etc.  Your memory may be impaired, but your feelings and emotions are not.

Neither of you can change MCI, but you can change your response to it.

Care partners may need some guidance in adjusting their communication with you. Some care partners may suggest you “try harder” to remember, or will quiz you, or give you vague hints in hopes that you’ll remember. Be patient with them because these old techniques of exercising your memory may have worked in the past, but they no longer do. Talk to your partner about your needs and what they can specifically do to better communicate with you.  We offer these tips:

Communication tips for repeating questions: 

  1. Ask your partner to repeat the answer to a question as if you had asked it for the first time. Saying, “I already told you that!” can just upset everyone involved.
  2. Encourage your partner to face you when you are speaking to one another. Don’t talk to each other when you are walking away or when you are in different rooms.
  3. Minimize and/or omit distractions and noise during a conversation. Remind your partner to turn off the television or stop their activity while you are having an important conversation.
  4. If you are a HABIT alumni, use your Memory Support System (MSS) to write things down that your partner says. Refer to your MSS (blue book/calendar) multiple times a day and search for the answer there before asking your partner. If your partner notices that you’ve asked the same question a few times, allow them to encourage you to write that information in your MSS.
  5. Tell your care partners to be brief and specific with the information they are communicating to you.
  6. Let your care partner know you need time to respond. Ask them to give you a moment, instead of interrupting or finishing your sentence.
  7. Try to tackle one topic or task at a time. Write down the details of that topic or task before moving on to the next one. If you have many tasks to complete, make a list and pick one task to work on at a time. If you are using your MSS, use the scheduled events/appointments or to-be-done list to record and/or break down tasks.
  8. Check in with your care partner after the conversation—are you both on the same page? Do you know what the other person is trying to convey?
  9. Speak kindly to yourself (and your care partner) when you are struggling. Being harsh with yourself is not going to help you recall the information any better or any faster. It will only make you feel worse emotionally. Have compassion for yourself and speak to yourself as you would a dear friend.
  10. MCI is causing the memory issues. So, remind yourself and others that it is not your fault when you don’t remember.

Learning new behaviors can take time to master.  So if your partner messes up, please forgive them, because they too are learning.  If you and your partner are struggling to communicate, you may want to consider getting help through an MCI support group or a partner support group. You can contact your local Alzheimer’s Association for MCI support 1(800)272-3900.