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What Now?

By Michael Plontz

Early detection of Mild Cognitive Impairment is essential for both loved one and caregiver.  A treatment program for any given condition or disease involves two potential avenues of approach:  prevention of the disease and/or treatment of the disease.  Obviously, prevention is the ideal since it eliminates the disease.  Polio and smallpox vaccines are examples of this approach.

Unfortunately, no one has found a way to prevent the occurrence of MCI, which is believed to be a precursor to Alzheimer’s disease (AD).  Any treatment to date only slows down the disease’s progression.  Researchers believe that the beginning of the disease is the result of “dents and bruises” that cells experience in a lifetime.  This sets off a waterfall of neurohormonal and neurophysiological processes that affect the complex architecture of the brain, eventually resulting in AD.

Your loved one’s doctor will do as much as he can for your loved one, but what can you, as a caregiver, do?

here are several advantages for a caregiver in the early diagnosis of MCI in a loved one.  Most importantly, you and your loved one can actively plan their future whether it is financial, long-term care or end-of-life planning.  You can improve your understanding of the changes that are—and will—take place in your loved one, and educate your family and friends.  You can seek out community resources.  You can improve your knowledge on safety issues and on preventative health.  You can stay up-to-date on progress being made with possible treatment options.  And you can increase your awareness of MCI in general, and of local and national research projects, including clinical trials.

Until a cure is found, planning ahead is essential.  The first thing to do is gather important papers together, organize them, and put them in a safe place.  Some of the papers that should be included are:

  • Bank accounts/safety deposit boxes (and account numbers)

  • Insurance information (health, long-term care, and life—and policy numbers)

  • Deeds and titles

  • Birth certificates

  • Social Security and Medicare numbers

  • An up-to-date will

  • Family attorney’s name and number

  • Military affiliations (including discharge papers)

At this early stage, your loved one can help plan for their long-term care also.  Will they prefer an assisted living facility or a nursing home, for example.  Legal issues should be discussed at this point as well.  These usually take the form of advanced directives.  The term, advanced directives is used to encompass all options that make your loved one’s wishes known.  Telling a caregiver now gives them a voice in decisions that will affect both of you.  Some of these include:

  • Durable Power of Attorney (POA)

  • Guardianship

  • Living Will

  • Trust

  • Representative payee ship

Although it is a difficult subject to talk about, your loved one’s end-of-life wishes should be discussed now.   So many families never touch on this subject, and, then at the time of death, quick decisions must be made quickly through a veil of grief.  Honor your loved one’s memory by finding out now what they want.

Learning more about your loved one’s condition is easier than ever thanks to a little invention called the Internet.  Although it may be difficult to find many web sites on the specific condition MCI, there are numerous web sites on Alzheimer’s disease and all of its stages.  When you learn about your loved one’s condition and then pass on that information to your family and friends you become an advocate for your loved one and his or her condition.  Advocates can affect changes in the quality of care and even legislature, and it is one of the most important things you can do for both of you.  Somewhere along the path of your education, you will find out all you can about the treatments presently used for your loved one’s condition.  Because MCI is a relatively new concept, doctors use the medications and treatments that have been designated for AD.  There is no cure yet, but the medications used now can slow the progression for up to almost two years.  This can keep your loved one at home for longer and give you more quality time together.

AD, of which MCI is a part, is one of the most researched diseases in the world.  There are numerous local and national research projects in progress, and most of these include clinical trials.  You might consider a clinical trial for your loved one for several reasons:

  • Active participation in your loved one’s health care

  • Getting your loved one the finest medical care at leading facilities

  • Your loved one being the first to benefit from treatments not yet available to the public

  • Helping others

Of course you and your loved one must give informed consent.  But think of all the good you could do—not only for yourselves, but for future generations.  Once again, it’s about taking charge and advocating for your loved one’s care.

 

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