When does MCI become dementia

Discussion in 'Memory concerns and seeking a diagnosis' started by Pollyx, Oct 28, 2015.

  1. Pollyx

    Pollyx Registered User

    Jul 18, 2015
    3
    Berkshire
    #1 Pollyx, Oct 28, 2015
    Last edited: Oct 28, 2015
    Hi,
    This is my first post...

    I write about my mother who was diagnosed with MCI by the memory clinic in 2013, after various tests (and ruling out other things).

    She is 78, and lives with my father, who now "organises" pretty much all of the day-to-day household things, and is very patiently, but constantly, having to remind her of what's going on. Her memory has worsened over the last year, and I really wonder how she would manage on her own. I also suspect that at GP/clinic appointments, the extent of problems are underestimated because together they manage, and my father perhaps doesn't let on how much she relies on him.

    I think we could now be in the realms of dementia, but realise the decline is a continuum, and am unsure of what the official distinction or threshold between MCI and dementia is. She is not due another follow-up at the clinic til March, but I think one might be appropriate sooner, and am quite prepared to instigate this if need be.

    My father is very wary of her moods, and reluctant to "upset" her, or to "lie to her".

    I am considering phoning/emailing their GP and telling him my concerns, and suggesting he has her re-assessed. I may have to do this behind my parents' back. Would there be any advantage to getting a dementia diagnosis? Medication? Support?

    Any advice, thoughts, comments welcome.

    Thanks
     
  2. marionq

    marionq Registered User

    Apr 24, 2013
    5,664
    Female
    Scotland
    My own experience with husband is that once there is a diagnosis other things fall into place. However you have to be willing as a couple to go along with advice and help and not everyone does this.

    The obvious first things such as attendance allowance and council tax reduction you may already have done but if not get them started as this can be an expensive illness further along the road. If she is prescribed medication a CPN will be a regular visitor to monitor the med. This can be a useful way of getting further advice and help eg from an OT or social services.

    We have a good memory clinic and I feel supported by them in several ways. Others may have a less good experience but I would still advise you to go ahead
     
  3. JackieJames

    JackieJames Registered User

    Dec 31, 2014
    83
    USA
    #3 JackieJames, Oct 28, 2015
    Last edited: Oct 28, 2015
    edit
     
  4. balloo

    balloo Registered User

    Sep 21, 2013
    227
    northamptonshire
    my MIL was diagnosed 3 years ago after having CT scan and memory nurse and OT come to see with us ,NOT seen them since only advice and help we have had is from local GP and Age UK who we get 9 hrs free respite a month . All they got us was a bath lift and stair rails we had to take down as to dangerous and put some up properly and safely . The district nurse has been a few time s when I have called or when she came out of hospital from a UTI although would not of needed to be in there 3 days if they had done what our GP said straight away. I stayed in with her as she got scared and could not call for help .
     
  5. Beate

    Beate Registered User

    May 21, 2014
    11,546
    Female
    London
    Our Memory Clinic sees us every six months but says if you have concerns, phone us for an earlier appointment. So why don't you just give them a ring?
     
  6. Grey Lad

    Grey Lad Registered User

    Sep 12, 2014
    5,737
    North East Lincs
    I think this is sound advice. A couple of things that strike me . Firstly we have been turned down for council tax reduction. MCI to dementia seems to be based on scores from memory tests. There is no real agreement on statistical chances of one becoming the other. I doesn't really matter in some respects as symptoms and behaviour are the key issues. G L
     
  7. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    I thought that if you get Attendance Allowance you get Council Tax Reduction automatically. Is that not the case?
     
  8. Grey Lad

    Grey Lad Registered User

    Sep 12, 2014
    5,737
    North East Lincs
    Hasn't happened here will need to chase it up. Thanks for the prompt colleagues on T P.
     
  9. JackieJames

    JackieJames Registered User

    Dec 31, 2014
    83
    USA
    #9 JackieJames, Oct 28, 2015
    Last edited: Oct 28, 2015
    Hello Polly:
    My mother received that diagnosis of MCI several years ago. Now, she seems to be getting worse and my concerns are for her safety as she lives alone. You state that your father is caring for your mother and that he takes her to the GP. You might speak to him prior to calling the GP.
    I have a question: Would a diagnosis of early dementia help? And how? I ask this of the forum.
     
  10. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,852
    England
    DWP (central government department) administers AA. Each local authority administers the Council Tax for that local government area. You apply by form for a reduction in Council Tax, with receipt of AA as being a qualifying requirement.
     
  11. Beate

    Beate Registered User

    May 21, 2014
    11,546
    Female
    London
    It depends on the personal circumstances. If Alzheimer's is diagnosed, there is medication that can help. For most other forms, there isn't medication.
    If the person with dementia is self-funding, care can be arranged without input by social Services, but it always is a good idea to ask for an assessment as each LA differs in what they offer and how much it costs.
    Some things like Attendance Allowance are not means-tested and only needs-based. In this case a written diagnosis report by a Memory Clinic can help support the application. For a council tax exemption on the grounds of severe mental impairment, a doctor has to sign and confirm a date from which this applies. This is often (not always) the diagnosis date. I don't see how someone with MCI (mild impairment) would qualify for both AA or council tax exemption on the grounds of severe impairment.
     
  12. canary

    canary Registered User

    Feb 25, 2014
    9,660
    Female
    South coast
    Having a diagnosis of dementia is often the way in to other support networks and benefits.

    If she is diagnosed with Alzheimers then there is medication that can slow down the progress of the dementia, although it doesnt always and not everyone can tolerate it. But if there is no diagnosis you cant try.

    (I would also mention that, unfortunately, there is no medication to slow down vascular dementia.)
     
  13. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    Sorry everyone-my misleading info! I should have said it's awarded by the LA once a diagnosis of dementia has been given-but you have to apply to the council. I made it sound as though the DWP does the applying. Thanks Katrine.
     
  14. Countryboy

    Countryboy Registered User

    Mar 17, 2005
    1,406
    Male
    Cornwall
    Never heard of MCI
    There is no single test that proves a person has Alzheimer's. A diagnosis is made through a complete assessment that considers all possible causes.
    Mini-mental state exam (MMSE)
    During the MMSE, a health professional asks a patient a series of questions designed to test a range of everyday mental skills.

    The maximum MMSE score is 30 points. A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer's declines about two to four points each year.
    Mini-cog
    During the mini-cog, a person is asked to complete two tasks:
    1. Remember and a few minutes later repeat the names of three common objects
    2. Draw a face of a clock showing all 12 numbers in the right places and a time specified by the examiner

    The problem with these test the Examiner assumes we should know the answer , but that not always correct So if your asked a question and don’t know what it means Tell them , on one of my test I was shown four different animals and was asked to put a tick beside the marsupial

    I’m 72+ and never in all that time every heard the word marsupial before so obviously I couldn’t give an answer So I told the examiner that, ok obviously I did have a one in four chance of getting it right if i guessed , remember you must speak up for yourself
     
  15. Essie

    Essie Registered User

    Feb 11, 2015
    566
    #15 Essie, Oct 28, 2015
    Last edited: Oct 28, 2015
    Tony, MCI stands for Mild Cognitive Impairment.

    Pollyx, Welcome to TP but so sorry you find yourself here....

    Re your question, as has been said, in terms of treatment benefits that really does depend on what form of dementia, if any, your Mum is diagnosed as having but in more general terms I would reiterate what other posters have said, a diagnosis will give your Mum (and Dad) access to a lot more resources, in all sorts of different areas, from support groups to NHS/SS services available only to those actually diagnosed with dementia.

    It is so hard sometimes to take that step to make something 'official' but if a condition exists it really is better to bite the bullet and get a proper diagnosis - it is, generally, so much better to be in 'the system' rather than outside it.

    On a slightly different topic if you don't yet have an LPA set up for your Mum now would really be the time to do it, it may prove invaluable in the future.
     
  16. Pollyx

    Pollyx Registered User

    Jul 18, 2015
    3
    Berkshire
    Thank you all

    Thanks all for your very helpful replies - greatly appreciated. I am responding to all replies in this one post.

    To answer a few points that came up...

    Yes, we have LPA in place.

    I did raise the subject with my father a few months ago, and he preferred for me to leave it to him to follow up with GP. He hasn't mentioned that he's done so, and I suspect he hasn't. I will speak with him again, but it's actually quite difficult to catch him for a serious conversation without my mother around; and if we spend any time alone, she often gets quite angry. He knows that any discussion of it will end in upset - she always was quite difficult, moody even before.

    My feeling is that if it is me that sets the ball rolling again, it will be me in trouble rather than him; which is easier for him, since I don't have to live with her. She'll likely have forgotten by the next time I see her. I could actually ask the GP to call her in on some other pretext, couldn't I?

    As to the point of whether to seek a diagnosis or not, since they are managing ok at the moment... I feel that should my father's health deteriorate such that he could no longer do what he does then, it would be better to have a diagnosis so that we could get quicker help from the LA. We have had a couple of scares in the last couple of years, when he had to spend the night in hospital - she woke up in the night panicking, having no recollection of where he was. Fortunately he was actually ok both times and was discharged the next day.

    She has had a CAT scan which didn't show anything untoward. Would vascular dementia have show up on that?

    I will try and bite the bullet, and persuade others to too.

    Thanks again.
     
  17. canary

    canary Registered User

    Feb 25, 2014
    9,660
    Female
    South coast
    "She has had a CAT scan which didn't show anything untoward. Would vascular dementia have show up on that?"

    How long ago did she have the scan? It often doesnt show anything in the initial stages.
     
  18. Pollyx

    Pollyx Registered User

    Jul 18, 2015
    3
    Berkshire
    Ah, ok. It would have been early in 2013. Time for another one then?
     
  19. blueboy

    blueboy Registered User

    Feb 21, 2015
    126
    Mum had a CAT scan when she was in hospital after a fall in the summer - the doc said that her brain just showed 'the normal signs of ageing'! This is someone who is incontinent, extremely confused, no short term memory etc etc. I wouldn't say that these were the normal signs of ageing!
     
  20. Bloodn0k

    Bloodn0k Registered User

    As to the point of whether to seek a diagnosis or not, since they are managing ok at the moment... I feel that should my father's health deteriorate such that he could no longer do what he does then, it would be better to have a diagnosis so that we could get quicker help from the LA. We have had a couple of scares in the last couple of years, when he had to spend the night in hospital - she woke up in the night panicking, having no recollection of where he was. Fortunately he was actually ok both times and was discharged the next day.

    She has had a CAT scan which didn't show anything untoward. Would vascular dementia have show up on that?

    I will try and bite the bullet, and persuade others to too.

    Thanks again.[/QUOTE]

    Please bear in mind that the situation can change rapidly and unpredictably. My late mother had survived a stroke but had been living alone in her own home but with daily visits by me and four daily visits from carers to help to ensure she was safe, fed and properly medicated. In her case, she met a nurse on Monday morning who performed an assessment and she scored very well in the memory test plus she had a long and lucid conversation with the nurse. The conclusion was that her MCI was indeed mild. The same afternoon, she would not answer the phone because she believed that she was in my house so it was not up to her to answer it. Early on the following morning (which was in mid-November) I found her wandering in the back garden in her bare feet looking for her keys which she had put on top of the bin. Inside the house, a gas ring was turned on but not lit and she said that she knew about that but did nothing about it because someone else had turned it on. She was taken to hospital that afternoon. Some weeks later, she was diagnosed with Vascular Dementia at the excellent Kielder Unit in North Tyneside. After that various assessments and decision making processes seemed to progress automatically. This was a roller-coaster ride because she was never able to go back to living in her own home after that.

    My mother's condition had been declining slowly over several months but there was a significant change within a matter of a few hours. The diagnosis helped to make things happen and helped me to make sure she was kept safe but it wasn't easy to live through.

    I hope this helps, good luck,


    Bill.
     

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