When someone you love is diagnosed with mild cognitive impairment or early-stage dementia, it can feel like the ground shifts beneath your feet. In this episode of Next Act Ninjas, host Rachael Van Pelt offers a compassionate yet practical roadmap for navigating the early stages—emotionally, medically, financially, and logistically. Whether you're supporting a parent, partner, or friend, you'll learn how to prepare for what’s next with empathy, clarity, and proactive planning. From lifestyle interventions and housing choices to legal documents and family dynamics, this conversation is essential listening for anyone facing cognitive decline in a loved one
When someone you love is diagnosed with mild cognitive impairment or early-stage dementia, it can feel like the ground shifts beneath your feet. In this episode of Next Act Ninjas, host Rachael Van Pelt offers a compassionate yet practical roadmap for navigating the early stages—emotionally, medically, financially, and logistically. Whether you're supporting a parent, partner, or friend, you'll learn how to prepare for what’s next with empathy, clarity, and proactive planning. From lifestyle interventions and housing choices to legal documents and family dynamics, this conversation is essential listening for anyone facing cognitive decline in a loved one
Chapters
00:00 My Loved One Has Mild Cognitive Impairment, Now What?
03:29 The Emotional Side of an MCI Diagnosis
05:31 Consulting With Cognition Specialists
07:03 How Healthy Lifestyle Slows Cognitive Decline
08:30 Alternative Approaches to Treating Cognitive Decline
09:48 The Mental Toll of an MCI Diagnosis
10:22 Tackling Legal and Financial Issues in the Early Stages
11:46 Housing and Living with Mild Cognitive Impairment
15:11 Building a Support System for Everyone Involved
16:55 Remain Hopeful, But Stay Prepared
18:20 Accept Help to Avoid Burnout
19:31 Protect Your Loved One's Dignity and Autonomy
Hey, hey, welcome back to Next Act Ninjas, the go-to podcast for mastering your health and wealth longevity. I'm your host, Rachael Van Pelt. Today's conversation centers on a topic that many of us will face, but few of us feel fully prepared for. The question, what to do when a loved one is first diagnosed with mild cognitive impairment or early-stage dementia?
I've had multiple people ask me lately how best to support their parent or spouse. So we're going to dig into this timely topic. And I don't want to just talk about medical treatment either, although I will touch on that. I want to address your emotional wellbeing and how to take practical forward thinking steps. Whether your loved one is a parent, a spouse or a close friend, my hope is that you're going to walk away from today's episode with a balanced, empathetic plan of action.
But let's start with an all too common scenario. You've noticed your mother has been stumbling over her words more frequently, she's forgotten an appointment or two, maybe even gotten disoriented in a familiar setting. So you go to the doctor together and they run a battery of tests and the results come back indicating mild cognitive impairment or MCI. Now you're facing what feels like a monumental shift in your family's future.
A new diagnosis of MCI or early-stage dementia can feel overwhelming. All at once, there's fear, confusion, and a rush of questions. How quickly will symptoms progress? What happens next? Who needs to be told? And, above all, how can you best support that person you love while also taking care of yourself? Today, I want to walk through these questions from a place of hope, compassion, and yes, realism. The goal here is not to shy away from tough facts, but to look them squarely in the face, acknowledging that while MCI or early dementia presents serious challenges, there are also meaningful proactive steps that you can take in the early stages to support a more hopeful path forward.
First though, let's clarify what a diagnosis of MCI or early-stage dementia truly means, because these terms get thrown around a lot. A diagnosis of MCI typically means that there are detectable changes in memory, thinking, or problem-solving that go beyond what we would consider normal aging. But the changes are not yet serious enough to significantly impact daily life, or what medically we refer to as activities of daily living, ADLs.
Early stage dementia is a broader term that could eventually encompass Alzheimer's disease, vascular dementia, or any other form of progressive cognitive decline. But in these early stages, many people, they still function relatively independently. They can keep doing their favorite activities and maintain strong social connections. It's possible for MCI to remain stable or progress very slowly. That said, it's important not to assume that everything's going to continue as normal. If you want to help your loved one live with more comfort and confidence in the years ahead, then you're going to want to set up proper medical, financial and social structures right now.
Before we dive into the logistics though, I want to take a moment to acknowledge the emotional side of things. While I know it's tempting to launch straight into research mode, I find it incredibly important to remember that your loved one is probably going to experience a wave of powerful emotions. They will likely feel grief at the loss of certain abilities and potential loss of independence. They're going to fear what the future holds and they're probably going to have a fair amount of embarrassment over their cognitive slips. That fear, grief, embarrassment can quickly turn into frustration, depression, even anger. I mean, put yourself in their shoes. How would you feel with the same diagnosis?
And of course, you're going to go through your own range of emotions. You're going to find yourself overwhelmed at times, overwhelmed by the demands of caregiving or uncertainty about how to help. In these early stages, it's very important to slow down, make space for all of those emotions rather than simply hide behind taking-action mode. And believe me, I get the impulse. I am the type of person that wants to bypass all of that emotional stuff and jump right into action. But you have to give yourself a bit of space to fully process all of the ramifications of this diagnosis, just as you would with any other chronic disease diagnosis.
Even in the early stages, family members may start noticing conflict or tension. Perhaps one sibling downplays the diagnosis while another goes into crisis mode, or your parent insists that they're fine and they just resist making any kind of changes. The best way to handle these emotional undercurrents is by maintaining open, honest conversations. You may even want to bring in a professional counselor or therapist early to help with those family discussions on how each of you is coping and what you might need from one another.
Once you've allowed some emotional breathing room for everyone involved, then and only then should you begin taking practical steps. A good first move is just to schedule a comprehensive medical evaluation, ideally with a specialist. You probably want a geriatrician or a neurologist who has experience working with early cognitive decline. These experts, they're going to rule out any reversible causes right away. For example, they're going to look for vitamin deficiencies or medication side effects or depression or any other condition that might present similarly to MCI.
This is a good time to compile all existing medical records, gather results from any prior tests, and just to ask lots of questions. Ask your loved one's doctor questions about the diagnosis. This is a time to be both curious and cautious. Some families worry about labeling their loved one too soon, while others find relief knowing that there's a formal diagnosis. Finding a balance between acceptance and caution is important. I think acceptance helps you take advantage of resources, while a dash of skepticism is going to encourage you to find second opinions and just to follow up thoroughly. It's especially important in these early stages to consult more than one specialist, too. You want to confirm the diagnosis or at least hear different perspectives on possible interventions.
And of course, health decisions go beyond medical visits, don't they? In these early stages of dementia, the best way to bolster overall health and potentially slow cognitive decline is through lifestyle modification. Many studies suggest that regular physical activity, good sleep, healthy diet, social engagement, all of those things can at least slow the progression. Why? Because these healthy lifestyle changes help to reduce the underlying cause. They reduce chronic inflammation, oxidative stress, insulin resistance, all of which have been implicated in the progression of cognitive impairment, including Alzheimer's disease and vascular dementia.
Regular exercise is recommended because it improves insulin sensitivity and blood flow to the brain. A diet rich in nutrient-dense foods is important for reducing inflammation and improving the relationship between your gut and brain. High-quality sleep, which includes lots of time spent in REM and deep sleep, that's important for blood flow to the brain and clearance of metabolic wastes and toxins, and especially the amyloid beta proteins that wreak havoc on your brain. Now, you probably already know that good sleep, diet, and exercise help everything from blood pressure to bone density, but it is important to remember that healthy lifestyle is key to maintaining cognitive function over time.
Of course, whenever we discuss early healthcare interventions, there are bound to be alternative viewpoints that argue for more or less medical oversight. Some experts question if we're over pathologizing normal age-related forgetfulness. Others push for aggressive testing and an immediate start to certain medications. There isn't a one size fits all approach. We have to take a thoughtful, individualized approach when we explore options.
If your loved one is interested in trying experimental treatments or off-label drug therapies, investigate whether they might qualify for a clinical trial. Keep an open mind, but maintain a healthy dose of skepticism. Before you commit to any experimental treatments, always ask questions like, "What's the evidence behind the therapy? What are potential side effects? Who's funding the research? Are there conflicts of interest?" Answers to these questions will help you confidently decide whether or not to enroll in a research study. Alternatively, if your loved one leans towards a more holistic approach, you might seek out an integrative health practitioner who focuses on treating hormonal imbalances, nutritional deficiencies, and environmental factors.
I think another area that deserves attention is monitoring mental health. Depression and anxiety are common partners of MCI, and they can exacerbate cognitive symptoms. If your loved one is experiencing persistent sadness, irritability, or withdrawal, a mental health evaluation may be in order. Treating depression, whether it's through talk therapy or medication or lifestyle changes, can significantly improve quality of life and sometimes stabilize cognitive function. So don't overlook this part of the puzzle when you're crafting a plan.
Beyond lifestyle and medical care, I think finances are probably the most pressing issue for many families facing MCI or early-stage dementia. This is a topic that is tempting to put off because talking about money, let's just face it, is uncomfortable. But when cognitive decline is still in the early-stage, that is exactly when you want to talk to your loved one about financial accounts and insurance policies and legal documents. You want to be able to honor their wishes later when they're not thinking as clearly. So make the time now to have the difficult conversations. Do it while they're still relatively independent.
Together, you're going to want to review and possibly revise wills, advanced directives, powers of attorney, and healthcare proxies. Getting those documents in place early is not only going to provide you with a peace of mind, but it's going to ensure that your loved one's decisions will be respected when their cognition worsens.
And don't forget to address the digital side of finances. Most people now have online bank accounts investment portals, automatic bill pays. So make sure that someone besides your loved one has a secure access to those passwords or login information, just in case. Now, if you sense reluctance from that loved one, just explain that taking these precautions now is going to help them maintain better control of their affairs in the future.
Now along with finances comes the question of housing and living arrangements. In the early stages of MCI, most people can continue to live at home quite comfortably, especially if they have support from friends and family and community. Some people remain able to drive and manage small errands without issue for a long time. That said, it's wise to proactively prepare for changes that are inevitable down the road. For example, if the home has steep steps or tricky layout that could pose safety risks, you might want to consider downsizing to a single-level ranch or a condo, something that's going to be less of a headache in the future. You don't want to wait too long for those kinds of moves. If a downsize makes sense, it's better to do that early before too much memory decline, because later it's going to be much harder for that person to adjust to any changes in their environment.
There's always the option of moving to a retirement community as well. Many of those communities now offer independent living to start while they have options to transition to assisted living and then memory care as dementia progresses. This "continuum of care" approach can offer tremendous peace of mind because it allows you to know that as their needs evolve, they're not going to have to keep uprooting their entire life over and over again.
Either way though, bringing up the topic of moving can be delicate. Many people are incredibly attached to their homes and they feel that even discussing other living arrangements accelerates their loss of independence. You have to be careful with this. Emphasize that you're not pushing them. You're just exploring all options so that if moving becomes necessary, you know their preferences.
In fact, I highly recommend doing a bit of research in advance. Visit some of those communities. Meet the staff. Maybe see if your loved one can participate in a social event to get a feel for the place. That way you can gauge if it'll be a good fit. Some communities have glossy brochures, but they lack adequate staffing or structured activities. Stay skeptical, ask hard questions, and do repeat visits. If a particular option doesn't feel quite right, keep looking.
Of course, not everyone has the resources to even entertain the option of these transitional communities, in which case the default option is going to be aging-in-place with in-home support, isn't it? That could mean staying in the current home, downsizing, or moving in with family. If the idea of moving is too big a leap, focus on making your loved one's existing environment safe and accommodating. Minor renovations, like smart home technology could make the world of difference for their day-to-day safety. On the other hand, in some cases, you might need to make a bigger home modification, like installing a first floor bedroom and master bath. Either way, the goal is to try to help your loved one age-in-place without having to move.
And regardless of what you decide, whatever feels like the right path, whether it's downsizing, staying put, assisted living, make sure you run the numbers with an experienced realtor or financial advisor, someone who can help you determine whether the plan makes financial sense. Make sure that any family member who might be involved in caretaking are a part of that decision. Remember, their time is money too. You don't want to, for example, downsize for financial reasons only to make the main caretakers involved have to drive an extra hour out of their way every day. That would be a costly mistake for everyone involved.
But let's take the discussion beyond healthcare, housing and finances. Those three things are the backbone of early decision-making, but it's just as important to remember that this is the time to build a strong social and emotional support system for you and your loved one. In these early stages of cognitive decline, make sure that you start talking to friends, neighbors or members of your faith community about the diagnosis, with your loved one's permission, of course. Often, just acknowledging what's going on is going to open doors for you that you probably haven't considered. Maybe you'll find a neighbor who's willing to pop in to chat or offer respite. You may discover local community centers that have senior programs that offer activities and a sense of belonging. Whatever help is available, celebrate that, you're going to be so glad to have it down the road.
If you have siblings or extended family, I highly recommend that you schedule a "family summit" so you can discuss everyone's roles. Maybe one person wants to take the lead on financial oversight, another doctor appointments, and somebody else the day-to-day companionship. Divide and conquer. Establish these roles and responsibilities early so that no one feels blindsided when your loved one suddenly needs more help.
And don't be afraid to tap into all of the wonderful community support that's out there. There are online forums and local Alzheimer's or dementia support groups. There's even social media communities that can provide connection and practical tips. Caregiver support groups in particular can be a lifesaver. It can be a great place for you to share your concerns, trade knowledge, find local resources, and just hear from people who face similar challenges.
Just keep in mind that every family's journey looks different. Some people with MCI or early-stage dementia will continue to enjoy their hobbies, see friends, and travel for years. Others are going to experience a more rapid decline. Part of your role is to allow for hope while gently preparing for the unknown. That might mean reminding yourself that your loved one is still the same person that they've always been, even if they need the occasional prompt or they forget where they placed the car keys.
One of the most common fears that families face is the possibility that MCI will progress to full-blown dementia. Now, unfortunately, we don't yet have a way to know the trajectory of decline. Some people remain stable for years while others decline more rapidly. We just don't know how fast it's going to be, which is why it's important to prepare early. Rather than seeing this diagnosis as a loss of normal life, consider it a wake-up call to organize finances, define care roles, explore living situations, and of course, nurture emotional bonds.
In the early stages, many people can still make autonomous decisions, so include them in all discussions. Ensure that their voice is not only heard, but respected. Encourage them to articulate their values and preferences for the future. This approach is the most empowering. It's going to let them decide how they want to live even as they come to terms with their diagnosis.
If you find yourself overwhelmed, that's understandable. Many caregivers are juggling full-time jobs and raising kids or grandkids while at the same time trying to support a loved one with cognitive changes. Burnout is real, so even if your loved one doesn't yet require round-the-clock assistance, ask for help. It's a sign of foresight, not failure. Whether that help looks like a neighbor stopping by once a week or you're paying a home aide to come give you respite care for a few hours a day, these small measures can preserve your wellbeing. It'll let you recharge so that you can continue providing best care possible.
Bottom line, you're not alone and there is hope. That diagnosis of MCI or early-stage dementia can be unsettling, but there are so many steps that you can take to smooth the road ahead. This is just a signal to pay attention, to plan, and to reinforce healthy habits. Medical research is going to continue to evolve. It may provide new insights into how we can better manage and maybe even reverse cognitive decline, but in the meantime, let's focus on practical steps like financial planning and housing decisions and lifestyle changes and social support.
Most importantly, don't lose sight of the person behind the diagnosis. They're still here with their personality, their memories, their hopes, their dreams. When you take proactive steps, you are lovingly protecting their dignity and autonomy. You're making the journey as supportive and positive as possible.
Thank you for joining me for another episode of Next Act Ninjas. If you would like some help thinking through aging-in-place options, hop on my calendar, you'll find the link in the show notes. I'd be happy to help you navigate these waters with both realism and compassion. Until next time, live well, love more, age less, my friends.