My husband has been diagnosed with MCI. He denied it. Is that a normal reaction? If so when will he acknowledge his illness?

Look up Anosagnosia.. In his reality, there IS nothing wrong with him . I learned this from a great CARETAKERS group . There are groups everywhere. For the past 1 1/2 years we have been meeting on line . Find yourself a meeting . Learn as much as you can about memory issues , it does not get better . It might be time to loose the keys to the car or disable it. He won’t be happy but you wont have to worry about an accident. He has all the symptoms of cognitive impairment. There is help out there . Talk to your Primary Care physician for him and the best suggestion for you is to find a meeting .

Can you get 2nd opinion? Did he get diagnosis from neurologist? Did he have brain MRI? Is he taking a medication that can cause this? These are all alarming behaviors you mentioned…You know that I waited a long time to call a dr for my mother…I had the name & phone #s of 2 neurologists & picked one w disabled access. I just could no longer ignore or pretend it was just a bad day or lack of sleep 😴

I would prepare by going to Elder law Atty…get power of attorney & health proxy…& have Atty also do Medicaid planning…maybe you need Asset Trust. Don’t wait with this until he’s totally incompetent.
Hugs 🤗

I agree with most everything written so far. My husband had MCI and the symptoms were far less severe than those you mentioned so most likely it has advanced to Alzheimer’s. I would just like to add that nobody likes to admit they are gradually losing their minds. Unlike a diagnosis of cancer or heart disease or almost anything else, it feels like an insult. There is a stigma (which shouldn’t exist of course) and the person doesn’t want to feel so diminished. So be gentle and empathic and assure him that you understand why he is angry and that you will be there to help him do his best.

In some cases, denial of illness is very much part of the problem of dementia and cognitive impairment. You husband suffers from anosognosia, the lack of insight into his own true condition.

The best approach is to consider gentle ways to make sure he (and you) remain safe and healthy. Some ideas are to simplify the home so there is "less stuff" to keep track of. Start finding other modes of transportation - ask friends, family, neighbors, members of faith community, paid drivers... to start doing the driving so he will get "there" and back home safely. Take over the bills and family business matters: some find it easier to autopay most bills and go over accounts monthly with spouse to "show" things are getting paid. Replace debit and credit cards with reloadable git cards from major credit card companies.

Please consider talking to his doctor about his reactions. His anger, yelling and easy startle indicated that he may be experiencing anxiety. Having a consistent routine and sometimes anti-anxiety medications can help.

Denial is extremely common in most, if not all, cases of dementia. The time line may vary, as the symptoms will vary depending on the cause of dementia. The problem with trying to get someone with dementia to understand it and acknowledge it is that it won't likely work. It will only frustrate you and could possible anger him. YOU know he has it, there's no point in trying to make him understand it. Your goal is to NOT engage in confrontations, to keep the "peace" and protect both him and yourself.

I also have to agree with others who have said this doesn't sound like MCI anymore, based on the behaviors you have described.

Please see:
https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment

At the bottom of the page are links to their helpline, support group locator and an online community (although you have us already!)

After securing the car(s), the next 2 steps should be having a FULL evaluation and getting legal advice from an EC atty. The website above provides a very nice list of what an evaluation should include. Initial checkup with his primary care might be okay, to get full blood work and urine test (culture is best), which might rule out some other medical issues as a cause for some of his behaviors. A UTI can exacerbate dementia. A specialist may be needed to try to determine what the underlying cause of his dementia is and perhaps Rx some medication that can alleviate some of the symptoms (aggression, sleep issues, depression, anxiety.)

I would in the meantime cut back or eliminate the "herbal" remedies, as they may interfere with other medications and/or his exams. Let the doctors check him out and prescribe. (Note: I am NOT a big fan of medications, BUT when it comes to aggression, anxiety, etc, including your mentions of abusive behavior, then I would be willing to give some a try.)

You indicate he is easily startled, but you also mention in the profile that he has vision problems AND hearing loss. The best way to avoid startling him is to approach him as best you can from in front of him. If he doesn't hear you coming, he will be startled and that could be dangerous.

As for the verbal abuse - is it reaction to something you have said or done, or is it just spontaneous? If it is a reaction, try to avoid whatever it was that elicited this reaction. No "reminding" him, no stating "Don't you know..." or "Don't you recall...", NEVER saying "I already told you..." Patience and guidance - never assume he will know or remember. If it's spontaneous abuse, it might be from his own anxiety and frustration, which makes getting that full checkup and specialist check very important. Dementia doesn't get better and the symptoms won't resolve on their own.

"I think he need some kind activities. Is there anything available?"

If there are simple hobbies he engaged in before, as long as no dangerous tools are involved, try those. Otherwise it is your guess as good as ours what might engage him. Puzzles? Crafts? Reading? Games?

"I feel so inadequate to care for him."

Again, getting medical help is #2 on your todo list. #1 is to ensure he can't drive. #3 is to get legal advice. The doctors may be able to Rx the right medications to calm him, reduce his anxiety and anger, and make life a bit easier for you. Learning more in the meantime will help you be better prepared for what is to come. This is a progressive condition - it won't get better. Things can change overnight, so you need to know what to possibly expect (not everyone follows the same timeline nor do all experience the same symptoms, but knowing what might occur helps you to be prepared!)

Dear disgustedtoo and Riley2166

Please stop and take a breath.

There are people who are new here and don't know the abbreviations (I confess that I have been here over a year and sometimes still have to stop and figure out what an abbreviation means).

Also, when you don't understand something, please ask nicely. Many on this site have been here quite a while and understand what the letters mean. But I have never seen a time that someone would not take the time to explain the meaning(s) when asked.

All of us here are under stress and it does not help to attack others on a site where we all come for help and understanding.

Before addressing your questions and other concerns, I have to concur with many others who have commented:

FIRST order of business is to ensure he has NO access to the car/keys. He is a danger to himself and others. If he injures or kills someone, lawsuits could finish you both financially.

I would NOT rely on a doctor or DMV to recommend revoking his license. The denial is already apparent and nothing they say/do will change that. It's nice if they are the ones to tell him, perhaps taking the onus off of you, but it will NOT stop him from attempting to drive.

PLEASE, lock up the keys, disable his car (kill switch or Club can be installed) or better yet, move it to where he can't access it. If you only have one car, get a kill switch or club, and ensure he doesn't see how to disable those before driving anywhere.

Jpaat21: I am so sorry to hear that your husband has Mild Cognitive Impairment and as such, perhaps he should not be the operator of a motor vehicle. Denial is a large part of dementia, unfortunately.

Why can't you spell out what MCI is - how are we supposed to know what this means? It sounds like he has dementia and YOU should NOT put up with his behavior as I doubt there is a way to stop it. People like this will never acknowledge or admit something is wrong with them. So YOU must take control and ask yourself if you want to put up with this and live like this and eventually let him destroy you? I would look into placement so you have a life which you deserve. I am so sick of people making excuses with dementia to the point where their own lives are ruined.

I'm really sorry for what you are going through. My mom never accepted/acknowledged any problem even when her dementia was past that point. She finally did decide to relinquish her role as trustee of her trust when we convinced her that it would help with her stress. Your husband is probably angry because he keeps making all these mistakes and is not ready to acknowledge that there is an issue with his cognition. I assume that he is an intelligent and independent man, and is very frustrated. I'm not sure I can offer any advice to help you "convince" him to accept his diagnosis as I (and my brothers) were unable to do that with Mom. Maybe take over some of the chores that are the most difficult for him and/or don't expect him to do them without guidance and reminders. In the meantime, I'm sending big hugs.

I highly agree with the book the 36 hour day! It is very helpful. Mom was diagnosed with Alzheimer's in 2014 - she firmly said to the doctor " You can't know that until I am dead"! She is deep into it now at 95, and in memory care for 3 1/2 years. Others have recommended and I concur 1. See a Doctor for other causes and possible meds for anxiety. 2. See an attorney and get your paper work in order ( POAs for healthcare and finance) 3. Start asking for help from family and friends/ hire someone to come stay so you can safely leave him. 4. Pull the battery wires or disable the car/ let him lose the keys. 5. Depending on your financial situation, get your finances separated to spend down his half if you will need Medicaid ( Medicare does not cover long term memory care). 6. Ask for help from your areas agency for aging or other organizations. Good luck, my experience is that it is a long painful road, with moments of joy and hours of sadness and worry.

I am so sorry you are going thru this. Yes, it is normal for them, and frustrating for those of us who have to deal with the consequences of that denial.

I am now the POA for the third person in our family with dementia. Not one of them ever did, or in my mother's case still hasn't accepted they had dementia.

My 89 year old mother who is only 1 point from being considered in late dementia. Her MMSE, Normal is 30, is now down to 16 and has dropped 2 points in the last year. She has been evaluated by no less than 7 Physicians including: Her PCP, 2 different Neurologists, 2 different Geriatric Specialists, and 3 doctors from the hospital after her 5th fall.

All of them tested her in various ways and then explained to her that she has mid to late dementia. My mother's response was to roll her eyes, take deep, annoyed breaths and exhale them, and talk under her breath about how none of this was true. She would not listen to anything they said to her. She still insists that I, have somehow manipulated the doctors and the tests. Including a Brain scan.

According to her Geriatric doctor, many patients with dementia, regardless of the type, are just not capable of processing the fact that there is something wrong with their brain.

Also, as a former EMT; Please do not let him drive.
Allowing an impaired individual, drive a vehicle, is extremely dangerous.

Not only could he injure or kill any number of others, he could harm himself. There are also the legal ramifications including: law suits against him, his property and even potentially you (depending on your state.)

In many states, if a person has been diagnosed with a determined level of dementia, the doctor can, (and is some States is required) to contact the DMV and notify them, of that persons incapacitation to drive. If you can have that done it takes the confrontation about driving away from you and goes directly to the state.

My mother seldom actually yells at me, but she is verbally, and occasionally physically abusive. She is always angry. No matter how much you love someone, do not let them abuse you. You are a person also and have the right to feel safe in your own home.

My mother is now in a board and care. She is fed three meals a day, plus snacks. She has her own room and 24 hour care. She has her own clothing, TV, and belongings around her. Her Board and care is only 2 miles from my home so I can get there in litterally 5 minutes if needed. I can and do take her out to eat and to all of her medical appointments. If there is something she wants. I will usually buy it for her.

Hang in there, all you can do is the best you can. Try to remember you are not alone in this. There are thousands of us in your situation.

God bless you.

When someone had dementia they don't accept that anything is wrong with them. Even when it's in the earliest stage where maybe they forget minor things but they still have comprehension of reality. That's when denial takes over. Not just with the demented person but many times with their own families too.
I've seen families make every kind of excuse for dementia behavior and cover for their loved one all the time because they're in denial or just don't know what to do for it.
You're clearly not in denial about your husband's illness and that's good.
The anger he has will increase. He will get startled more easily and will likely get to the point where you will have to be next to him 24 hours a day. It's time to bring in outside help or look into care facility placement.
In the meantime, he cannot be allowed to drive anymore. He's not just endangering his life every time he gets behind the wheel, but also the lives of everyone else on the road. Do whatever you have to and make sure he can't drive the car.
Please for your sake and his look at a few care facilities. You will need one at some point.

The answers given so far are spot on and very familiar to me with my husband’s journey. Like
you, I thought he was in denial. The neurologist educated me about anosognosia - the brain’s inability to understand the diagnosis. It presents in some but not all patients. I had to stop my husband from driving. That was a long process but we got there. Best to you in this very hard life shared with the one we love most …. who has become a different person in many, many ways.

Sorry to say but they will NEVER acknowledge he has issues.........that is how the brain is once it gets into dementia mode. Take away the keys and/or disable the car so he cannot get it running. Also with the driving issues, you would hope that he remembers what a red light and/or stop sign means and doesn't go thru them and hit/kill someone. Dementia has many stages and its just starting. Wishing you luck. but check with an Elder Care Attorney for any future happenings and start checking into NH that will accept medicaid when the time comes. The attorney can help with all of that.

Telling my mom the diagnosis didn’t help; but writing it down in big font and giving her a copy seemed to help because she referred to it often. I wrote down all the medical issues she had with the explanation of what they were (briefly and simply). After that, I created a daily sheet of paper of the day (concierge schedule). I gave it to her every day. This helped her because she wondered what was on the schedule for the day. Then, if we were talking and she forgot something and got frustrated; I would say “that’s okay mom, this is who you are now. You are safe and cared for and God loves you. We are here and you are not alone- I am your memory and and you trust me. It is okay.” I repeated it over and over as needed.

It took my mother a whole year after diagnosis to admit that she had Parkinson's. So the denial is expected. Just be there with him. If he is anything like my Mom, eventually he will have a brief moment of clarity where his inability to do things will become so obvious to himself that he will have to admit the diagnosis

His impairment is well past "mild.". He does not need to acknowledge it. He does need supervision.

He still drives??????

Yes, who wants to admit they are losing their mind. He is probably well aware of how his life is going to be and no amount of Medication is going to cure him.

I, too, think your husband is way past MCI. He should not be driving. You may want to see if there is a medication to help with the anger. I hope he was diagnosed by a Neurologist. If not, he should go to one.

My mother is now in the moderately advanced stage of full blown dementia & STILL says there's nothing wrong with her at all, and it's all the others in her Memory Care ALF that are 'stupid morons' and 'idiots', if that gives you any idea of the level of denial many people remain in who suffer from dementia.

The diagnosis of 'mild cognitive impairment' is extremely misleading by suggesting anything about it is 'mild'. It's not.

Read up on the topic of dementia and then pick up a copy of The 36 Hour Day which is a wonderful reference manual on the subject. Watch Teepa Snow videos on YouTube as well.

Disable your husband's vehicle immediately as he is a danger to himself and others while driving!!!!!!!!! Getting lost while driving is your first indication of a huge problem he's having. You don't want to have to go identify his body at the morgue one of these days, God forbid, or learn that he's killed another person or a child by driving recklessly.

Talk to his doctor about his anger issues and heightened startle reflex; anti anxiety meds CAN help with such issues.

Wishing you the best of luck with a difficult situation.

Definitely way past MCI now, sorry to say. He does not need to acknowledge it. It just doesn't matter. You know the truth. You seriously can NOT let him drive any more. He is a danger to himself and others. Don't try to argue with him about it, just hide the keys and/or disable the car. Have it towed somewhere to get "worked on" and it just never comes back.

I would look into something for him to take for his agitation (what I'm calling it from being angry and yelling). Look into natural remedies or call his doctor and explain symptoms.

When was he last at doc for checkup and blood work? Maybe a UTI? Maybe deficient in something? My mom is declining so they just tested B12 and thyroid which were fine in her care but who knows??

How long has it been since diagnosed with MCI. His current behavior is no longer MCI. MCI would be more of a chronic “forgetfulness” that doesn't affect day to day life. Your husband's symptoms certainly point to dementia, a loss of brain function that affects daily activities.

It's pretty normal for someone with dementia to deny it. You're not going to convince him otherwise so don't try. Doing so may aggravate him to the point of confrontation and anger. Sometimes the person may feel there is something wrong, but tries to cover it up by not acknowledging the problems. He may never acknowledge his dementia.

What causes him to startle easily? Do you call his name or say something to him without him seeing you? He may not realize you are in the same room as he is and get startled at the sound of your voice. If so, make sure he sees you before speaking

I should lay off the "mood swing herbs" if I were you. If they are making any difference, they may be masking his condition or they may even be making it worse. Herbal does not = gentle and always safe. Hemlock, opium and deadly nightshade are all 100% natural, remember.

It is very normal for a person diagnosed with the early stages of dementia to refuse to accept that this is the reason life has suddenly become so complicated and baffling. Many people will blame almost anything else for difficulties with navigation, constantly losing things, being unable to manage straightforward tasks and processes (e.g. locking doors) which they used to do without thinking (or so they and we all thought).

Who diagnosed the MCI? And what has been suggested for next steps?

OMG...so close to how my husband started out at age 59. He was first diagnosed with MCI then a year later they said Early onset Alzheimer's. He first started losing keys, kept running off our driveway and could not use the computer at the office.
It has been 9 yrs now and he still gets around physically and was never sick a day in his life prior to this disease...no cold, no flu, nothing!
I had to sell his truck and keep him from driving a couple of years ago. It seems now he can hardly understand much of what I say to him and he has great difficulty in expressing his thoughts and feelings. I will say something about a TV show and he is looking but must not really see the show.. he does not have sundowner symptoms but does see people in our yard. It is very difficult to watch and he stays angry alot and follows me every where I go in and out of the house. My husband still WILL NOT acknowledge he has any disease or problem with anything so hang in there!

I'm not a big fan of the MCI dx either, but the label matters less than how you & your DH are coping, how to go forward from here, rolling with the waves of this new sea you find yourselves in.

Of course a physical examination and blood tests should be done to help rule out other causes for his symptoms (eg nutritional deficiency). 

I was not sure of the MCI criteria so looked it up.

'MCI is generally defined as significant memory loss without the loss of other cognitive functions.

* report of memory problems (preferably confirmed by another person)
*greater-than normal memory impairment for age
* normal general thinking and reasoning skills
* ability to perform normal daily activities

So I'm thinking forgetting a few chores could be normal.

Forgetting where the plates are but being able to read & understand PLATES written on the cupboard door may be MCI?

A neighbour not knowing what the fridge was or how to open it was dx as Alzheimer's.

Has stroke been ruled out?

This does not sound like MCI. (I don't like the MCI diagnosis, I think it is a baby step some doctors take to ease into the dementia diagnosis)
What you describe sounds like Dementia of one type or another.
It is important to get an accurate diagnoses though.
He should not be driving.
He should not be left alone.
He will probably never acknowledge he has a problem because he does not think he has one. By the time you get a diagnosis most people with dementia do not realize what they are doing and not doing.
It would be wise to set up an appointment with an Elder Care Attorney and discuss what can be done to protect your assets, protect your husband and see what needs to be done for the future.
Will you be able to keep him home with the help of caregivers? If so for how long? Will you have to place him in Memory Care? If so at what point will you have to place him?

Here is the link to your local Area Agency on Aging:

https://www.paainc.org/

Give them a call today. Hopefully they will assign you to a social worker who can provide support and guidance.

Has your husband been seen by a geriatric psychiatrist? It sounds to me like he might need meds to counteract his anger and agitation. Call his doctor today and ask if they have a recommendation and find out if you need a referral.

If your husband threatens you with violence, do not hesitate to call 911 and have him admitted to a psych facility. Sometimes this is the best way to figure out what meds work and at what dosage.

Sounds worse than MCI to me. It seems to have moved on to dementia. He's not likely to acknowledge it either, ever. Did you get a diagnosis for the cause of his mental decline? Was this diagnosis from a primary care physician or a neurologist? Maybe there is a treatable cause. I suggest you get on with making plans for his future care either with caregiver/companions if he goes out, or placement in a facility where he can't get out and get lost. You are going to need help about him sooner or later. Find a support group. But seriously, see if you can get to why this is happening to him.