MCI

Lgb35

I am new to the group and was reading some older posts regarding MCI. My DH was diagnosed with MCI officially in April 2023. His MOCA was 15. Not good. His spatial scores are still good so our neurologist did not advise against driving. We are going to the Cleveland Clinic. DH is still working. He is an outside sales person for construction materials so he is constantly on the road. He has not admitted to ever being lost or confused while driving but he does use a GPS religiously. He talks about working another 5-10 years because he wants everything paid off for my sake. I know this is not going to happen. He often tells me he is not going to be around long enough to be a burden to me. I have tried to explain to him that at that point it’s not about him it’s about his family having time with him. Even if he doesn’t know our name he will still be making memories for us. I am worried about so many things at this point. When do I make him stop driving? When do I tell him it’s time to stop working? When he is in the office people talking frustrates him and he can’t focus. When the time comes where he does stop driving and working will he be able to handle it. This sucks!

Ed1937

Stacey, welcome. Sorry you need the forum, but it's great. When a doctor tells you it's okay for him to drive, that really makes it hard for you. You know your husband better than anyone else, but you have to keep in mind that if he should get in an accident with major damage or death to someone, you could both be sued for everything you have. As his caregiver, you are responsible for him driving. Many people will tell you that with a diagnosis, you will not stand a chance in court. Just something to be aware of. And of course if he maims a little kid, who has to live a long life disabled, you will have to live the rest of your life with your decision to allow him to drive. I'm sorry it's so hard.

jfkoc

Spatial ability is one thing. Reaction time quite another.

Now re the noise at the office your husband mat have a hearing problem. Please make an appt with an otolynengologist (sp)....not an audiologist ASAP.

When is your at a Cleveland Clinic?

-Judith

harshedbuzz

I am so sorry you are dealing with all of this.

MoCA is a screening test. It's not as thorough as a full neuropsych exam would be. It's normally given to identify folks who need to be worked up for cognitive issues and also to track progression in an establish patient with dementia. A score of 15-- assuming he cooperated is pretty significant. The range for MCI in a person with a high school or better education would be 18-24; 10-17 is considered moderate dementia. That said, I have seen my dad do remarkably well on MoCA relative to his ability to function IRL. The last one he took at the geripsych's office was 6-9 months before he died from complications of aspiration pneumonia when he was already stage 6 and he scored a 23.

Did you ask the neurologist specifically about driving and working? It might make sense to look at him going out of disability before he is fired for cause. You could have a specialized OT vet his driving but that would only give you a snapshot of how he is on a given day. Driving is one of those things that's OK until it isn't. Dementia and MCI are about so much more than just poor memory-- higher order thinking skills, executive function, empathy, and social filter can be problems fairly early on. I could see where his kind of work would be especially challenging with the onset of those kinds of deficits.

HB

M1

Hi stacey, I replied on your other thread---I would worry a GREAT DEAL about him getting fired because he could lose a lot of benefits that way. Much more so, if he is travelling for work and had an accident while driving for work, he could put the company at huge risk. Please don't delay on getting with an attorney ASAP about this. He proably needs to apply for SSDI and medical leave now--and you will need to convince him that this is the best way to secure your financial future.

Vitruvius

Spatial perception is less affected in some forms of dementia. My DW has the Semantic Variant of Primary Progressive Aphasia, aka Semantic Dementia (SD), it in turn is a variant of FTD. FTD is apparently known to have much less of an impact on spatial perception and direction than Alzheimer's in all but the last stages.

DW remarkably retained excellent navigation skills well into Stage 6. She would give me accurate turn-by-turn directions to places she had only rarely been to. BUT she did so because she no longer recognized me as her husband and thought I had never taken her there before and therefore needed the directions. When my DW had a similar MoCA, her executive reasoning skills were severely compromised, yet memory and orientation not as much.

Point being that dementia is about far more than just memory or orientiering. Reasoning, decision making, and reactions are often affected in subtle ways before the more obvious stereotypical signs emerge. Office conversations may be difficult for a PWD because they can not keep up and not sort out overlapping discussions. This was an early sign with my DW who withdrew from several groups she belonged to, and in retrospect people in those groups noted that she seemed to have problems keeping up with multi person discussions.

I urge you to heed the advice given here and I must say that doctors seem to somewhat minimize potential dementia, possibly out of some professional caution.

SDianeL

My DH was diagnosed with possible vascular dementia 2 years ago. He went through the Neuro-Psyche 3 hour eval and definitely had visuospatial difficulties. I had no idea. They mask their symptoms. The only thing I noticed was that he was driving too slowly and sometimes got confused at roundabouts. (don't we all). She said he should stop driving immediately. I was shocked. The year before that he was driving a huge RV down the highways. She said that once they put memory loss in his medical record, if he were in an accident even if it wasn't his fault, we could be sued and lose everything. He did not want to stop driving. I told him what the doctor said and he finally agreed. Dementia & Alzheimer's progress differently for each person. The Neurologists can't tell you how long before he declines. He can be stable for years and decline rapidly. That's happening to my DH now. No he won't be able to handle it. You will have to help him. He will become angry and take it out on you. Be prepared for that. Start learning all you can about the disease. Read the book "The 36 Hour Day" it helped me a lot.

Gthoma

Hi Stacey. I'm sorry you're dealing with this but you came to the right place. Everyone has good suggestions. I'd be really concerned about driving but since it sounds like this is part of his job it sounds like an even more significant bridge to cross than most.

I'd go see an attorney and get some advice specific to your state. It may be difficult for DH so you might consider going alone if you have to. While you're at it, do you have a POA? Advance Healthcare directive? An attorney can help you set these up. You'll be.glad you did. DW and i did 2 years before DWs diagnosis and I'm really glad we did.

Best wishes. We're all on the same journey so hang in there.