Dementia or old age?

I'd go with the neurologist since she seems to be functioning at a pretty high level. She probably would benefit from some support though, even without MCI, and of course you would want to remain vigilant.

The body allocates resources in times of stress, and caregiving is tremendously stressful, so forgetting things when distracted by something else (like caregiving an adult with dementia) wouldn't be unusual. I'd forget a lot of stuff when I had my mom here with me, and I still do if I get lost in thought about her care.

There are some things that can be done to support your mom. For instance, a hearing aid or voice amplifier could help her follow conversations better and not leave her isolated. My mom is more confused on days her hearing's bad (it varies), so she has a cheap Sony headset and a little thumbwheel voice amplifier she can plug into for days she's struggling. She won't wear a hearing aid. Usually I have to help her put it on, but it beats shouting our conversations.

If she doesn't have any, getting mom some assistance for basic things like housecleaning or laundry, or getting an aide in a few times a week to give her a break, bathe dad, do lunch prep, can help.

Helping her ordering groceries online for delivery could help (unless it's an opportunity for her to get away from caregiving), or helping her set up online autopayment payment would take more off her plate.

Sometimes med prescriptions can be refilled online-that might be something to do as well, or if their provider has a healthcare portal you could set that up if they don't have one.

Because of the MCI you probably don't want her to have to 'remember' a new skill if that's going to be challenging, but could set things up to happen automatically.

It wouldn't hurt if you made sure she kept a list of passwords somewhere safe that you could access for any online accounts, in case she becomes incapacitated or forgets her logins.

I agree with getting help in a bit here and there. If you find someone whose chemistry is good for one or all of you, it could benefit you when their care needs increase. You could tell both of them that they’re helping out this new person with nursing school credit or something like that as your mom may get overwhelmed quickly. I’m glad you’re on the path to getting the DPOA, makes complete sense to me.

I strongly agree with the recommendation to check the finances. I my mom “only” has MCI, and since the diagnosis I’ve been getting her bank statements, but she was living alone and handling bills herself. There were some large, round number checks, but I knew she liked to give gifts/donations and let it slide. But after seeing more suspicious activity, I finally used my POA to get added to her account (without running it by her) so I could see check images online. Lots of donations to scam charities - they exist, but they’re PACs that spend most of their budgets on themselves. Sometimes she’d give twice in a row. Contrary to her claim and past practice that she only donates “at year end,” she’d been doing this regularly for the past two years - the limit to what I could access.

I typed up a spreadsheet and brought it to her doctor, and that was a factor in the decision to move her to a CCRC against her wishes. The move was way easier since I could write checks from her account. It’s been six months, and she still hasn’t noticed or asked me about the 20-30 checks I’ve written - another sign of impairment, I’d say.

You should keep an eye on finances she would be an easy target for a scam. Also just because she is still doing things doesn’t mean she is doing them well or without problems. This is a time to monitor things and be aware of when you need to step in. Stress is not good for dementia. Taking care of your dad may make things worse on her. My understanding is that mild cognitive impairment is pre dementia and is NOT a normal part of aging.

When my DW was diagnosed with alz we visited an attorney and we both made our wills and we both gave POA to each other and to our daughter. In the event that I can no longer care for my DW our daughter will have the authority to do what she needs. I wish you the best with your parents.