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Supporting Aging in Place: Providing Strategies for Persons with MCI

Supporting Aging in Place: Providing Strategies for Persons with MCI
Megan L. Malone, MA, CCC-SLP, Jennifer Loehr, MA, CCC-SLP
February 19, 2016

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As a result of this course, participants should be able to: 

  1. Describe the causes, signs, symptoms, and possible treatment options for MCI 
  2. Describe the different types of memory and memory stages and how to help residents access spared cognitive function to use compensatory strategies for continued safety and independence. 
  3. List environmental interventions and intervention strategies to help residents remain safe in their living environment. 
  4. Describe a community-based group for older adults that supports aging in place concepts/strategies.

Before getting into the meat of the course there are a few acknowledgements.  The community based program that will be describing toward the end of the course is a result of a project we have been working on in the speech pathology department at Kent State University.  I would like to thank and acknowledge the students who have worked on that project, as well as my co-supervisor Amy Vaughn who has been pivotal in making this experience possible. We have had some really great outcomes that I am excited to share.

Needs of the Older Population

MCI & Dementia Prevalence

According to the Alzheimer’s Association, about 5.2 million American have Alzheimer’s disease (2014). Approximately 200,000 of individuals younger than age 65 have younger-onset Alzheimer's (i.e., dementia). Some long term studies suggest that about 10-20% of those age 65 and older may have mild cognitive impairment (MCI). 

There is an increase in needs in the older population.  Therefore, it is important for practitioners serving this population really understand the nuances of the different diagnoses are and how to intervene. 

Depression Risks

One major issue in the older population is the risk for depression.  Depression is more common in people who have other illnesses as many older adults do. For example, they may have heart disease or cancer. Usually with those chronic diseases, depression can accompany those problems.  Some estimates of major depression in older people living in a community range from less than 1% to about 5%, but then rise to about 13.5% in those who require home healthcare, and about 11.5% in older hospital patients. As those health needs increase the risk for depression increases as well.

What is MCI?

According to the Alzheimer's Association, Mild Cognitive Impairment (MCI) is something that causes cognitive changes that are serious enough to be noticed by the individuals experiencing them or other people, but the changes are not severe enough to interfere with daily life or function. That is really the discriminating feature between MCI and something like dementia or an Alzheimer's disease.  Certain things are bothersome to the person and are a little more difficult than they used to be, but those changes do not really affect how they get through daily life. 

Because the changes caused by MCI are not severe enough to affect daily life, the person with MCI does not meet the diagnostic guidelines for dementia. The key phrase, again, is “daily life”. Those with MCI have an increased risk for eventually developing Alzheimer's or another type of dementia, however not all people with MCI get worse and some actually can get a little bit better.

That really gives us some basis to work with these clients because there is evidence that shows that we can actually make a difference and help people improve so their symptoms do not impact daily life and eventually cause a diagnosis of dementia. 

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megan l malone

Megan L. Malone, MA, CCC-SLP

Megan Malone is a speech-language pathologist working as a Clinical Instructor at Kent State University and in home health care for Gentiva Health Services. She previously worked for 9 years as a senior research associate and lead trainer at Myers Research Institute, in Cleveland, OH where she oversaw federally/privately funded grants focused on implementing interventions with older adults with dementia. She has spoken numerous times at the annual conventions of the American Speech and Hearing Association, Gerontological Society of America, American Society on Aging, and the Alzheimer’s Association, along with several state speech and hearing conventions. She has published articles in the Journal of Communication Disorders, Alzheimer’s Care Quarterly, The Gerontologist, and Dementia.

jennifer loehr

Jennifer Loehr, MA, CCC-SLP

Jenny Loehr is a speech language pathologist with over 25 years experience working with adult neurology. She has presented at over 20 state and national conferences and online continuing education programs on the topic of dementia. She is the co-author of the book, Here's How to Treat Dementia (Plural Publishing 2013) and is an LSVT certified clinician. She currently works in development and implementation of the Memory Care Program with Encompass home health training and mentoring physical, occupational and speech language pathologists working with the dementia population in the independent and assisted living communities. 

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This presentation will review the signs and symptoms of mild cognitive impairment (MCI), the impact on resident safety, and interventions that will allow these residents to remain independent and safely age in place.

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