Your Confidence Toolbox: Simple Strategies for Managing Forgetfulness With Mild Cognitive Impairment (MCI)

Even before receiving a diagnosis of mild cognitive impairment (MCI), many people with the condition experience difficulties with memory and thinking that take a toll on their confidence.

Regardless of whether your MCI symptoms stay the same, get worse, or improve, it’s important to maintain your confidence and daily living capabilities to the best of your ability. Here are some strategies that can help.

Keeping your home organized and uncluttered can help your mind feel less cluttered, too.

“A less stressful, more organized life is likely going to be beneficial for mood and reduce anxiety in someone with MCI,” says Daniel Callow, PhD, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine in Baltimore.

• Keep things in the same place. Pick a single spot, like your kitchen table, to keep important items like your medications, keys, and organizing tools like a calendar or checklist.
• Reduce physical clutter. Keep your counters and tables clear of extra items so that your essential items stand out.
• Use visual organizing tools. A calendar, checklist, or whiteboard can be helpful to keep track of tasks like chores, appointments, and errands.
• Use colorful labels. A big, bright, bold note or label can help you remember where things are located or tasks you need to complete.
• Link or combine tasks. It’s easier to remember to do things when you do them at the same time, like taking your medications with your morning coffee or buying groceries right after your morning walk.
• Stick to a routine. The more you do regular tasks at the same time every day, the easier it is to remember them.

It’s important to try different organizing tools to find out what works for you, says Erin Klein, a speech-language pathologist at Johns Hopkins Medicine. These can include planners and calendars, pill boxes, strategically placed notes, and alarms on your phone or a tabletop clock.

“Strategies will be identified as they’re appropriate for each patient, depending on what’s safe and attainable for them,” Klein says, noting that some people may need more involved strategies — like an alarm or a phone call — to make sure they do essential tasks like taking medications at the right time.

On top of sticking to a routine most of the time and using organizing tools, certain strategies for thinking and reflection can help you get through the day with confidence.

How you use labels and notes will depend on your personal needs, but many people find it helpful to put a checklist by the door that notes the things you want to take with you, like your wallet, phone, and keys.

Even if you do your best to plan and stay organized, you may encounter difficulties during daily tasks. For example, you may walk away from your shopping cart in the grocery store and forget where you left it, or you might forget where you parked.

When you have trouble with a task or forget something, it’s important to stay grounded and not give yourself too hard of a time, says Klein. “Where was your thinking directed or focused?” she asks, adding that it shouldn’t be, “I can’t believe this is happening again,” but instead should focus on solving the immediate problem.

Sometimes in her sessions with people with MCI, Klein says, “We introduce grounding techniques, something to bring their focus back to center.” This can be a phrase to tell yourself or a brief exercise that involves sensory or body awareness — whatever works for the person.

Dr. Callow emphasizes that feeling bad or stressing about forgetting things is not only unhelpful, it may actually be counterproductive and make your memory worse. “A less stressful, more organized life is likely going to be beneficial for mood and reduce anxiety in someone with MCI,” he says, adding that anxiety and depression are linked to further cognitive decline in mild cognitive impairment.

To do the things you want to do while living with mild cognitive impairment, it’s essential to prioritize tasks.

• Do difficult tasks early. Plan to do more difficult tasks earlier in the day, when you are less likely to be fatigued.
• Reduce distractions. Don’t have the TV or radio on while you’re doing tasks you need to focus on.
• Don’t try to multitask. Do one thing at a time, instead of trying to organize your pills while your dinner is cooking on the stove or in the microwave.
• Be kind to yourself. Tasks can take longer than they used to and involve greater frustration when you have MCI. It’s okay if certain things don’t get done, and it’s not your fault.
• Get help from others. Seeing a medical professional like a speech or occupational therapist can help you find strategies to organize your tasks and time. Joining an MCI or dementia support group can also help you feel less alone and learn from other people going through the same struggles.

One of the most important things to prioritize is sleep, since poor sleep can have a negative effect on your cognitive functioning. Prioritizing sleep means sticking to a set bedtime and wake time as much as possible, Callow says, as well as limiting screen time and eating before you go to bed. You should also make your sleep environment as comfortable as possible, which can mean keeping it cool or warm enough, as well as placing night lights strategically so that it’s easy to get up to go to the bathroom.

Getting enough physical activity can also help you sleep better. “There’s some strong evidence that exercise and physical activity could improve sleep in individuals with mild cognitive impairment,” says Callow, adding that it’s important to get any sleep disorder — like sleep apnea or restless legs syndrome — diagnosed and treated.

Some people with MCI find that mindfulness practices like meditation, tai chi, and yoga help them reduce anxiety and stay focused throughout the day. Klein says that it’s also important to avoid risky substances that can make you feel more anxious or depressed, which often include alcohol, caffeine, and recreational drugs.

It’s common for people with mild cognitive impairment to have trouble following a conversation, finding a word, or finishing a sentence.

“Communication skills and cognitive skills cannot work independently of each other,” says Klein. “There can definitely be an impact interpersonally or vocationally.”

While you can’t always prevent a disruption in memory or focus during a conversation, it matters how you react when this happens, says Klein: “Where did your emotions go when you couldn’t think of the word? Were you focused on, Now they’re waiting for me?”

Klein proposes a better strategy: If, for example, you can’t think of the word “meatball,” instead think, I know it’s in the category of food, and it’s a hot food, and it’s an Italian food. Hopefully, you'll arrive at the word or are able to describe it out loud.

Feeling pressure to communicate normally or hide their challenges can lead people with MCI to avoid actively participating in conversations, which is the opposite of what they need to maintain their communication skills, Klein says.

How Family and Friends Can Help With Communication

• Don’t make assumptions. Don’t exclude someone from a conversation or assume they’ll have difficulty understanding something — MCI affects everyone differently.
• Speak directly to the person. Don’t ask questions through someone’s family member or caregiver when the person is right there.
• Ask questions about communicating. Discuss what could make the person feel more comfortable communicating, including whether they prefer talking in person, on the phone, or by email.
• Keep things light. It’s okay to laugh about someone’s difficulties with memory or communication — don’t treat their issues like a failure or tragedy.
• Give the person time. “If your loved one is trying to remember something, give them an opportunity to use an external strategy before jumping in,” says Klein, adding that you can gently ask questions to get them closer to their word or thought.
• Stay connected. Even if communicating is more difficult, it’s important to keep interacting with people who have cognitive challenges. “Humans are social creatures, and greater social engagement is associated with better mood, quality of life, and cognitive resilience,” says Callow.

• While mild cognitive impairment can cause memory and thinking difficulties, using organizational and grounding strategies in your daily routine can boost confidence and lower frustration.
• Prioritizing important tasks, reducing distractions, limiting multitasking, and embracing kindness toward yourself can help in managing daily demands and reducing anxiety associated with MCI.
• Maintaining good sleep habits and getting regular physical activity can enhance cognitive function and overall well-being if you have MCI.