ABSTRACT
This chapter looks at the concerns of clinicians, patients, families and managers of services, in the context of Mild Cognitive Impairment (MCI) or mild NeuroCognitive Disorders (mild NCD). Each of these have specific anxieties, such as these: ‘How can I help when medications are not very effective?’; ‘What is going to happen to me?’; ‘How do I keep my patience and maintain a relationship with someone who doesn’t want to acknowledge their problems?’; ‘Is it worth offering anything to someone who may not have long to live?’ Psychodynamic counselling or psychotherapy can help people to remain in touch with others; it can reduce loneliness, enable grief work for past losses and assist carers to understand and to tolerate the difficulties of changing relationships which have enormous emotional significance. It may be particularly important as people move from managing ‘on their own’ to acknowledging their dependence on others. The chapter covers in addition epidemiology, co-morbidity and medical treatments of MCI or mild NCD; understanding and handling changes and difficult feeling evoked in carers, family members and therapists as well as patients; child carers and young children and working through diagnosis.
