Posted: May 18th, 2016

The patient was diagnosed by her Primary Care Provider (PCP) 18 months ago with Mild Cognitive Impairment (MCI) and prescribed Donepezil 5 mg by mouth at bedtime.

– The patient was diagnosed by her Primary Care Provider (PCP) 18 months ago with Mild Cognitive Impairment (MCI) and prescribed Donepezil 5 mg by mouth at bedtime. She has functioned independently with assistance from her two adult children who live within 5 miles of her home.
– The patient (pt.) has complained of increased forgetfulness. In addition the son reports she has had difficulty sleeping (calling him by phone at all hours of the night) and increased agitation and irritability. Last week she slapped his wife when she attempted to adjust his mother’s disheveled clothing.
– No previous history of psychiatric illness
– No history of substance use disorder
– Currently being treated for hypertension (atenolol, chlorothiazide), type II diabetes (glipizide), and insomnia (diphenhydramine).
– Hospitalized 2 years ago following a “mild” heart attack, two cardiac stents inserted.
– Lives in a private home alone following the death of her husband 7 years ago.
– Retired from her part time job as a home health-aid 5 years ago after her employer terminated her for excessive absences and lateness.
– No family history of psychiatric disorders. Mother died at age 39 due to “brain tumor”
– And her father died at age 62 as a result of a Cerebral Vascular Accident (CVA). No siblings.