Mild cognitive impairment (MCI) refers to non-normative changes in memory and cognition. While researchers are beginning to address the social consequences of MCI, no investigations havetracked how married couples respond to MCI over time as symptoms stabilize or become more severe. Guided by life course and symbolic interactionist tenets, we examined how 40 older couples in the United States adjusted to daily life after one partner was diagnosed with MCI and how their marital roles and relationship changed over a three- to four-year period. Data were collected from 2004 through 2010. All couples experienced an initial period of transition in coping with MCI where they made adjustments in their daily lives and interactions. Following this adjustment period, four trajectories of care emerged depending on the extent of the older adult’s decline and the spouse’s response. We conclude that changes associated with MCI affect role identity and have consequences for spousal relationships.