Memory Center Introduction Kaiser Permanente Napa-Solano Service Area - PowerPoint PPT Presentation

Memory Center Introduction Kaiser Permanente Napa-Solano Service Area Fairfield, Napa, Vacaville and Vallejo Medical Offices Memory Classes in Vallejo, Vacaville and Fairfield

Scope of Today’s Class About The Memory Center at KP Napa-Solano Memory and Aging Overview Questions & Answers Your Individual Appointment Life Care Planning Caregiver Information and Support 2 Memory Classes in Vallejo, Vacaville and Fairfield

The Memory Center at KP Napa-Solano 3 Memory Classes in Vallejo, Vacaville and Fairfield

Team-Based Approach to Memory - Patient - Family - Nurse Practitioner Data Three - Social Worker Data One - Geriatrician - Primary Care Physician Data Two 4 Memory Classes in Vallejo, Vacaville and Fairfield

Memory Center Team Members Napa-Solano Service Area Physicians Memory Specialists/Geriatricians Saad Basheer, MD Maya Kahwagi, MD Chandra Keebler, MD Michael Mason, MD Nurse Practitioner Sari Fredrickson, NP Social Worker Elizabeth McCoy, MSW Medical Assistants Emerciana Rodgers Marissa Yamamoto Manager Estrella Shoka, MBA Consultations Neurology Pharmacy Psychiatry – Arlene Brown, MD 5

Components of the Memory Center 1. Memory Class 2. Individual Appointment 3. Caregiver Support Group 4. Ongoing Support 6 Memory Classes in Vallejo, Vacaville and Fairfield

Memory and Aging 7 Memory Classes in Vallejo, Vacaville and Fairfield

Brain Function is More Than Memory Different Parts of the Brain Have Different Jobs Frontal Lobe Parietal Lobe thinking, memory, language and touch behavior, and movement Occipital Lobe Temporal Lobe vision Hearing, learning and feelings Cerebellum Brain Stem balanc e and coordination breathing, heart rate and temperature When you age your brain may change in different ways. Memory is just one of the many functions we evaluate at the Memory Center. 8 Memory Classes in Vallejo, Vacaville and Fairfield

Your Brain Does a Lot! Logic Personality Math Creativity Data Three Language Intuition Data One Reading Music Writing Art Data Two Analysis Spatial Abilities Memory 9 Memory Classes in Vallejo, Vacaville and Fairfield

Why Does Memory Change?  Physical brain changes – Brain shrinks – Starts age 30! – Nerve cells don’t communicate – Blood doesn’t flow as well  Stress, Depression and anxiety  Alcohol and/or substances Data One  Vitamin deficiencies  Infections  Some prescription medications and some medical conditions (hearing, thyroid, etc.) may look like memory problems Medications such as Benadryl, Unisom, and Tylenol PM and many prescription medications can negatively affect memory. *Check with your doctor before taking supplements and over the counter medications! 10 Memory Classes in Vallejo, Vacaville and Fairfield

Normal vs. Abnormal Cognitive Changes Normal Age-Related Changes Possible Cognitive Problem Bad decisions once in a while Poor judgment and decision-making Missing a monthly payment Inability to manage a budget Forgetting what day it is and Losing track of the date or season remembering later Forgetting which word to use sometimes Difficulty having a conversation Misplacing things and being unable to Losing things occasionally retrace steps to find them Data Three 11 Memory Classes in Vallejo, Vacaville and Fairfield

Examples of Abnormal Cognitive Changes Data Three Unable to Shop Alone Trouble with Basic Household Duties Data Two Inappropriate Social Behaviors Inability to Manage Finances 12 Memory Classes in Vallejo, Vacaville and Fairfield

3 Main Types of Cognitive Changes 1. Age-Related 2. Mild Cognitive 3. Dementia Memory Changes Impairment (MCI)  Very common! Not bad!  Difficulty with one area  Difficulty with two or Data Three of brain function more areas of brain  Delayed Recall function (not just  Memory issues do not Data One memory)  Forgetting Details affect basic functions overall- we can still do  Affects function  Does not dramatically the things we need to worsen with time  Gradually worsens with Data Two do! time  Does not affect function  May improve, remain  Not reversible- such as stable over time, or caused by infection or progress to dementia medication 13 Memory Classes in Vallejo, Vacaville and Fairfield

How Dementia is Like Vehicles Vehicles Dementia Vascular Dementia Alzheimer’s Disease Frontotemporal Dementia Parkinson’s Variants Mixed Dementia Rare Dementias Lewy Body Dementia 14 Memory Classes in Vallejo, Vacaville and Fairfield

Dementia and Alzheimer’s Disease Dementia Alzheimer’s Vascular Mixed Lewy Body Other Disease Dementia Dementia Dementia Dementias 50-80% 10-15% Data Three 10-20% 5-10% <5% Data One Alzheimer’s Disease Vascular Dementia  95% are age-related,  Related to stroke or blood 5% are family-related vessel blockage Data Two  Likelihood increases with age  Neurons can’t get oxygen  Neurons can’t communicate  Seen with uncontrolled diabetes, blood pressure, or  Main problem: Memory cholesterol  Gradually worsens  Can have stepwise decline 15 Memory Classes in Vallejo, Vacaville and Fairfield

Symptoms of Dementia Lack of Awareness Short Term Memory Problems  The person with the problem  Repeating oneself may not know they have a  Forgetting conversations problem, but others may  Difficulty with words notice Functional Problems Other Brain Problems  Paying bills  Accounting  Judgment  Planning  Cooking  Appointments  Decision-  Awareness making  Driving  Shopping  Orientation  Social life 16 Memory Classes in Vallejo, Vacaville and Fairfield

Dementia Diagnosis… how do we know? Personal History Testing  What is happening? How is it  Assessment/Questioning different from before?  Brain Questionnaire  Pattern of memory and  Neurological exam thinking problems  Blood tests  Any difficulty with function –  Brain imaging (like CT or doing things MRI) 17 Memory Classes in Vallejo, Vacaville and Fairfield

3 “Stages” of Dementia 1. Mild 2. Moderate 3. Advanced  Gradually worsens  Staging is not based on degree of memory loss, but on degree of functional loss Data Two  People with dementia will have different needs at different stages 18 Memory Classes in Vallejo, Vacaville and Fairfield

Tips to Help Agitation and Behavior Sometimes loved ones can have behavior changes- like irritability, hallucinations, paranoia, severe agitation, and aggressive or combative behavior. Data Three  Create a calm environment Data One  Redirect the conversation  Remove stressors  Keep a routine Data Two  Simplify tasks  Provide an opportunity for exercise  Let us know to help! 19 Memory Classes in Vallejo, Vacaville and Fairfield

Caring for Loved Ones with Dementia If non-drug approaches fail, sometimes medications can help:  Anti-depressants, anti-seizure medications, anti-anxiety medications, Data Three anti-psychotic medications Data One In general, caregivers should:  Be calm and supportive Data Two  Agree and redirect rather than confront  Watch for safety issues  Plan for the future 20 Memory Classes in Vallejo, Vacaville and Fairfield

Treating Memory Loss: Lifestyle Diet Exercise Data One Data Two Mental Activity Social Activity 21 Memory Classes in Vallejo, Vacaville and Fairfield

Treatment for Memory Problems: Diet  Studies show that people who eat more of a Mediterranean diet have less dementia!  Fresh Vegetables  Fresh Fruits  Lean Protein – fish/chicken- baked or broiled (Not fried)  Nuts!  Healthy oils- like Olive Oil 22 Memory Classes in Vallejo, Vacaville and Fairfield

Treatment for Memory Problems: Exercise  Research shows daily exercise can help prevent and slow memory decline  Think of it as pumping blood to the brain!  Start slow- increase as needed  Even 10 minutes 2x per day helps! 23 Memory Classes in Vallejo, Vacaville and Fairfield

Treatment for Memory Problems: Mental Activity  Studies show keeping your brain active with different things every day is like exercise for your brain!  Board games, card games, word find, soduku, crosswords, etc. 24 Memory Classes in Vallejo, Vacaville and Fairfield

Treatment for Memory Problems: Social Activity  Getting together in social situations 2-3 x per week or more has been shown helpful!  Consider things like church groups, senior centers, meeting with friends, etc. 25 Memory Classes in Vallejo, Vacavil le and Fairfield

Treating Memory Loss: Lifestyle Ways to Help You Remember  Keep lists  Follow a routine  Make connections in your mind  Keep a detailed calendar  Put important items in the same place Work as a team to help treat memory loss!  Repeat names when you meet people *Control Risk Factors*  Keep your mind and body active  Blood pressure  Aspirin or other medications if  Jog your memory when you forget a  Blood sugar needed word by going through the “ABCs” in  Cholesterol your head 26 Memory Classes in Vallejo, Vacaville and Fairfield

Treating Memory Loss: Medications  Not a cure – do not reverse dementia progression  Help with symptom management  Two classes of medications: Data Three Cholinesterase Inhibitor Early stages, up to 2 years Slows memory deterioration Donepezil (Aricept), Rivastigmine (Exelon), Galantamine (Razadyne) NMDA Receptor Agonist Moderate to advanced dementia Minimal gains seen Memantine (Namenda) 27 Memory Classes in Vallejo, Vacaville and Fairfield