Family involvement critical when evaluating
and treating possible memory disorder

Adults of all ages sometimes lose their car keys, can’t remember where they parked their car or forget an acquaintance’s name. However, when frequent memory loss is associated with other difficulties, it may be a sign of a memory disorder, says Donna Irish, R.N., a gerontological nurse practitioner at St. John’s Memory Disorders Clinic, which is located inside St. John’s Clinic – Geriatrics in St. John’s Fremont Medical Building.

“There are many different types of dementia, which is a loss in the brain functions responsible for thinking, reasoning, and social awareness,” Irish says. “While Alzheimer’s is the most frequent dementia, we evaluate for all types.”

According to the Alzheimer’s Association, approximately one in 10 people over the age of 65 suffers from Alzheimer's disease, with prevalence rates rising sharply with increasing age, approaching 50 percent for those 85 and older.
Other conditions, such as small strokes in the brain, vitamin deficiencies, thyroid disorders and sleep disorders can also cause memory loss.

St. John’s neurologist Thomas Habiger, M.D., is the medical director of St. John’s Memory Disorders Clinic. As the only clinic of its kind in the region, St. John’s Memory Disorders Clinic includes the services of Habiger and Michael Luzecky, M.D., and neuropsychologist Michael Whetstone, Ph.D.

When a patient is referred to the Memory Disorders Clinic, a complete neurological and medical evaluation is conducted in order to identify causes of memory problems and find the most effective plan for each individual patient. The evaluation may include laboratory testing, a brain scan, a neuropsychological consultation, neuropsychometric testing, social services, and referrals for physical therapy or occupational therapy.

Irish says referrals to the sleep lab may also be part of the evaluation to rule out sleep disorders. A report, including recommendations for treatment, is provided to the patient’s primary care physician after the evaluation.

“In some cases, we find during the evaluation that the patient doesn’t have a memory disorder but is depressed or is taking medication that may cause dementia,” Irish says.

Family involvement is critical when evaluating and treating a patient with a possible memory disorder, Irish says.

“Before a patient comes in for their first appointment, we send out a packet of information and request that a family member come with the patient to the appointments. It’s very important that we get family feedback not only about the patient’s medical history, but behavioral issues as well. Family involvement also gives us the opportunity to educate the family about the patient’s condition and how they can help,” Irish says.

After the evaluation and diagnosis, the clinic determines a course of treatment for the patient that may include medication to slow the progression of the dementia.

Nonmedical treatments such as behavior management and memory aids are also used.
Irish says the Memory Disorders Clinic also encourages patients and their family members to utilize the local chapter of the Alzheimer’s Association, which can be reached at 417-886-2199, for support and information.

Common symptoms of dementia

Recent memory loss that affects job skills. Does the person often forget names, assignments, or phone numbers without remembering them later?

Difficulty performing familiar tasks: does the person prepare a meal and forget to serve part of it and later not remember preparing it?

Problems with language: does the person forget simple words or substitute unrelated words, making sentences incomprehensible?

Problems with time and place: Has your loved one become lost on their own street, not knowing how they got there or how to get back home?

Poor or decreased judgment: Has the person been caring for a child and entirely forgotten their responsibility for the child? Have they dressed inappropriately, perhaps wearing a coat on a hot day?

Problems with abstract thinking: Has the person frequently put things in inappropriate places such as an iron in the freezer or a watch in the sugar bowl?

Changes in mood or behavior: Have you seen rapid mood swings - from calm to tears to anger - for no apparent reason?

Changes in personality: Have you seen a drastic change in your loved one’s personality, becoming extremely confused, suspicious or fearful?

Loss of initiative: Has the person become persistently passive about daily chores, business activities or social activities? Do you often have to prompt them to become involved?


Memory Aids

• Use hearing aids and eyeglasses
• Work at remembering
• Try to focus on one thing at a time
• Get organized
• Set up a routine
• Use memory cues: notes, timers, memos, calendar notes, diagrams
• Link the known to the unknown
• Use mnemonic devices: visual associations, rhymes, categorizing, placing items in “rooms” in your mind
• Use the “chunking” technique: remember information such as phone numbers and Social Security numbers in chunks
• Rehearse: repeat someone else’s name several times during the conversation after meeting them. Mentally run through what you need to do or say in a situation.
• Repeat key information out loud so you can hear it.
• Keep your mind and body active.