Meeting the complex needs of a loved one with dementia can be physically and emotionally overwhelming. In addition to managing challenging cognitive and behavioral changes, caregivers become responsible for their loved one’s primary care needs.
This means keeping up with checkups and immunizations, juggling appointment schedules and communicating with providers. Getting to and attending office visits can become more complicated as the disease progresses.
Inside Emory Healthcare’s Integrated Memory Care Clinic, however, our specialized care team provides both memory care and primary care in one location. The clinic is the first program of its kind in the United States. It’s a model for supporting people with dementia due to Alzheimer’s disease, frontotemporal degeneration, Lewy body disease, cerebrovascular disease and other causes.
Filling a Gap in Dementia and Primary Care
The Integrated Memory Care Clinic opened in 2015, but the idea for this unique model of care took root several years prior at the Emory Cognitive Neurology Clinic. Carolyn Clevenger, clinical director and nurse practitioner, and Janet Cellar, retired advanced practice nurse in neurology, listened to their patients’ caregivers. They understood the challenges families faced managing the various appointments for their loved ones.
For example, when a person living with dementia and diabetes experiences low or high blood sugar, this may cause the person to experience psychiatric symptoms. In traditional health care systems, the patient and family must decide who to follow up with. That could be an endocrinologist, primary care provider, psychiatrist or dementia specialist.
“Janet and Carolyn questioned if there was a way to combine the practices,” says Laura Medders, LCSW, program director at the clinic. “They listened to the concerns of the families and then designed the clinic as closely as they could to meet the challenges the families described.” The Integrated Memory Care Clinic blossomed as a result, offering patients one comprehensive practice to address the concern.
The program provides dementia and primary care to patients in one place by nurse practitioners with advanced training and specialization in dementia, geriatrics and palliative care. Caregivers can also receive counseling, support and education about dementia. This enables them to navigate the ups and downs of caring for a person with dementia.
First Program of its Kind for Dementia Patients and Caregivers
The clinical team at Emory’s integrated memory care program becomes the patients’ primary care provider for a range of health care services, from treating a cold to:
- Cognitive assessments to evaluate the current dementia stage
- Monitoring and treating chronic conditions like high blood pressure
- Preventive care, like immunizations
- Referrals to specialists, as needed
- Treatment for acute issues, like rashes or infections
Through the clinic, caregivers receive education and counseling, and help with:
- Navigating care coordination
- Planning for future care needs of their loved one
- Psychological and emotional support
The number of visits a patient requires is based on their needs. If the patient has multiple chronic health conditions or a concerning new symptom, they may see a nurse practitioner more frequently.
Appointments are one hour for the first visit and 40 minutes for existing patients. Generous appointment times allow patients and caregivers to talk in detail about their health status and concerns. Plus, they have time to delve into more nuanced issues related to dementia, such as whether a patient should continue getting cancer screenings.
Our Integrated Memory Care team includes social workers and psychiatric nurse practitioners, which is helpful for managing complicated behavioral symptoms related to dementia. The psychiatric nurse also helps dementia patients with a history of schizophrenia or depression.
“Having all these resources within one clinical practice reduces the amount of back-and-forth families have to do. This applies not only to driving their loved one to appointments but also the feeling they need to be the messenger between providers,” says Medders.
Lower Hospitalization Rates
Caregivers of established patients can call an after-hours line when urgent issues come up on nights or weekends. The service has contributed to lower hospitalization rates for patients of the program.
“We are quite good at keeping people out of the hospital unnecessarily,” says Medders. “The after-hours number for our patients and families helps answer questions about a new symptom or whether an emergency room visit is required.”
Community Program Partners with Senior Living Communities
In 2022, the Integrated Memory Care Clinic in Community Program was launched to meet a growing need for patients to receive dementia and primary care where they live. It is the first program of its kind in the U.S., and its model is available in select senior living communities in the Atlanta area.
The community program meets new challenges caregivers face after their loved one moves from home to a care facility.
“Families would tell us they wanted their person to continue seeing the IMCC clinic team, but it was really difficult to get them to our clinic,” says Medders.
The time it took for caregivers to take their person out of the care facility, to the clinic and back while working full-time jobs and caring for their families added new stressors.
In response, the clinic created a separate program. Now, primary care and dementia nurse practitioners visit patients in their assisted care home settings. For a monthly fee, patients enrolled in the program also have access to a dementia care assistant. In weekly one-on-one visits, the care assistant engages with patients in activities, meeting them at every stage of their dementia. The assistant considers the patient’s interests–past and present–and their existing strengths.
Care assistants can observe the patient’s health on a weekly basis and report any concerns to the clinical team. This visit also serves as an additional line of support.
“We consider our Integrated Memory Care Community Program a holistic wraparound service,” says Medders.
Caring for loved ones with dementia is physically, mentally and emotionally challenging. Emory Healthcare’s new program elevates the care of memory patients and helps families take care of their own well-being.
To make an appointment, call 404-712-6929 or visit us online to learn more about Emory Healthcare’s memory care program.
