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

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

Sep 03, 2023 132 likes •530 views

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 Todays Class About The Memory Center at KP Napa-Solano Memory

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Memory Center Introduction

Kaiser Permanente Napa-Solano Service Area Fairfield, Napa, Vacaville and Vallejo Medical Offices

Memory Classes in Vallejo, Vacaville and Fairfield

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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

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The Memory Center at KP Napa-Solano

3 Memory Classes in Vallejo, Vacaville and Fairfield

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Data One Data Two Data Three

Team-Based Approach to Memory

  • Patient
  • Family
  • Nurse Practitioner
  • Social Worker
  • Geriatrician
  • Primary Care Physician

4 Memory Classes in Vallejo, Vacaville and Fairfield

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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

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Components of the Memory Center

  • 1. Memory Class
  • 2. Individual Appointment
  • 3. Caregiver Support Group
  • 4. Ongoing Support

Memory Classes in Vallejo, Vacaville and Fairfield 6

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Memory and Aging

7 Memory Classes in Vallejo, Vacaville and Fairfield

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SLIDE 8

balanc

Brain Function is More Than Memory

Different Parts of the Brain Have Different Jobs

Frontal Lobe Parietal Lobe Occipital Lobe Temporal Lobe e and coordination vision thinking, memory, language and touch behavior, and movement Hearing, learning and feelings Cerebellum Brain Stem 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

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Data One Data Two Data Three

Your Brain Does a Lot!

Logic Math Language Reading Writing Analysis Memory Personality Creativity Intuition Music Art Spatial Abilities

9 Memory Classes in Vallejo, Vacaville and Fairfield

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Data One

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
  • 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

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Data Three

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 remembering later Losing track of the date or season Forgetting which word to use sometimes Difficulty having a conversation Losing things occasionally Misplacing things and being unable to retrace steps to find them

11 Memory Classes in Vallejo, Vacaville and Fairfield

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Data Two Data Three

Examples of Abnormal Cognitive Changes

Unable to Shop Alone Trouble with Basic Household Duties Inability to Manage Finances Inappropriate Social Behaviors

12 Memory Classes in Vallejo, Vacaville and Fairfield

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Data One Data Two Data Three

3 Main Types of Cognitive Changes

  • 1. Age-Related

Memory Changes

  • Very common! Not bad!
  • Delayed Recall
  • Forgetting Details
  • Does not dramatically

worsen with time

  • Does not affect function
  • 2. Mild Cognitive

Impairment (MCI)

  • Difficulty with one area
  • f brain function
  • Memory issues do not

affect basic functions

  • verall- we can still do

the things we need to do!

  • May improve, remain

stable over time, or progress to dementia

  • 3. Dementia
  • Difficulty with two or

more areas of brain function (not just memory)

  • Affects function
  • Gradually worsens with

time

  • Not reversible- such as

caused by infection or medication

13 Memory Classes in Vallejo, Vacaville and Fairfield

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How Dementia is Like Vehicles

Vehicles Dementia

Alzheimer’s Disease Vascular Dementia Mixed Dementia Lewy Body Dementia Frontotemporal Dementia Parkinson’s Variants Rare Dementias

14 Memory Classes in Vallejo, Vacaville and Fairfield

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Data One Data Two Data Three

Dementia and Alzheimer’s Disease

Dementia

Alzheimer’s Vascular Mixed Disease Dementia Dementia

50-80% 10-15% 10-20% Alzheimer’s Disease

  • 95% are age-related,

5% are family-related

  • Likelihood increases with age
  • Neurons can’t communicate
  • Main problem: Memory
  • Gradually worsens

Lewy Body Other Dementia Dementias

5-10% <5% Vascular Dementia

  • Related to stroke or blood

vessel blockage

  • Neurons can’t get oxygen
  • Seen with uncontrolled

diabetes, blood pressure, or cholesterol

  • Can have stepwise decline

15 Memory Classes in Vallejo, Vacaville and Fairfield

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Symptoms of Dementia

Lack of Awareness Short Term Memory Problems Other Brain Problems Functional Problems

  • The person with the problem

may not know they have a problem, but others may notice

  • Judgment
  • Decision-

making

  • Planning
  • Awareness
  • Orientation
  • Repeating oneself
  • Forgetting conversations
  • Difficulty with words
  • Paying bills
  • Cooking
  • Driving
  • Social life
  • Accounting
  • Appointments
  • Shopping

16 Memory Classes in Vallejo, Vacaville and Fairfield

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Dementia Diagnosis… how do we know?

Personal History

  • What is happening? How is it

different from before?

  • Pattern of memory and

thinking problems

  • Any difficulty with function –

doing things

Testing

  • Assessment/Questioning
  • Brain Questionnaire
  • Neurological exam
  • Blood tests
  • Brain imaging (like CT or

MRI)

17 Memory Classes in Vallejo, Vacaville and Fairfield

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Data Two

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

  • People with dementia will have

different needs at different stages

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Data One Data Two Data Three

Tips to Help Agitation and Behavior

Sometimes loved ones can have behavior changes- like irritability, hallucinations, paranoia, severe agitation, and aggressive or combative behavior.

  • Create a calm environment
  • Redirect the conversation
  • Remove stressors
  • Keep a routine
  • Simplify tasks
  • Provide an opportunity for exercise
  • Let us know to help!

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Data One Data Two Data Three

Caring for Loved Ones with Dementia

If non-drug approaches fail, sometimes medications can help:

  • Anti-depressants, anti-seizure

medications, anti-anxiety medications, anti-psychotic medications

In general, caregivers should:

  • Be calm and supportive
  • Agree and redirect rather than confront
  • Watch for safety issues
  • Plan for the future

20 Memory Classes in Vallejo, Vacaville and Fairfield

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Data Two

Treating Memory Loss: Lifestyle

Diet Mental Activity Exercise

Data One

Social Activity

21 Memory Classes in Vallejo, Vacaville and Fairfield

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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

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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

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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

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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.

le and Fairfield 25 Memory Classes in Vallejo, Vacavil

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Treating Memory Loss: Lifestyle

Work as a team to help treat memory loss!

*Control Risk Factors*

  • Blood pressure
  • Aspirin or other

medications if

  • Blood sugar

needed

  • Cholesterol

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
  • Repeat names when you meet

people

  • Keep your mind and body active
  • Jog your memory when you forget a

word by going through the “ABCs” in your head

26 Memory Classes in Vallejo, Vacaville and Fairfield

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Data Three

Treating Memory Loss: Medications

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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)

  • Not a cure – do not reverse dementia

progression

  • Help with symptom management
  • Two classes of medications:

Memory Classes in Vallejo, Vacaville and Fairfield

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Safety Considerations

Travel

  • If someone is concerned, stop

driving and get tested Driving

  • In CA, doctors required to report

dementia diagnosis, but will not take away license

  • Difficulty with unfamiliar places

Wandering

  • Identification

Cooking

  • May forget burner or stove
  • May turn on water and forget to

Water Usage turn it off

  • New places can be confusing
  • New settings can worsen memory
  • Familiar things can help orient

28 Memory Classes in Vallejo, Vacaville and Fairfield

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Summary

  • Our brains do more than just memory
  • When we or someone we know notices changes – get information

and get help!

  • Many times memory changes are normal or very mild
  • Sometimes, if one’s memory gets a little worse, affects their function

and is not reversible - it is dementia

  • The most common dementias are Alzheimer’s and Vascular / Mixed
  • We want to help know where people are to get the right help and the

right treatment

Memory Classes in Vallejo, Vacaville, Napa and Fairfield

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Questions About Memory Questions About Memory

30 Memory Classes in Vallejo, Vacaville and Fairfield

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Your Individual Appointment Your Individual Appointment

31 Memory Classes in Vallejo, Vacaville and Fairfield

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Components of the Memory Center

  • 1. Memory Class
  • 2. Individual Appointment
  • 3. Caregiver Support Group
  • 4. Ongoing Support

Memory Classes in Vallejo, Vacaville and Fairfield 32

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What to Expect at Your Appointment

  • Review Memory Questionnaire
  • Review history
  • Memory test
  • Physical examination
  • Diagnosis
  • Treatment recommendations
  • Review Advanced Directives
  • Discuss home safety
  • Follow-up recommendations

Preparing For Your Visit

  • Bring your medications
  • Come with a trusted person
  • Make sure to eat or drink prior
  • Bring a copy of your Advanced Directive

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Life Care Planning Life Care Planning

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Data One

What is Life Care Planning?

  • Designated Decision Maker

– Who will make healthcare decisions for you if you can’t speak for yourself?

  • Ensuring your future health care

wishes are known and documented

  • Terms you may see:

– Advance Directive – Living Will – Health Care Agent

  • Share the plan with all members of

your team!

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Planning for the Future

Decision-Making Caregiver Support Living Situation In-home support Safe Return Life Alert Designated Decision Maker Advanced Directives POLST Alzheimer’s Association 24/7 Hotline Support Groups

36 Memory Classes in Vallejo, Vacaville and Fairfield

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Complete Memory Questionnaire Caregiver Information and Support

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Caregiver Information and Support

  • Caregiver Support Group

– 2nd Thursday afternoon of each month in Vallejo – Facilitated by Memory Clinic Social Worker, Elizabeth McCoy

  • Caregiver information outside Kaiser Permanente

– Kaiser Permanente partnerships with other organizations

  • Alzheimer’s Association and Collabria Care

38 Memory Classes in Vallejo, Vacaville and Fairfield