Marin Memory Clinic

Introduction

The Marin Memory Clinic utilizes a multi-disciplinary approach to the evaluation and management of memory problems. Our team can determine if you or a loved one's memory problems are due to normal changes that occur with aging, treatable physical causes, or progressive changes in brain functioning. Our clinic has a highly specialized team of service providers that are specifically trained in the diagnosis and treatment of memory disorders. The Marin Memory Clinic clinicians will take the time to answer questions and provide and individualized and comprehensive care and treatment plan to each patient.

The initial evaluation is designed to be simple or complex, as the person's problem requires. Only those tests and referrals necessary for an accurate diagnosis are ordered. Specialists from other disciplines associated with the clinic, such as Neurologist, Psychiatrist, Gerontologists are consulted as needed. The team come together to review clinical information and recommend appropriate treatment.

Once the evaluation process is complete, a written report is provided to the patient, primary care physician. The neuropsychologist will meet with each patient and family to review and explain all results. Time is taken to teach about the diagnosis and make specific recommendations about organizing care. When the cause of the memory problems is reversible, early identification and treatment may greatly improve the individual's mental status. If the condition is irreversible, the evaluation will determine the extent of the disease process and assit the family in maximizing the patient's function. Treatment may be available to slow the progression of the illness.

The patient will generally be followed in the Memory Clinic at six to twelve month intervals. This allows staff to establish and maintain close working relationships with both individual and families, as well as treatment efficacy and course of the disease or symptom.

What to expect during your clinic evaluation

You and your family (if present) will meet with a clinician for an hour and he/she will conduct a through and comprehensive history of the patient's current problems with memory, thinking, mood and affect, past medical and family history, medications and other important information to gain an in-depth understanding of the problem. The presence of an informed relative, caregiver, or friend is essential for a thorough evaluation of the problem since the individual may forget important details.

After the interview, we will administer a series of non-invasive cognitive test, along with observations of the individual's mood and behavior to determine how your brain is functioning. The assessment takes about two hours to complete. Laboratory testing may be ordered by a consulting specialist to check for metabolic, hormonal, and electrolyte imbalances, as well as infectious causes of cognitive changes. A computerized brain scan (CAT scan, PET scan, or MRI) may be also requested to study the structure of the brain and determine if changes such as stroke or tumor have occurred that may be responsible for the memory disorder. A complete physical examination by the patient's primary care doctor is recommended. If the patient does not have a primary care physician, the Memory Clinic can assit the patient in finding one.

After all information has been gathered, including medical records, brain imaging, and neuropsychological results, one of the doctors will meet with you and your family to discuss the results and treatment recommendations.

Be sure to bring:

Eye glasses and hearing aides
MRI's or other brain scans
List of medications
Other pertinent medical records (lab work, etc.)
Insurance Cards

Treament

At Marin Memory Clinic, we adopted a biopsychosocial framework which has significant implications for intervention and outcome. At the biological level, we consider developmental factors, pathology, and the physical health of the individual. Changes at the neurobiological level have a direct impact on neuropsychological functioning and the ability to perceive, process and experience emotions. With the onset of memory problems and/or dementia, family members and sometimes close friends find themselves in the role of caregiver. Quality of caregiving clearly has implications for the person with memory problems and/or dementia, and is closely related to carer sense of well-being. Thus, in order to meet the needs of people with memory problems and their families, we focus on an holistic approach to intervention, in which assessment and interventions encompass all three levels of the biopsychosocial model. At the biological level, drug treatments may be offered, and physical health problems can be attended to. At the psychological level, a range of therapeutic and supportive interventions may be offered to maximize functioning and well-being, and to assit in the process of adapting and coping with memory problems. At the social level, carers may be helped in their task of interacting with the person with memory difficulties by means of information, support and therapeutic help, care staff can be educated and support in using beneficial approach, education for professionals can assist in ensuring that people with memory problems access the necessary health care and are dealt with appropriately, and advocacy can be provided to ensure that the voice of the person with memory and cognitive difficulties is heard. Thus, at Marin Memory Center, our goals for treatment are to optimize functioning and well-being, to minimize excess disability, to enhance self-efficacy and coping skills, and to combat threats of self-esteem.

Treatment and rehabilitation is conducted in the context of a natural trajectory of change over time, which varies according to the individual, the nature of the impairment, and the social context. Our comprehensive intervention approach for people with memory problems and their family include:

Biological Level

Recommendations for treatment of any reversible causes
Recommendations for medication aimed at slowing progression
Recommendation for treatment of physical health problems to reduce excess disability
Recommendation for monitoring or reducing medications affecting cognition

Neurosychological Lelvel

Interventions to assist with effects of cognitive impairments, and to develop adaptive behaviors (e.g., Cognitive Rehabilitation)
Psychotherapy, counseling, life review, reminiscence, identity maintenance, strategies for dealing with anxiety and depression
Environmental adaptation and enrichment

Social Level

Interventions for caregiver, e.g., psychoeducation, individual counseling, couple and family therapy
Staff training and environmental enrichment
Approaches to counter discriminatory attitudes
Equitable access to services; assistance with benefit claims

Frequently asked Questions

How do I know if my memory problems are serious?

As we age, we all experience a natural decline in memory, and cognitive functioning. However, if your memory problems consistently interfere with your daily life, then you may need an evaluation.

What are some signs that memory problems may be a concern?

A person with memory problems may: often repeat themselves or ask the same question multiple times; have trouble managing finances and doing calculations; need constant reminders to do thinks like chores, shopping, or taking medicine.

So if I have memory problems, this means thay I have Alzheimer's Disease?

No, Alzheimer's Disease is one of many causes of memory problems. Some of the causes are reversible, others no. Among the typical causes of memory problems include:

Medications
Examples of medications that can interfere with memory include over-the-counter and prescription medications such as sleeping pills, antihistamines, anti-anxiety, antidepressants, pain medication etc.
Alcohol and illicit drig use
Heavy alcohol use can cause deficiencies in vitamin B1 (thiamine), which can harm memory. Both alcohol and illicit drugs can change chemicals in the brain that affect memory.
Stress and Depression
Stress, particularly due to emotional trauma, can cause memory loss. Depression, which is common with aging, cause a lack of attention and focus that can affect memory. Ususally treating this conditions could improve mood and the memory problems may then also improve.
Head Injury
A blow to the head can cause a loss of consciousness and memory loss. This is not unusual in the elderly patient with balance difficulty. In fact the aging process is also accompany by some degree of brain atrophy, which could certainly affect negatively the outcome of a head injury. These type of memory problems tend to stay the same, or even at times improve.
Thyroid Dysfunction
An underactive or overactive thyroid can interfere with remembering recent events.
Sleep Deprivation
Lack of quality of sleep, whether from stress, insomnia, or sleep apnea, for example can affect memory. A thorough evaluation of sleep is necessary in some instances to determine if it is indeed the main cause of memory problems.
Nutritional Deficiencies
Deficiencies of vitamins B1 and B12 can affect memory. Such deficiencies can be treated quite easily sometimes remarkably improving the symptoms.
Normal Aging
As part of the normal aging process, there should be an age related memory decline which is normal of the developmental process.
Mild Cognitive Impairment
Mild Cognitive Imapirment is a condition characterized by a memory deficit beyond that expected for age, which is not sufficient to impair day-to-day activities.
Dementia
Dementia is a term used for a condition in which there is increasing impairment of memory and other aspects of thinking that are sufficiently severe to impair day-to-day activities. There are many causes of dementia, but the most common is Alzheimer's disease, in which therre is a progressive loss of brain cells accompanied by others abnormalities of the brain. A diagnosis of Alzheimer's Diesease is made by comfirming that a patient has dementia and by excluding other conditions that could be affecting brain functions.

Is there really something that can be done about memory loss and cognitive decline?

Yes. As more and more research is done, we are continually making advances in medication and other rehabilitative treatments. The important thing to consider is that the earlier we identify specific brain changes in an individual, the more options and benefits can be derived from treatment.

Home Safety Assessment

Today one in six (30 million) American provides care for an older adult parent, relative or friend. As our population continues aging, an increasing number of older adults will need assistance with normal everyday activities in and around their homes. According to the State of Home Safety in America, the Home Safety Council's comprehensive study of home injuries, an average of more than 7,000 adults age 65 and older die as the result of a home injury each year in the United States. Falls are the leading cause of home injury death among older adults, accounting for 52.5 percent of all home injury deaths for adults between the ages of 65 and 74. Residential fire injuries are the second leading cause of home injury and death for adults 65 and older and poisoning is the third. While the statistics are staggering, home injuries are almost entirely avoidable with proper education and simple home modifications.

People diagnosed with dementia face many challenges whenever they live. As a caregiver, you face the challenge of making the environment inside and outside safe for your love one. Some of the safety concerns are:

Burn and fire safety

Difficult behavior affecting safety

Falls and slips

Guns and knives

Medications

Poisons and hazardous material

Scam, fraud, crime

Wandering

To help caregivers understand the home dangers facing older adults with dementia and take critical actions that will help keep the entire family safer in and around the home, Marin Memory Center works to assess, educate, and empower family members to find and fix home dangers before an injury occurs. Our goal is to raise home safety awareness and help keep older adults safe and independent as long as possible. Our home safety evaluation model includes in-home assessment of all areas in and around the house, as well as suggestions for possible modifications or solutions to problems associated with safety and dementia. The clinician will take information regarding the level of cognitive impairment, and make suggestions accordingly, focusing especially on activities of daily living, level of impairment, course of the disease, and level of assistance receive on a daily basis. A comprehensive report will be generated to assist the patient and his or her family to make the appropriate decisions to maintain a safe and comfortable environment, promoting independent living.

Additional Services

In addition to the assessment and treatment of individuals, the Marin Memory Clinic provides other valuable services:

Cognitive Rehabiliation
Consultation with nursing home administrators to provide assistance with care and placement of residents and behavior concerns
Seminars, consultation and educational presentations
Competency Evaluations
Driving Capacity Evaluations

If you like more information about the Marin Memory Clinic, please contact us here or at
Marin Memory Clinic Phone: 415-457-3451