We can transform memory care in the Hudson Valley — one visit at a time

A recent patient of mine, who was diagnosed with Alzheimer's disease a year ago, walked into my office with her husband for a follow-up visit. I asked if she made it to the cognitive rehab appointment we discussed at our last visit. She sighed and explained that between neurology appointments to adjust her memory-enhancing medications, cardiology visits for her heart condition, and nephrology check-ups for her chronic kidney disease, she simply couldn’t find the time. Her husband, a chef for 55 years, does what he can when he can get a half-day off work. He has his own health issues requiring regular doctor visits.

They shared this nervously, expecting me to be upset. But the only emotion I felt was a profound sense of failure. She wasn't the first patient to miss an appointment due to the increasing demands on her time, and I knew she wouldn't be the last. Unfortunately, this is a reality for millions of families and their loved ones suffering from cognitive impairment.

As we enter June, Alzheimer's and Brain Awareness Month, 55 million people (about twice the population of Texas) living with dementia come to mind. In Hudson Valley, 1 in 10 people aged 65 and above are living with Alzheimer's disease. It has been an uphill battle to navigate the labyrinth of healthcare for our patients. Multiple appointments, ever-increasing wait times, and fragmented services create barriers to effective management.

Realizing the need in our community, the geriatric medicine department at Phelps Hospital has collaborated with the Alzheimer’s Association, our hospital’s Caregiver Center, and the rehabilitation department to rethink how we approach memory care. We have designed a workflow so these patients can have all necessary consultations in one appointment under one roof at Phelps Hospital.

CARE Day, which stands for Cognitive Assessment and Resource Engagement Day, is planned to be a dedicated half-day on June 11 for our patients with memory decline. Patients will see their geriatrician and have a cognitive care plan visit where we address current functional status, cognition, assess her care partner, and chart a plan to manage the disease together. After that, they will meet with an Alzheimer's Association care specialist, who will be present on-site for a dedicated 30-minute visit to establish a relationship and guide families with numerous training sessions and resources in the community. Patients will then meet with the Caregiver Center, a local Phelps Hospital resource, to assess caregiver stress and identify ways to empower them to better care for their loved ones, advocating for early identification of caregiver needs and support to reduce burnout. The patient ends the day by seeing our cognitive rehab team, run by the occupational therapy and speech therapy department at Phelps Hospital, for a comprehensive evaluation to identify areas where the patient can learn compensatory mechanisms to function better despite cognitive decline.

This approach ensures that patients visiting their geriatricians also learn about holistic management of their condition with the Alzheimer's Association, gain access to our caregiver center, and learn non-pharmacological ways to improve their function through cognitive rehab. The innovative model reduces the number of appointments and makes it easier for families to access essential care, removing significant barriers.

We want to prove to our patients that they are not alone in navigating this disease. Together, we are creating a future where no one faces this journey alone. As we shine a light on Alzheimer's and related dementias this June, we are hoping to enhance patient-centered care and continue making every effort to fight against this relentless disease.

Kanishk Sharma, MD, practices Geriatric Medicine and Improvement Science at Northwell Health Phelps Hospital and and is assistant professor in the Department of Medicine at Zucker School of Medicine at Hofstra/Northwell.

This article originally appeared on Rockland/Westchester Journal News: Phelps Hospital memory care wants to tackle Alzheimer's