Pine Rest Mission Statement
Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity and compassion.

Interprofessional Aspects of Dementia Care:
Working Together for Quality of Life

By Melinda Waldrop, MD, Alan Armstrong, MD, and Suzann Ogland-Hand, PhD

As health care professionals working in a psychiatric setting, we often have to remind ourselves that a dementia like Alzheimer’s disease is a neurological disease, and not a primary psychiatric disorder. Yet, in order to help persons with dementia and their family members work together for quality of life, collaboration among a variety of health care providers is critical.

Health professionals in the field of aging advocate for early diagnosis and treatment of dementia. Again, the hope is to maintain the highest quality of life for the person with dementia and their family members. By obtaining early diagnosis and treatment, persons with dementia and their family have time to adjust to the diagnosis and understand the illness as well as its possible impacts on the future.

Early diagnosis also allows time to plan for the future. Once a person and a family have accepted the diagnosis, families are able to do longer-term planning, in terms of legal, health, and quality of life issues.

Depression and anxiety are common for both persons with dementia as well as their caregivers. Early diagnosis allows for prevention and better management of these and other mental health conditions.

Early Diagnosis Is Very Important

The earlier the illness is diagnosed and treated, the better the outcome. Generally, persons with possible cognitive loss and their family members usually contact their primary care physicians. Someone may start to be aware of and concerned about a decline in their functioning or memory. Other times, family members are the first to notice a change in their loved one. Reversible causes of dementia do exist, so clearly the first step is to rule out the reversible causes. With early detection of a problem, the outcome is better for all involved.

A dementia work-up is complicated and requires more time than spending a few minutes in an office setting with a doctor. Generally, a dementia work-up includes a very thorough history, as well as a number of laboratory studies and tests. A thorough history in the setting of dementia is a time consuming process.

In dementia evaluation, the findings from these studies are often normal or considered “not clinically significant,” meaning that reversible causes of dementia have been excluded. Currently, no diagnostic laboratory or blood test exists for Alzheimer’s disease or many other types of progressive dementias. In research for dementia of the Alzheimer’s type, autopsy is the only reliable diagnostic test because it can tell us the location and size of cell death in the brain.

Other syndromes may have Alzheimer’s-like symptoms, including normal pressure hydrocephalus (water on the brain), under-active thyroid, multiple strokes, over-active parathyroid, low B12, and subdural hematoma (blood clot on the brain). Also, many different medical conditions may be accompanied by dementia, such as strokes, uncontrolled diabetes, uncontrolled hypertension, Parkinson’s disease, Huntington’s disease, Down’s Syndrome, alcohol dependence, benzodiazepine dependence, anoxic events (prolonged lack of oxygen), and head trauma.

Your doctor is an important resource in determining the cause of the decline. If the presentation is unusual, or if the person with dementia or their family members are interested in learning more about the cognitive strengths and weaknesses, neuropsychological testing will better define the deficits in memory and cognition. If the decline is very subtle but suspicious for Alzheimer’s, a physician might order a PET scan, which actually looks at brain function (rather than structure, which is seen in CT and MRI scans). Primary care physicians, psychiatrists and psychologists all offer expertise in the diagnosis and management of the behavioral disturbances associated with dementia.

Working Together For Quality Of Life

Dementia is a complicated and chronic problem. Therefore, it is essential that health care providers communicate and collaborate together in assessment and treatment over time. In most communities, high levels of communication, coordination and collaboration between health care professionals is uncommon. Care can be fragmented and not well-coordinated. The person with dementia often needs a family advocate. Also, once the diagnosis is made, people need to be in treatment centers experienced in managing these difficult conditions.

For a person with dementia and their family members, the illness is a challenging one. Choices have to be made that keep everyone healthy. With health care professionals communicating and collaborating, we work together for quality of life for the families we serve.

(Excerpted from "Today" magazine's "Living With Dementia" issue. The complete article is available online at: http://www.pinerest.org/education/today/dementia/quality.asp)

Melinda Waldrop, MD, is an attending psychiatrist for Older Adult Services at Pine Rest. She completed a medical degree at the University of Tennessee Center for the Health Sciences, and a psychiatry residency at Vanderbilt University Medical Center and Tulane University Medical Center. Dr. Waldrop has extensive experience in industry-sponsored research, focusing on geriatric issues.

Alan Armstrong, MD, is Service Chief of General Medicine and an attending physician for the Dementia Living Center. He received a medical degree from Wayne State University School of Medicine and completed an internal medicine residency at St. Joseph Mercy Hospital - Ann Arbor MI, Heart of the University of Michigan Medical Center. Dr. Armstrong has had extensive experience in working with the geriatric population.

Suzann Ogland-Hand earned a PhD in clinical psychology from Fuller Theological Seminary’s Graduate School of Psychology and received postdoctoral training in geropsychology at the Palo Alto VA Medical Center in California. She has been a member of the Pine Rest staff since 1996. She currently serves as Director of Pine Rest’s Center for Senior Care and as an outpatient geropsychologist. She has researched and written extensively on behavioral health in older adults and caregivers.

The Top 10 Warning Signs of Dementia

1. Recent memory loss that affects job skills

2. Difficulty performing familiar tasks

3. Difficulty finding the right word when speaking

4. Difficulty remembering the date, or feeling lost

5. Loss of judgment

6. Placing items in unusual locations

7. Difficulty with abstract thinking

8. Changes in mood or behavior

9. Changes in personality

10.Loss of “get-up-and-go”

If you or someone you know has any of these symptoms, you should contact your physician for a complete medical examination.

Source: WorriedAboutMemoryLoss.com.

Searching For a Clinician Just Got Easier

With 23 outpatient clinics and over 225 psychologists, psychologists, and masters-level social workers, Pine Rest Christian Mental Health Services offers comprehensive behavioral health care. While that’s good news for the communities we serve, it can be a little overwhelming when you’re considering counseling for yourself or a loved one.

The clinician search page on the Pine Rest Web site can help make that decision a little easier. This updated search tool to allow you to choose from a list of clinicians, a specific behavioral health concern (i.e., ADHD, depression, substance abuse/addictions, women's issues, anger management, grief), or a particular clinic (City Clinic, Grand Haven Clinic, Pella Clinic). Recognizing some people feel more comfortable talking with a male clinician and others a female clinician, we have also added this option to your search.

Using this updated search feature can help you find the clinical social worker, psychologist, or psychiatrist that meets your needs and is available at our Web site at: http://www.pinerest.org/services/clinicians/default.asp.

November 7, 14, 21, 28
Anger Management Classes for Adults
Led by Jim Bottenhorn, MA, LLP, Director of Pine Rest’s Contact Center. 7 p.m. to 8:30 p.m. on Pine Rest's main campus, 300 68th Street, SE, Grand Rapids. Open to adults and older teens. Registration is required. Cost: $65/individual or $95/two family members. Class fee due at first class. Call 616/493-6033 for more information and to register.
For more information click here.

November 10
Marriage and Family Building Series
"The Third Option: Presenting Hope and Help for Distressed Couples," featuring Pat Ennis, MSW, LMSW. This series of speakers and topics equips pastors, church, and lay leaders wit the tools and resources for strengthening marriages and supporting families in their congregations.
For more information click here.

November 11, 18
PREP Couples Communication Workshop
PREP is a skills building program designed to help committed couples of any status (married or unmarried) and any age learn to communicate more effectively, manage conflicts, and solve problems without damaging intimacy and trust. It has been featured on national shows such as Oprah, 20/20, and 48 Hours.
For more information click here.

November 28, December 5, 12
Pine Rest's Anger Management For Teens
Led by Ryan LaRue, MSW, LMSW, ACSW, outpatient therapist at Pine Rest Campus Clinic. 4:15 -5:30 p.m. in the Van Andel Center on Pine Rest's main campus, 300 68th Street, SE, Grand Rapids. Open to male and female teens ages 12-17. Cost: $75/person. Call 616/222-4584 for more information or to register.
For more information click here.

November 6
'It’s Bigger Than You Think – Daring to Address Addiction in Your Church'
Conference co-sponsored by Pine Rest Christian Mental Health Services and EverGreen Ministries’ Bridge to Life Recovery.
For more information click here.

November 14
Dementia Screening Day
Pine Rest and Saint Mary's Alzheimer's Disease and Memory Disorders Program will be co-hosting this annual community service event at their respective locations. The public is invited to receive a free, confidential, screening to learn if they or a loved one are experiencing dementia and, if so, how they can get help.
For more information click here.

November 13, December 11, January 8, February 12
Pine Rest’s Southwest Clinic To Host 'Family Connection' Support Group
"Family Connection" helps spouses, parents, siblings and other caregivers more effectively deal with the stresses created by the symptoms or behaviors associated with mental illness. The support group offers guidance through shared experiences, sharing effective coping strategies, and gaining knowledge about various disorders in a safe and confidential setting.
For more information click here.

November 8
Professional Lecture Series
"Treatment Planning: Improving Documentation Skills and Clinical Use of the Treatment Plan." Featuring David Mee-Lee, M.D., M.S. from 9 a.m. to 4:00 p.m. in the Mulder Center Gymnasium on Pine Rest’s main campus, 300 68th Street SE, in Cutlerville. Call 616/455.6500 or
For more information click here.

December 6
Professional Lecture Series
"Improving Outcomes for the Addicted Corrections Client: Teaming Corrections Professionals with Addiction Treatment Providers" Featuring Michael Johnson, MSW, LMSW. 9 a.m. to 11:30 a.m. in the Mulder Center Gymnasium on Pine Rest’s main campus, 300 68th Street SE, in Cutlerville. Call 616/455.6500 or
For more information click here.

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Disclaimer

Copyright © 2006, Pine Rest Christian Mental Health Services. All rights reserved. The contents of Mental Health News & Information are for informational purposes only. The content is not intended to be a substitute for professional medical or mental health advice, diagnosis, or treatment. It cannot and should not be used as a basis for diagnosis or choice of treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical or mental health condition.