Older Adult Memory Care Clinic

The Ochsner older adult memory care clinic is located at Ochsner Medical Center in New Orleans.

We provide treatment for older adults, ages 75 and older, with age-related cognitive decline, Alzheimer’s disease and other types of dementia and additional medical conditions that affect memory. The Ochsner memory care clinic also offers supportive services for caregivers.

All patients who come to our memory care clinic undergo a detailed assessment by dementia experts during their first visit. Caregivers are an essential part of the care team and should attend patient appointments.

During the first visit to the memory care clinic, the patient will meet with a neuropsychologist, who will assess cognition, including memory and problem-solving, and a psychometrist, who will provide testing that is incorporated into the neuropsychologist’s assessment. A neurology nurse practitioner will do a neurological exam that looks for possible movement disorders. Depending on individual needs, the patient and caregiver may also meet with a social worker or a care manager from our Care Ecosystem program.

Meeting with several specialists on the same day saves the patient and caregiver from needing to make multiple appointments. Because our team can collaborate in real time, patients may receive a diagnosis or support services more quickly than usual.

For patients 85 years old and older, we offer a separate specialized clinic. This clinic includes a geriatrician, a neurology nurse practitioner and a neuropsychologist. In addition to our usual memory care treatments and services, the geriatrician assists with meeting the unique needs of patients in their mid-80s and beyond.

Following assessments, we will determine a diagnosis and design a multidisciplinary memory care treatment plan specific to each patient.

Depending on a patient’s needs, treatments and services may include:

• Caregiver training for behavioral interventions, such as training in calming techniques, how to deal with memory loss or support in creating a daily routine

• Medications/treatments to manage cognitive and behavioral symptoms associated with dementia

• Music therapy

• Participation in the Care Ecosystem program

• Support groups

When needed, patients can be referred to other Ochsner specialists, including:

• Behavioral neurologist

• Neurologists

• Occupational therapists

• Palliative care

• Physical therapists

• Speech-language pathologists

• The Ochsner movement disorder clinic

The Care Ecosystem is a comprehensive care-management program that provides services to people with dementia and their caregivers. The program is funded by a grant from the National Institute on Aging and is free for those who qualify. Participants also receive a $25 gift card for participation in select Care Ecosystem visits.

The goals of the program are to:

• Help participants live in their homes for as long as possible

• Improve quality of life

• Prevent unnecessary hospitalization

To reach these goals, we offer the following:

• Assistance with advance care planning

• Assistance with long-term care and medical decision-making

• Behavior management

• Caregiver support and training

• Guidance for navigating insurance applications or benefits

• Medication reconciliation and review

• Safety assessment

To be eligible for the Care Ecosystem, you must:

• Be a resident of Louisiana

• Be diagnosed with dementia

• Have a caregiver

• Have had one or more emergency department visits or hospitalizations in the past year

• Live in the community, not in an assisted living facility or nursing home

Read more about the Care Ecosystem model. To learn more, call 504-703-9077 or email brainhealth@ochsner.org.

The Brain Health and Cognitive Disorders program understands that for most patients their cognitive problem is far from simple. This is why each patient undergoes a thorough work up that can include a neurological evaluation, neuropsychological testing, labs, imaging, and other diagnostic tests. This comprehensive and detailed approach allows for better answers and more tailored treatment recommendations. Additionally, our large health system collaborates with a wide range of disciplines ensuring optimal management of each patient’s cognitive concern.

• Highly Trained Specialists: The team consists of board certified and board eligible neuropsychologists, board certified neurologists, nurse practitioners, psychometrists, and other allied health professionals.
• Comprehensive and Interdisciplinary Approach: With cognitive concerns, it is important to have an exhaustive and detailed assessment to understand why the problem is occurring. Knowing why, helps us then know how to best treat the problem. Ochsner has multiple specialties that can provide the best treatment for your cognitive or memory impairment.
  • For instance, did you know that adequately treating depression, poor sleep, or vascular problems may help improve your problems with memory? Our assessment can help figure out what works best for you!
• A Focus on Brain Health: We know from decades of research that healthy living make for a healthier brain. With a generous gift, we are embarking on an innovative program to help patients engage in healthier lifestyle choices to hopefully reduce their risk for cognitive decline.

Pediatric:

Learning Disorders

• ADHD
• Developmental and Intellectual Disorders,
• Cognitive problems due to neurologic illnesses (e.g., seizures, Multiple Sclerosis (MS), Traumatic Brain Injury (TBI), tumors, or stroke)

Adult/Geriatric:

• General memory loss and age-related cognitive decline
• Early and late onset Alzheimer’s Disease
• Vascular dementia
• Fronto-temporal Dementias (Behavior-variant and Language-variants)
• Lewy Body Dementia
• Parkinson’s Disease, Dementia and candidacy for Deep Brain Stimulation (DBS)
• Rarer dementia syndromes
• Cognitive problems following a stroke, TBI, MS, seizures, or other neurologic illnesses
• Cognitive problems due to depression, poor sleep, or other concerns
• Decision-making capacity
• Fitness for Duty assessment, if cognitive impairment is identified at work

Memory Assessment Program

Once referred by your physician, the following happens:

• Medical Evaluation to rule out common reversible causes of cognitive dysfunction
  • Neurologic and Physical Exam
  • Labs
  • Possible referral for imaging
• Neuropsychological Evaluation
  • Comprehensive history and clinical interview
  • Detailed neuropsychological testing (1 to 3 hours)
  • Detailed report and treatment plan
• Multi-disciplinary Memory Clinic
  • Feedback regarding diagnosis and cause for cognitive problems
  • Treatment plan discussion
  • Possible medication management
  • Possible meeting with social worker for any planning or family needs
  • Possible meeting with allied health professionals (e.g., referral for a driving evaluation)
• Ongoing follow-up to track cognitive functioning over time and response to intervention along with family support

Outpatient Neuropsychological Assessment

Once referred by your neurologist or other physician, we conduct a detailed assessment to understand your cognitive functioning, causes for cognitive or memory difficulties, and design a treatment plan with strategies to manage your cognitive symptoms.

Learn more on our Neuropsychology Program.

This is an innovative initiative designed to help prevent or reduce one’s risk of cognitive decline. The initiative consists of a series of seminars or “talks” designed to help individuals learn about risk factors (e.g., poor diet, stress) to cause cognitive problems and engage in activities that promote long term brain health.

Talk with your doctor about how you can participate in this program.

Dementia is an umbrella term applied to any condition that causes changes in brain function that lead to difficulties doing daily activities. The most common type of dementia is Alzheimer’s disease.

Alzheimer’s disease causes many changes in the brain, including inflammation, damage to blood vessels and unusual protein build-up called plaques. These changes affect behavior, memory and thinking. Most people with this type of dementia start developing dementia symptoms around age 65 or later. Symptoms of Alzheimer’s disease are mild in the early stages and more severe in later stages.

Most types of dementia are rare. Still, there are more than a hundred types. After Alzheimer’s disease, the most common types of dementia are:

• Frontotemporal dementia. This type of dementia occurs due to the loss of nerve cells in the parts of the brain just behind the forehead and near the ears. Most people with frontotemporal dementia have symptoms before age 65. It’s progressive, meaning symptoms worsen with time. There are three subtypes:
• Behavioral variant frontotemporal dementia, which affects personality and behavior
• Movement disorders, which impact coordination and cause issues with activities such as holding objects or walking
• Primary progressive aphasia, which impairs communication and language
• Lewy body dementia. This condition is caused by protein deposits called Lewy bodies that occur in the brain. Lewy bodies affect movement, thinking and problem-solving skills. Some people experience cognitive symptoms first, and others have movement symptoms first. Symptoms usually appear at age 50 or later.
• Vascular dementia. A form of dementia that impacts behavior and thinking, vascular dementia is caused by damage to blood vessels in the brain. Having a stroke or another condition that impairs blood or oxygen flow to the brain increases the risk of developing vascular dementia. Symptoms may start suddenly or develop slowly. Some people with vascular dementia have another type of dementia too.

The Ochsner memory care clinic offers several resources for patients and caregivers, including:

• Books and other printed materials you can take home

• Dementia care navigators who can answer your questions

• Seminars about brain health

• Support groups

Additionally, there are several local resources, including:

• Alzheimer’s Association — Louisiana Chapter

• The Pro Bono Project, which helps with legal matters such as power of attorney documents

There is no cure for Alzheimer’s disease or other types of dementia.

Cognitive behavioral therapy is a type of talk therapy. It can help people in the early stages of dementia learn to manage symptoms of anxiety, depression and irritability that often come with the condition.

The Care Ecosystem was designed to help address the unmet needs of persons with dementia and their caregivers. The goals of the program include improving quality of life, preventing unnecessary hospitalizations, and delaying admissions to long-term care institutions.

• Caregiver support
• Community-based resources and referrals
• Assistance navigating insurance benefits or applications
• Advanced care planning: Power and attorney & living will
• Advanced care planning: Financial planning and long term care
• Medication support
• Safety Assessment
• Behavior Management
• Medical decision assistance

• Has memory problems with associated diagnosis
• Has a caregiver
• Lives in the community (not nursing home or assisted living)
• Age is 55 or older

Current program is free of charge and participants will receive a $25 gift card for select visits. Participation is optional.

Amanda Bailey, Care Team Navigator: Amanda.bailey@ochsner.org

Ashley LaRoche, CCRC. Supervisor and Care Team Navigator: Ashley.laroche@ochsner.org

John Sawyer, PhD, Principal Investigator, Neuropsychologist

Brian Mizuki, PsyD, Co-Investigator, Neuropsychologist

Beth Arredondo, PhD, Co-Investigator, Neuropsychologist

Britta Staubes, PharmD, Ochsner Clinical Pharmacist

Colleen Knoop, APRN, Advanced Practice Nurse Practitioner in Neurology

• Alzheimer’s Association local chapter
• ProBono Legal Help New Orleans: Power of Attorney and Living Will assistance
• New Orleans Senior Resource Guide: Community resources, health at home services, day programs, housing, & legal resources.

• Email: brainhealth@ochsner.org
• Phone: 504-703-0755

Adapted from the Care Ecosystem. For more resources and information, go to UCSF: CARE Ecosystem.

To refer a patient:

Call the Clinic Concierge at 504-842-7436 or 1-855-312-4190

• The Clinic Concierge assists with getting copies of patient records and scheduling clinic appointments.
• The Clinic Concierge team can also capture your preference for receiving post visit follow-up from the patient's appointment.

Referral information can be faxed to: 504-842-0130