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My Approach

My approach to care and management has been developed based on many years of working with individuals and their families affected by a neurodegenerative condition or dementia. This type of an illness is horizontal - it affects everyone connected to the person. I see my most important value to you as being a physician who listens to your concerns, helps you understand the impact of a 'diagnosis' and how to make the most of your life despite new labels and ongoing challenges. To better focus on your needs, our office is not contracted with insurance companies or Medicare. In addition to better listening, my expertise is in helping you

problem solve, manage medications and assist with planning. 

First Visit

  • Gathering the history of a problem and how it has affected an individual and/or family members is a crucial first step. We establish what has changed and what are the most pressing concerns.

  • Prior testing and diagnoses may also be reviewed.

  • Neurological examination, cognitive screening and record review guide next steps. This is often bloodwork,  brain imaging and additional detailed cognitive testing if appropriate. These tests are covered by insurance.

  • Review of lifestyle and medications can reveal areas for improvement.

  • Referrals to appropriate support and education services in the community.

  • Begin discussion of long term goals and how to maximize quality of life.

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Follow up Visits

  • These are usually scheduled every 3 to 6 months, depending on complexity of medical or social challenges. Each visit includes a review of medications, the home situation, sleep, stressors/mood, diet, interim medical issues and physical well being.

  • We emphasize maximizing quality of life for patient and their family.

  • Always looking towards the horizon allows us to keep steady footing in the present.

Continuing the Journey

  • When our life plans change course unexpectedly, it is easy to get off balance and perhaps never recover. Persons with cognitive impairment frequently have impaired prospection - the ability to mentally simulate potential events at a future point in time. So we need to start planning for tomorrow today. This can be further complicated by lack of insight into the changes by person's with Alzheimer's Disease and other dementias.  

  • We can't always make a situation better, but ignoring changes can indeed make it worse. By openly discussing goals and priorities, individuals and their families can feel better assured they have some sense of control in the years ahead. 

  • Advance Directives can be improved upon, addressing concerns unique to a dementia diagnosis.

  • The only certainty we have in this life is that it will end. By re-imaging our ending, we can better enjoy the life we are now living.

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