New Mem­ory Clinic

Wiarton Echo - - FRONT PAGE - Zoe Kessler Ed­i­tor

In mid-March, a mem­ory clinic will launch in Lion’s Head and Tober­mory, of­fer­ing re­lief to se­niors and their fam­i­lies con­cerned about mem­ory and other cog­ni­tive-re­lated is­sues.

Two fam­ily physi­cians with the Penin­sula Fam­ily Health Team – Drs. Elaine Blau in Tober­mory and Jonathan Thomas in Lion’s Head, will launch a new pro­gram called the Pri­mary Care Mem­ory Clinic.

The clinic is one of 17 clin­ics open­ing in ru­ral, re­mote and un­der­ser­viced com­mu­ni­ties in On­tario, ac­cord­ing to a news re­lease is­sued by the Adopt­ing Re­search to Im­prove Care (ARC­TIC) Pro­gram, Jan. 23.

Ini­tially, the clinic will pro­vide ser­vices to pa­tients of the Penin­sula FHT, but the hope is that even­tu­ally it will be open to re­fer­rals from other com­mu­ni­ties.

An ini­tial group of 4-6 pa­tients of the Penin­sula FHT will be seen by an in­ter-dis­ci­plinary team who will pro­vide as­sess­ments and sug­gest treat­ment pro­grams and fol­low-up. A sec­ond group will be as­sessed in mid-April.

Pamela Lough­lean, ex­ec­u­tive di­rec­tor of the Penin­sula FHT, de­scribed the ap­proach as a “ded­i­cated, one-stop shop,” in a tele­phone in­ter­view, Jan. 26.

She called the clinic “a great as­set for our com­mu­nity, be­cause that ser­vice has not been re­ally avail­able,” adding, “We’re very ex­cited to have been cho­sen.”

While the spe­cific de­tails of the clin­ics have not yet been ironed out, “We are en­vi­sion­ing a col­lab­o­ra­tive team of four or five,” Lough­lean said.

The team would in­clude a fam­ily physi­cian, nurse prac­ti­tion­ers and a so­cial worker.

“We are also ex­tremely for­tu­nate to have sup­port from a coun­selor from the Alzheimer So­ci­ety of Grey-Bruce,” she said.

Each pa­tient will par­tic­i­pate in a ses­sion which will last about three hours, in­clud­ing a bat­tery of cog­ni­tive tests and in­ter­views. A fam­ily mem­ber or care­giver will also be in­ter­viewed to de­ter­mine the level of im­pair­ment of the pa­tient.

Once the in­ter­views are com­pleted, the team mem­bers meet with the fam­ily physi­cian in charge of the mem­ory clinic and the re­sults of each test and in­ter­view are pre­sented for dis­cus­sion.

Next, the en­tire team will meet with the care­giver/fam­ily mem­ber and the pa­tient, Lough­lean said.

“When they leave that day, there is a roadmap for other sup­ports and other next steps,” she said, which will be done at the Penin­sula FHT, with the Alzheimer So­ci­ety or through a re­fer­ral to a spe­cial­ist.

Dr. Jonathon Thomas, lead physi­cian of the clinic, said, “This is go­ing to be a very slow and cau­tious roll­out be­cause we don’t want to com­pro­mise the care we’re giv­ing.” Each of the two physi­cians in­volved also have full-time fam­ily prac­tices, Thomas said in an in­ter­view, Feb. 7.

“I my­self am per­son­ally very ex­cited,” he said.

“We are start­ing a process here that I think is go­ing to be­come the stan­dard of care over the next decades.”

Thomas said, “This can be a su­per com­plex spectrum of symp­toms. It’s hard to do much in 15 min­utes.”

Thomas added a proper as­sess­ment is “of­ten more than a sin­gle fam­ily doc­tor is able to do un­der their typ­i­cal time re­straints.”

The as­sess­ments will ob­jec­tify and quan­tify the de­gree and what type of im­pair­ments are present, in­clud­ing what ar­eas of the brain are in­volved, he said.

“Hope­fully based on that, it al­lows us to cus­tomize some treat­ment sug­ges­tions,” he said, adding, “Some­times, it’s more about sup­port­ive care and let­ting them know what to ex­pect.”

The goal, he said, is to slow the pro­gres­sion or re­duce the risks of cog­ni­tive im­pair­ment, such as de­ter­min­ing, “Are they safe to drive? Able to man­age their fi­nances?” and so on.

“My hope is that, that way we’ll iden­tify things per­haps ear­lier than we have been,” Thomas said.

The fam­ily physi­cians of­fer­ing the clinic par­tic­i­pated in a five-day ac­cred­ited train­ing pro­gram from Dr. Linda Lee, a Kitch­ener-based fam­ily physi­cian and founder of the Pri­mary Care Mem­ory Clinic con­cept.

Dr. Lee’s clinic model al­lows pri­mary care teams to care for pa­tients liv­ing with de­men­tia and to pro­vide sup­port for their care­givers.

Ac­cord­ing to the ARC­TIC news re­lease, the spe­cial­ized train­ing re­ceived by fam­ily physi­cians not only al­lows them to care for their pa­tients with mem­ory prob­lems but “has re­duced the need for spe­cial­ist re­fer­rals from up to 80 per cent of pa­tients with mem­ory is­sues to fewer than 10 per cent who re­quire spe­cial­ist level care, im­prov­ing the pa­tient and care­giver ex­pe­ri­ence.”

This also al­le­vi­ates the lev­els of de­mand for spe­cial­ists by pro­vid­ing an op­tion to those who are not yet re­quir­ing at­ten­tion from a spe­cial­ist.

Ac­cord­ing to a re­port is­sued by Com­mu­nity Foun­da­tion Grey Bruce’s Vi­tal Signs re­port, 2016, Grey Bruce has a higher pop­u­la­tion over 65 than the pro­vin­cial av­er­age.

Many se­niors – per­haps the high­est per­cent­age of them – live in the Mu­nic­i­pal­ity of North­ern Bruce Penin­sula, as re­ported by the Ru­ral On­tario In­sti­tute in 2014.

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