Promoting Dementia Screening While Dispelling Dementia Myths

Back In Detroit

SPEAKER_03 0:00

What's up family? We are back in Detroit. Get back good, dude. No, it's not Coney Island. No, we're not going to the casino. But that is also very, very fun when you come to Detroit. We are digging in with what it means to get screened and get tested for detention. How do you do it? Where can you do it? Does it hurt? Is it gonna is it gonna cost all your life savings? And when should you do it? And who should do it? Yeah, yeah, yeah, yeah. Listen and watch right here. We're at the Rosa Park Dairy Active Center at Wayne State University of Green W G E P. Look that up, see, thought I wasn't gonna remember. I got it. Because they're doing the work, people. And when people are doing the work, parenting up is part. Okay, so come on. Come on, listen. Come on, snuggle up with the ears and your eyeballs. It's about to be tough. Parenting up. Caregiving advantage with comedian based models. It's the intense journey of unexpectedness, which means fooling and responsible for my mama. For over a decade, I've been skipping away at the unknown, advocating for her. Caregiver movies, OG, 15 village members, car willing to pop up with Caregivers. I hope you enjoyed it.

Supporter Shoutout And Body Talk

SPEAKER_03 1:54

Today's supporter shout out comes from YouTube, Terry Brown. It's a unicycle. It's a unicycle. Now, what was Terry referring to? There was a previous episode where we talked about how you should treat your body and how you should care for your body. Because your body is the greatest machine known to man, and for it to function as effectively and efficiently as possible, you gotta take care of it. We treat the body like a Ferrari, not a scooter, was what I refer to in. I guess Sarah's been having some problems with a damn unicycle. Anyway, that is hilarious. Now, if you would like to be the recipient of a supporter shout-out, know what to do. Leave a review or a comment on Apple Podcasts or YouTube with marking up everywhere.

Why Dementia Screening Matters

SPEAKER_03 3:17

Today's episode Promoting Dementia Screening While Dispelling Dementia Myths. Hello, everybody. We are in Detroit. Yes, I do love this city. I love the people and I love the work that they are doing in the world of dementia care. So we are at the Rosa Parks Geriatric Center in Detroit, Michigan, with three of the baddest chicks on the block. Okay. You didn't know that dementia care could be sexy, but look, we're looking at it. We're looking at it right now. So introduce yourselves and let us know what your connection is to the Rosa Parks Geriatric Center.

SPEAKER_00 3:54

My name is Lisa Ben Zemmerick, and I uh am a nurse practitioner in the center. I uh see primary care patients as well as part of my role, and what brings me here today is that I coordinate the memory evaluation center. So I'm responsible for the testing and I'm part of an interprofessional team of nursing, physicians, and social work.

SPEAKER_01 4:16

So hello, my name is Dr. Cynthia McNeil. I am also a nurse practitioner. I do work in internal medicine, but my role for this particular project is that I'm the principal investigator for a federal-funded uh program called the Geriatric Workforce Enhancement Program, where we partner with different entities in the city of Detroit to improve the care that geriatrics receive. So I'm coming out of Wayne State University, College of Nursing, as the lead for this particular grant in collaboration with other interdisciplinary colleagues to improve care and to address dementia specifically.

SPEAKER_05 4:50

My name is Dr. Bibband Diol. I am an assistant professor at Wayne State University and I am a physician in the Rosa Parks Clinic. I do the primary care for elderly as well as I also do the memory clinic in collaboration with Lisa.

SPEAKER_03 5:09

I told y'all. Didn't I say bad chicks? And I and I think I was kind of downplayed it. They didn't even bother to tell you what all they've done before they took on these roles. I'm not gonna take you through that, but just know it's fancy. They're fancy and they know a lot, and they're about to tell us a lot. So we're here today to really talk about dispelling the myths of dementia and to encourage people to get screening. So many people, we hear it here at the parenting up community, and I hear it like at the hair salon, where people are afraid to go get a test because it's like, well, if I don't know I have it, some kind of way it'll go away. It's an ostrich syndrome. So the first thing is I would like for you all to share with us is it hard for to have these

Mini-Cog Screening Without The Fear

SPEAKER_03 6:03

tests? Is the screening easy? Does it hurt?

SPEAKER_00 6:06

No, none of the above. It is easy to do. Um it we uh at the memory clinic, we tend to um chat people up a little bit to relax them. Um we uh will ask simple questions. Uh it just helps us kind of guide our uh assessment. Um the what the first very simple one is asking um, we give you three words to remember and then um have you draw a clock, and then we ask you those three words. So it's nothing terribly invasive. Um, and that's how we start out to see if there's a problem or not.

SPEAKER_03 6:40

Now, who how do I sign up for this screening or this test that you just described? Does my primary care have to refer me to you? Can I just call you, send an email? How's that happen?

SPEAKER_00 6:54

Any of the above. Um, our goal is to really start the second time. Any of the above. I um I really think that the goal here is to get people diagnosed earlier. Um, when I first came into this role, it was uh 30 years ago, and there wasn't a lot um for people. No way you've been working 30 years in 28. But there wasn't a lot to offer people, and now we have a lot of treatments that we can offer. We're looking for people that are early stage, so a lot of those treatments are uh uh uh made for those individuals. So it's important that people know um and we can help as if we know. It's uh that kind of if you know, we can help you. If you don't, then we don't, you know.

SPEAKER_03 7:38

So okay, Dr. McNeil, I would ask you, uh, as the principal investigator, what have you seen to show uh I guess what have you seen that seems like it's the reason people are hesitant to get screened? Like, so they've heard, hey, you can come in, but then they don't. Have you got any reasons on why that might be?

Barriers That Keep People Away

SPEAKER_01 8:04

A lot of reasons. There's a whole grocery list of reasons why that occurs. One of the reasons is there's barriers. Like not everybody has access to care. Not everybody has access to this information to really understand of the importance of just screening and health promotion just in general. So that just mindset of, you know, if I just ignore it, whether that's my blood pressure, whether that's my diabetes, whether that's my memory issues, I don't have to address it. It doesn't exist. So that that's one of the main things. And like I said, the other thing is just access. You know, people don't know where to go. Um, and I take responsibility to some of that as a primary care provider because when you look at the statistics, a lot of primary care providers don't feel comfortable having these conversations. They don't feel comfortable doing initial screening or have we even passing out resources. So as somebody that works in internal medicine, but I'm also a professor at the university and I train future providers, I really want to address that. I want to make sure that people are equipped because as our population ages, this is going to be more of a frequent conversation that needs to occur, and we need providers that are confident to have these conversations and know where the resources are. So that's another thing that I've heard. I've heard participants or clients say, Well, I had concerns, but my primary care gave me a referral to someplace and they was they didn't have an opening for nine months or 10 months. Um, or I had some concerns, or somebody just told me that's just part of aging. So a lot of that type of behavior on the end of the provider uh side is something that we're trying to address with this federal funding. Increasing education, increasing training so that we have more providers that are available, A, and prepare, B, to really have these conversations and get these people linked to the necessary screenings and treatments that are out here.

SPEAKER_03 9:50

That's right. Does that sound way better than what you heard on the internet? I think so. I think so. Doc, what about you? When people come to the memory clinic, the to the memory portion of the clinic, they do a lot here, y'all.

What Brings Families To Clinic

SPEAKER_03 10:07

They do a lot, and I don't, and I want to make sure I am not mis um labeling any of the different departments. But you're very involved at the memory clinic. Yes. When individuals come initially, what are some of the things that you've noticed that they say, I'm here because my child noticed something, I kept getting lost coming home from work. What are the things that prompt them to come?

SPEAKER_05 10:33

So all of these are very common uh complaints. Um the main thing that I do want people to know is there's no fear. Don't fear the diagnosis. There are so many stages to dementia. There's one thing called mild cognitive impairment, which is not even dementia. It's very early, early signs. And all people with that kind of uh memory problem does not automatically, you know, progress to dementia. But knowing about this and planning and creating a safety net in your life is very important because uh if you're not aware, you won't know. And then you cannot create that safety network around you. So when patients come to me, some of them are very aware, they have a good insight, they know that there's something wrong, and they bring it up with either our as we as a primary care physician or to their own primary care physicians, or they look up memory clinics and stuff like that, and they just re-refer themselves to come and uh talk about it. Um, thus, most of the time it's also the family because they notice things and they are you know um uh concerned about their the the memory. So when family members notice that they are repetitive or they're forgetting their medicines or some other incident that has happened, like somebody's uh finances are not in order, or somebody uh involved them in a fraud or something, or they they got lost while driving. So there are so many instances that sometimes precipitate a family member to intervene, and the patient themselves may not know that they are having a problem. Uh so it all it is all stages. Sometimes they can catch it very early because their family's paying more attention to the person, and sometimes they are not living with the the the uh patient, and they f the incident happens and then everybody kind of thinks, rethinking. Panics.

SPEAKER_03 12:26

That's happened in my house. And then was like my phone.

SPEAKER_05 12:29

Yeah, and there was like, oh my god. And and we also notice something that is very common in elderly when couples are uh together, um they compensate for each other and nobody notices the deficiencies. Unfortunately, if one of them passes or is not no longer there, then the person who's uh behind, we uh is a lot more changes are noticed noticeable in that person, which were not like when the couple was together and compensating with with each other. So there can be many scenarios, but one thing that you have to understand is that for norm for uh uh memory problems are not a normal part of aging, it is a disease process. So when you grow older, you can slow down in getting information, take more time in um uh getting that information, uh, but it's still not normal older adults should not have dementia. It is something that you need to be aware of and it impacts your personal life, your medical health, a lot of things around you, and you need a support system to get through it.

SPEAKER_00 13:40

And I think what I heard Dr. Jol say a couple times, it's important to bring what we like in the clinic is to bring um family or friends with the person. Okay. Because that um that kind of gives us our our second look at things. So while Dr. Jill and I are with the family, or with the patient, testing them and examining them, our social workers with the family getting their side of the story. And it's frequently what Dr. Jill said, like, especially with a couple, the one individual's passed away, they the family says, Oh, she didn't have trouble till yesterday, when really we figure out that they probably had been having issues, but the spouse had been covering for them or helping them out.

SPEAKER_03 14:19

That is precisely what happened with uh my maternal grandparents. And uh my mom and her siblings were caught completely off guard. My grandmother passed first, and so my grandfather, it appeared that he was heartbroken and didn't know up from down because his wife died. When we backed into a lot of family conversations, they had been compensating. Yes. We didn't know how much he couldn't see. He couldn't see, but she couldn't lift anything. She had gotten very, very weak. So they had this whole little system with doing the laundry where she would sort it and walk with him and get his hand in point and have him pick it up and then walk him all the way out to where the to where the washing machine and dryer was and tell him to put we were like, how long have you how long did how long was this a good idea? That's right. You know, and and then we also a lot of us felt guilty like and poo-poo on us, like how much had we not been around during the time when they do in the laundry to see this? Like when they said, Oh, we're going back to the back to get the laundry, why was it taking two of them? Just things that we didn't notice because they did it so smoothly and they never complained. So um that that right there in your face, like hiding in plain sight, is a is a very real thing.

Screening Versus Testing Explained

SPEAKER_03 15:42

Something I would like you all to clarify for those of us who don't have white coats, okay? Um screening versus testing. We get a little confused on that. Like testing, screening, a lot of times we put them all together, us lay people, and it sounds like I gotta give you blood, you're gonna stick something, I I gotta be in hospital overnight. And so I would really like you all to clarify how simple and non-invasive this stuff is in like what's screening and then what is testing.

SPEAKER_00 16:20

Well, screening is the uh mini cog that Dr. uh Diole talked about. Um page and you just ask. Give them three words, have them draw a clock, and then you have them recall those two. And it is over. And it's over.

SPEAKER_03 16:34

It's over, y'all.

SPEAKER_00 16:35

Now, depending on how they score there, if they score a certain amount um that indicates they need more testing, then we do a test. We the one we do here in our clinic is called the slums, but they're all similar, the mini cog or um the mocha, uh, the MMSC, and they're looking at orientation, they look at problem solving, ability to understand a uh uh a uh paragraph, they ask questions.

SPEAKER_03 17:01

Also written?

SPEAKER_00 17:02

They're paper pencil.

SPEAKER_03 17:03

These are paper pencils, so after the screening, you get to paper pencil testing. If they need that. If they need that, it if you only if you need it, but so I'm am I like let's say if this were me, am I just like sitting in your office doing this? Do y'all do it virtually?

SPEAKER_00 17:19

No, we no, we do it in the office. I do it with the patient, it's usually my myself and the patient. Um it it's paper pencil, 30 questions, uh very simple to do. Okay. Um I uh the other thing we do is a geriatric depression scale because oftentimes older people can be depressed and that will affect their memory. Um and after that, Dr. Gio examines them, and then based on the physical, we will do um, they will have a blood draw looking for reversible causes. Um, thyroid, B12. Some of these uh tests can get off as people get older, and that can affect their memory, but we can fix that, those types of things.

SPEAKER_03 17:56

Like things we could fix.

SPEAKER_00 17:58

And then we will do an imaging study, and Dr. Jewel can speak to that.

SPEAKER_05 18:02

Right. So um it all starts with, of course, the screening, the the the more complicated tests after like a simple screening, then we then we get into it. So the first thing is of course that simple question telling I have a memory problem, and then we take on forward. So depending upon how bad the memory problem is, um it we we kind of progress from there. Now, the reason for the testing, like we have blood tests now, but they were not available uh before. So everything was very clinical history from the patient, do the testing or the screening and the questionnaire, everything was paper pen. So there was no definite saying that hey, this is the test and it will diagnose you. No, it is a combination of all these things, and at the end of it, uh, your story, family story, testing, uh lab work, and then we figure out what kind of uh um memory problem it is because there are many different kinds of dementia. There is a slowly progressive, which is the Alzheimer's, and there is vascular, there's Louis Bari, there is frontal, so there's a lot of kinds, so it's just not one kind, dementia is just a one common umbrella that somebody has a memory problem that's interfering with their day-to-day functioning or uh making them not be able to be completely independent. Um, so uh, but that is like further down, but everybody doesn't have to go through it because they might not be at that stage to be further tested. Um, so it was used to be clinical, and um the reason we do imaging in the past we used to just do a simple CAT scan without contrast just to make sure that there is no tumor, there is no stroke, there is nothing else in the brain that would give you somebody a memory problem besides the dementia uh situation. So we have to rule out from our point of view. Uh, now we are more doing MRIs rather than CAT scans because it gives us more information about the brain structure, the areas that can affect memory. Uh, so it's a different way of looking at it. Um, but now we have a blood test that can tell us about Alzheimer's at least. So it is the the main uh proteins that are um uh responsible for um Alzheimer's are the tau protein and the amyloid deposits, and now um there are commercially available blood tests that can measure the level of the Tau protein, and it is a very good test, I think, or very um uh useful test telling us if somebody has Alzheimer's or no, but at least if it's negative, we know definitely they don't have Alzheimer's. If they have if the test comes there levels like negative, intermediate, and uh high levels. So high levels definitely show that somebody has tau proteins, but that doesn't mean they have the disease unless they have symptoms. So people can have these tests positive several years before the dementia actually sets in. So um you have to clinically coordinate. So I mean you can have a test positive, but if they don't have memory problems, that doesn't mean they have dementia.

SPEAKER_03 21:04

I'm so excited with so many questions. I gotta make sure I can get this in in order. This is very interesting. This is so interesting. It is. Um uh I don't like blood, so I I couldn't do the whole anything medical for real, but I like physics and I like science, like I like understanding why things are the way they are. First thing I want to ask on on what you just described, um, is in the interim from hey, there's some something, a plaque or amyloid or something I may be not saying the words correctly, but I'm not showing symptoms. What would be your suggestion on like what I should do? Do I wait till I see symptoms? Are there lifestyle changes or medicines that you all would suggest that could help me maybe not get? Get the symptoms?

SPEAKER_05 22:01

So the test, the blood test is really not indicated if you don't have symptoms. Okay. Right? So you have to have symptoms for a sub to order it. But there can be very, very strong family histories of uh Alzheimer's dementia. In those situations, there is a genetic testing available. But in addition to genetic testing that was always available before for the Apo E protein, uh now we have the blood test. So that can be used. People can always pay for it and get it done. You know, if the insurance doesn't cover, but it's not indicated to do it unless you have symptoms of dementia. Because we are we are trying to work up dementia. Otherwise, it's a lot of anxiety, a lot of people may not get symptoms, may not so it's it's it's a lot into it, like trying to figure out oh, let me find out if I have it or no. Because then you can do any test, I guess. But here the focus is that there are people who are worried about uh do they have Alzheimer's or a different kind of uh uh dementia. Yes, so this helps us differentiate very easily with just a blood test. In the past, you had to take a from the spinal tap, you had to do a lumbar puncture, it was more complicated, more like it was you wouldn't want to do that.

SPEAKER_03 23:12

Yeah, not if you don't not if you can just do a blood test. I definitely wouldn't want to do that.

SPEAKER_05 23:15

So so I think for us in our practice, we have started doing this more more so now than it was in the past because it is available now. So it helps us uh define what kind of dementia we are, and it also helps the patients to expect how their disease is gonna progress or what kind of treatments are available, and very important for those new infusion therapies are there. The earlier you diagnose, the earlier these people can avail those treatments. They are complicated treatments, I understand that. They're newer there, but if they meet the criteria and they are wanted, it's an option that's available, which was not available many years ago.

Early Signs Beyond Forgetfulness

SPEAKER_03 23:54

Right. What are the types of symptoms that a person or someone who loves them was watching this segment and they can say, Oh yeah, you know what? My sister is doing something like that. I didn't even know that that might be a problem. Are there like uh the top five or ten or three that you all would say, if this is happening, you should probably come in for a screening either here or or wherever is close to where they live?

SPEAKER_00 24:23

Yeah, and I think like um Dr. Jim Duole mentioned a few of them. Um a lot of it is repetitiveness, um, forgetting to pay bills. Uh some of it is personality change. They may not have been they may be a different person now than they were in the past. Um what's an example of that? Well, you might have someone that was really easygoing, all of a sudden they become very agitated. Um, and that would be indicative of a different type of um di uh diagnosis than Alzheimer's disease. You um would have people that may forget to pay their bills, uh, they may um forget the grandchildren or the great grandchildren, especially when there gets to be more of them and they're more recent, uh, some of those things uh they forget. Usually when people come to us, and I think because we're geriatricians and say they have a memory problem, we usually sit up and take notice and at least, you know, do a mini cog and get them screened um uh right off the bat. I think what we talked about earlier with um other providers that are in the community, oftentimes they don't have time, they don't know what to do with the information if they were to find it, you know, and think, oh, now what do I do with them like uh Dr. McNeil was saying earlier. So I think would you add anything else to that?

SPEAKER_05 25:39

Yeah, so some of the other things that are like, you know, they will say, so the the symptoms that we are looking for are the symptoms that were not present before and is a change from their baseline. Like a somebody who is very good at cooking great, now forgetting the pots and pans on the stove and burning burning the pans down. Uh but these are like simple things, but for high prof high uh achieving professionals or highly functional individuals, like let's say there's a surgeon, he has done hundreds of cholysystectomies and stuff like that without having, and now he's making mistakes. The level of functioning is so high that with these tests, you may not they may not be forgetting things, but they are not as skilled as they were in the things that they have done all their life and are not making mistakes, is an indication that now this is not right. For a for a homemaker who's great at organizing parties, great at doing things, and now is suddenly not organizing it as well, could be very, very early signs of things that they have been doing and not able to do. So it just doesn't is memory, it's also their performance, their functionality, their executive function. So it could be at many different levels. Because for that person who is highly educated, highly skillful, to come down to a level of uh forgetting things uh is it takes a lot to come down from there. So you have to look at the person's baseline level of functioning and see what they were all normally doing that they're no longer doing it in an as skillful manner or in an as um you know normal manner for that.

SPEAKER_03 27:15

I think that thank you for saying it like that, because that helps um family members or just friends or neighbors that are around to I think hope hopefully this will help people be a little more emboldened and feel um like they have the the power or the standing to say something or take action because okay, so my friends are surgeon, and you know, he or she they're not forgetting anything, they're still showing up for a dinner party or pinakle party. But I surgeries that used to take them 30 minutes are now taking an hour, and that doesn't quite sound right. And but so often we we may say, Well, I don't want to get in it. They didn't ask me anything, it's not none of my business. They seem like they're doing okay, they're functioning. Who am I? What do I know? Well, after viewing this, what you know is that that's not the best um thing to ignore, and that's not typically just a part of aging is when you so abruptly can't function as well.

SPEAKER_00 28:20

No, and we'll get like uh in the especially after the holidays, a family comes in and you know, the the mom isn't making the turkey dressing like she'd done in the past, where that some of these higher level things, um, like Dr. Jill said, getting the dinner party together, we might have the stuffing and then later on we might have something else. And um that those are some of the things that families will say, you know, her stuff, you know, stuffing isn't how it used to be. And it may be simple things like that. It doesn't have to be these, you know, earth-shaking things, it can be simple things like that.

SPEAKER_05 28:53

Because change is change, change, yeah, change changes change. If you don't have a valid explanation for that change and it's not really what your my mom used to be or my dad used to be, and oh, you didn't never did this before, like that kind of a situation. You find things odd that are not the usual things for that person, it's always good to investigate further. It could be from other reasons to not only dementia. Some you know, I know that people don't uh really think that older adults use uh recreational drugs and stuff like that. That could be somebody who is just doing something else. I'm not saying everything is dementia, but at least it brings up the question why is this happening? Right, what uh what is the explanation for and then it leads to further.

Safety First With Driving And Cooking

SPEAKER_05 29:34

The other very important thing is to go on a drive with your parent and see how they are driving.

SPEAKER_03 29:40

Wait a minute now, John. You mean I'm supposed you're encouraging us to let the parent drive if they were driving with course. Hold on, wipe out.

SPEAKER_05 29:52

A lot of information comes from that because this is this is something they have been doing all their life, right? Driving. Uh, some of those things are very automatic. So I guess break uh like the mechanics of things, but how they're navigating the traffic, how they're navigating the directions, are they getting confused? Are they not so it gives you a lot of information? The reason I'm is asking is that uh asking like or saying this is that the two most important dangerous or potentially dangerous or things, in my opinion, are people who cook that can lead to a hazardous fire or something, and people are driving who have an impairment of certain kind and then causing an accident, hurting themselves or others. So those are some things we latch on very early in our practice because if we suspect people having memory issues, those are some of the things we address earlier than anything else because we want the safety first while we are working this out. We'll tell them sometimes to hold on to driving, let somebody drive till we work this out to make sure that everybody's safe.

SPEAKER_01 30:57

It's all about safety. I'm listening to this conversation, and I think that one of the things that I see a lot is that not just a spouse making excuses, but I think that the individual and the family, you know, over time will make, you know, oh, she was tired, you know, okay, okay, she was just, you know, fatigued. And so you don't get to see them until they're at their wits' end. So, like that's usually what my experience is. Like they're at their wits' end. It's been six months, twelve months, and they ran out of excuses to make to explain why the stove has been left on three or four times, or why you know, we lost the car three and four times at the mall and that kind of thing. So typically, by the time they get to being vocal about their concerns, they've already gone through months of, okay, let me just, you know, maybe I'm just tired, maybe this, maybe that, or even the loved ones, okay, making excuses. So that's one of the reasons I always think about making sure that we as providers advocate because when they open their mouth and vocalize to us their concern, they've already had six, eight, ten, twelve months of making excuses, trying to figure out what's going on. And if we don't do action, if we don't act right now to get them screened, to get them tested. I mean, we're just kind of again prolonging and making the situation worse. So I just hear like these stories and they they coincide with the stories that I've encountered. But one of the things that I would say is that they don't come right away. Right? They don't come after the second incident. They come, you know, 12 months later, 18 months later, and now it's this, I'm in my wits and now, and now it's a safety concern, and now I'm my children are talking about, you know, having me move into with them, that kind of thing. But it's a panic. Right.

SPEAKER_03 32:39

It's an all-out panic. When a person um is coming, I'm gonna say we'll start with getting screening, right? I think I've picked up on screening happens, and then how depending on how the screening goes, we might give you some tests. Is that right? That's correct. Listen here, okay? I've been paying attention, I've been paying attention. So can I make somebody come get screens? Like, like what if I have an auntie who, you know, I tell her we're about to go to lunch and then we show up at the Rose of Parks Jerry and City.

SPEAKER_00 33:12

Meet them all go ahead. Like, well, how does it be? I'm pretty good with that. I'm pretty good at controlling people and going along with me. So yeah. I think if you come at it from a more very relaxed perspective and you don't jam it down their throat, most people, I mean, in my career, I probably had maybe five people not get tested. I I can pretty much get people tested. And I think um it it is like you said, it's in the delivery. If you if you're honest with people and we just want you to go and see, and people that don't think they have a problem with their memory, they're gonna come right in. And so we uh those people are great, but we pretty much can work with anybody. We do work with early.

SPEAKER_05 33:57

We might not be able to convince sometimes that they have a problem, but we we have a couple of visits and everything comes around to being it's it's a hard decision, it's a hard diagnosis to accept. People have fear of wo you know the disease, and uh and they know that once they are diagnosed, there is it is progressive. So it's hard, it's very hard, but every person is different, everybody's disease is different. I you cannot compare your memory issue to another person's memory issue because it's it's it there's a lot of things that get into it. So there's no need to fear, start with you know, screening and being aware and talk to your doctor, then they can always refer to you um to other other uh doctors, and there's there's a lot of help out there, there's a lot of awareness, and uh but uh but we have to do it. Yes, yes.

SPEAKER_03 34:47

I so appreciate you kind of giving a bit of a segue, if you will, on um dispelling the myths and the and or the fears. What are some top fears or popular fears? If that I don't I don't like saying popular fears, but I think it you know, fears that come up often such that you all are not surprised if you hear a particular myth or fear that has precluded a person or a family member from getting screened andor

Stigma, Myths, And Hopeful Care

SPEAKER_03 35:22

tested.

SPEAKER_00 35:22

I think our history has it precludes people because they remember grandma that was senile. They remember um back in the day when we didn't have stuff to treat people with. Okay. And so I I shared earlier that when I worked in oncology for 10 years and I came here, and when I the first this was 30 years ago, and I was like, oh, there's not anything. I mean, it was it was a hard thing to tell people about, but now we have so much. We have medicines, we have oral medicines, we have IV medicines, we have so much to help people with. It's important that they get tested early so that we can do that, help people with that.

SPEAKER_05 36:02

I think their most important fear is the fear of losing their independence and being dependent on someone, things that they have taken for granted that I can do it. Uh, and and you know, then it involves their children, involves their other family members. It's very hard to be on the receiving end. Dr. McNeil.

SPEAKER_01 36:20

Yeah, I think one of the biggest things is just stigma around the diagnosis and just the word dementia. And I think that, you know, some of uh the community kind of plays into that, right? I think it's not only getting the individuals to get screened and diagnosed, but changing the mentality of and the culture of the society and the communities so that we can all be educated and we can all learn. And I've heard the most heartbreaking stories I've heard with those individuals diagnosed with dementia is that they went in, they did the testing, they got diagnosed, and their provider was like, okay, this is the end for you. Good luck to you. Uh get your affairs in order. And that was what they did to my mom. And that was so heartbreaking because I know there are communities, there are support systems, there are all kinds of, I've just spoken to members, churches, that spoke to members of different organizations that have dementia. They're advocating, they're speaking, they're teaching, like you're still valuable, you're still necessary.

SPEAKER_03 37:24

Going on vacation. Absolutely.

SPEAKER_01 37:26

Going on vacation, you know, doing creating organizations that led by people with it with dementia. Like there's still viability in that individual, and that diagnosis is just that it's not, it's not them. The diagnosis is not them. They just have this thing, just like diabetes or hypertension, that they have to navigate. Yeah. This is too common for us to recreate the wheel every time a family gets this diagnosis. I mean, we should just be surrounding them with all of these resources. And every rosa, every click, any, every clinic should be a Rosa Parks clinic.

SPEAKER_03 37:57

I hear, here, here, here, do that. That's the model. So that makes a phenomenal point.

Finding Resources Outside Detroit

SPEAKER_03 38:06

Let's say uh someone views this conversation and they're not in Metro Detroit, and they're either going to go talk to their provider or they want to know what they should put in the search engine on the internet. How do they try to find something similar to what you all have here? What do you call it?

SPEAKER_01 38:28

Care. Really care. Right. Underline. I think, you know, people really underestimate the Alzheimer's Association. And I and wherever you are, you know, they the Alzheimer's Association really, really try to really connect people with resources. They have a 1-800 number, you know, they could send a social worker out to your home. Like they have things. So if you are diagnosed with dementia, you know, I think that could be one of the initial resources that you reach out to. Call that 1-800 number, they'll ask you where you are, they'll get you aligned with resources in your particular community. Get involved with those support groups because they talk to each other. They tell you these are the things I do that work for me with my diagnosis. This is how I navigate this with, you know, I got a whiteboard, or I have a shared calendar with my family, or I have a camera that my family can log into. With technology nowadays, people are living in their homes even longer now, right? So embracing those strategies, embracing the resources, embracing organizations that have been committed to making this not a taboo type of situation and surroundings with resources. That would be what I would suggest.

SPEAKER_00 39:40

And every um state has area agency on aging. Okay. So whether it's agency. So that's another resource for individuals that would be more local. I think the churches are are downplayed a lot because they do have a lot of them, will have um elderly support in their church that someone is responsible for, whether it be the parish nurse. And so a lot of individuals I find are hesitant because they don't want people to know. But once you get beyond that, there's a great wealth of help there as well.

SPEAKER_03 40:29

Just past the threshold. Yeah. There's all this help, and that's and that's what we're doing here on the Parent and Help Podcast is to say, hey, just get to the other side, go over the threshold. And there are millions of people over here doing the work behind the scenes in clinics, in research labs, policy makers, things of things of all nature. This is going so well. And you all know I'm a talker, so I'm gonna try to. I know I have one question that's burning, that I have to get this one out, and after that, uh, you know, whatever your final thoughts may be that we can uh share with the audience.

What Age Should You Screen

SPEAKER_03 41:08

What age do you have to be to get screened or tested for dementia?

SPEAKER_05 41:15

Uh so there is no age to diagnose anybody with dementia. It's just a kind of dementia that we're looking at. So the thing is memory problems. If somebody has a memory problem, it can be any age and they do. It could be 30.

SPEAKER_03 41:29

Yeah, it's not as rare. I hope they don't have to be. Yes. But it can happen.

SPEAKER_05 41:34

There are there are rare cases of early dementia also in younger age. They're especially if they have a very, very strong family history uh of dementia. But there are other kinds of dementia like vascular if somebody had a stroke. So stroke can happen at any age, uh or at least, you know, if somebody has risk factors for it, and uh the dementia can be diagnosed at that time too. The only only I because many people think of dementia as that Alzheimer's old age dementia, that generally happens after the age of 60. Uh, you know, can happen, but every uh five years that you go, it kind of doubles the incidence. So it's higher as uh in higher age groups, the incidence is uh or the prevalence is more. Uh but uh the it has to start with um like having some kind of a memory issue or some kind of uh um incidence that involve memory. Um yeah, so we have patients, some that are in late late 50s, one of uh couple, but they have other diagnoses also that led to the to the memory loss. So I wouldn't say like it and result is dementia, but it could be other other reasons also.

SPEAKER_03 42:40

Well, this has been eye-opening, and it's actually given me a lot of hope. Because now I can uh speak with people with more confidence when I tell them about first of all, screening and testing. I'm not ashamed to admit I was like, it's how like that. That is not the same thing. I think they have said them together too many times. Screening and testing. And is it is a joiner, right? Yeah, okay. So thank you for that. Um thank you for all the work that you do in the community and how much advocacy you, how much time, effort, and energy you're putting into it. Thank you so much for you and your team for the federal grant that is allowing us to do this on a continuing basis because momentum matters. I'm a huge sports fan, and you know, you don't want to lose momentum to the other team. And in this case, the other team is a disease. And so we we gaining we're gaining on it with the different treatments and the different uh screening and tests and the awareness of uh things like uh brain health and what we can do with our diet, and uh the goal is to keep the pressure on dementia and until we bring it down. That's right. Absolutely, absolutely. Well, thank you all so very much. Thank you. Thank you very much. Thank you. Thanks for having us. Yes, yes, thank you.

Baseline Screening And Final Sendoff

SPEAKER_03 43:53

The snuggle up screening, testing, testing, screening, testing, testing, one, two, testing, testing, one, two. Yes, people, go get tested. Get screened. Why? Well, because at a minimum, uh, let's have a baseline. I'm gonna uh suggest let's not wait till you have a whole bunch of problems. Go ahead and get a baseline screening of what your memory may be. Okay? And you know better than anyone else. If you're not quite right, you're with yourself when you get lost on the way to the mall. Or when you realize that your money is not adding up the way it used to. Love yourself enough to let go of the fear of being embarrassed if your mind has started to decline in some way. It's not your fault. You didn't do anything wrong. There's nothing for you to be ashamed about. Whether you're talking to a geriatric professional, your primary care professional, maybe there's somebody at your church. The point is, you're not alone. There are a lot of people out here doing the work. As you just saw with the members of the Rosa Parks Geriatric Center. They out here bust them butt, trying to make sure that we identify the disease earlier and that we do something about it. But it starts with us. I'm gonna get screen. Thank you for tuning in. I mean, really, really, really. Thank you so very much for tuning in. Weather podcast. Or if you're listening on your favorite podcast, are your platforms?