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From a community supporter: Optimizing Quality of Life

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From a community supporter: Optimizing Quality of Life

0092901-17SN Sept 29, 2017: Terry and her mother Jenny Wyatt pose for the cover of the Emory Nursing Magazine at the Pleasant Hill Victory AME Church in Atlanta, GA. Stephen Nowland/Emory University

Special promotional content provided by Emory Integrated Memory Care. 

Before Mary McCreary became a patient at the IMCC, her primary care physician recommended she have a routine colonoscopy but Lloyd McCreary, her husband and caregiver, resisted.

“When I switched Mary’s care to the IMCC, her nurse practitioner said she no longer needed a colonoscopy,” Lloyd said. “Mary was at a stage where procedures like colonoscopies, pap smears, and mammograms no longer made sense.”

Key to the success of the Integrated Memory Care Clinic is collaborating with caregivers to optimize patients’ quality of life. That includes counseling them on the pros and cons of diagnostic procedures and treatments and what to expect and plan for during the early, middle, and late stages of dementia.

Mary was diagnosed with young-onset Alzheimer’s disease at age 56. When Lloyd could no longer care for Mary at home, he explored different care options with the help of friends from his support group and IMCC social worker Laura Medders. Mary eventually transitioned to hospice care at the personal care home where she lived. 

Lloyd remained on the clinic’s Patient and Family Advisory Council even after Mary was no longer a patient. “The IMCC provided much-needed support and valuable information about what I should expect regarding Mary’s condition and care.”

Treating Co-Existing Health Conditions

In her prime, Joung Ja Lee helped her husband Keun So run a convenience store in North Florida. Customers depended on the Lees for gas and groceries for many years. But when she developed advanced vascular dementia and Alzheimer’s disease, Joung had to depend on her daughter, Esther Lee, and the nurse-led team at the Emory Integrated Memory Care Clinic (IMCC) to manage her condition.

Open since 2015, the IMCC has quickly become a model of care for patients like Joung. It is the first nurse-led clinic in the nation specializing in primary care for dementia patients and the first nurse-led medical home at Emory Healthcare.

When Esther brought her mother to the IMCC for a checkup, the normally feisty Joung wasn’t feeling well. Her arms and legs ached, her hands felt sore, and she was tired and cold all the time.

Her daughter talked calmly and candidly with nurse practitioner (NP) Alison Schlenger, who managed her mother’s care at the IMCC.  Joung was taking several medications daily—for hypertension, arthritis, osteoporosis, and depression related to her dementia.

Schlenger listened carefully to Esther as she examined Joung and soon had an explanation as to why her patient wasn’t feeling well.

Lab results showed that Joung’s hemoglobin level and red blood cell count were consistently low, making her feel tired. Her GFR (glomerular filtration rate), a measure of how well the kidneys filter out protein, indicated stage 3 chronic kidney disease.

“This type of kidney disease is not uncommon in older patients with hypertension,” Schlenger told Esther. “We’d like to get nephrology on board with a consult to make sure your mother stays functional.”

By the end of her visit, Joung had completed new lab work, received a dosage change in her arthritis and depression medications, and had an appointment scheduled with an Emory nephrologist. 

For Schlenger and the rest of the IMCC team, making life easier for dementia patients and their families is what it’s all about. According to Schlenger, “our goal is to identify and manage symptoms of dementia, prevent and treat co-existing health conditions, and support families in order to optimize quality of life for every patient.”

Celebrated her while she was here”

Terry Wyatt and Jenny Loveless, a daughter-mother team, lived within an hour’s drive of the Integrated Memory Care Clinic (IMCC). The nurses at IMCC managed Jenny’s mother’s care for a variety of conditions, including diabetes, high blood pressure, atrial defibrillation, and low vision. Loveless also had dementia.

“Most of mom’s doctor’s appointments” moved to Emory, said Terry. “My mother didn’t want to give up the heart doctor who put in her pacemaker, so the clinic coordinated her care with her heart doctor and endocrinologist at the other health system.”

The IMCC made life easier for Terry, who was caring for her mother and a teenage nephew at home. “Going from doctor to doctor was hard enough,” she said. “The IMCC nipped that in the bud by providing most of her care in one place.”

Having appointments in a centralized location meant that mother and daughter were able to lead an active life together. They spent time at a local senior center, volunteered at two churches, worked the concession stand during high school football games, and catered small events. Jenny, who trained as classical singer in New Orleans, sang at church every Sunday.

“Every day, we concentrated on conversing about mom’s past,” said Terry. “She talked to her brother in Los Angeles once, sometimes twice a day. She loved to be involved in things, and we did everything she wanted to do within reason. We wanted to celebrate her while she was here.”

Integrated Memory Care Clinic has been open since 2015, and in 2022, the program launched a domiciliary practice, Integrated Memory Care in Community, that makes the comprehensive dementia care model available in select senior living communities. More information about both programs can be found at the web site or by calling 404-712-6929.