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To Test or Not to Test: For La Verne Seniors on National Memory Screening Day Their Answers Were Clear-Cut

November 17, 2009
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Inter Valley Health Plan Nurse Candice Fagan

Inter Valley Health Plan Nurse Candice Fagan

An attractive, blue-eyed woman with long blonde hair seemed like she was in the most unlikely of places. Yesterday, a friend of hers drove her from her Chino Hills home to the La Verne Community Center to undergo a free screening for memory loss on what was National Memory Screening Day at La Verne and some 2,200 other participating centers around the country.

Along with about 100 other people, the woman was there to find out whether her memory slips and occasional cognitive confusion was just an overloaded mind being forgetful or the symptoms of more serious diseases like dementia and Alzheimer’s disease.

“I’m not putting my freezer in the keys; you see; I’m not even using the right words now,” she said stopping herself, a look of alarm crossing her face after her momentary dyslexic dysfunction.

“I mean to say, ‘I’m not putting my keys in the freezer yet,’ but I’m concerned. My grandmother had Alzheimer’s, and my mother died of it last year.”

Courageous Decision

She said she had a friend drive her to La Verne because she often gets lost driving to friends’ houses, forgets more things than she thinks she should, and because of her family’s medical history. But instead of fearing the worst or appearing anxious, she appeared eager to have her name called and undergo a five-to-10 minute written screening conducted by one of Inter Valley Health Partners’ trained nurses.

“It’s very exciting,” she said. “I’m very pleased. This screening is absolutely fabulous. It’s something I have to face.

“My mother’s illness dragged on for eight years, which wiped out all her finances. I don’t want to do that to my family. I don’t want to scare them and drive off and get lost and be found dead like the man we heard the speaker describe this morning.”

But if there’s no cure for Alzheimer’s why put yourself through the agony of finding out? What’s the point?

“If you plan ahead, it might not be as devastating,” came her answer. “When my mother was diagnosed, we didn’t know what to do. We didn’t know what was available. Many long-term care facilities turned us away because she had Alzheimer’s. It’s nice to hear there are choices. Hearing them tell us there are other options available, getting the literature. I think that will help.

“Knowledge is power.”

Disseminating some of that power and knowledge were Community Senior Services (www.Communityseniorservices.com), Inter Valley Health Plan (www.ivhp.com), Claremont Place (www.Seniorsforliving.com), Visiting Nurse Association & Hospice of Southern California (www.vnasocal.org), Comfort Keepers (www.comfortkeepers.com), ProMed Health Care (www.promedhealth.com)  and Hillcrest Homes (www.hilcrest.org).

Quiet Strength

Nancy Niemeier was just as honest and forthright about her reasons for attending the National Memory Screening Day event and learning if she might be one of the estimated 5.3 million people in the United States living with Alzheimer’s, a new diagnosis made every 70 seconds and a disease predicted to double every 20 years.

“Sometimes, I’ll get angry over nothing,” said Nancy, who couldn’t have been more agreeable, cooperative or charming. “Words sometimes will just burst out of me. Something is not right. I’m not like that.

“My mother had dementia, and her sister and my grandmother, so that’s another reason I would like to be screened.”
 
This reporter suggested that people get angry over all sorts of matters (their kids, taxes, corporate scandals), but she said her outbursts were different and uncharacteristic.

If her screening were to suggest she had a problem, how would she react?

“I would go see my primary care physician and see where to go from there,” she said calmly and matter-of-factly. “I know there’s no cure, but we might be able to slow it down. That’s what I would like to do.”

And, of course, knowing early allows more time for worst-case-scenario planning, right?

“Getting your affairs in order is important,” she said. “I hope I have them in order already. My funeral is paid for, both my kids are employed. My daughter is a pharmacist and my son is an assistant principal, so I’m not too concerned about leaving them a lot of money.

“I want to spend it and have fun,” she laughs. Then she was called in to take the short test, abbreviating the conversation.

Another nurse, not Nancy’s, explained how the simple test worked and how it was a mere screening, not a diagnosis of illness intended to replace a consultation with a physician or other qualified healthcare professional.

Multiple Causes of Memory Loss

“There are lots of reasons why memory impairment could be happening,” said Nurse Candice Fagan. “There could be thyroid problems, nutritional problems or other disorders. So what this does is give the doctor and the person taking the test an idea as to whether further testing is indicated.”
 
The testing broke down as follows:

Top Score – 9: No significant cognitive impairment and further testing is not indicated.

5-8: Further testing by a medical doctor is suggested.

0-4: Cognitive impairment is indicated and further testing is recommended. Please take these results to your primary physician for consultation.

Candice said the nurses had “identified quite a few people that had some pretty significant cognitive impairment” during the morning.

Was the cause simply old age?

“One looked to be age-related, as she was quite elderly,” Candice said. “But normal aging does not cause memory or cognitive impairment. So even if I had a 90-year-old woman who had a score of 0-to-4, I would say that wasn’t normal. I would say there’s something going on. And maybe she can be helped by either medication, improvement in her nutrition or some other treatment.”

Shortly after, Nancy exited the evaluation room, her test over and her follow-up chat with the nurse completed. She scored an eight out of nine. She seemed as unflappable as when she first entered the room.

Thanksgiving First

“The nurse had the same name as my daughter, so that was nice,” Nancy said. “I didn’t feel anxious. I got some good answers … things I need to talk to my physician about. I’ll probably call and make the appointment but I can’t go until after Thanksgiving. That’s because I’m having Thanksgiving at my house with all my family, so I have a lot to do.”

Nancy said that the only thing on the test that had tripped her up was collectively remembering a full name, street address and city, “John Brown, 42 Market Street, Chicago.” She got the name and street correct, but couldn’t recall the city, or it didn’t come to her at first. She had been shown the information at the beginning of the test and asked to recall it at the end of the exercise.

In her defense of not getting a perfect score, Nancy said she relies heavily on a day-timer to note appointments, addresses and the like. “I don’t do anything without my calendar,” she said.

Yes, a short pencil is better than a long memory, this reporter agreed.

The National Memory Screening Day in La Verne was no doubt a success for the sponsors and those undergoing evaluations. There were more applicants than were slots available to be screened, suggesting the event could grow even larger next year.

As devastating as a preliminary screening indicating possible dementia could be, the day for many put to rest their unnecessary fears and anxieties about their potentially diminishing brain power.

“What we’re trying to do is alleviate fear in some people,” said Inter Valley Health Plan spokeswoman Marci Lerner. “We all forget where we put our car keys, but it’s when we can’t remember what the car keys are for that we have a problem.”

Nikole Bresciani,  with the City of La Verne, said National Screening Day in La Verne was a phenomenal event. “We had a great turnout,” she added.

“As you age, a lot of people are always wondering whether they have Alzheimer’s. It’s the first question they ask. ‘Am I getting Alzheimer’s or am I just getting older?’”

Today, in La Verne, many took their first steps toward getting some answers – and for many what they heard was a relief and a great way to start the day.

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