Gathering Around

Top Hospitals and Healthcare 2016: When memory fails, Riverside Health System’s Geriatric Assessment Clinic brings individuals and their families together to plan for what comes next.

Terry Sweaney, Faith Shartzer, Denise Butler, Jessica Coleman, M.D., and Danielle Leiva.

Photo by Tracey Lee

At the Riverside Center for Excellence in Aging and Lifelong Health, a team of health professionals leads patients and their family members through some of life’s toughest questions—How long can I stay in my home? Can I still drive? Why do I need a living will?  

Frank conversations are a key part of the Geriatric Assessment Clinic, where patients with suspected memory impairments and their families are referred for comprehensive medical evaluations and support. “One of the biggest goals … is to make sure we keep people in their desired place of aging for as long as possible,” says geriatrician Dr. Jessica Coleman, the center’s medical director. 

As part of the clinic’s assessment, which costs $195 and takes 3-4 hours, patients meet with a registered nurse and a social worker who make functional, dietary and memory assessments, screen for depression and track medications. “They are also evaluated by a physical therapist, to decrease their fall risk, and to screen for other neurological conditions that can contribute to memory impairment,” says Coleman. While this is going on, Coleman or another geriatrician will meet privately with family members or caregivers to hear their concerns, and get a sense of the changes that they have noticed in their loved one. A geriatrician will then make a physical assessment, and order any neurological testing or lab work that may be needed.

“There are many things that people can suffer from that are not dementia,” says Rick Jackson of Riverside Health System, who directs the center’s operations. He notes that some of the conditions that can contribute to memory loss and confusion can include severe clinical depression, potassium and B12 deficiencies, substance abuse and use of analgesics.

When test results are in, the team reviews them with the patient and caregivers, and makes recommendations, which may include taking the 5-week caregiver support course “Caring for You, Caring for Me.” They also make referrals for home health aides, respite care, nursing homes, safe driver evaluations, personal emergency response systems, advanced medical directives and financial and legal services. 

When patients learn that they have Alzheimer’s or other forms of dementia, they can be very emotional. “That’s why we provide a diagnosis with dignity,” says Coleman. “We do it in a room where we have family present, we have everybody who was there at the initial visit present so we can sit and talk about, ‘Here’s what we found and how does that make you feel’?—that’s the most important thing—and ‘What do we need to do going forward?’” RiversideOnline.com/CEALH


Geriatrics News

The Michael J. Fox Foundation awarded a $1 million grant to the schools of medicine and engineering at Virginia Commonwealth University in September. The grant is specifically being used by researchers to track eye movements in patients with Parkinson’s disease using a diagnostic tool developed at VCU. The objective of this eye tracking study is to begin diagnosing the patterns that indicate the onset of Parkinson’s in an effort to advance early-stage treatments well before a patient begins to display outward symptoms.

In August, Winchester Medical Center became one of the first in the nation to offer a new dissolvable stent to patients with coronary artery disease. Instead of a metal mesh material, the Absorb stent is made with naturally-dissolving polyactide, which over time is absorbed harmlessly by the body and allows blood vessels to heal themselves without remaining permanently in place. Dr. Neil S. Gaither, chairman of the Invasive Cardiology Clinical Council at Winchester Medical Center has said the new stent product is the next generation tool for treating blocked blood vessels.

Advanced Physical Therapy of Virginia in Roanoke is celebrating 10 years of service. The PT clinic operates as an outpatient orthopaedic practice and treats geriatric patients who have balance and inner ear disorders. Owner Remco Schreuders is a former director of the LewisGale Clinic Rehabilitation Center. He partnered with his colleague Tom Ellexson in 2006 to open the practice.


Geriatrics Top Honors 2016


VCU Medical Center
Richmond, VCUHealth.org, 804-828-9000

Wythe County Community Hospital
Wytheville, WCCH.org, 276-228-0200

Guggenheimer Health
Lynchburg, CentraHealth.com, 434-947-5100

Mary Washington Hospital
Fredericksburg, MaryWashingtonHealthcare.com, 540-741-1100

Carilion Roanoke Memorial
Roanoke, CarilionClinic.org, 540-981-7000

See all of our top hospitals for 2016, below.



Cancer
LewisGale Regional Cancer Center
UVA Cancer Center


Cardiology
VCU Pauley Heart Center


Dermatology
Inova Melanoma and Skin Cancer Center


Diabetes
EVMS and Sentara Heart Hospital


Gastroenterology
Centra Lynchburg General Hospital


Neurosurgery
Bon Secours St. Mary's


Orthopaedics
Carilion Clinic 

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