presented by Becky Khayum & Emily Rogalski
This presentation will describe different neurodegenerative dementia syndromes and their relationship to brain anatomy and underlying neuropathology, including some of the challenges in reaching the correct diagnosis. It will emphasize the benefits of using a team care model for diagnosing and treating dementia syndromes across clinical settings. It will describe how to complete a person-centered vs. diagnostic assessment as well as practical recommendations for meeting reimbursement standards.
Becky Khayum is a speech-language pathologist and co-founder of MemoryCare Corporation, a company that provides therapy, support, and counseling for individuals with neurodegenerative disease in the Chicago and Indianapolis areas. She specializes in the non-pharmacological treatment of dementia syndromes, with a focus on person-centered care. Khayum also participates in research targeting treatment approaches for Primary Progressive Aphasia and is currently collaborating with the Northwestern Cognitive Neurology and Alzheimer’s Disease Center on the Communication Bridge Study, an Internet-based speech-language therapy program for individuals with dementia. Khayum holds an MS degree in speech-language pathology from the University of Arizona and a BS degree in communication disorders from Purdue University.
Dr. Emily Rogalski is a neuroscientist and Associate Professor of Psychiatry and Behavioral Sciences at Northwestern University’s Feinberg School of Medicine. She currently serves as Associate Director of the Mesulam Cognitive Neurology and Alzheimer's Disease Center and as Imaging Core Leader of our NIA-funded Alzheimer’s Disease Center. Dr. Rogalski research falls under the broad umbrella of aging and dementia and uses a multimodal approach to investigate two aging perspectives: primary progressive aphasia (PPA) in which neurodegenerative disease invades the language network and SuperAging in which individuals are seemingly resistant to the deleterious changes in memory associated with “normal” or more typical cognitive aging. She receives research support from the National Institutes of Health and other philanthropic sources. Dr. Rogalski’s investigations assist in defining the clinical and anatomical features of different dementia syndromes over the course of disease as well as identifying genetic and other risk factors. Her lab uses advanced neuroimaging techniques including tau and amyloid PET as well as MRI. Dr. Rogalski also develop educational programs, support groups, and person-centered intervention programs for families and individuals living with dementia. Her team is currently running a clinical trial investigating the effectiveness of Communication Bridge, a telemedicine person-centered intervention to maximize quality of life for individuals with dementia.
This chapter will describe different neurodegenerative dementia syndromes and their relationship to brain anatomy and underlying neuropathology, including some of the challenges in reaching the correct diagnosis. It will also describe the key members of the care team and their roles in diagnosis and treatment.
The heterogeneity of symptoms and the progressive nature of the neurodegenerative dementia syndromes requires a holistic approach, with the following variables taken into account when an SLP is designing a plan of treatment: (1) individual’s cognitive/communication strengths and weaknesses and their severity, (2) individual’s hobbies and interests, (3) individual’s (and care partners) assessment of challenges and therapy goals, (4) motivation, and (5) care partner involvement/support. Discussion will cover how to integrate the use of functionally-focused standardized tests into a person-centered, dynamic assessment that will identify ways to increase life participation in meaningful activities. The A-FROM / life participation approach for aphasia (LPAA) and Michelle Bourgeois’ “Flip the Rehab Model” will be introduced as important models to guide person-centered assessment and treatment planning.
This chapter will describe the various care settings where SLPs may provide treatment for individuals with different dementia syndromes and considerations for goal development. Treatment settings include outpatient clinics, independent/assisted living communities, home health, hospital (inpatient), subacute care (skilled nursing facility), and memory units. Practical strategies for utilizing an interdisciplinary team approach to care, increasing involvement of family members, and getting staff buy-in will be discussed. Goal writing and how to document progress for a neurodegenerative condition will also be discussed, to ensure reimbursement.