Novant Health neurologist Dr. Andrew Evans’ earliest memories of his grandmother are of a sweet lady who was a joy for the family to be around. Her name was Bennett, and she worked for years as a home economist putting on kitchen demos for an energy company.
And then family noticed she was having trouble using the microwave. Soon, Evans’ grandmother was diagnosed with mini strokes and went from living independently to moving in with Evans’ family. It was in Evans’ childhood home that something really out of character happened: Bennett struck his 14-year-old brother.
“It happened one night when Mom and Dad were going out to have a date, which they didn’t get to do often at all because Grandmother was there,” said Evans, who was 12. “My older brother and I were, quote, ‘babysitting’… The phone rang and my brother went to answer the phone. Grandmother thought that was inappropriate for him, so after he picked up the phone, all of a sudden she smacked him.” Evans said he doesn’t remember much besides the utter shock of the moment. He would later learn that it was an advanced symptom of dementia.
Evans worked alongside other Novant Health team members who have had personal experience with family members with memory issues. Together, they designed Novant Health’s new Memory Care in Winston-Salem. The outpatient facility, designed with patients and their families in mind, was created to deliver specialized care at a single location.
The new facility will also position Novant Health to have the infrastructure in place for a specialty Evans said he expects to be at the forefront of research and innovation in coming years as Baby Boomers age. Evans said he expects the burden of dementia to increase within the next 10 years especially as treatments for dementia advance.
‘You identify triggers’
Now, as a neurologist, Evans said he looks at his grandmother’s actions completely differently. And he’s learned how moments like the one he experienced as a boy can be prevented through advance planning.
“First of all, acknowledging that the caregiving roles were reversed would have been important,” Evans said. “My brother and I would have known we don’t have to answer the phone. We can let Grandmother have that power so that she feels like she is the caregiver in that situation, but we didn’t know that existed at the time. You identify triggers and you work on it.”
Evans, who deeply loved his grandmother and later named his son Bennett after her, said patients who can take a collaborative approach with caregivers and healthcare providers often experience the best results. “You should prepare for the worst and hope for the best,” he said.
Novant Health Memory Care will help memory care patients at all stages, including working with patients with mild memory impairment where they need help keeping track of appointments and day-to-day life, up to patients with more-progressed symptoms that include issues with communication, verbal or physical behavioral problems and problems with activities of daily living, such as bathing and preparing meals. The clinic will have two neuropsychologists and a geriatric nurse practitioner on staff to provide care for patients.
“A glimpse of her old self’
Evans said one of his big hopes for the new center is that having a focus on patients as well as caregivers will also help ease the strain on caregivers, who are often working with the patients to make difficult decisions about when to move in with family or into a nursing home. He added that the homelike space with soothing colors, favoring sofas over exam beds, will help keep patients at ease.
Evans’ time with his grandmother, he said, was part of what inspired him to specialize in neurology. Even as her condition worsened and she no longer recognized her own daughter, he said, he was able to gather moments with her that now are beautiful memories.
One of those best later memories also took place at a telephone. “She got on the phone with my aunt in Tennessee one time toward the end, when things had already progressed pretty far and all of a sudden started having a conversation with her and knew who she was by her voice,” he said. “It was odd how the circuitry of her brain wasn’t working for me and my mother, but all of a sudden she got on the phone and it triggered something different. By that stage she wasn’t speaking much, but then, all of a sudden, it was like a glimpse of her old self.”
Looking for a memory care provider? www.novanthealth.org/neuroprovider