In recent years, primary care physicians have seen a growing number of adults complaining of memory problems. Unfortunately, most of the patients are given a prescription and sent home — only to wait for the problem to get worse. As the country's population of older adults continues to grow, the medical community needs to take a new look at how to care for those with memory problems. Medications are only one small part of a comprehensive solution.

Quality care requires a team of expert health-care providers who truly understand the diseases that can lead to memory loss, their presentation, potential complications and the importance of ongoing support for the patient and the family. It takes a village to care for a patient with memory loss.

In order to diagnose a memory problem, a physician must begin with a history, physical examination and memory testing. While Alzheimer's is the most common diagnosis, there are other conditions that cause memory loss and can be corrected to prevent further decline in memory. Examples include depression, medication, alcohol, strokes, vitamin B-12 and thyroid deficiencies and normal pressure hydrocephalus, a disease that causes the brain to swell.

Coexisting medical problems must be identified and treated meticulously, which can help reduce the rate of memory loss. Accompanying symptoms associated with memory loss, such as personality changes, hallucinations and delusions, disruptive behavior, insomnia and agitation, must be assessed and treated if necessary.

A neuropsychologist may be required to perform extensive testing of memory and intellectual function. The neuropsychologist, together with the physician, provides feedback on the diagnosis and consequences of memory loss. In this setting, the team must discuss the patient's competency to manage affairs, drive a car and function in the community.

Neuropsychologists assist the family in how to deal with forgetfulness. For example, exercising the mind and the body slows memory loss. Crossword puzzles, reading, studying and attending lectures are far more beneficial than mindless television watching. Physical activity is beneficial as well. Although an active mind will not bring back lost memory, it could slow the rate of decline.

Another critical member of the medical team is the social worker. Social workers with special training have a special understanding of memory loss and the resources available in the community. They can do much to educate the patient and caregivers. Social workers can guide patients and caregivers to the appropriate support groups, therapists and other resources available to cope with memory loss.

For patients with severe memory loss or advanced Alzheimer's disease, crises can often occur. For example, I received a frantic call from a woman whose father, who has memory loss, had become agitated, confused and combative. What should she do?

In this instance, a social worker can help by assessing the situation and arranging a visit to the doctor, sending someone to the home, or, on occasion, being there for reassurance. The social worker is also a vital asset in preventing abuse or neglect of a patient, which can occur due to family desperation and frustration.

Ultimately, nothing is more important than educating the patient and family. The severity and stage of the disease should be explained. For patients with mild to moderate declines in short-term memory, early Alzheimer's is no more than a minor disability. Learning to adapt is as simple as writing down appointments, leaving notes and developing a system to fill the gaps in memory. But it is not just the patient who must learn to cope with memory loss; caregivers must also go through an intensive education process. As the disease progresses the patient is likely to be very different from the person he once was. For caregivers, this can be a very difficult and painful process. Look to the Alzheimer's Association for guidance in your area.

The message is clear — it takes a village to care for someone with memory loss. Merely receiving medication and nothing else creates a recipe for disaster. Always seek out a team of health-care providers who truly understand the complex tapestry of caring for Alzheimer's disease and other memory disorders.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.drdavidhealth.com.

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