Michelle Dhanak, MD - Geriatric Specialist at ElderConsult

Michelle Dhanak-9-17.jpg

I joined ElderConsult Geriatric Medicine in September 2017. I am originally from the Bay Area, and joined the practice when I returned to the East Bay from New Zealand, where I had been an internist specializing in geriatric medicine for almost 10 years.

My wonderful 94-year-old mother who lives with dementia  drew me home. I wanted the opportunity to live and care for her, to enjoy the experience of three generations living together and ensure my daughter had time with her grandmother.

While in New Zealand, I obtained my fellowship in geriatrics through the Royal Australian College of Physicians. I am also a fellow of the American College of Physicians. I am passionate about caring for elders, and believe in collaborating with them, their families, and the care community to ensure the person is receiving care that addresses their needs, and promotes dignity and independence.
As a Geriatrician, I minimize medications, facilitate increased mobility and enjoyment of each day, treat pain, focus on health in food choices, as well as the difficult behaviors that can be distressing to the elder and their family.
I treat patients in the North Bay and East Bay areas of the San Francisco Bay Area.

ElderConsult treats patients from the North Bay to Carmel.

I am available for the following:

  • Assessment and Consultation with family members
  • Consultation/evaluation of medications, nutrition, daily living assessment, behavioral challenges/dementia
  • House calls and ongoing medical care
  • Educational talks for families, staff and elder care professionals

Michelle Dhanak, MD
Geriatric Specialist

Trump Gets Perfect Score On Dementia Testing, Too Bad It's Not The Right Test

Trump Gets Perfect Score On Dementia Testing, Too Bad It's Not The Right Test

"I am happy that our president got a perfect score of 30 out of 30 on his cognitive screen, the Montreal Cognitive Assessment, or MoCA, a tool commonly used to identify mild cognitive impairment. Passing this test means less than most people think. At all levels of our society, I find that the popular understanding of decision-making “capacity” is not nearly adequate for the silver tsunami of elders in the pipeline. MoCA, and other tests used to judge capacity, only roughly approximate an elder’s fitness to manage his or her life. These tests often fail to catch the nuances that can mean the difference between an elder getting the care they need rather than being swindled out of their life savings.

Dementia with Agitation... Now What?

Listen to a radio interview with Elizabeth Landsverk, MD as she speaks with Frank Samson on his show “The Aging Boomer” from January 5, 2018.  They discuss many issues of interest to elder care professionals and families caring for loved ones living with dementia:

  • What is a geriatrician?
  • What is dementia?
  • What are the different types of dementia?
  • How is dementia diagnosed?
  • How do decrease risks of developing this brain disease?
  • How to deal with pain?
  • What are strategies for dealing with potential or actual financial elder abuse?

The interview is 30 minutes.

How do you manage family gatherings when someone has dementia?

The holidays are coming. We all look forward to the feasts and family time. But what if you have a parent, elder or loved one who is struggling with the beginnings of dementia? What if you return to your family home and realize that Mom or Dad can no longer manage their affairs? How do you manage family gatherings when someone has dementia? Here are some things to keep in mind to make holiday gatherings the best that they can be.

  • If you live far from your loved ones, don't be surprised if your regular phone calls home haven't given you an accurate picture of your elder's situation. With the passage of time, elders can become more frail. Day-to-day changes may be gradual. Keep an eye out for warning signs. Things may have changed with family since you last saw them.
  • Early signs of cognitive decline include: more forgetfulness, often with appointments, or taking medications, or paying bills; also changes in personality, such as getting more angry about small things, becoming more apathetic, not wanting to go to activities previously enjoyed, may be more suspicious, making up explanations of why they are losing items.
  • If an elder is slipping, that doesn't mean that life has to stop. Elders with dementia can still enjoy life. Focus on activities that are stimulating, but not overwhelming. What does your loved one like to do? We say “What makes life worth living?” Whatever your elder's answer is, do more of that as possible. You can still go out to the ball game, but if finances permit, get a box seat away from the crowds and or go early, have snacks and avoid alcohol. Think of simpler alternatives, if the hubbub of the restaurant causes agitation; how about a picnic in a quiet park? Or in the back yard?
  • Exercise can play a huge role in decreasing the risk of progression or decline. Some studies show that exercise can decrease the risk of dementia or progression by about 40%. Physical activity can also decrease restlessness and sleeplessness. Walking in the park is almost always a winner.
  • If your elder is agitated, avoid “anti-anxiety” pills, except for emergencies. No elder with dementia should take a tranquilizer such as Xanax/Alprazolam; it is short-acting and very addictive. These medications may be very calming at first, but may actually lead to more agitation in the long run. This is also true of alcohol. Minimize alcohol at family gatherings, or water it down for elders with agitation. Try non-alcoholic beer. If you're concerned about tranquilizers or alcohol, remember that they can't be stopped abruptly. If you think there's a problem, keep in mind that it needs to be solved gradually.
  • Remember that large gatherings can be challenging for those with dementia. Don’t expect a loved one who cannot sit for long at a restaurant to be able to manage with everyone. Perhaps your elder can join for part of the festivities, and then rest in an adjoining room on the side, where guests can visit for twenty minutes. If your elder gets upset, it may be time for them to go home.

Rituals, families, feasts; these are what make life more meaningful. Dementia doesn't put an end to enjoying these things. Small changes can make the holidays happier for all.
Please send any questions or comments to the Community Chat page on our web site- just click on the button on the top right that says “Ask A Question” And Happy Holidays!

Elizabeth Landsverk, MD
Geriatric Specialist