San Francisco Bay Area Dementia Experts


Older individuals have unique medical needs. They are less physically robust.  They commonly suffer from underlying emotional or medical issues, such as depression, dementia or delirium. This can complicate treatment. Most of these older individuals also cope with chronic conditions, such as intractable pain or limited mobility. These problems may lead to a quicker decline if not treated promptly. In addition, most older people live with legal, financial or family issues that may complicate an already challenging medical situation.

Our physicians have specialized training and experience in the unique medical needs of elders, as well as expertise in treatment dementia. Contrary to popular belief, just treating specific diseases may not always result in an improved quality of life; instead, this piecemeal approach often leads to increased complications. As we treat each patient and each condition, it’s important to consider the whole picture: medication side effects, mood, ability to function, chronic pain, engagement with life.

Our medical techniques are based on the knowledge of our experienced doctors, who have a holistic approach. We understand the unique challenges older individuals face. We incorporate a complete review of available records, physical examination, evaluation of memory and cognitive function. We screen for depression and other mood or behavior problems. We also perform in-depth consultations with the patient, caregivers, physicians and family members.

Our particular expertise is in working to calm elders experiencing behavioral problems arising from conditions such as Alzheimer’s disease or other dementias (dementia is not just one disease; it has many causes.) Elders living with dementia often can be difficult to manage, especially if they become agitated or aggressive. By using behavioral techniques and carefully calibrating medication, we can often improve the quality of life for those with challenging behaviors.

Following a consultation, we provide a detailed report to the person assessed, and if desired, to a care facility, physician or family. At ElderConsult, we do not simply treat diseases. We treat the entire person. From initial consultation through continuing care, our patients receive compassionate, holistic treatment.

What to Expect at the Consultation

Our primary service is a comprehensive examination by a medical professional who specializes in the diagnosis and treatment of older individuals. This assessment is a thorough evaluation of every area of an elder’s life: health, mental and emotional status, functionality and overall well-being.

This examination compliments the work of a primary care physician in the same way that a patient with a heart problem consults with a cardiologist or a person with a hip problem sees an orthopedist. Unlike an orthopedist, however, we examine the entire patient rather than one organ or one physiological system.  Elders, particularly those with memory or cognition issues, present special medical challenges that our expertise and experience can diagnose and treat.

Our consultation integrates all the available information about a patient into a single, complete set of conclusions and recommendations. An elder  is often treated and assisted by a number of different doctors, who may communicate with one another infrequently, or not at all. In this situation, it is difficult for the patient’s family to develop an accurate understanding of the challenges the patient is facing, and what the patient’s prognosis may be.

This is particularly important when thinking about quality-of-life or end-of-life issues. Without a comprehensive evaluation by a geriatric expert, families must make difficult decisions without a clear sense of an elder’s condition, capabilities or prognosis. We strive to address the concerns of the elder, their family or caregivers to help the elder enjoy their days and engage as fully as possible in meaningful endeavors.

What to Expect During Follow-up and Continuing Care

We strongly advise a follow-up visit or visits to benefit the most from our services. Because elders are far more sensitive to medication, it may take  several adjustments over a period of time to determine the proper dosage for an individual. The most difficult challenge is the change of medications for agitation, especially tapering of Ativan®, Xanax®, and sleeping pills, which often takes months.

The process can be complicated, and demands close supervision. Improperly done, it can result in delirium and/or agitation. In other cases, follow-up several days or weeks after the initial visit is a good idea, whether the goal is to create an exercise program, or to improve appetite.

Communication with ElderConsult Providers

Communication with patients, family and all caregivers is a priority. We have a HIPPA compliant Patient Portal system that will allow non-urgent email communication through a secure system. This will be discussed at the time the initial appointment is made.