Dementia & Memory Care
Three Rivers Concierge Medicine, Internal Medicine Physicians located in Creve Coeur, MO
Dementia is a challenging condition that affects memory, cognitive function, and daily activities. At Three Rivers Concierge Medicine, Dr. Kathryn Shoemaker offers comprehensive care for patients with dementia, focusing on early diagnosis, treatment, and ongoing management. With a holistic approach to dementia care, we provide not only medical treatment but also emotional and practical support for patients and their families.
Dementia Care Q & A
What is Dementia?
Dementia is an umbrella term for various cognitive impairments that affect memory, thinking, and behavior. It is often caused by brain cell damage that leads to progressive decline in mental functions. Common symptoms of dementia include:
- Memory loss
- Disorientation and confusion
- Difficulty with communication and problem-solving
- Mood swings, including anxiety or depression
- Changes in personality and behavior
While the severity and progression of dementia can vary, it is crucial to seek medical advice early to manage the condition effectively and improve the quality of life.
What Causes Dementia?
Dementia is caused by damage to nerve cells in the brain, and the underlying conditions responsible can vary. Some common causes include:
- Alzheimer’s disease: The most common cause of dementia, characterized by the buildup of abnormal proteins in the brain.
- Lewy body dementia: A type of dementia marked by abnormal protein deposits in brain cells.
- Vascular dementia: Results from reduced blood flow to the brain due to conditions like stroke.
- Frontotemporal dementia: A less common form of dementia that involves the progressive degeneration of the frontal and temporal lobes of the brain.
In some cases, dementia can be linked to treatable conditions like hormonal imbalances, metabolic disorders, or infections. Early intervention is key to addressing these causes.
How is Dementia Treated?
While there is no cure for most forms of dementia, treatment focuses on slowing the progression of symptoms and improving the quality of life for patients. At Three Rivers Concierge Medicine, Dr. Shoemaker offers both conventional treatments and alternative approaches. Treatment options may include:
- Medications: Drugs such as cholinesterase inhibitors or memantine can help improve cognitive function or slow symptom progression.
- Therapeutic interventions: Non-pharmacological treatments like music therapy, art therapy, and cognitive therapies help patients manage daily tasks and emotions.
- Lifestyle changes: Modifying the environment to reduce stress and ensuring a structured routine can greatly benefit individuals with dementia.
Dr. Shoemaker is also trained in the Bredesen Protocol, a holistic approach to dementia care that includes personalized treatment plans, cognitive assessments, and lifestyle modifications aimed at improving brain health.
How Can Families Support Loved Ones with Dementia?
Supporting someone with dementia can be challenging. Dr. Shoemaker works closely with families to provide emotional and practical support, offering guidance on how to communicate effectively with loved ones, create a safe environment, and manage symptoms. Coping strategies for caregivers are also an essential part of the dementia care process, and ongoing education helps families navigate the journey ahead.
Frequently Asked Questions
Do you specialize in dementia care?
Dr. Shoemaker provides comprehensive dementia evaluation and management within the primary care setting, including early cognitive screening, diagnosis, medication management, and coordination with neurologists when needed. Three Rivers Concierge Medicine in Creve Coeur takes a whole-person approach that includes the Bredesen Protocol — a holistic, evidence-informed framework for brain health that addresses lifestyle, nutrition, and metabolic factors alongside conventional treatment. This integrated model means your cognitive care isn't siloed from your overall health management.
What is the Bredesen Protocol?
The Bredesen Protocol, developed by Dr. Dale Bredesen and detailed in research published in the journal Aging, is a personalized approach to cognitive health that identifies and addresses the multiple factors contributing to cognitive decline — including metabolic dysfunction, inflammation, hormonal imbalances, nutritional deficiencies, and toxic exposures. Rather than relying solely on medication, it combines targeted lifestyle modifications, dietary changes, supplementation, and medical interventions based on your individual assessment. Dr. Shoemaker is trained in this protocol and integrates it into her primary care approach at Three Rivers.
Can dementia be detected early?
Yes — according to the Alzheimer's Association, cognitive changes often begin years or even decades before a clinical dementia diagnosis, and early detection allows for interventions that may slow progression and preserve function longer. Dr. Shoemaker incorporates cognitive screening into routine evaluations and investigates treatable causes of memory concerns, including thyroid dysfunction, vitamin deficiencies, sleep disorders, and medication side effects. At Three Rivers in St. Louis, we take memory concerns seriously at any stage rather than waiting for them to become severe.
How does concierge medicine help families dealing with dementia?
Dementia affects the entire family, not just the patient — and the concierge model provides the time, access, and continuity that this situation demands. Dr. Shoemaker works closely with family members and caregivers, providing education, emotional support, and practical guidance on communication strategies, safety modifications, and care planning. Direct physician access means families can reach Dr. Shoemaker when urgent questions arise, not wait for a callback days later.
What treatments are available for dementia?
While there is no cure for most forms of dementia, treatments can slow progression and improve quality of life — including cholinesterase inhibitors, memantine, and newer FDA-approved therapies like lecanemab (Leqembi) for early Alzheimer's, along with lifestyle modifications, cognitive therapies, and complementary approaches like music and art therapy. Dr. Shoemaker tailors treatment to the specific type of dementia and the individual patient's needs and goals. At Three Rivers in Creve Coeur, we combine conventional medical treatment with the Bredesen Protocol's holistic framework.
When should I be concerned about memory changes?
If you or a loved one notices persistent difficulty with word recall, misplacing items frequently, trouble following conversations or instructions, personality changes, or difficulty with familiar tasks, it's worth discussing with a physician. Not every memory lapse indicates dementia — stress, sleep deprivation, medication side effects, and hormonal changes can all impair cognition. Dr. Shoemaker at Three Rivers evaluates the full picture to determine what's driving the change and whether intervention is warranted.
