Medical Guide: Dementia, ADHD and Dental Care

Check out three stories that ran in the December Medical Guide issues of Alameda and Oakland Magazines. I would like to thank everyone I interviewed for these pieces.

Here are the articles, which I will split into three separate posts (eventually).


Coping With Dementia

Warning Signs


    It was about six years ago, while longtime Alameda resident Robert “Bob” McPeak was enjoying his retirement, when his family began to notice some changes in his behavior.
    “Slowly, over time, we noticed that he was growing more forgetful and where he once was really self-motivated to get things done—projects around the house, for example—it was taking some prodding and nagging on our part to get him to accomplish things,” explains Paula Whitton, his daughter.
    As time progressed and the situation worsened, Whitton and her family had McPeak, 78, undergo a comprehensive series of medical tests and psychological assessments. First, his doctors labeled his condition mild cognitive impairment. Eventually, he was diagnosed with Alzheimer’s disease, a brain disorder first described by German physician Alois Alzheimer in 1906 and the most common form of dementia.
    Dementia is the broad term for a general decline in a person’s mental abilities that is severe enough to interfere with daily living and activities. It affects memory, problem solving, learning and other mental functions. A variety of conditions fall within the category of dementia, including injuries to the brain from tumors, head injury or stroke; diseases, such as Alzheimer’s or Parkinson’s; or long-term alcohol dependence. Often, depression is mistaken for dementia, especially in older patients.
    Roberta Tracy, program director of the Oakland-based Bay Area Community Services Adult Day Care, has been a social worker in senior services for more than 20 years. Bay Area Community Services operates Adult Day Health Care programs in Berkeley, Hayward and Oakland, which provide compassionate care for seniors with dementia.
Tracy lists many warning signs, including:
    • Recent memory loss;
    • Difficulty performing daily tasks;
    • Problems with language—confusing everyday words or using wrong words (Tracy had one patient who kept “saying ‘air’ when she really meant ‘water’.”);
    • Not knowing the time, date or where they are;
    • Getting lost easily;
    • Poor judgment, such as forgetting to put on a coat when it’s cold outside;
    • Trouble with abstract thinking, such as being unable to balance a checkbook;
    • Confusion involving everyday items, such as putting the teapot in the freezer;
    • Extreme mood swings and personality changes with no explanation.
    “Sometimes these signs are coupled with depression because the patient is aware of what’s happening to them,” Tracy explains. Often the patient’s spouse works hard to compensate for the symptoms, too.
    Whitton corroborates Tracy’s observations by citing examples with her father.
    “He would get frustrated easily and react by being annoyed and cranky, which is really unlike him. He’s always been very happy-go-lucky,” she says.
    Once family members realize that there might be something wrong, Tracy says it’s important to get early diagnosis to get the right treatment. 
    “Sometimes these symptoms can be caused by over-medication or mixing the wrong medications, and it’s critical to rule these situations out,” says Tracy.
    Through early detection, McPeak’s doctors carefully prescribed medication to combat the advancing symptoms of his disease. And, although there is no cure for Alzheimer’s disease, paying attention to the warning signs—and then acting on them—has given the McPeak family a little more enjoyable time together.

Closer to Home

Alzheimer’s Services of the East Bay, Berkeley: (510) 644-8292; Hayward: (510) 888-1411; Oakland: (510) 268-1410


General Resources

When Your Loved One Has Dementia: A Simple Guide for Caregivers, by Joy A. Glenner, Jean M. Stehman, Judtih Davagnino, Margaret Davagnino, Margaret J. Galanter and Martha L. Green; 2005.

What If It’s Not Alzheimer’s?: A Caregiver’s Guide to Dementia, by John Q. Trojanowski, M.D., Lisa Radin and Gary Radin; 2008.

Health Agencies and Web Sites
Alzheimer’s Association,, (800) 272-3900

Family Caregiver Alliance,, (415) 434-3388,


Attention Deficit Hyperactivity Disorder

Tools for Understanding

Attention Deficit Hyperactivity Disorder

    Ryan (not his real name) was frustrated. Before he was diagnosed with ADHD—Attention Deficit Hyperactivity Disorder—he struggled to get through each day in the classroom and then each night trying to focus on getting all his homework finished. Like most children diagnosed with ADHD, Ryan has difficulty with attention and learning, which can lead to additional problems in behavior, social skills and self-esteem. His mother, also frustrated, worked diligently with Ryan’s teachers and schools to have him tested and diagnosed, and to get him the right tools to succeed.
    “It’s a full-time job sometimes. Kids are mislabeled as bad kids and disruptive when it’s not their faults,” says Ryan’s mom. “ADHD kids need tutors and extra attention. They are dealing with low self-esteem and depression—all while just trying to be a normal kid.”
    Depending on which expert you ask, anywhere from 3 percent to 8 percent of school-age children are affected by attention-related difficulties, the result of a neurobiological disorder related to problems with the dopamine neurotransmitter systems in the brain.
    Symptoms of ADHD are many and far ranging, making the disorder difficult to diagnose. Ryan’s mother notes that he had a poor attention span, weak impulse control and hyperactivity or restlessness. Other symptoms include fidgeting, 
blurting out and interrupting, forget-fulness, difficulty organizing, and avoiding activities that require long periods of concentration (like homework). 
There are several subgroups of ADHD; not all include hyperactivity.
    “Many parents don’t want their children to be labeled ADHD. As a parent, you don’t want your kid to be different in any way, and you want them to be successful,” says Mary Lanctot, a special resource teacher in Alameda. However, she notes, diagnosis is the first step to getting ADHD children on track for success in school and life skills.
    Poor nutrition, ineffective parenting, drugs or allergies do not cause ADHD. There are other medical conditions that can cause ADHD-like symptoms (such as severe head trauma, thyroid problems, fetal alcohol syndrome and lead intoxication). A professional evaluation should be obtained to rule out other medical conditions and to diagnose the issue properly. In some cases, doctors will prescribe medications to 
alleviate the extreme symptoms of the disorder and help get students on track. Other aids include behavior modification and working with parents and schools.
    “It can make a world of difference when a parent works together with the teacher to help the student,” Lanctot says, adding that taking care of the disorder will help prevent absences from school, as well as serious social and behavioral problems as children grow older.
    Lanctot believes that much can happen in the classroom to help ADHD kids stay organized and complete important tasks. These tips work for both teachers and parents:
    • Make eye contact with the child.
    • Have the child sit close to the teacher and close to the parent/tutor when working on schoolwork.
    • Understand what kind of learning styles the child uses—is he visual, auditory or tactile/kinesthetic?
    • Be very specific when giving instruction or directions.
    Getting the help he needed has made an incredible difference in Ryan’s performance at school and in his day-to-day life, but that’s not the end of the story. 
    “This is something that he will always be working on,” says his mom. “We’ll be working on it together.” 

Closer to Home

CHADD of Alameda County,, (510) 581-9941

East Bay Learning Disabilities Association,, (510) 433-7934

AD/HD Awareness Week (September) 

General Resources

How to Reach and Teach Children with ADD/ADHD: Practical Techniques, Strategies, and Interventions,by Sandra F. Rief, M.A.; 2005.

Parenting Children With ADHD: 10 Lessons That Medicine Cannot Teach (APA Lifetools), by Vincent J. Monastra, Ph.D.; 2004.

Health Agencies and Web Sites
Attention Deficit Disorder Association,, (856) 439-9099

Children and Adults With Attention Deficit/Hyperactivity Disorder,, (301) 306-7070

All Kinds of Minds,, (888) 956-4637

OneADDplace: The Source for ADD and ADHD Information,

The National Resource Center on AD/HD,


Your Family Dentist

The First Line of Defense

Your Family Dentist

    When Don Trester visits his dental hygienist, Jo Ann Galliano, three times each year, he knows that he is doing more than just getting his teeth cleaned—he is setting up his first line of defense in his overall healthcare.
    Galliano checks his glands, takes his blood pressure, checks his mouth and gums for lesions and works on getting him to stop smoking and chewing gum. Trester, who lives in Alameda and is a transportation engineer for the city of Oakland, relies on these regular visits to Galliano to help keep him in good health.
    “She is very thorough and diligent about checking for things in my mouth, looking for any signs of trouble,” Trester says. Galliano sends him to his doctor as soon as she spies anything suspicious.
    “The hygienist is usually the first level of detection for a number of health issues,” explains Galliano, program director for the Chabot College dental hygiene program and a private practice hygienist in Alameda. “Research shows that oral health and system health are intrinsically linked. As a result, we’ve started to change the mentality that dentists and hygienists only deal with the mouth.” 
    According to studies conducted by the American Academy of Periodontology, the mouth-body connection is strong, indicating that periodontal bacteria can enter the blood stream and travel to major organs and begin new infections. This situation contributes to heart disease and increases the risk of stroke as well as the risk of giving birth to a preterm, low-birth-weight baby for women. It also poses a serious threat to anyone whose health is compromised by diabetes, respiratory diseases or osteoporosis. New studies also indicate a link between oral hygiene and rheumatoid arthritis.
    “We used to think that bad teeth and a bad heart were just the result of bad eating—that heart problems and gum problems were tied to a bad diet,” says Alameda dentist William Gardner. “But now we know that there is a definite link between coronary/heart disease and periodontal [gum] disease. We’ve found that these diseases are managed better if teeth are cleaned regularly. Helping control one helps the other,” Gardner notes. In addition to systemic disorders, dental health practitioners can help detect melanomas (skin cancer) in the mouth and provide solutions to alleviate the pain of some types of migraine headaches.
    Both Galliano and Gardner insist that they are not medical physicians and do not diagnose illness or disease.
    “We provide information and refer patients to their physicians. We try to get them to go to the doctor, but it’s really up to them to follow up,” says Galliano.
    And though Galliano hasn’t convinced Trester to completely stop smoking (he’s down to just six cigarettes a day), she did get him to stop chewing gum. But, having her as his first line of medical defense is something he can still sink his teeth into.

Closer to Home

California Dental Hygienists’ Association,, (818) 500-8217


General Resources

Things You Should Know About Teeth: A Dental Health Guide, by Benjamin Lee, B.D.S., 2007.

Health Agencies and Web Sites
American Dental Association,, (312) 440-2500

American Dental Hygienists’ Association,, (312) 440-8900

American Academy of Periodontology,, (312) 787-5518


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