The Minneapolis Geriatric Research, Education and Clinical Center integrates high-quality, cost-effective models of clinical care, basic and applied research, and geriatric education with existing Department of Veterans Affairs and community programs and resources.
To improve the delivery of health care to elderly Veterans through a multidisciplinary program emphasizing disorders of the aging nervous system.
The Minneapolis GRECC was established in 1978. It currently serves elderly Veterans in VISN 23, which spans Minnesota, Iowa, Nebraska, and the Dakotas. In fiscal year 2013 the Minneapolis GRECC published 54 peer reviewed papers, provided 2,745 person hours of geriatric education, and expended $4,514,279 in research awards. Its current research interests include: clinical trials in Alzheimer's disease; animal models of Alzheimer's disease; brain imaging and biological markers of dementia; assessing the driving ability of dementia patients; and new models of delivering care.
The GRECC Clinical Program seeks to distinguish, define and disseminate the best ways to identify and treat dementia. We manage a clinical service, conduct clinical studies and train other health care professionals in geriatric-focused medicine and research. The clinical staff includes a neurologist, geriatric psychiatrist, internist, social worker, occupational therapist and psychometrist. Affiliated staff includes geriatricians, neuropsychologists and geriatric clinical pharmacists.
Memory Clinic -- GRECC operates a half day clinic on Thursdays where patients are seen who have been referred from Primary Care. GRECC uses a multi-disciplinary approach to patient care, so each new patient is seen by a physician, pharmacist and social worker. The physician takes a medical history and performs an exam focusing on memory and mental ability. The social worker discusses the home environment with the patient and caregiver to determine personal safety, family functioning and coping skills. (Referrals to community agencies are made if needed.) The pharmacist reviews the patient's medications and makes recommendations if medication concerns are noted. The entire appointment lasts about two hours. For the new patient, a typical treatment plan includes these sessions as well as screening labs/blood work, a functional assessment, brain MRI and possibly neuropsychological testing. A driving referral is made if there is concern about driving safety. Patients are followed at six-month and annual intervals. Since GRECC is a specialty clinic, patients with other medical problems are referred to the appropriate service within the VA or to their private physician.
Occupational Therapy Clinic -- In this clinic, Veterans are evaluated with the Cognitive Performance Test (CPT), a standardized assessment that measures cognition associated with daily living activities. The CPT uses seven common tasks (Medbox, Shop, Wash, Toast, Phone, Dress and Travel) where the information-processing demands are systematically varied to assess functional capacity levels. CPT scores predict capacity for managing medications, meals, finances, driving and independent living. Caregivers observe the assessment to educate themselves about their loved one's capabilities and needs. Assessments are performed annually to measure change and adjust the Veteran's care plan. The CPT provides the functional diagnosis and stage for the diagnostic work-up.
Family Meeting Clinic -- Once a work-up has been completed, GRECC staff review the results at a consensus diagnosis conference. After a diagnosis is made, a meeting is scheduled to discuss the diagnosis and next steps with the patient and family. The patient's physician and the Occupational Therapist attend the meeting to answer any questions raised by the Veteran or family. If the Veteran is to continue to be seen in the GRECC Clinic, a follow-up appointment is scheduled.
Service Connected Clinic -- Since the GRECC Clinic operates just one day a week, an intermittent clinic is offered to enable service-connected Veterans to be seen within the 30 day window prescribed by the VA. Physicians from GRECC staff the clinic; other appointments are made to ensure that Veterans are seen by GRECC affiliates including Pharmacy, Social Work, Occupational Therapy and Psychometry.
Research Clinic -- GRECC conducts clinical research studies and appropriate patients may be invited to participate. Participation is not a requirement for treatment in GRECC; study participation is strictly voluntary. It is our hope that GRECC research will help Veterans and their families assist us in educating other health care professionals about memory loss and its treatments. Contact Susan Rottunda at 612-467-3345 if you would like more information about research studies that involve Veterans. Or email us at firstname.lastname@example.org. For aging-related research studies for non-veterans, contact the Alzheimer's Association at www.alz.org/research/clinical_trials/find_clinical_trials_trialmatch.asp.
The Minneapolis VA GRECC offers a variety of educational opportunities for professionals and the public.