As a home care agency dedicated to improving the lives of elderly clients, we all understand the profound challenges families face when caring for loved ones with dementia. Behavioral symptoms such as agitation, paranoia, anxiety, depression, and other psychiatric issues not only interfere with caregiving but also diminish the quality of life for those affected.

To address these challenges, a home care agency in Maryland has adopted a strategy that integrates geriatric psychiatry into its care model.

They’ve done this specifically through a partnership with a local geriatric psycho-pharmacologic house calls practice inspired by Olney Psychiatry, founded by Dr. Nicholas Schor, MD in Olney, Maryland, who treats dementia patients in their homes (or facilities).

This home care approach, led by Andrea Kohn, RN, CRNP, founder, medical director, and co-owner (along with husband, Steve) of Medical Consulting and Management in Rockville, Maryland, combines holistic care and caregiver oversight along with cutting-edge genetic testing to deliver personalized solutions for dementia patients and their families.

The Role of Geriatric Psychiatry and Pharmacology in Dementia Care

Geriatric psychiatry and pharmacology focus on the mental health needs of older adults, particularly those with cognitive impairments like dementia. Behavioral symptoms associated with dementia can be overwhelming for families and caregivers, often leading to frustration and burnout.

By incorporating psychiatric expertise into home care, they help alleviate these challenges and improve the overall well-being of both patients and their families.

Their approach emphasizes collaboration between caregivers, families, and psychiatric professionals to create tailored care plans.

This includes addressing behavioral symptoms through medication management, therapeutic interventions, and caregiver education. The goal is to reduce suffering, enhance the quality of life, and foster a supportive environment for dementia patients.

Genetic Testing: A Game-Changer in Psychiatric Care

One of the most innovative tools they rely on is genetic testing, specifically through GeneSight. This pharmacogenomic test analyzes a patient’s DNA to determine how they metabolize various psychiatric medications.

By identifying genetic variations, GeneSight provides valuable insights into which medications are likely to be effective, which may require dose adjustments, and which could pose risks of side effects. This eliminates the trial-and-error approach often associated with prescribing psychiatric medications, leading to faster and more accurate treatment with fewer side effects.

For dementia patients, genetic testing is particularly beneficial. Many individuals with dementia experience heightened sensitivity to medications, making it crucial to find the right balance. GeneSight’s comprehensive report helps clinicians like Andrea Kohn, RN, CRNP prescribe medications that align with the patient’s unique genetic profile, ensuring optimal outcomes and greater success with caregivers.

Addressing MTHFR Deficits

Another critical aspect of genetic testing is identifying MTHFR gene mutations, which can impact the body’s ability to process folate — a key nutrient for brain health. According to WebMD, MTHFR mutations can lead to elevated levels of homocysteine, an amino acid associated with increased risk of cognitive decline and psychiatric symptoms.

For patients with MTHFR deficits, supplements like L-methylfolate can be prescribed to enhance medication efficacy and support overall brain function.

By addressing MTHFR deficits, they can further refine treatment plans for dementia patients, ensuring they receive the nutrients and medications necessary for improved mental health and cognitive stability, as well as the highest quality of life possible.

Holistic Care: Beyond Medication

While pharmacologic interventions play a significant role, their approach to geriatric psychiatry extends beyond medication. Andrea Kohn, RN, CRNP emphasizes holistic care, incorporating lifestyle modifications, therapeutic activities, and caregiver support into treatment plans.

This includes:

• Behavioral Therapy: Techniques to manage agitation, anxiety, and depression, helping patients feel more at ease.
• Cognitive Stimulation: Activities designed to engage the brain and slow cognitive decline, such as puzzles, memory games, and creative tasks.
• Caregiver Education: Training caregivers to recognize and respond to behavioral symptoms effectively, fostering a more harmonious caregiving environment.
• Family Support: Providing families with resources and guidance to navigate the complexities of dementia care and how to respond to their loved ones.

Collaboration with Families and Care Teams

One of the most challenging aspects of dementia care is helping families who feel overwhelmed and uncertain about how to support their loved ones. Their geriatric psychiatry model prioritizes collaboration, ensuring families are actively involved in the care process. This includes regular communication, shared decision-making, and access to educational resources.

By working closely with families, they can address their concerns, provide reassurance, and empower them to take an active role in their loved ones’ care. This collaborative approach not only improves outcomes for patients but also reduces stress and anxiety for families.

The Impact on Caregiving

Integrating geriatric psychiatry into home care has transformative effects on caregiving. Caregivers often struggle to manage behavioral symptoms, leading to burnout and reduced effectiveness.

With the support of psychiatric professionals and tools like GeneSight, caregivers can feel more confident and equipped to manage challenges. This reduces caregiver stress and enhances the overall quality of care provided by reducing turnover among staff.

Conclusion: Applying This Strategy in Your Agency

As the demand for specialized dementia care grows, home care agencies across the country are looking for ways to provide deeper support to both families and caregivers. The integrated model developed by Andrea and Steve Kohn at Medical Consulting and Management offers a powerful example of what’s possible when geriatric psychiatry, genetic insights, and holistic support are combined.

While not every agency has immediate access to in-home psychiatric providers or pharmacogenomic tools, there are steps any agency can take to begin shifting toward this model:

• Form partnerships with local geriatric specialists or mobile psychiatric services
• Explore pharmacogenomic testing providers to support more personalized medication plans
• Train your caregivers and families on behavioral symptom management and emotional support
• Build multidisciplinary teams that include both medical and non-medical perspectives
• Keep communication open with families to ensure collaborative, compassionate care

By embracing a more holistic and personalized approach to dementia care, home care agencies can improve outcomes, reduce burnout, and offer peace of mind to the families they serve.

More About Medical Consulting and Management (MCM)

Medical Consulting and Management (MCM) was founded in 2004 to help families navigate the complexities of healthcare and face difficult life decisions with greater clarity — all while remaining safe, comfortable, and strong at home.

🔹 MCM’s Expertise and Specialization

Andrea Kohn brings over 35 years of experience in the Washington, D.C. metro area’s long-term healthcare system.

MCM specializes in geriatric psychiatry and managing complex cases related to Alzheimer’s, Parkinson’s, dementia, and many other comorbidities.

🔹 Our Holistic Care Philosophy

MCM takes a comprehensive approach to care, addressing not just medical needs, but also social, emotional, and family dynamics.

This holistic model ensures clients receive well-rounded, personalized support.

🔹 Local Roots and Community Insight

Andrea and Steve Kohn have deep roots in Montgomery County, Maryland.

Their local expertise allows them to navigate the area’s healthcare landscape effectively for their clients.

🔹 Family Liaison Services

MCM acts as a bridge for families during healthcare complications — whether at home, in hospitals, or rehab facilities.

They maintain clear communication with physicians, caregivers, and family members to keep everyone aligned and informed.

🔹 Andrea’s Empowering Book

Andrea Kohn is the author of “Return to Sender: A Collection of Medical Advocacy Stories Through the Eyes of a Nurse” — available on Amazon.com.

The book offers powerful, real-world stories and tools to help families advocate effectively during complex medical situations.

🔹 Efficient Communication & Team Collaboration

MCM’s team of CRNPs and RNs collaborates with a staff of over 200 caregivers.

They coordinate closely with doctors, therapists, and other healthcare professionals for streamlined care and faster outcomes.

Article Done by: Steve Kohn

Contact MCM

For more information, please contact Medical Consulting and Management at (301) 424-5539

or info@mcmhomehealth.com (www.mcmhomehealth.com).