THE GERIATRIC HOSPITAL & MEMORY CLINIC

The Raul Blanco Cervantes geriatric hospital was originally the Tuberculous hospital and in 1989 when specialized hospitals where established, it converted to a teaching and research center for geriatrics. In 1992 under collaboration with the CCSS, a residency program was established with the School of Medicine of the University of Costa Rica.

This hospital is a shining light among the National health care system hospitals in Costa Rica. Yes, it gets as crowded as the other CAJA hospitals but the quality of care and attention is given to the seniors seeking medical assistance is exemplary. The staff is conscientious and kind and even with the normal waits, at noon everyone, including the person accompanying the senior, gets a complimentary cup of hot soup and crackers to nourish them and boost their spirits.

It is challenging for most seniors with chronic conditions to go through regular Ebais clinics in their areas. Every consultation they see a different doctor, usually one just graduated from medical school, and with only get 15 minutes per consultation the doctor usually doesn’t have time to completely review their history. Also, for specialized tests they are sent to different hospitals and clinics, the dates are usually months away, and often test results get lost and have to be repeated.

The geriatric hospital is a one-stop facility with its own diagnostic clinic where the patient’s history is thoroughly reviewed, and most testing is done at the hospital. To qualify for Blanco Cervantes, you must be affiliated with the CAJA, be over 60, have a chronic condition, and get a referral from your Ebais clinic in which you present to the hospital for a doctor’s review and soon after, they will let you know if your condition qualifies.

They offer an array of specialists such as gastroenterologists, ophthalmologists, cardiologists, and oncologists. However, unfortunately, they don’t have orthopedic services available.

Their neurology service is an integral part of what they offer, and their Memory Clinic has been a pioneer in neurological services in the country. They evaluate, diagnose, and treat those experiencing memory issues, mild cognitive decline, or dementia. Presently there is an estimated 20,000 to 25,000 with dementia in this country. But because many people aren’t diagnosed, that number could be much higher.

The clinic was established in 2007 by gerontologists Dr. Erik Miranda and Dr. Daniel Valerio, and operates using the international protocols set by Mount Sinai Hospital in New York City. All cases include testing of blood, kidney and liver function, electrolytes, thyroid, HIV, vitamin B12 deficiency and folic acid, a CT brain scan, and when warranted, an MRI. Their interdisciplinary team of specialists in cognitive decline includes geriatricians, neurologists, and psychiatrists, who in together assess each week the individual cases and render a diagnosis and treatment once all testing is complete.

Memory clinics are beginning to appear in Hospitals like San Juan de Dios, however, only Blanco Cervantes uses the Mt. Sinai methodology of diagnoses by a consortium of neurological specialists.

When diagnosed with Alzheimer’s or another related dementia, the patient and their family attend an educational program on dementia and are referred to the physical and cognitive therapy clinic designed to help improve and slow memory decline and the cognitive and physical disabilities associated with dementia.

In 2014 the memory clinic created a study on dementia in Costa Rica for the Europe PMC, an open science platform that enables access to a worldwide collection of life science publications from around the world. In this study, they identified and analyzed the main types of dementia and mild cognitive decline in a memory disorders unit under the social security health system in Costa Rica. Unfortunately, the numbers compiled in that study have increased 3-4x more in the last years; no other study has since been conducted.

Medical students from the University of Costa Rica practice their residency for 3-4 months at the hospital which gives them experience working with seniors and their medical issues. Unfortunately, their time spent at the memory clinic is minimal and doesn’t give them a comprehensive understanding of dementia.

The numbers and information on dementia compiled by the memory clinic are sent to the Ministry of Health. There a database on dementia in Costa Rica is in the process of being developed. This data will eventually be available to health practitioners throughout the country.

Dr. Valerio expressed how in rural areas, there is a scarcity of professionals educated in dementia, and often the elderly with the beginnings of this condition are told it’s a normal part of aging. It is not. The importance of the extensive testing done at the memory clinic helps doctors to reverse the treatable dementia causes and provide medications and procedures to slow symptoms in the incurable causes like Alzheimer’s.

Dr. Valerio pointed out that not all cognitive decline is uncurable or progressive, so early diagnosis is essential. For instance, many seniors have a Vitamin B12 deficiency that can create dementia-like symptoms and is reversible with a monthly injection. Thyroid imbalance and alcohol-induced dementia are also correctable.

Many ex-pats are seniors and over 65, and many may eventually experience some level of memory loss or cognitive decline. As residents, by law, you are required to join the CAJA healthcare, and this gives you eligibility to use the geriatric hospital and their memory clinic services.

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