A Caregiver’s Perspective: How a Multidisciplinary Care Team Supports Dementia and Depression

Frank, a memory care assisted living resident at NewBridge on the Charles in Dedham, MA, first began experiencing symptoms of depression around 15 years ago.

After years of limited success with various depression treatments, his symptoms have recently improved under the care of the team at Hebrew SeniorLife’s Deanna and Sidney Wolk Center for Memory Health. Because Frank has been diagnosed with Alzheimer’s disease, Carol, his partner and caregiver, has offered to share their journey and the transformative impact of Hebrew SeniorLife. (Names have been changed to protect patient privacy.) 

Receiving a dual diagnosis 

In 2010, Frank sought out the care of a psychiatrist after he developed depression while experiencing extreme work-related stress. “The depression at that time was likely coinciding with mild cognitive impairment, but the timeline is fuzzy. It was hard to tease out which one came first,” explains Carol. He was hospitalized and diagnosed with severe depression and pursued therapy and medication.  

He received electroconvulsive therapy, or ECT, in 2012. ECT is a depression treatment where small electric currents are sent to the brain. “All of a sudden, he was doing much better! For a few years, he was being treated by a psychiatrist and on medication and was doing relatively well. However, it was clear that his cognition was getting worse,” says Carol.

The isolation from the pandemic was difficult for Frank, leading to a second depression-related hospitalization. It was during that hospitalization that doctors began the testing process that would eventually lead to his Alzheimer’s diagnosis. While the medical treatment they received was high-quality, they didn’t receive much guidance about what came next after the diagnosis.

Additionally, Frank’s decline quickened after his diagnosis. After a safety-related incident made it clear that he couldn’t continue living at home, Carol began to search for options. “I looked into many places, and it was very clear that NewBridge had the best memory program,” she says. He’s been living in the community for two years as of February 2025. 

Connecting with the Wolk Center for Memory Health 

As a resident of NewBridge on the Charles, Frank has access to Hebrew SeniorLife’s Harvard Medical School-affiliated specialized geriatric primary care practices. Dr. Matthew Shuster, one of the on-site primary care geriatricians, told Frank and Carol more about what the Wolk Center for Memory Health could offer them. “He really understands seniors, and he’s very caring. I’m so thankful for Dr. Shuster,” says Carol.

As a memory clinic with a multidisciplinary team, the Wolk Center for Memory Health provides outpatient care for brain health, cognitive and behavioral problems, and memory loss. You don’t have to be a Hebrew SeniorLife resident to become a patient. However, as part of the Hebrew SeniorLife umbrella, care at the Wolk Center for Memory Health seamlessly integrates into the offerings for residents across our locations.

“Once we started the evaluation process with Frank at the Wolk Center, I started feeling so much better. I’m hugely grateful for the team approach, which has made all the difference in the world. I felt like it wasn’t just one person telling me he had Alzheimer’s but that nothing could be done. Instead, it was more, ‘Yes, he has Alzheimer’s, but we can work with him, and we can work with you, too,’” says Carol.

Despite feeling nervous about the change, they shifted Frank’s psychiatry care to the Wolk Center for Memory Health. “We had lost the psychiatrist we were accustomed to, and Dr. Mohit Chopra became his psychiatrist. That piece of his care has been wonderful. I think we’ve been seen by Dr. Chopra probably 20 times now,” she explains.

Carol also appreciates how appointments aren’t rushed, giving Frank the time and space he needs to express himself. “It’s not a 10-minute session or some designated amount of time. If more time is needed, Dr. Chopra continues. That’s been wonderful because you don’t feel like you’re just cut off, especially with Frank being slowed down. It took a lot to get him to say anything, never mind express what was happening. But Dr. Chopra took the time, which made a huge difference in Frank’s care,” she adds.

Dr. Rashmi Kaura, a palliative care and geriatric specialist at the Wolk Center for Memory Health, met with Carol and Frank’s children and Frank’s brother. “While I am Frank’s partner and health care proxy, we wanted his family to be involved and able to ask questions directly to the doctor. Having Dr. Kaura on family meetings over Zoom was magnificent because family members live far away. Dr. Kaura is skilled at explaining Alzheimer’s in a factual but reassuring way. She took the time needed to respond to all questions,” says Carol.

Turning to TMS to treat depression 

After a year of treatment at the Wolk Center for Memory Health, Frank’s care team and Carol explored additional options to address his ongoing depression. Since his symptoms remained challenging, they decided to pursue transcranial direct current stimulation, or tDCS, a non-invasive brain stimulation therapy. Frank completed 35 tDCS sessions from January through April 2024.

“It has a good effect. Frank seemed a little bit better, and it seemed to be making him a little more aware of his surroundings and a little more connected, but it wasn’t totally there,” describes Carol.

Because of Frank’s positive response to tDCS, transcranial magnetic stimulation, or TMS, was recommended. Unlike ECT, which uses an electric current, TMS uses magnets that hover over the head to stimulate the part of the brain that controls mood.  

“We took a little break because I was exhausted. I had taken Frank to the 35 tDCS treatments, and he had other appointments as well. I was spending all my time doing it,” she adds.

Recognizing that Carol needed some relief, the Wolk Center for Memory Health support staff jumped into action. While she brought Frank in for his first few TMS sessions, staff helped her arrange transportation for the remaining appointments to get him back and forth from NewBridge on the Charles. Carol hired an aide to attend those appointments with Frank.

“Wendy Shulman, the office manager, was a superstar in figuring out the scheduling. I don’t know how she did it, but she did. They just really went out of their way to facilitate it,” says Carol. 

While she still had to take Frank to other appointments during this time, the transportation Frank had for most of his TMS sessions allowed Carol to take care of herself. “I finally had a breather and was able to start going back and scheduling my own doctor’s appointments because I hadn’t gone to one in two years,” she explains. 

Experiencing relief through TMS treatments 

Between June and August 2024, Frank completed 35 TMS sessions. The regimen started with hour-long sessions five times a week. He then tapered the frequency of his visits, cutting down to twice-weekly visits by the end of his regimen.   

Carol immediately noticed a difference in his depression. “He is doing better — much better! He is talking more, and he’s more willing to participate in activities,” she says. She also believes his growing comfort in his new home at NewBridge on the Charles could be contributing to his progress.

At NewBridge on the Charles, Frank has responded very positively to the music programming offered and the intergenerational connections he has made. “There are interns, and they’re really the dynamos because they’re so young. They’ve got enthusiasm. Frank just loves them because he loves young people and responds very well to them,” says Carol. He also enjoys music therapy sessions.

Carol cites the hard work of Whitney Peruzzi, the lead expressive therapist and therapeutic program manager for memory care assisted living at NewBridge on the Charles.  

“Whitney has been unbelievable at coordinating field trips. That’s been good for Frank because he responds really well to getting out in the fresh air and doing something different. Sometimes before TMS, he’d resist, but now he’s much more open,” says Carol. 

His compassionate personality is also reemerging. “Just in the last few weeks, he’s showing more awareness of his surroundings. He noticed that it was going to snow and said to me, ‘You better go. I want you to get home before the snow comes.’ He hadn’t noticed anything before and was wrapped up in his own world. All of a sudden, he was noticing and showing concern for me and others. He’s always been like that,” she adds. 

Ultimately, Carol is very pleased with the care that Frank is receiving at Hebrew SeniorLife. “I’m very grateful. It takes a village. It took everyone to do this,” says Carol. And Frank isn’t the only one benefitting. “I’m feeling better too. Because I have more time, I’m actually beginning to try to reach out to a couple of friends,” she concludes.

Frank isn’t the only patient who has benefitted from TMS. Read about John Bengel’s life-changing experience with TMS for depression in our blog post. 

TMS treatment for older adults in the Boston area

If you think transcranial magnetic stimulation may be right for you or a loved one, the Wolk Center for Memory Health can help. We offer New England’s only TMS program specifically created with older adults in mind. We’re happy to coordinate with your care team, including your psychiatrist and/or primary care physician. Contact us online or call us at 617-363-8600.

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