A pharmacist with dog in tow are Alzheimer's patients best friends

Memoli, who has 20 years of experience in long-term care, is certified in dementia care and geriatric pharmacy and has a specialty in psychiatry. "I think there is a tremendous need for understanding dementia care, because it is not the same as long-term care," Memoli said. "It is somewhere in between palliative care and long-term care."

Having started her career as a hospital pharmacist reviewing patients' charts in long-term care facilities, Memoli said, "Early in my career, I worked in emergency medicine, and I dealt primarily with the elderly. I knew that dementia patients loved to touch things."

Memoli, who has three Labrador retrievers, felt that Bullet had the perfect disposition to provide therapy to patients. She and Bullet received pet therapy training from Pet Therapy International. "I took her in to work with the residents, and they formed a relationship with her just as they would if they had a dog of their own," she said. "They looked forward to her coming back. They get excited, and when she comes up to them, they'll say her name is Bullet. They'll remember certain things about her that they won't necessarily remember about their own children."

Recalling when Bullet mischievously uncovered sandwiches a patient had been hiding under a sofa, Memoli said, "I pulled the cushion up and found peanut-butter-and-jelly sandwiches. Bullet was like the FBI."

According to Memoli, dementia patients are very different from other patients, especially toward end-of-life care. "You are not necessarily looking at doing rescue therapy for other disease states," she explained. "You need to look at the philosophy of the physician, the patient's family, and the patient. You have to understand where they are coming from and what they are looking for."

Memoli gave the example of a dementia patient who has high cholesterol. "We know most drugs for hyperlipidemia work to decrease cardiovascular risk in five to 10 years. If the patient's end of life is imminent, we may or may not decide to treat him or her with an antihyperlipidemic agent because we are not trying to stop a cardiovascular event five to 10 years from now."

Memoli explained that Alzheimer's can strike people as young as 60 and even at age 40 in the mentally impaired population. "Patients who are diagnosed with dementia at the earlier ages die much more quickly and they progress through the stages much faster than if they were 80 years old when they got it," she said. "The older you are, the more probability you have of getting dementia."

Heredity also plays a factor in the onset of Alzheimer's, and women are more likely to get the disease than men.

Because people are living longer, Memoli foresees that there will be an increase in the number of people who have dementia. She hopes that more pharmacists will specialize in treating Alzheimer's patients. With Connecticut having recently passed a law requiring health professionals in long-term care to get training on Alzheimer's disease, it is no wonder that Peggy is a sought-after speaker on the lecture circuit.

Although Memoli sees 1,400 Alzheimer's patients every month (Bullet sees fewer patients because she lacks Memoli's stamina), the workload doesn't faze her. "I never consider it to be a burden," she said. "My personal philosophy is that all of us are put here to do something. This is my contribution to society."