Providing care for movement and memory disorders

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By: David DiPino
Contributing Writer

During the COVID-19 Pandemic, the Palm Beach Neuroscience Institute (PBNI) office of neurologist Dr. Arif Dalvi and advanced practice registered nurse (APRN) Shellyann Timmons has remained open and seeing patients for various neurological disorders including for the care of Parkinson’s disease, essential tremor and gait disorders.

In addition to providing treatment for movement disorders, Dr. Dalvi and APRN Timmons regularly see patients with dementia related cognitive impairments in the PBNI Memory Disorder Clinic, led by Dr. Dalvi. In most cases, Dr. Dalvi and APRN Timmons are providing treatment to one of the most vulnerable populations for COVID-19, the older population with underlying health ailments such as neurological conditions. Safety protocols have been implemented in order to protect both patients and staff.

“Given the population we serve, we are treating those that are considered in a higher risk category for contracting and/or succumbing to COVID-19. In our office, we have several approaches to limiting exposure to our patients and staff. We are taking precautions seriously and adhering to Centers for Disease Control and Prevention (CDC) guidelines,” said APRN Timmons.

At their PBNI office, every patient is telephone screened with a list of safety questions related to COVID-19 exposure when making their appointment, the day before the appointment, and when they arrive. All staff and patients are required to wear masks when entering the office and in the waiting room area. Appointments are spaced out to ensure limited crowding in the waiting room. Visits include just the patient into the office and caregivers are updated via a phone call during the appointment.

“This ensures the caregiver is included in the visit, has an opportunity to ask questions or provide additional information if needed, all while safely remaining in their cars, at home, or in one of the designated waiting areas in the building,” Timmons said.

“The COVID-19 virus has proven to be unpredictable and can affect anyone, though some are at higher risk. I would say that everyone must stay diligent in adhering to the latest information regarding safety precautions. Social distancing, hand washing, and wearing facial coverings are paramount in doing one’s part in limiting exposure and transmission of this virus.”

This type of open and safe clinic protocol is of the utmost importance because it is difficult for Dr. Dalvi’s and APRN Timmons’ patients to be seen via telehealth appointment due to various reasons.

“Proper evaluation of patients with a neurological disease such as Parkinson’s disease requires an in-person evaluation. However, we remain flexible and make accommodations for telehealth, when necessary, but these visits are limited in comparison to our face to face office visits,” Timmons said.

As an APRN, Timmons collaborates with Dr. Dalvi and the rest of the PBNI care team to obtain a patient’s comprehensive health history and review their medical records as well as conduct a psychosocial assessment and perform a concentrated neurological physical exam with each patient as it relates to movement disorders and/or dementia.

“I assist with formulating an individualized, holistic treatment plan, called a care plan, which may include ancillary services such as speech, physical, and occupational therapies. We work very closely with a clinical social worker to provide information to connect the patient and caregiver to various community resources, support groups, and educational seminars. Prior to the COVID-19 pandemic we were involved in performing several community based presentations to provide education on Parkinson’s disease and other movement related disorders,” Timmons said.

A personal experience in caring for her grandmother after she was diagnosed with Alzheimer’s disease and a passion to care for the aging population led APRN Timmons to specialize in neurology care.

“As an APRN, I feel a duty to ensure the people I come in contact with are afforded the tools to be advocates for themselves and their loved ones. My belief in health literacy drives me to assist others. What I have found is that the patient’s we care for at Palm Beach Neuroscience Institute are eager to learn together and be a part of their health care team to have a valuable quality of life. Having a disease that is progressive in nature but can be managed successfully with the right information, treatment options, and teamwork is important. I love the fact that I can be a part of that team,” she said.

Shellyann Timmons, APRN is on-staff at the Palm Beach Neuroscience Institute. Submitted photo.

“There has been a focus, and rightfully so, towards our aging population and the ailments that they experience, especially as it relates to dementia. More and more family members, friends and co-workers are dealing with questions, concerns, symptoms, early signs, or wanting to seek knowledge in order to take preventative measures to delay or avoid dementia related cognitive impairments.”

To stay neurologically healthy, Timmons has a few suggestions to share with the community.

“In order to stay neurologically healthy it is very important to eat a well-balanced diet, participate in physical and cognitive stimulating exercises, and remain socially engaged in this new normal. We promote the MIND diet to promote a healthy memory. We also advise our patients to stay in contact with friends and family via online modalities if necessary, to reduce isolation while being socially distanced,” she said.

As a healthcare provider, Timmons praises her peers in the care community and relishes opportunities to share with the community on recommendations to stay safe, remain resilient, and protect themselves and others during this unprecedented time.

“To all the Healthcare Heroes that continue to answer the call of protecting, curing, treating, caring, and teaching patients, their loved ones, and their fellow peers I stand with you. I support you. I thank you. We do what we do because it is who we are. I have never been more proud to be a part of one of the best professions I know. Be careful and continue to do great work,” said APRN Timmons.

Shellyann Timmons, APRN is on-staff at the Palm Beach Neuroscience Institute. Dr. Arif Dalvi is Director of the Comprehensive Movement Disorder Center, and Director of the Memory Disorder Clinic, Palm Beach Neuroscience Institute. In addition, Dr. Dalvi is on-staff at Delray Medical Center as well as Good Samaritan Medical Center and St. Mary’s Medical Center in West Palm Beach. Dr. Dalvi specializes in the neurological diagnosis and treatment of Parkinson’s disease, movement disorders, tremor, Deep Brain Stimulator Programming (DBS), Botox for dystonia, spasticity and migraines, memory disorders, dementia, Alzheimer’s disease and Tourette’s syndrome.

Dr. Dalvi and APRN Timmons’ office is located at the Palm Beach Neuroscience Institute, 8756 Boynton Beach Blvd. Suite 2500, Boynton Beach, FL 33472. For more information visit: www.PBNI.com or call 561-572-9371.