Asheville – Dr. Peggy Noel was recently awarded the distinguished Order of the Long Leaf Pine. This honor is bestowed by the Office of the Governor of North Carolina on citizens who have dedicated their lives to community service. Noel received the award for her lifelong work in geriatrics, particularly for founding MemoryCare in 2000, where she currently serves as medical director. Upon receiving the award, Noel expressed her gratitude, stating, “I’m grateful for 35 years of a rewarding career and to be blessed with work that has so much meaning and purpose.”
Noel’s passion for geriatrics seems almost innate. She remarked, “I always loved being around older adults, and I had a wonderful grandmother.” Unfortunately, her grandmother developed dementia during a time when family members were often excluded from care, highlighting a key difference in the approach taken by MemoryCare.
MemoryCare is a medical practice that includes six physicians, one nurse practitioner, six care managers, and over 20 staff members. Patients undergo a comprehensive set of cognitive and physical tests before receiving a diagnosis and any prescriptions to assist with dementia. Behavioral management is also provided if necessary.
MemoryCare collaborates with primary care physicians to coordinate care with other agencies. They assist families in planning for the later stages of the disease, which may involve making decisions about long-term care and advance directives.
Noel noted that most, but not all, of MemoryCare’s patients are aging in place. “They are fortunate to have family members devoted to assisting them with the functions they can no longer perform independently due to dementia. Once individuals with dementia transition to facility care, the staff there can help. The goal for most people is to remain at home as long as possible, and MemoryCare is dedicated to helping our patients and their family caregivers achieve that goal.”
Noel explained, “I established MemoryCare after recognizing the crucial role of family caregivers in dementia care during my experience as a geriatrician.” An important function of MemoryCare is training, counseling, and supporting caregivers. The organization maintains a lending library of resources for caregivers, and thanks to Dogwood Health Trust, they now offer virtual education for low-income families. They also assist families in applying for financial aid.
MemoryCare operates as a nonprofit because providing in-home care for individuals suffering from dementia—or any disease—has historically received only minimal reimbursement from major insurers. According to MemoryCare’s 2023 annual report, the average annual expenditure for comprehensive care per family was $2,087, with only 14% of revenues allocated to overhead. In 2023, 21% of caregiver fees were waived due to hardship.
The team at MemoryCare is grateful that Givens Estates has provided an in-kind land lease for the practice. Other major supporters include the SECU Foundation, Dogwood Health Trust, WNC Bridge Foundation, the Deerfield Charitable Foundation, and the Buncombe County Aging Coordinating Consortium. The Haywood County Satellite Clinic operates out of space provided by the Haywood County Senior Resource Center. In 2023, 760 individuals, 24 community partners or sponsorships, and nine foundations contributed to their efforts. The report states, “The majority of donors have been touched by MemoryCare services.”
There is currently no known cure for dementia, and in 2021, the World Health Organization identified it as the seventh leading cause of death worldwide. In 2023, it was estimated that $345 billion would be spent on dementia care in the United States alone. However, MemoryCare is viewed as a cost-saver because it not only helps patients receive appropriate diagnoses but also “educates families about potential safety risks and appropriate utilization of the acute care system.”
Noel stated that MemoryCare was a pioneer in the field and is the only organization of its kind serving the 22 counties of Western North Carolina. In July, MemoryCare was selected to participate in a pilot program by the Centers for Medicare and Medicaid Services. Named Guiding an Improved Dementia Experience (GUIDE), the program will explore “a new payment approach” for individuals living at home with dementia. Reimbursable services may include “comprehensive, person-centered assessments and care plans; care coordination; 24/7 access to an interdisciplinary care team member or help line; and certain respite services to support caregivers.”
“Dr. Noel is extraordinary and highly revered in the community,” said MemoryCare’s Development and Education Coordinator, Jennifer Marlowe. “I’ve only been here a few months, but I’ve already heard so much admiration for Dr. Noel from patients, volunteers, and donors. It’s refreshing to be part of an organization that is doing meaningful work in an innovative way.”