Young Onset Dementia / Atypical Dementia

Ms. Pilcher's maternal grandmother and grandfather sailing in Westport, MA harbor

Young Onset

Growing up in a family with Young Onset Dementia inspired Dr. Pilcher, at a young age, to work toward improving care and support for other families facing this challenge. Both Dr. Pilcher's maternal Grandmother and Aunt were diagnosed with Young Onset Alzheimer's Disease. 


Dr. Pilcher has dedicated her entire career to the study and understanding of dementia, but she maintains a current focus on finding creative solutions and creating supports for the Young Onset population.


 In addition to living with devastating losses, families facing this diagnosis also confront unique challenges. Getting a diagnosis may be a long, twisted and arduous path that ends with a sense of being more lost than you were before. Those living with dementia may face early retirement and/or a sudden loss of income. Many caregivers discover a lack of understanding among their peers and a shrinking social network. Often, well spouses are burdoned with caring for both their spouse with dementia and their children simultaneously.Resources are scant and providers that truly understand the disease are hard to find. What resources are available are geared toward the elderly population and are either inappropriate, unhelpful and uninformed.


The process of navigating this disease can be unpredictable,  stressful and at times downright intimidating.


Because of both her professional and personal understanding of these unique challenges, Dr. Pilcher is passionate about finding creative solutions and providing informed education and support for families coping with a Young Onset diagnosis.

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Atypical Dementia

Younger people with dementia are also likely to have a less common form of dementia such as Dementia with Lewy Bodies or one of the many variants of Frontotemporal Lobe Dementia. 


For these diagnoses, the primary symptom being experienced is usually not memory loss. Rather, due to issues with disinhibition, executive function and compulsiveness, people with these variants may be more likely to put themselves in danger. People with aphasic dementias will experience extreme difficulty with communication as others will assume they lack the capacity for receptive language.


As a result, these diagnoses require different care strategies, approaches and communication techniques. 


Dr. Pilcher has spent her career understanding and teaching these alternative strategies for redirecting and/or addressing difficult behavior. Dr. Pilcher can help your family develop a strategic, individualized approach for your loved one that takes into account the specific symptoms, personality and family dynamics you are encountering. As Ms. Royal has both nursing and dementia expertise, Dr. Pilcher and Ms. Royal often work as a team to support clients and family members who are facing these challenges.

Mental Health Challenges

Emotional, Psychological & Psychiatric Support

Our growing team consists of members who have invaluable experience in the field of mental health.  Clear Guidance Owner, Daniel McShane, spent the first half of his career working as an inpatient Case Manager at a psychiatric hospital. Additionally, Life Care Manager, Kathleen Quinn, worked for over 20 years as a charge nurse at a psychiatric hospital. Their combined social work and nursing backgrounds allows Clear Guidance to provide comprehensive support to you and/or a loved one.  


The Clear Guidance Team can develop and implement behavior modification plans, and coordinate with therapists or other providers. Additionally, our team can assist in helping you or your loved one acquire and maintain coping skills to improve quality of life. We offer medication monitoring for compliance and side effects by one of our registered nurses, and provide feedback.


Our overall approach is to maintain independence and avoid re-hospitalization whenever possible. However, if an individual is or will be in an inpatient setting, our team also can communicate with staff there to ensure they have an up-to-date medical history and are provided the appropriate treatments. In the alternative, if an individual is  looking to live at home, we can assist with discharge planning in order to have a successful and safe transition to the home environment. 


Clear Guidance also provides support to family members of loved ones struggling with mental health challenges. We do so by maintaining open lines of communication with everyone involved, helping to monitor or supervise your loved one or their care, assisting with placement and/or other supports, and providing feedback to family members or other decision makers. 

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