Geriatric and Seniors Therapists in Palo Alto, CA

Photo of Lawrence Feinstein, PhD, Psychologist
Lawrence Feinstein
Psychologist, PhD
Verified Verified
Palo Alto, CA 94302  (Online Only)
Bay Area Health Psychology is a group practice (see our website); I am the Director. I specialize in Clinical Health Psychology to assist people with chronic medical conditions, anxiety, and depression to manage their health and treatment. I also assist people with progressions of aging such as dementia, memory loss, and Alzheimer's Disease. And I help caregivers cope with the tasks of living with someone with a chronic condition. I provide EMDR treatment using a special web application, and offer Couples/Marital Therapy based on a "dynamic interaction" model developed during my research at UCLA plus training by the Gottmans.
Bay Area Health Psychology is a group practice (see our website); I am the Director. I specialize in Clinical Health Psychology to assist people with chronic medical conditions, anxiety, and depression to manage their health and treatment. I also assist people with progressions of aging such as dementia, memory loss, and Alzheimer's Disease. And I help caregivers cope with the tasks of living with someone with a chronic condition. I provide EMDR treatment using a special web application, and offer Couples/Marital Therapy based on a "dynamic interaction" model developed during my research at UCLA plus training by the Gottmans.
(650) 999-0220 View (650) 999-0220
Photo of Lori Buelna, LCSW, GC-C, Clinical Social Work/Therapist
Lori Buelna
Clinical Social Work/Therapist, LCSW, GC-C
Verified Verified
Palo Alto, CA 94303
I am knowledgeable in Behavioral Health, Medical/Geriatrics, dementia, long term care planning.
Perhaps you are overwhelmed with stress, dealing with anxiety/depression and poor sleep due to a life transition, or caregiver stress. Maybe you or a loved one is managing a serious health condition and hope to learn of coping skills and various resources. You may be a parent, a teen or young adult experiencing stress or loss of a loved one or a relationship. I believe people are insightful, resilient and have the innate ability to adapt and adjust to all types of challenging circumstances. You deserve to set aside time and space to think through your thoughts, values, identify feelings in order to move forward to find balance.
I am knowledgeable in Behavioral Health, Medical/Geriatrics, dementia, long term care planning.
Perhaps you are overwhelmed with stress, dealing with anxiety/depression and poor sleep due to a life transition, or caregiver stress. Maybe you or a loved one is managing a serious health condition and hope to learn of coping skills and various resources. You may be a parent, a teen or young adult experiencing stress or loss of a loved one or a relationship. I believe people are insightful, resilient and have the innate ability to adapt and adjust to all types of challenging circumstances. You deserve to set aside time and space to think through your thoughts, values, identify feelings in order to move forward to find balance.
(408) 413-1402 View (408) 413-1402
Photo of Nina M Poletika, LMFT, CT, Marriage & Family Therapist
Nina M Poletika
Marriage & Family Therapist, LMFT, CT
Verified Verified
Palo Alto, CA 94306
Do you have a loved one with Alzheimer's or related dementia and are feeling overwhelmed? You are not alone. I specialize in helping caregivers (adult children or spouses) with their complex emotional reactions, ongoing loss & grief, and finding better ways to cope. Having a difficult time when trying to navigate cognitive decline is central to being a helping family member. Professionally, I am experienced and well trained. Personally, I have been on a similar journey with my own mother who had dementia for 10 years.
Do you have a loved one with Alzheimer's or related dementia and are feeling overwhelmed? You are not alone. I specialize in helping caregivers (adult children or spouses) with their complex emotional reactions, ongoing loss & grief, and finding better ways to cope. Having a difficult time when trying to navigate cognitive decline is central to being a helping family member. Professionally, I am experienced and well trained. Personally, I have been on a similar journey with my own mother who had dementia for 10 years.
(650) 276-5441 View (650) 276-5441
Photo of Richard D Abbey, PhD, Psychologist
Richard D Abbey
Psychologist, PhD
Verified Verified
1 Endorsed
Palo Alto, CA 94306
What do I do if my child can focus on interesting things but takes 3 hours to do 30 minutes of homework? What if my child doesn't seem to be doing as well as I thought they would in school, can something be done? How do I stop feeling so down and blue, or anxious? What if I had a concussion and I am not getting better, but the doctor told me to just rest and do nothing, are there ways for me to improve my condition? Do I have the early signs of dementia? what can be done if I do? My child went to college and failed, is there hope for them to get better? I provide solutions to these questions and more!
What do I do if my child can focus on interesting things but takes 3 hours to do 30 minutes of homework? What if my child doesn't seem to be doing as well as I thought they would in school, can something be done? How do I stop feeling so down and blue, or anxious? What if I had a concussion and I am not getting better, but the doctor told me to just rest and do nothing, are there ways for me to improve my condition? Do I have the early signs of dementia? what can be done if I do? My child went to college and failed, is there hope for them to get better? I provide solutions to these questions and more!
(650) 353-9221 View (650) 353-9221
Photo of Barbara Moss Keller - Barbara Moss Keller, LCSW, LCSW, Clinical Social Work/Therapist
Barbara Moss Keller, LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
Palo Alto, CA 94301
LCSW & coach in mental health, medical, well care, EAP & business. My practice is solution focused & eclectic: active, direct, conversational, compassionate and supportive. Therapy is for anxiety, depression, mood dysregulation, stress, & life transitions. We collaboratively identify core issues & goals. I see adults of all ages, older teens, couples, & families to navigate life transitions, wellness, and illness to achieve an integrated balance of mind, body & spirit. I work with a diverse and international population as a therapist & coach in education, career, & employment pursuits. I provide situational assessments & referrals.
LCSW & coach in mental health, medical, well care, EAP & business. My practice is solution focused & eclectic: active, direct, conversational, compassionate and supportive. Therapy is for anxiety, depression, mood dysregulation, stress, & life transitions. We collaboratively identify core issues & goals. I see adults of all ages, older teens, couples, & families to navigate life transitions, wellness, and illness to achieve an integrated balance of mind, body & spirit. I work with a diverse and international population as a therapist & coach in education, career, & employment pursuits. I provide situational assessments & referrals.
(650) 445-0655 View (650) 445-0655
Photo of Rayna Hirst, PhD, Psychologist
Rayna Hirst
Psychologist, PhD
Verified Verified
Palo Alto, CA 94301
Dr. Rayna Hirst is a licensed clinical neuropsychologist conducting neuropsychological evaluations, including dementia, psychiatric disorders (e.g., depression, anxiety, ADHD), and medical/neurological diagnoses (e.g., multiple sclerosis, Parkinson’s disease, traumatic brain injury, neuro-oncology). Dr. Hirst is an Associate Professor and Director of the Neuropsychology Program at Palo Alto University, providing didactic and supervisory education to doctoral students who are training in clinical neuropsychology.
Dr. Rayna Hirst is a licensed clinical neuropsychologist conducting neuropsychological evaluations, including dementia, psychiatric disorders (e.g., depression, anxiety, ADHD), and medical/neurological diagnoses (e.g., multiple sclerosis, Parkinson’s disease, traumatic brain injury, neuro-oncology). Dr. Hirst is an Associate Professor and Director of the Neuropsychology Program at Palo Alto University, providing didactic and supervisory education to doctoral students who are training in clinical neuropsychology.
(650) 398-1242 View (650) 398-1242
Photo of Joaquin Burciaga, PhD, Psychologist
Joaquin Burciaga
Psychologist, PhD
Verified Verified
Palo Alto, CA 94301
Dr. Joaquin Burciaga is a clinical neuropsychologist. He has extensive training in the neuropsychological evaluation of individuals across the lifespan. This includes the evaluation of adults and older adults with epilepsy, traumatic brain injury, brain tumors, Parkinson’s disease, Alzheimer’s disease, frontotemporal dementia, dementia with Lewy bodies, and various other dementing disorders, and answering questions of decision-making capacity. Dr. Burciaga also conducts pre- and post-surgical evaluations for candidates pursuing surgical interventions for the treatment of epilepsy and deep brain stimulation for Parkinson’s disease.
Dr. Joaquin Burciaga is a clinical neuropsychologist. He has extensive training in the neuropsychological evaluation of individuals across the lifespan. This includes the evaluation of adults and older adults with epilepsy, traumatic brain injury, brain tumors, Parkinson’s disease, Alzheimer’s disease, frontotemporal dementia, dementia with Lewy bodies, and various other dementing disorders, and answering questions of decision-making capacity. Dr. Burciaga also conducts pre- and post-surgical evaluations for candidates pursuing surgical interventions for the treatment of epilepsy and deep brain stimulation for Parkinson’s disease.
(628) 209-0717 View (628) 209-0717
Photo of Roxanne Shooshani, LMFT, Marriage & Family Therapist
Roxanne Shooshani
Marriage & Family Therapist, LMFT
Verified Verified
Palo Alto, CA 94301  (Online Only)
Are you struggling to cope with getting through the day? Feeling burnt out, anxious, depressed, and isolated? If you are experiencing emotional difficulties, you do not have to go through it alone. I can support you through life's many challenges - Whether it's the mental health impacts from chronic pain, medical illnesses, social isolation, questioning your gender and/or sexuality, trauma, difficulties in relationships, existential issues, grief, or the hardships that come along with being in different stages of life - from teenagehood to older age.
Are you struggling to cope with getting through the day? Feeling burnt out, anxious, depressed, and isolated? If you are experiencing emotional difficulties, you do not have to go through it alone. I can support you through life's many challenges - Whether it's the mental health impacts from chronic pain, medical illnesses, social isolation, questioning your gender and/or sexuality, trauma, difficulties in relationships, existential issues, grief, or the hardships that come along with being in different stages of life - from teenagehood to older age.
(415) 895-9571 View (415) 895-9571
Photo of Ben Seider, PhD, Psychologist
Ben Seider
Psychologist, PhD
Verified Verified
2 Endorsed
Palo Alto, CA 94306
I provide psychotherapy for individuals (adolescents, and adults), couples and families. I help individuals who are experiencing difficulties with anxiety, mood, problems with relationships, and various addictions. I work from a client-centered perspective that is both integrative, collaborative, and recovery-based (i.e., incorporates client's strengths as opposed to solely focusing on negatives or pathology). As such, I am able to draw upon my expertise in Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical-Behavioral Therapy (DBT), and Couples and Family Therapy to flexibly design treatment to meet the specific needs of my clients.
I provide psychotherapy for individuals (adolescents, and adults), couples and families. I help individuals who are experiencing difficulties with anxiety, mood, problems with relationships, and various addictions. I work from a client-centered perspective that is both integrative, collaborative, and recovery-based (i.e., incorporates client's strengths as opposed to solely focusing on negatives or pathology). As such, I am able to draw upon my expertise in Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical-Behavioral Therapy (DBT), and Couples and Family Therapy to flexibly design treatment to meet the specific needs of my clients.
(415) 779-7332 View (415) 779-7332
Photo of Liana Huang, LCSW, EMDR, Clinical Social Work/Therapist
Liana Huang
Clinical Social Work/Therapist, LCSW, EMDR
Verified Verified
Palo Alto, CA 94301
When we are exposed to trauma at an early age, it can seriously impact how we feel about ourselves and our relationships with others. Trauma can also profoundly affect whether we feel this is a safe world and can contribute to depression, anxiety, and relational/familial issues. My practice is from a strengths-based, trauma-informed perspective with a non-judgmental framework. I aim to understand clients’ internal responses and to provide more options for emotional regulation and problem-solving.
When we are exposed to trauma at an early age, it can seriously impact how we feel about ourselves and our relationships with others. Trauma can also profoundly affect whether we feel this is a safe world and can contribute to depression, anxiety, and relational/familial issues. My practice is from a strengths-based, trauma-informed perspective with a non-judgmental framework. I aim to understand clients’ internal responses and to provide more options for emotional regulation and problem-solving.
(650) 590-5776 View (650) 590-5776
Photo of Mary A Brayton, MA, MFT, Marriage & Family Therapist
Mary A Brayton
Marriage & Family Therapist, MA, MFT
Verified Verified
Palo Alto, CA 94301
How Can I Help You? ...by being a therapist you feel comfortable talking to. If you are having trouble relaxing, are worried about a loved one,are facing divorce or major illness, are feeling irritable, confused, depressed,lonely, are concerned about your teen taking risks or a child hating school talking with me can help. Talking can give you objective perspective, help you develop coping skills, lessen the isolation that makes people feel"crazy" and reduce inner turmoil that can lead to physical ailments. We work together to identify and build on your current personal strengths in this healing process.
How Can I Help You? ...by being a therapist you feel comfortable talking to. If you are having trouble relaxing, are worried about a loved one,are facing divorce or major illness, are feeling irritable, confused, depressed,lonely, are concerned about your teen taking risks or a child hating school talking with me can help. Talking can give you objective perspective, help you develop coping skills, lessen the isolation that makes people feel"crazy" and reduce inner turmoil that can lead to physical ailments. We work together to identify and build on your current personal strengths in this healing process.
(650) 209-7873 View (650) 209-7873
Photo of Jayn Rajandran - Dr. Jayn Rajandran PsyD / Jayn.Org, PsyD, LMFT, IO, Psych, CGE, Marriage & Family Therapist
Dr. Jayn Rajandran PsyD / Jayn.Org
Marriage & Family Therapist, PsyD, LMFT, IO, Psych, CGE
Verified Verified
Palo Alto, CA 94301
Concierge therapy offered in Palo Alto, Rockridge & SF locations. You decide on the day, time, location, in-person or online. This modality is for busy professionals/students who want to graduate psychotherapy fast. Sessions are fun and focused. Most clients can graduate from therapy within 3-6 months for life transition problems. For severe trauma and mental health cases, it can a little longer. Specializing in teens, couples and individuals struggling with trauma, sexual abuse, substances abuse, depression, anxiety, grief, suicide, trust, abandonment, severe mental health and anger.
Concierge therapy offered in Palo Alto, Rockridge & SF locations. You decide on the day, time, location, in-person or online. This modality is for busy professionals/students who want to graduate psychotherapy fast. Sessions are fun and focused. Most clients can graduate from therapy within 3-6 months for life transition problems. For severe trauma and mental health cases, it can a little longer. Specializing in teens, couples and individuals struggling with trauma, sexual abuse, substances abuse, depression, anxiety, grief, suicide, trust, abandonment, severe mental health and anger.
(650) 727-1761 View (650) 727-1761
Photo of Agustina Peroni, LMFT, Marriage & Family Therapist
Agustina Peroni
Marriage & Family Therapist, LMFT
Verified Verified
Palo Alto, CA 94306  (Online Only)
Hola! Hello! I am Agustina. I am a bilingual (Spanish/English) Licensed Marriage and Family Therapist with more than 5 years of experience. I graduated from Palo Alto university in 2019 and worked at county based community agencies as well as hospitals.
Hola! Hello! I am Agustina. I am a bilingual (Spanish/English) Licensed Marriage and Family Therapist with more than 5 years of experience. I graduated from Palo Alto university in 2019 and worked at county based community agencies as well as hospitals.
(650) 405-3237 View (650) 405-3237
Photo of Chantal Daley, LMFT, Marriage & Family Therapist
Chantal Daley
Marriage & Family Therapist, LMFT
Verified Verified
Palo Alto, CA 94301
Do you find yourself having a difficult time coping with anxiety, depression, and trauma? Do you have a hard time communicating and setting boundaries with others? Life is full of obstacles and hardships that may be difficult to overcome without the right tools, resources, and, guidance leading to the manifestation of these symptoms. I specialize in working with adults, couples, and adolescents using a Psychodynamic approach to explore unconscious thoughts and behaviors. In doing this, we are able to collaboratively recognize old ineffective patterns and process unresolved feelings and trauma.
Do you find yourself having a difficult time coping with anxiety, depression, and trauma? Do you have a hard time communicating and setting boundaries with others? Life is full of obstacles and hardships that may be difficult to overcome without the right tools, resources, and, guidance leading to the manifestation of these symptoms. I specialize in working with adults, couples, and adolescents using a Psychodynamic approach to explore unconscious thoughts and behaviors. In doing this, we are able to collaboratively recognize old ineffective patterns and process unresolved feelings and trauma.
(650) 405-0267 View (650) 405-0267
Photo of Jose Luna, ASW, EMDR
Jose Luna
Associate Clinical Social Worker, ASW, EMDR
Verified Verified
1 Endorsed
Palo Alto, CA 94301  (Online Only)
My therapeutic approach mainly focuses on helping my clients identify their strengths to help alleviate anxiety, depression, and trauma. I am a firm believer that our childhood experiences contribute to our beliefs, behavioral patterns, and selecting a romantic partner. Therapy is a process! To allow ourselves to be intimate and vulnerable with someone about our experiences and trauma can be daunting. As a therapist, it is my goal to help validate, create a safe environment and help understand aspects of lived experiences.
My therapeutic approach mainly focuses on helping my clients identify their strengths to help alleviate anxiety, depression, and trauma. I am a firm believer that our childhood experiences contribute to our beliefs, behavioral patterns, and selecting a romantic partner. Therapy is a process! To allow ourselves to be intimate and vulnerable with someone about our experiences and trauma can be daunting. As a therapist, it is my goal to help validate, create a safe environment and help understand aspects of lived experiences.
(650) 679-7121 View (650) 679-7121
Photo of Kathryn Hedjasi, MA, MBA, LMFT, Marriage & Family Therapist
Kathryn Hedjasi
Marriage & Family Therapist, MA, MBA, LMFT
Verified Verified
Palo Alto, CA 94306  (Online Only)
Do you find yourself struggling? Hurting? I can help you feel better! You have the ability to THRIVE regardless of your circumstances armed with my support & many new tools in your arsenal. I can help you tap into your own resilience & ability to heal. Wherever you are at in life, whether satisfied but looking to improve, struggling daily & feeling as if the floor is about to fall out, in crisis-mode, on a journey of self-discovery, or simply looking for support from a fully present empathetic skilled partner in your personal, interpersonal & professional goals. I AM HERE FOR YOU!
Do you find yourself struggling? Hurting? I can help you feel better! You have the ability to THRIVE regardless of your circumstances armed with my support & many new tools in your arsenal. I can help you tap into your own resilience & ability to heal. Wherever you are at in life, whether satisfied but looking to improve, struggling daily & feeling as if the floor is about to fall out, in crisis-mode, on a journey of self-discovery, or simply looking for support from a fully present empathetic skilled partner in your personal, interpersonal & professional goals. I AM HERE FOR YOU!
(650) 262-4006 View (650) 262-4006
Photo of Janelle De Veyra, LMFT, Marriage & Family Therapist
Janelle De Veyra
Marriage & Family Therapist, LMFT
Verified Verified
Palo Alto, CA 94301
Do you struggle with depression, anxiety, and trauma? Do you experience difficulties managing family and relationship issues? I believe that healing happens when we pay attention to all the parts that make us whole—our mind, body, and soul. The subconscious mind controls most of our reality and choices, so building awareness and active presence can improve the quality of daily living and assist in not only surviving, but thriving through life. As an intuitive & holistic therapist, I will assist you in strengthening your inner psyche and developing new tools to manage negative feelings and thoughts.
Do you struggle with depression, anxiety, and trauma? Do you experience difficulties managing family and relationship issues? I believe that healing happens when we pay attention to all the parts that make us whole—our mind, body, and soul. The subconscious mind controls most of our reality and choices, so building awareness and active presence can improve the quality of daily living and assist in not only surviving, but thriving through life. As an intuitive & holistic therapist, I will assist you in strengthening your inner psyche and developing new tools to manage negative feelings and thoughts.
(650) 480-3572 View (650) 480-3572
Photo of Mansi Verma, PhD, MPhil, MA, Psychological Associate
Mansi Verma
Psychological Associate, PhD, MPhil, MA
Verified Verified
Palo Alto, CA 94303
When we feel overwhelmed by feelings of sadness or our inability to cope with everyday life problems, often our interpersonal relationships suffer, or we may face difficulty in concentrating on work or studies. We either end up internalizing our frustration and become withdrawn, irritable, anxious, or addicted. Or we may externalize and become aggressive or abusive, etc. Further, sometimes there are certain unresolved/unidentified issues that may have been silently creating conflicts in our lives, and as a result, may have been holding us back from performing at our best.
When we feel overwhelmed by feelings of sadness or our inability to cope with everyday life problems, often our interpersonal relationships suffer, or we may face difficulty in concentrating on work or studies. We either end up internalizing our frustration and become withdrawn, irritable, anxious, or addicted. Or we may externalize and become aggressive or abusive, etc. Further, sometimes there are certain unresolved/unidentified issues that may have been silently creating conflicts in our lives, and as a result, may have been holding us back from performing at our best.
(650) 753-0028 View (650) 753-0028
Photo of Brittney Green, LMFT, EMDR, IFS, Marriage & Family Therapist
Brittney Green
Marriage & Family Therapist, LMFT, EMDR, IFS
Verified Verified
Palo Alto, CA 94301
Life can feel impossible to avoid struggling and we often don't feel we have the skills to cope successfully through. Unfortunately, sometimes we don't have all the resources we need for a given situation. Parts of us take on desperate roles trying to help us to survive. This might look like anxiety, depression, PTSD, addiction, and relationship/family issues. I aim to help you process unresolved issues and feelings and find solutions.
Life can feel impossible to avoid struggling and we often don't feel we have the skills to cope successfully through. Unfortunately, sometimes we don't have all the resources we need for a given situation. Parts of us take on desperate roles trying to help us to survive. This might look like anxiety, depression, PTSD, addiction, and relationship/family issues. I aim to help you process unresolved issues and feelings and find solutions.
(650) 563-7293 View (650) 563-7293
Photo of Catherine Nelson, MFT, Marriage & Family Therapist
Catherine Nelson
Marriage & Family Therapist, MFT
Verified Verified
Palo Alto, CA 94301
My ideal client is someone who suffers from Trauma and who has chronic depression and/or chronic anxiety. This person may also have some physical issues that point to areas of concern in the therapy. Everyone needs to feel safe, respected and to have their feelings validated. They may want to feel better but afraid of what therapy might uncover. They may also need to go more slowly in therapy. Reaching out for therapy expresses a hope that they can feel better.
My ideal client is someone who suffers from Trauma and who has chronic depression and/or chronic anxiety. This person may also have some physical issues that point to areas of concern in the therapy. Everyone needs to feel safe, respected and to have their feelings validated. They may want to feel better but afraid of what therapy might uncover. They may also need to go more slowly in therapy. Reaching out for therapy expresses a hope that they can feel better.
(650) 899-7224 View (650) 899-7224
1
Geriatric and Seniors Therapists

Is one ever too old for mental health therapy?

Individuals of all ages can benefit from mental health therapy. Indeed, older adults in particular may benefit from the social and psychological support a therapist can provide; the topics that older adults address in therapy may simply differ from those of younger clients. Seniors should seek out a therapist who has experience working with older individuals and who is well-versed in addressing common concerns among elderly individuals, such as depression, anxiety, loneliness, dementia, and physical mobility challenges.

How can geriatric therapy improve the quality of life of aging individuals?

Therapy for aging adults can greatly improve quality of life by providing an opportunity for them to process difficult emotions related to end-of-life, navigate relational or caregiver challenges, and develop coping skills for common mental health conditions, like anxiety or depression. Subsequent reductions in negative emotions and mental health disorder symptoms can make day-to-day living much more manageable for aging adults and those that care for them. The ongoing relationship with a trusted therapist can also help seniors combat loneliness and provide a sense of structure for their routine.

How is counseling for elderly different from counseling for other age groups?

Many aspects of geriatric counseling are similar to counseling in younger age groups; in general, counseling offers an opportunity for clients to process difficult life events and develop coping skills they can use outside of the therapy session. However, therapists who specialize in working with elderly clients may place a special emphasis on specific topics, such as caregiver relationships and reducing loneliness. They may be specially equipped to deal with certain physical conditions or facilitate discussion surrounding end-of-life topics. Counseling for the elderly may also place a greater emphasis on social work-type topics to ensure that geriatric clients have access to necessary resources, such as food, a safe home environment, and healthcare.

Can geriatric counseling help people who suffer from dementia?

Counseling can be highly effective for aging adults with dementia. While some therapists specializing in dementia may work with clients solely on topics surrounding memory loss, they can also assist clients with conditions that may co-occur at old age, such as anxiety or depression. Counselors specializing in working with older adults can also offer an objective assessment of a client’s functioning or disease progression to caregivers, and they may be particularly knowledgeable about community resources that may benefit dementia clients and their families. Therapists specializing in dementia may also be trained in specialized forms of therapy for memory-loss|memory loss, such as Cognitive Stimulation Therapy (CST)—which can help mentally stimulate dementia clients to preserve cognitive functioning.