Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • care managerChicago's Geriatric Care Manager Center of Excellence

Alzheimer’s from the Inside Out
As a geriatric care manager, we have knowledge of Alzheimer’s Disease and its progression, less about its causes and...
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March 26, 2011
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In the Caregiver's Words

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It seems that anything that has to do with baby boomers is big these days.   More boomers are retiring, more are changing careers, and yes, more are moving. Why? Very simply, there are a lot of baby boomers. The Bipartisan Policy Center estimates that about 10.6 million to 11.3 million housing units will be vacated by boomers during the present decade and this number may rise even more now that we are seeing the recession slip away. By the next decade, the number of boomers moving out is expected to represent 14.4 to 15.0 million vacated housing units. So with the economy on the mend, older adults are facing some choices.

To move or not to move? It may not be time to move, but it may be time to make an older loved one's home safer. In an earlier postings, I offered suggestions to:

·     De-cluttering and updating electrical circuits. The older our loved one's become, the older the residence is where they have always lived, and I offered some tips in an earlier posting about what to look for and how to update what needs updating (Ways to Make Elders' Homes Safer).

·     Also, the two big hazards tend to be falls and fires. I have written a number of posts about how to "fall-proof" and "fire-proof" your loved one's home (Making Homes Safer Against Fires and Falls)

Is it time to move to a senior residential community? In an earlier posting I talked about how there is not one right choice; it is all about finding a good fit for needs and interests. The main options are:

·     Independent living — Is your older loved one just looking to downsize? If so, there are residential options like townhomes or condos with built-in support services for maintenance, cleaning, and more in some senior campuses.

·     Assisted living — If there are medical caregiving or other health — or mobility-related issues are addressed, it may be time to look for a facility where all of that is readily available as needed.

·     Skilled nursing — If your loved one has been living independently but has had a fall or a deterioration of health such that more extensive medical attention is needed, it may be time to look for skilled nursing.

·     Secure living — If the move is precipitated by the onset of dementia or Alzheimer's, you may want the peace of mind that comes from facilities that will keep your loved one safe from wandering.

·     Continuum of care living — Many facilities across the United States are offering the equivalent of one-stop residential shopping. It is possible to initially buy an independent living resident with all the autonomy your loved one may wish. As needs change, the same people can help facilitate easy transitions to more support as required.

            Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
As we age, our bodies give us feedback we’re not used to. Activities that never required a second thought suddenly take some planning. Sometimes it’s hard to know if a new pain or sensation is something that we should worry about, or just a natural part of the aging process. We’ve compiled a list for you. If you or someone you love experiences any symptoms on this list, take them seriously and consult a physician immediately.
1. Confusion/Speech Difficulty. Call 911. These two symptoms are the most common manifestations of stroke. As the difficulty recovering from stroke depends heavily on the speed of attention to the event, it is wise to take this very seriously. Other reasons to suspect stroke include numbness, weakness, paralysis on one side of the body, or further difficulty with balance.
2. Vision Issues. Blurry, double vision? This is also a potential warning of stroke. Additionally, if you experience pain in your eyes, you should seek urgent treatment.
3. Chest Pain. This is a big one. If you have pain that lasts longer than a minute or two, it’s no time to wait. Treating a cardio event in the early stages is key.
4. Shortness of Breath. Any sudden difficulty catching your breath for longer than a few seconds should be your cue to get to the emergency room.
5. Stomach Pain. If it’s sudden, intense, and lasts longer than 30 minutes, a visit to urgent care is called for. Unresolved pain needs dealt with, and abdominal pain could need special attention. Don’t take the risk.
6. High Fever. If an adult has a fever that has reached 104 degrees, they need to be seen by a physician. The same is true for a newborn (up to 3 months) with a fever that reaches 100.4F. Excessive fevers need to be brought down. Let the professionals help.
7. Unusual Vomiting. When abdominal pain is unrelieved after vomiting, or if there is blood in the vomit, the situation needs caution and monitoring. If the unusual vomiting is accompanied by a high fever and lasts more than a few hours, children should be seen immediately. Adults should be seen if the episode lasts longer than a day.
8. Seizures. If seizures are part of your medical history, follow your doctor’s orders for managing; however, if seizures increase in occurrence, this is call to revisit your care plan. A first-time seizure requires immediate attention, as does a seizure experienced by anyone who lives with diabetes, or who is pregnant.
9. Head Injury. Take even a head bump seriously if you have a lingering headache. Head injuries can cause seizure, difficulty with speech, and confusion. Loss of sensation, strength, and coordination are also key indicators that any issues with head injury should be taken seriously.
If your symptom is something not listed above, be seen sooner than later. Aging happens differently to everyone, and health is high priority. Finally, trust your instincts. If something feels “off”, check it out. You’re right that it probably is nothing, but it’s much better to know than to worry. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.
When I talk to people about advocacy and geriatric care management, they get that part of what we do in our professional role is look out for older adults and guard against abuse of a variety of sorts. One of those kinds of abuse is financial abuse in the form of scams that target older adults. Scammers target older adults in part because, as a group, older adults can be more vulnerable, but older adults also are the ones who will have accumulated some amount of money over their lives - their nest eggs. But did you know that more than 90% of reported financial scams targeting seniors are perpetrated by their own family members? If you are a caregiver to an older adult or just a concerned person in the orbit of a senior, here are some of the common scams going around.
1. Meet you at the Funeral - Believe it or not, some scammers will go to a complete stranger's funeral claiming to the family or widow that money is owed for some prior contract or other obligation. But that is not all. Beware of the "add-ons" that some funeral homes may try to railroad at this vulnerable time in a family's loss. It is a really good reason that we all should make our own funeral arrangements before the time comes.
2. Boomers don't Age - With the boomers starting to fill the ranks of the over 65 cohort, there is a host of anti-aging products to assist those who feel 70 is the new 50. Help your senior to see through the false claims as well as the fake products posing as the brand names like Botox. And remember that if it is not fake in the case of Botox, that it Botox made from a deadly toxin; be certain of the recipe.
3. Fake Drugs - With pharmaceutical prices still a large part of any senior's budget, the lure of non-U.S. pharmacies is still there. Be sure that the distributors actually offer the real deal. FDA has been reporting an average of 20 major investigations of fake manufacturers every year.
4. Just Bill Medicare - Anyone over age 65 will qualify for Medicare to pay part of their medical costs. Some providers working the system, however, can purport to offer services and then bill Medicare. Since they can use your elder's personal information for a direct billing, the older patient will never be the wiser.
The list, of course, goes on. The reason why some of these frauds may happen is that they take advantage of a senior who is not as tech savvy on the web as younger web surfers may be. And at any age, we all can be victims of the deal that sounds too good to pass up. So, if you are a caregiver, lend an eye and an ear to that older adult in your orbit. Your vigilance will benefit them, and it also will give you the benefit of advance learning for when you are there one day. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@cr eativecaremanagement.com.
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably know is more than 372,000 in the United States alone. The number who have had the disease and survived is a bit more murky, because not all cases are detected or reported. We know how many have been vaccinated: about 40% of eligible Americans have had at least one dose so far and about one in four Americans have received both doses. We all have been making the push to that finish line to be rewarded with a 94% immunity from COVID. The number that has not been broadcast as much, if at all, is the number of people who have lost a loved one to COVID…not just known of someone as almost all of us do. The number of people who have lost a dear family member or friend is estimated to be about nine individuals for every person who has succumbed to COVID. Do the math for our own domestic turf, and that is well over 3 million Americans who have been … and likely continue to be … grieving for a loved one who has died. Some people may say that these losses … well … just happen, and people eventually get over it or through it. Hold that thought, because scientists have studied the biological effects of grief and found that grieving is actually life-threatening. Sure, we probably all realize that grief can lead to depression which is not to be taken at all lightly. But it also leads to changes in the immune system and it triggers inflammation in the entire body. Chronic inflammation in the body also can lead to cardiovascular disease, diabetes (type 2) and even some forms of cancer. We don’t see this from the outside, but it is analogous to instantly becoming morbidly obese; grieving is the same kind of ticking time bomb. So, what can we do if we have had this kind of loss or know someone who has lost a loved one? A grieving person will not move beyond that sense of loss, but they will – often with professional help – move forward able to retain a loving memory that walks alongside the loss. So, people don’t get over grief nearly so much as learn to move forward with it. Lora McInerny is the host of a really helpful web site whose name speaks volumes. It is titled, “Terrible. Thanks for Asking.” She had been through a deep personal loss, and had just a few too many people ask the wrong question, “How are you doing?” Some even chimed in with the cliché, “These things happen for a reason.” A better question can be “What did you do today…or yesterday?” or “What have you been doing?” You get the picture. If you have not experienced a loss, there is a good chance that you know someone who has. I recommend you visit the web site. Make someone’s day better. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
Anyone who has raised children in the 21^st century can probably remember helping their young ones learn how to stay safe while out of the house, and later while driving the car and in between while surfing the internet. If you also have an older loved one, you may now have to work with mom or dad to be alert to the new scams targeting the unsuspecting who have internet access. It is not just a matter of helping your older loved one install current anti-viral and anti-malware software. The new scammers are taking advantage of the perfect storm of technology, trust and assets.
Today more than three in five adults over age 65 have access to the internet, and nearly four of every five have a cell phone. According to Microsoft there is a new consumer scam taking advantage of these technologies and the trust of their owners to dupe an estimated 3.3 million individuals – many of them 65 years and older – of an estimated $1.5 billion. It starts with their phone when an alleged representative of Microsoft or Windows calls advising of a virus detected on their equipment. The consultant directs them to log on and go to a support web site that will double-check their computers for the trouble. Once logged on to the site, malware is installed that can hijack any personal or financial information your trusting loved one may have on their computer. But be aware that Microsoft does not make outbound calls. Or it may be just the phone alone that gives the bad guys access to your older loved one. Ask your loved one if they have received any calls where no one was on the line when they picked up. If so, they may be part of an automated system that is accumulating a data base of people who can be targeted for later scams. If your older loved one does not yet have caller ID, have it installed. Or the number one fraud presently taking advantage of people’s phone access poses as a representative of the IRS. This may be the one phone call everyone dreads, but the simple fact is that the IRS does not make outbound phone calls. That said, when an unknown caller invokes the name of the IRS and then proceeds to make demands, most people – elders included – can become very intimidated. Let your older loved one know about this, and if they ever receive a call like this or from any of a number of agencies or federal offices, simply look up the number of the nearest office by that name and call them yourself. Again, the IRS – or any other predator - does not call you; you need to call them. Charlotte Bishop is an Aging Life Care Professional and a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
It may surprise you to learn that as many as one in five caregivers are lending their help to an older adult who is still working a nine-to-five job. A lot of my writing has been about what we sometimes call the old-old, that is individuals who are advanced significantly above our traditional cut-off of 65 years of age defining someone as old. But there has been a steady advance over the past two to three decades in the portion of the labor force that is 65 years of age or older. In 1985, fewer than one in nine workers was over 65, but that figure has increased to almost one in five workers now who is over 65 years of age.

So much for the talk about taking care of a frail, elderly parent. Yet, older workers can benefit every bit as much from a caregiver’s help as someone who fits the more classic picture we have of taking food to an elderly shut-in. As a caregiver, encourage the following adaptations to the workplace:
1. At least every two hours take a short break to stretch and flex the muscles. Muscle flexibility is the main predictor of on-the-job injuries for any worker, and agility or flexibility begin to erode dramatically for
  
  workers as they age. When the muscles are tighter in an older worker, it can exaggerate the high blood pressure they may already have because muscle pressure restricts blood flow. Failure to stretch regularly also can lead to repetitive stress injuries like carpal tunnel syndrome, rotator cuff tears or
  
  elbow or knee inflammation.
2. Strengthen the core. I am not talking about grandpa making six-pack abs, but trunk and core strength all around the waist from front to back will minimize the risk of low back injuries, hernias, etc. Developing a strong core also is key to postural steadiness and avoiding falls.
3. Use new gripping methods to compensate for less nimble hands and fingers. Grip-assistive devices are important to more than opening a jar of pickles. Larger handles for older workers’ tools, handles instead of knobs, etc. can be very helpful.
4. Hydrate often and in quantity. Older bodies tend to have lower fluid content than younger bodies. The rule of thumb is to consume as many ounces of fluid as half their body weight (160 pounds = 80 ounces). This is all the more critical if an older worker is exposed to extremes in temperature on the job or if they are on diuretic medications for hypertension.
5. Have regular vision checks. More than just visual acuity changes with advancing age. Cataracts, dry eye and age-related macular degeneration are far more common among those over age 65 than younger workers.
6. Recognize that all of the above are exaggerated by pre-existing conditions. If your older parent/worker already is obese, diabetic, hypothyroid or suffers from hypertension, etc., these conditions may amplify the vulnerability he or she may have.
  
  Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to Charlotte Bishop.

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