Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Guest blogChicago's Geriatric Care Manager Center of Excellence

What “Senior Real Estate Specialists” Do
I have posted a number of times on how to make home safer as well as how to evaluate...
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September 4, 2013
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Caregivers Need to Prepare for Medicare Too
I recently spoke with one of the financial advisors we list on our Geriatric Care Management Support Tools page,...
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August 28, 2013
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It Is Never “Just” Diabetes
I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights,...
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August 21, 2013
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Dangerous Drugs and Medical Devices Caregivers Should Be Aware Of
I have had the good fortune to connect with Jennifer Mesko, Managing Editor of a great website and resource,...
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August 14, 2013
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The Other Reason Caregivers Should Panic About Tylenol
I have asked our vice president for geriatric care management and senior services, Dr. Steve Steiber, to share a...
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August 7, 2013
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Emotionally Healthy Older Adults
I had the good fortune recently to meet Jennifer Muskat, the Director of Client Services for San Diego Home...
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June 10, 2013
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In the Caregiver's Words

Recent Client Praise

Chicago Retirement Community Experts
With over two decades of experience in elder care services, we have assessed and developed close relationships with the best retirement communities in Chicago and its surrounding areas so we can connect you with the best of the best.
Life in a Retirement Community
If you are considering transitioning your elder loved one to a retirement community in Chicago area area, you know that choices are plenty and oftentimes it’s not clear what is the right choice. That is where we come in. Our Chicago elder care specialists work to ensure the best living arrangements possible for your loved one.
What is a retirement community?
A retirement community refers to a housing complex or building of older adults living independently surrounded by their peers, without any extensive outside assistance. Life in a retirement community is about convenience and the independent freedom to connect socially with other retirees in a safe and relaxing environment. Residents are free to explore their surrounding communities, and many of them maintain and operate their own vehicles.
Is retirement community right for you?
If your elder adult is interested in the freedom of independent living with the benefit of being surrounded by their peers, a retirement community may be what they are looking for. However, to make sure this is the ideal arrangement for your loved one, we always begin by conducting a thorough evaluation of their lifestyle preferences, their physical and mental state, and even an associated budget. Then, based on the information we uncover during evaluation, we develop a personal geriatric care plan for your loved one and present top choices for retirement communities in the area. We even take care of the application paperwork for you. We know that trying to maintain a balanced lifestyle, while taking care of an elder loved one is difficult, but if you have the right people helping you, it is doable. So, contact our geriatric care managers today for a free initial consultation and let us help you make your life and the life or your elder loved one balanced and stress-free.
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Recent Client Praise

I started in my last post talking about older loved ones and “aging in place.” That first post was about the aging part and Activities of Daily Living. In this installment, I have a tip on how to assess the “place” part of aging in place. I call it the “mitten test.” If you live in the upper portions of the U.S., your winter mittens may just about be ready for the storage closet. But your mittens have another useful purpose that can help you make home an easier place for your older loved ones. You can use them to identify spots in your loved one’s home that can be adapted to fit their changing capabilities. As our bodies age, certain of our nerve pathways begin to fail, and the human anatomy uncannily reroutes many of the circuits as they stop firing. But with age, more and more of those pathways may slow or fail for a variety of reasons, and it just makes it harder for older adults to do the simple manual tasks they used to do without even a thought. Turning a door knob, turning on a lamp or taking the lid off a jar become challenging, maybe even impossible. It is hard for those of you who may be in the prime of your lives to really get this, no matter how empathetic, so I recommend an easy exercise to help you experience what this erosion of manual dexterity and fine motor skills feels like. In doing so, you can also help identify challenging hardware or activities that can be more easily managed with a bit of creative help. With a pair of mittens, walk through each of the rooms in your elder loved one’s home and go through the normal activities of the person who lives in those rooms. As you enter a room, it is may be more challenging to flip a light switch or twist the switch on a lamp with your hands in mittens. These can be remedied by retrofitting wall switches with the larger rectangular switches that one merely presses on and off. Likewise, the lamp twist switches that are challenging with mittens can be replaced with wider winged grips. And even before you enter a room, the door knob may be your undoing if the knob is too small or too slippery. Handles may be an appropriate replacement. The mittens are effective barriers to everything from opening the ketchup bottle to a twisting the lid on a jar of apple sauce or beverage bottle and more. And if a key itself is hard for an older loved one to grip when opening a door, hardware stores have over-sized sheaths to make gripping easier. With your mittens still on, try tying your shoe laces or buttoning a shirt or blouse. It may be time to get creative with Velcro-equipped shoes or other substitute hardware for buttons. And go through the motions of other self-grooming activities to determine what challenges are manageable and which are just out of reach. The number of what are called “assistive devices” will amaze you as you look to television remote controls, computer access and more. Check out the Department of Health and Human Services Assistive Technology site. 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.

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Free White Paper: Exercises for Seniors, Depression Prevention for Seniors

Cases of depression are increasing in people who are 65 and over. Any number of factors can cause this as we age, including more medical complications, the sense of loss, and isolation. Additionally, many who aren't diagnosed with depression simply feel down about life. We've compiled a series of senior resources to help you or a loved one stay upbeat and positive.

Inside "Caregiver Counsel for Taking the Old out of Aging"

Ways to give your brain the extra boost it needs to stay sharp as you age

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Caregiving in this century is not just handholding; it combines the latest technologies with caring to allow virtually anyone to be virtually anywhere they are needed. As a geriatric care manager I often am in the role of the “person who knows resources” that caregivers and their loved ones can rely upon.

A new study produced by a partnership between the National Alliance for Caregiving and United Healthcare offers results of a nation-wide online survey of caregivers who are leveraging their caregiving with web-based and mobile technologies. The survey was based on the responses of 1000 Caregivers at least 18 years of age, who provided at least five hours of unpaid care to an adult relative or friend and had already used some form of technology to assist them in their caregiving. To see the full report, please go to The e-Connected Family Caregiver: Bringing Caregiving into the 12st Century. Here are just a few of what I think are their insights for modern caregiving.

The survey asked these people to rate how helpful they found each of twelve different technologies to be. You may get some ideas for your own needs from their answers. The three “most helpful technologies" included:

Health record tracking that would help the caregiver to follow their loved one’s history, current status and other metrics even if they cannot be at all appointments;

Shared electronic calendars to allow everyone to track a loved one’s doctor appointments and other needs;

Electronic reminder systems to help the loved one stay on schedule with medications as well as actually dispense the pills.

Although the most common challenge to using these and other technologies was their real or perceived cost, the greatest benefits caregivers see for themselves and their loved ones are, in order:

Saving time,

Managing logistics more easily,

Enhancing safety for their loved ones,

Increasing the effectiveness of the caregiver, and

Reducing the stress that a lot of caregivers feel.

So, what beyond cost stands in the way of caregivers embracing these new technologies and others? Most caregivers want to be told about technologies from a trusted source like their physician before they will buy it. Or they want to actually have someone walk them through how the technology works.

One of the clear themes to emerge beyond the value of technology is the basic fact that almost all caregivers already use technology in the form of Internet access. So, check out the National Alliance for Caregiving website as well as two other medical sites that survey respondents endorsed as trustworthy:

WebMD and The Mayo Clinic. Participants in the survey also gave high marks to the Medicare web site and the Administration on Aging web site.

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 throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.

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Career Opportunities at CCM

Open Positions:
Creative Care Management is looking for full- and part-time professionals to provide geriatric care management services to our clients. CCM was founded more than twenty years ago and is a team of certified professionals providing answers to older adults in Northern Illinois and their families.

Qualified applicants should have:

a nursing, social work or other degree in the helping professions

experience with older adults or others with special needs is a plus

GCMs will evaluate an older person's situation, identify solutions, and work with the family to design a plan for maximizing an elder's independence and well being. Geriatric care management involves an in-depth assessment, developing a care plan, arranging for services, and following up or monitoring care. A GCM can also assist in the medical management of a client and suggest potential alternatives not considered, and they assure a loved one receives the best possible personalized care and all the benefits to which they are entitled.
Please send a bio and credentials to:

Steve Steiber

ssteiber@creativecasemanagement.com

or call 847-869-5118 x 511.

Happy Valentine’s Day…a couple days late. February is American Heart month, so why would I start by talking about your older loved one’s pancreas? Let’s start with the fact that one in four adults over age 65 develops diabetes. And although it is over-simplifying things a bit to say that type 2 diabetes is all about having too many sweets, there is a strong connection between consuming too many carbohydrates over one’s lifetime and developing type 2 diabetes. Unfortunately, there also is a strong connection between diabetes and cardiovascular disease. But wait, it gets even scarier. The combined prevalence of prediabetes and diabetes – both undiagnosed and diagnosed, respectively – is estimated to be between 50% and 80% among older Americans. So, why does this affect the heart? Well, diabetes has a way of making a person’s blood a bit sticky. Well not literally sticky like gum on a sidewalk, but uncontrolled diabetes leaves more sugar floating in the bloodstream, and the sticky cells that have been tangled up with the blood sugar tend to block the smallest vessels in the cardiovascular system. The heart may pump blood through some very big arteries, but the muscle itself is made up of a lot of microvascular pathways that keep it fed and oxygenated. Once we add free sugar to the mix, some of those tiny vessels become clogged. The less well-controlled the diabetes is, the more sugar is roaming the cardiovascular highway, and the more blockage there is. No surprise then, that in excess of 70% of both men and women over age 60 have some level of cardiovascular disease. Now, we could go on about the damage to other microvascular regions of the human body like the kidneys or even the eyes and the feet and the hands, but the lesson is already clear. As we reflect on our past valentine’s day, go a bit lighter on the candy that may still remain in the box and a bit heavier on the love. Because in addition to hurting the little vessels of the heart, the excess chocolates that we cannot burn as energy for our bodies get stored. And you probably already see where this is going; the unused sugar gets converted to fat, and each pound of that unwanted baggage creates another mile of blood vessels. It is a bit crazy to think that we have to feed the fat, but every cell of the human anatomy is no more than one cell away from a supply of blood. So Valentine’s Day has to share the calendar with American Heart Month. And if we all do that, then maybe we can even consider renaming February as American All Around Healthy month? 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.

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It is absolutely great news that Pfizer and BioNTech have brought a vaccine for COVID-19 from discovery to approval by the US Food and Drug Administration just today. We all can see the promise of “normal” on our collective horizon and almost breathe a collective sigh of relief. We have been more than a bit distracted by COVID-19 for how long…ten or more months? And what used to be the major concern of everyone with an older loved one can now get some press. And there may be good news in the Alzheimer’s fight as well. A company called Cassava Sciences has shared results from a Phase 2b clinical trial that show its therapy helps to block a protein that triggers brain inflammation and the loss of neurons. They are moving to Phase 3 trials on patients who have been diagnosed with Alzheimer’s Disease. The drug is called sumifilam, and it is an oral medication that can be taken once a day. The Phase 2b study focused on how oral administration in a range of dosing could block the proliferation of a protein called HMGB1 that causes inflammation in the brain. The same drug also helps to restore both the shape and function of a beneficial protein in the brain called filamin A, and while it is doing that it also is strengthening the natural defenses of brain by blocking access across the blood brain barrier of inflammatory proteins like albumin. In more straightforward lay terms, this tablet can help manage three pathways by which Alzheimer’s disease can negatively impact the brain. Part of the evidence the scientists presented to get approval to move forward with a Phase 3 clinical trial focused on some of these biomarkers of harm to the brain. Simifilam also showed a reduction of Ptau-181, the “tau tangles” that are a physical characteristic of Alzheimer’s as well as improved performance on cognitive tests. As this promising therapy rolls out with a Phase 3 trial across a number of sites in Arizona and Florida among patients with mild to moderate Alzheimer’s Disease who are 50 to 85 years of age, I will keep you informed of findings. You also can follow any reports to the public by going to a government site for clinical trials related to Alzheimer’s. Spoiler alert – there are nearly 1,300 trials currently in motion on some aspect of Alzheimer’s Disease. We will keep you posted on anything truly noteworthy coming from any of these trials so you don’t have to work on your doctorate in biochemistry to decipher what the reports tell us. So, please consider this two doses of good news on the medical front this week. And when it comes to clinical trials, please remember that the two key tests the FDA applies are that a treatment or vaccine is safe and effective…in that order. Please do not be sucked down the rabbit hole of those who suggest otherwise. Just Google thalidomide…FDA withheld approval of that therapy when the European Medicines Agency signed off. 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
April showers are supposed to bring May flowers, but what does May bring? It brings Mental Health Awareness Month…among other things. If you are a caregiver to an older loved one, this is particularly important. Mental illness – particularly depression – is a high risk for individuals as they age. One out of every four older adults has some form of diagnosable mental illness in any given year. About six percent of older adults manifest some form of clinical depression, but older adults can also respond to talk therapy and medication for their mental health issues at rates comparable to younger adults. Yet, older adults more often go undiagnosed and therefore untreated. Some people have a lifelong battle with a mental illness like depression, but for many more it may be precipitated by a condition like stroke, Parkinson’s disease, diabetes, cancer or arthritis. But older adults also have a life that has accumulated losses, most specifically they have lost friends, family, loved ones. We all probably know that the average life expectancy in the U.S. is just under 79 years…that means that the typical 79 year old has lost half of their friends and family by that time. The rate of suicide for 75+ year olds in the U.S. also is higher than any other younger cohort, in part because those over 65 have a “success rate” in their suicide attempts that is five times more lethal than those who are younger. This is not to depress you; it is a wake-up call. It will be up to those of you who are caregivers to older loved ones to look for the signs, because only half of depressed patients are diagnosed by their primary care physicians and only half of patients who discuss any depressive symptoms with their physicians will get any treatment. So, what should you look for?
- Any signs of a sad or “blue” phase that lasts more than a couple weeks
- Difficulty remembering things or confusion in even familiar settings
- Self-medicating with pain medications or alcohol
- Perpetual worries around money or health or loved ones
- Sustained challenges sleeping or concentrating
- Intense caregiving for a loved one that is not allowing them to “get a break”
If you see any of these signs, bring them to your loved one’s physician’s attention…and be persistent if the signs and symptoms persist. Sadness or depression are not “just part of getting older.” Eighty percent of older adults who are diagnosed and get treatment recover from their depression. Your “mental health awareness” can be their mental health cure! 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
We are less than a week away from Mother's Day, and preparations are in motion, cards are purchased, reservations are made and flowers will be sent. That is what Mother's Day has come to represent for most of us, but there will be some for whom Mother's Day is more an occasion for dread or sadness. That is because Mom is no longer here to celebrate the date. Especially in my work as a certified geriatric care manager, I've talked with caregivers who have lost a mother. I find that there can be a lot of denial or depression as May comes around. It seems easier to ignore the day, or maybe the sad, slippery slope of depression seems unavoidable. That is where I come back to one of my mantras for all caregivers, and that is that the caregiver needs to care for herself or himself. What does caring for the caregiver look like when one is facing an important, but seemingly hollow, holiday? You can begin by letting the mom who lives in your memory remind you of the good times or the kind words or the special places. Mother's Words. If you have a sibling, perhaps start the conversation about what "mom used to say." If she used words of encouragement like, "It is not about what the other kids do; it is about just doing your best." Or maybe mom liked to talk about finding the "silver lining." Mother's Things. Those of us who have lost a mother also probably saved an item or maybe several of the things that delighted mom or that we particularly associate with her. Maybe your mom kept a collection of your pictures or clippings from the school paper? My mom kept a small spiral notebook of jokes so that she could remember and share them with others. Most of them were admittedly a bit corny, but they make me smile even now when I go through the pages of memories on days like Mother's Day or her birthday. Mother's Actions. It can also be special to do some of the things that your mother used to do as a way of "taking a walk with mom." Maybe mom had a favorite park or garden where she liked to go on "her day." May is such a wonderful month for all the new blossoms of spring, and taking that walk can bring back wonderful memories complete with beautiful buds and their wonderful scents. Or some find it really great to go to mom's favorite restaurant and have their own favorite dish or order the chocolate pie that always was mom's guilty pleasure. It really all comes down to making the day special for yourself just as you used to make it special for your mom by caring for the caregiver. Doing that special something for yourself just as you used to do it for your mom can actually make you both feel better about her day. And if you are a mom with kids of your own, it can also be a wonderful way to let them know how to someday manage their own transition of Mother's Day. Charlotte Bishop is a certified 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.
Every 25 seconds, somewhere in America someone experiences a coronary event, most typically a heart attack. Although 70 to 90 percent of these sudden coronary events are among men, heart attack is the leading cause of death in women 65 years of age and older. If you are a caregiver to an older loved one, this is an important risk to understand...but for a reason you may not expect. Ageism! The care that older adults receive may be different from the care a younger individual receive, but age should not deny care that will offer better health and quality of life. Yet, that can happen. If you are that caregiver to an older adult who has just suffered a heart attack remember first that time is critical. A heart attack happens when the small vessels that bring blood to the heart muscle are sufficiently blocked that an area of the heart muscle is being starved of oxygen. The longer that vessel remains blocked more of the muscle will die. Ageism may be the obstacle to surgical intervention that can not only save an older adult's life, but also restore better quality of life. Listen for the three words: "Not a candidate." Many physicians practice medicine by the birthdays, and there are still physicians who will look at an 80 year old patient as someone who is not a good candidate in their opinions. But, as Harrison Ford once said, "It's not the birthdays; it's the mileage." In fact, there is perhaps greater variability in the relative fitness among 80+ year olds than any other age bracket. They should not all be lumped into the "unqualified" category. You may very well find one patient who truly is frail, but another who still runs marathons. The procedures to revascularize an older patient's heart can be successful, but patients must be carefully selected. If you are the advocate for your older loved one with a heart attack, listen for ageism, but be sensitive also to gender differences. Women tend to be smaller than men, and they also tend to have smaller blood vessels. This may preclude their being good candidates for surgery. A patient who has already had bypass surgery also can be a relatively poor candidate for revascularization. Some patients with other comorbidities like diabetes or dementia or pulmonary conditions also may not be good candidates. But it is not their birthdays alone that may disqualify them. Even in such cases, there are some relatively new and less invasive procedures that may be very appropriate for those who otherwise may not be good candidates for conventional revascularization. There are new laser procedures that do not require a full "open procedure." And we all have heard of balloon angioplasty or implantation of stents. There is even catheter-based aortic valve replacement as a new option for certain patients. You do not have to be a heart surgeon to be able to speak with your older loved one's doctor about options. But as a caregiver you need to be very attentive to the ageism that may harm your loved one more than their medical condition. 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.