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

That “Other Caregiver Talk” with an Older Loved One
In my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved...
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September 26, 2013
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For Caregivers with Single Senior Parents
There are nearly 40 million people in America 65 years of age or older, and that number is expected...
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September 24, 2013
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Caregiver (Sibling) Rivalry
Raise your hand if you ever had a disagreement with a brother or sister as you were growing up. ...
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September 5, 2013
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A Hearing Test for Caregivers
We often refer to Geriatric Care Managers as the eyes and ears for the family when they cannot be...
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May 9, 2013
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In the Caregiver's Words

Recent Client Praise

Perhaps you’re thinking about ways to make caregiving easier in the next coming year. You may have read tips and advice about caregiving and creating care plans, especially if you follow this blog, but don’t know exactly what care managers do on a task by task basis. An elderly care plan should encompass all facets of a senior’s life. In days of old, care plans merely addressed pressing health concerns. Today, caregivers design care plans that include health, lifestyle and social dimensions, improving their residents’ quality of life across the board.

As a care manager, one of the goals I try to instill through CCM is providing assistance within the context of a senior resident’s accustomed environment. If the resident lives in a nursing home or care facility, the care plans should allow for home-like routines. A reliable Chicago senior care provider must also encourage healthy lifestyles that fit the resident’s beliefs and personal preferences.

Before actually preparing a care plan, we first observe the senior resident’s daily routine. We try to find out if there are tasks the resident prefers to avoid, e.g., picking up clutter, cooking a meal or bathing, and why the person avoids them. We also might prepare an ADL (activities of daily living) questionnaire for the senior and loved ones to fill out. The resident’s daily needs, lifestyle choices, hobbies and interests will be explored as well. In addition, we’ll about activities the resident would like to pursue, but currently cannot, because of a constraining physical or mental condition.

Once we have all the pertinent data from observation and needs assessment, we’ll go over these findings with the senior resident. They decide whether certain devices would be of help, especially in the performance of ADLs. Identified care needs, however, should be administered in such a way as to preserve the dignity of the resident and promote his independence as much as possible. Appropriate ways to encourage the patient to engage in a hobby and interact with others are considered too.

When the assessment is completed, they start identifying together short and long-term goals for the resident to work toward. Goals are written by both the care manager and the senior, and should have the patient's strengths and needs in mind. Throughout the entire process of goal setting, the senior gets the ultimate vote over specific objectives he or she deems worth striving for. After all, a geriatric care plan helps ensure that an aging individual continues to enjoy life. This is why it is so important to find reliable Chicago senior services only from established managers. Creative Care Management also makes sure to link seniors and their families with the appropriate local resources in Chicago for care providers and other needs.

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.
It's June, and school is out for a lot of kids and everyone is thinking of taking time off. In fact, by a certain time of the year most people who are going to take a summer vacation will have made their plans. We all know how to make plans and make reservations to get to where we want to go. If we look beyond what month it is and think about seasons of our lives, we may also be thinking about retirement. By a certain time of life most people will have made retirement plans. We all know where to turn to get advice on how to make plans and maybe even a picture of where we would like to be once we become financially independent. As a geriatric care manager, let me suggest also that by a certain time of life most people will not have made plans for getting older. In fact, the plans that need to be made for getting older typically will not be made by an older adult, but rather by their caregivers. And the typical caregiver will not always know where to turn to make those plans for their older loved one. So, please allow me to share with you what is usually 60% of my first conversations with someone who e-mails us or makes a call as a way of explaining what a geriatric care manager does. Looking at that first example of summer vacations, it would be really great if there were a geriatric care equivalent to Travelocity. Or talking of retirement, it would be really easy if having a plan for getting older would be like following that arrow line in the television commercial. But there is hope. Making plans for getting older can be easier than a lot of caregivers think. The majority of the first conversations I have with clients are a lot about what they are looking for like: • home medical care for an older parent, or • a senior community where mom or dad can move or • where to go for what they see as the onset of dementia in a loved one. As the conversation unfolds, it usually becomes clear that what is needed first is an overall assessment and then a plan for the options available to support a loved one in maintaining their maximum quality of life. One of my associates calls us the "wedding planners" for getting older. To just get home care may be a bit like that wedding planner who just tells you where they have a great stock of wedding dresses when you were really looking to plan that "special day." To just get a list of senior communities in the area may ignore the other options for aging in place that could come from a full assessment leading to a plan. And it may be dementia or it may be interactions among any of the multiple medications that your loved one has been prescribed by multiple providers. What may be more helpful is someone to look at the big picture and help make a plan. If you are a caregiver, think about your concerns for your older loved one, but also consider looking into geriatric care managers. They are essential in providing an overall informed assessment and even more important for discovering all your options. The person who can best do that likely is the person who sees the big picture and knows all the resources available. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
How about a free genetic test to learn more about your ancestors? Free… And finding out about the people who no longer are alive to tell their stories? And your older mom or dad figure why not... Well, identity theft is why not. How many of you have taken the test to find out more about your ancestors? You know, the one where you offer a sample of your saliva in a tube, mail it off and they return a “report” to you that details what they know about where other people with similar genetic profiles call “home.” Most people find they have ancestral roots that go back to a lot of places, not just the family homeland they heard about as children. So, of course, scammers would be finding a way to use this test which is supposed to put us all on the map in order to defraud unsuspecting elders. The U.S. Department of Health and Human Services Office of Inspector General has sent out an alert. Scammers are offering people qualified for Medicare to get the same test that you or I may have paid for on-line. You may have thought your older parents were pretty insulated from this kind of scam, but here is how it works. We’ve all been to the public health or “aging well” events where a roomful of professionals are giving away books on senior residential options, refrigerator magnets, sticky note pads and a cool bag for carrying home the haul of freebies. There are other ways like telemarketing and door to door calls, but scammers are offering the unsuspecting older individuals a free cheek swab by simply providing their Medicare identity, and the target who does not recall that they no longer need to provide their social security number don’t hesitate to offer that in exchange for an ancestral map. Well, it becomes an access point to a different kind of map, your loved one’s financial map. And with the address and social information, scammers can begin the kind of work they do all too well. So, prepare your older loved one to be vigilant about:
- If a testing kit arrives at your loved one’s home, tell them to not do a thing if their physician did not request a test. Better yet, take note of the address of return and report it to the authorities.
- If a stranger offers a genetic test and…by the way…asks for a Social Security or Medicare number, stop. In fact, anyone other than a physician’s office or lab should not be given any of these pieces of identification.
- If anyone asks for Medicare information, and they are not a medical provider to your loved one, beware. So, this is more than saliva in a test tube. If you suspect Medicare fraud, depart the Office of the Inspector General of the Department of Health and Human Services.
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.
Dementia is the condition that adult Americans fear the most, and tragically there are conditions that can give a false alarm to trigger that fear. What walks like dementia and quacks like dementia may not necessarily be dementia! There are a number of medical conditions that mimic dementia – quite convincingly – until the condition is examined more closely and treatment is administered. So, in a real sense, dementia is a diagnosis by exclusion…diagnosis by eliminating the “look alikes”. Did you know that…
1. Thyroid disease can mimic dementia– Physicians can readily diagnose when the thyroid gland is producing too much or too little hormone by calibrating the levels of Thyroid Stimulating Hormone in the blood. But it often takes a specialist, an endocrinologist to make the definitive call. They talk about “subclinical characteristics” such as fuzzy memory along with others like dry skin or fatigue or hair loss. Hypothyroidism is one that can be readily treated by a thyroid supplement and symptoms simply fade away.
2. Diabetes can mimic dementia – As if it is not difficult for a diabetic to manage sugar and carbohydrate intake to avoid “running high or low,” the condition can actually affect memory as well. In older adults who have not yet been diagnosed with type 2 diabetes, they may appear irritable and confused or may have difficulty with recall. These mental states are caused by changes in the body’s blood vessels which may not give enough flow to the brain resulting in dementia-like symptoms. If diagnosed early the problems can be reversed and normal cognition restored.
3. Alcohol abuse can mimic dementia – We all have seen someone who has been “over-served,” and that person is not only an impaired driver, but their brains generally are not sharp. Well, the next day that same person recovered motor and cognitive functions, and life is normal again. Repeat offenders, however, will create more lasting effects on the brain and memory shortcomings. The memory issues may not be dementia, but they can only be reversed if a person stops the abusive behavior early enough, and for some the cure is to abstain entirely.
So these are three conditions in which dementia can be the wrong diagnosis, and they are also issues that can be remedied. There are more conditions that can pose as dementia, but they are not. They may not just go away on their own, but unlike dementia, they can, in fact, “go away.” More to come next week. 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.
COVID 19 was not in my calendar for 2020, and I strongly suspect it was not in yours either. I often have said that family life crises don’t make appointments; they just show up. And I am usually talking about how to be prepared for the inevitable call from or about an older loved one in your orbit…AND how to be prepared for your and their next steps. Well, this time, preparing for a crisis could be closer to home, because all of us need to be prepared so that the people who may get the call that we have taken ill can be prepared. What do you need to do to make a Plan? When I have spoken in the past, some people back off from talking about a loved one in a crisis. This list is about you, so please forgive me for getting “personal.” Here is my “short list” of the documents you need to have and make them available to your partner, your kids or other close friend … sometimes with no notice:
- Medical Release – the document you need so your medical providers to speak with your loved one’s about your health status, medications and prognosis.
- Power of Attorney (POA) for Finance - a legally binding document that gives a person (referred to as the “agent” or “attorney in fact” permission or power to act on your behalf in matters of property or finance.
- Power of Attorney (POA) for Healthcare - a legally binding document that gives a person power to act on your behalf in matters of medical treatment. The “power” typically is in force when it is deemed the person in question can no longer act for themselves or if they are not conscious.
- Practitioner Orders for Life-Sustaining Treatment (POLST) – a document (varies state by state) that specifies in advance what measures you wish to have in the event you cannot expressly grant permission yourself. These orders typically revolve around life-saving measures; they are sometimes referred to as advanced directives and are placed in your medical files. The forms are downloadable at your state’s web site.
- Health and Life Insurance Policies – the health policy will help everyone involved understand what is covered and which physicians and other providers are available to you. The Life insurance policy should be in a safe place so that it can be readily accessed should that become necessary.
- Estate Plan – is (potentially) a wide-ranging document that let’s everyone know how any real estate or other holdings are titled and what the “plan” is for when your will is executed.
- Trust documents – help to identify how your estate is to be transmitted to beneficiaries. Trust names need to be consistent with life insurance, will and holdings in order to be in effect.
- Last Will and Testament – the legal document by which you express your wishes of how property is to be distributed at death, and names one or more persons, the executor, to manage your estate until its final distribution.
- The Grab and Go – This is a list that typically is sealed in a plastic bag. It includes your medical insurance documentation, a list of allergies, a list of medications, primary care physician contact details and in case of emergency (ICE) contact information.
Please email (info@creativecaremanagement.com) me with any questions on any of these…as well as how to take the next steps which is your plan. Do yourself a favor…don’t wait. 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.
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral to an orthopedic surgeon…a hip specialist, no less. …or have had shortness of breath and your primary care provider recommends you be checked out by a cardiologist. …have a generalized fever for a number of days, you’ve lost your appetite and you have general body ache and sinus congestion. After the COVID test, there may be a referral to an infectious disease specialist. Even the doctors sometimes complain about how “over-specialized” medicine has become. When did you last get a referral to a specialist who focuses on…well, lots of your body’s functions and their health? They are calling it lifestyle medicine, and it has a lot to offer almost everyone. One practitioner describes this emerging specialty: “it's the use of evidence-based lifestyle and therapeutic interventions to prevent, treat, and reverse chronic diseases.” (click here) What is the focus of “lifestyle medicine?” For those of you who are accustomed to a trip to your older loved one’s doctor as a lengthy review of existing prescriptions…and often getting one more added when leaving their provider’s office, this new specialty may seem a bit radical. But it’s radical in the right direction. The five pillars of lifestyle medicine include:
- A whole food diet with nutrition built around predominantly plant-based healthy foods;
- Sufficient quantity and quality sleep on a regular basis;
- Stress management…primarily achieved through eliminating the stressors that many of us take for granted as part of 21^st century living;
- Healthy relationships – get rid of that old idea about keeping friends close and enemies closer…just keep healthy friends;
- Avoid toxic substances like tobacco, excess alcohol consumption and such.
Do you see the real difference with this “new specialty?” It puts control back within the individual and works to avoid undue prescribing or tolerating unhealthy habits. And it’s guaranteed to improve cardiovascular function and minimize bone and joint issues. The key, however, lies within a patient who implements the changes. And this method has been largely “on the books” in medicine for years, but it’s been neglected…perhaps because too many patients are inclined to ignore, for instance, the first and second line treatments for heart issues…diet and exercise. If you are a caregiver to an older loved one, help them to this “new cure” perhaps by “being the change” yourself. 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.