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

Senior Scams Spike During the Holidays
We are fortunate to have a new contribution from a good friend and colleague, Julie Northcutt of Caregiverlist.com. Julie...
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December 14, 2011
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Summer Visits for a Senior Care Check-up
In this posting, I have invited Julie Northcutt, President of Caregiverlist.com, a company that uses new technology to deliver...
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June 3, 2011
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Safer Senior Living – The Kitchen
In my last posting I spoke to ways to improve the safety and accessibility of the bath for seniors...
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April 10, 2011
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In the Caregiver's Words

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September is Alzheimer’s Awareness Month, so we’re going to be sharing four posts that will help everyone with what we have seen to be the most important information about dementia in general and Alzheimer’s specifically. Our title here offers the “Four D’s” which provide a great starting point for understanding the medical condition that a majority of Americans fear more than death.
Dementia. It’s a category that includes about 100 specific cognitive conditions. Generally speaking, most dementias are diagnoses of exclusion. That’s medical talk for the fact that one narrows down what a person is manifesting by successive steps of eliminating other possible explanations for a behavior. Forgetting someone’s name is retrieval and it is not a warning sign of Alzheimer’s. Forgetting that you know the person at all, however, is a storage problem, and it can be a sign of a more serious brain issue. Misplacing the keys, according to the experts, can happen to just about anyone, but forgetting how to start the car and put it in gear should be cause for concern. If your loved one gets confused on the way back to your table from the restroom while dining out, that may be cause for concern. You should also look for smaller signs as basic as their stride. If their steps begin to more resemble a shuffle this may be a sign of a more fundamental uncertainty. Distraction. Who isn’t distracted? We live in an age of “multi-tasking” and where all manner of digital interruptions happen all day and into the night. Some of them we invite like podcasts, news segments, and streaming. Others are a bit more insidious like the “phone” that we all carry with us so that we won’t miss a text, breaking news or a call from a friend…or spam. And then there are those who take their constant companion to bed to catch up on last items, posts or other “essential information.” Oh, and this last one has been proven to be disruptive of normal sleep by your device’s light itself…never mind the content. Many of us have become a digital juggling act and yet wonder why we forgot the reason we walked into the kitchen from the living room. Delirium. Against all of the potential warning signs for possible dementia, be careful about a hasty judgment. A change in mental acuity that is rapid in its onset is better classified as a delirium – not dementia. These episodes can arise from urinary tract or other infections, dehydration or even some hormonal imbalances. Certain medications like steroids or combinations of medications can precipitate short term cognitive imbalances. And what your loved one’s neurologist prescribed for one condition may not mix well with what a cardiologist has prescribed. Be sure that there is a quarterback on your loved one’s medical team who knows what all the players are prescribing. Depression. Older individuals run a constant risk of isolation and all the effects associated with insufficient stimulation and socialization as well as loss. Their social network has diminished leading to less cognitive stimulation and the loss of friends, loss of status and loss of opportunities to feel validation simply lead to a smaller and smaller world which can result in sedentary solitude. Loneliness can look a lot like dementia, but it’s depression and can be addressed. Consider when your loved one last had a complete physical. By complete, we mean one in which all the medications they may have been taking are reconsidered. This is especially true if your loved one sees multiple providers each prescribing against the conditions in which they specialize; what the cardiologist prescribes may not “mix” well with what the neurologist or pulmonologist are prescribing. There may also be subtle cues that some have missed without a thorough exam that could include a neuropsychiatric evaluation or even something as basic as a hearing test. To read more on this subject, please check out our book…chapter 6. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Caregiver Advice on Bad Medicine Many are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed and how to spot warning signs. Download
I had left you last week with what may have seemed to be an optimistic note regarding the latest Alzheimer’s therapy to gain FDA approval. I am going to hand this second part over to one of my senior team members, Steven Steiber, Ph.D. Steve has his doctorate in behavioral science and nearly 40 years in clinical and market research in biopharma. Please read what he has to say: “I’d like to start with some of the reaction to the Centers for Medicare and Medicaid Services (CMS) current unenthusiastic opinion on whether they will cover Lecanemab. When FDA approves a medication, it’s on the simple premise that the drug is first “safe” and second is “effective.” That sounds pretty rigorous, and yes, there’s a good deal of statistical testing with relatively large samples of patients in double-blinded (neither the patients nor the clinicians know if they’re using the new medication or a placebo) clinical trials. CMS takes this a step beyond what the numbers say and asks if the therapy is both “reasonable” and “necessary?” I believe they’ll announce their final decision in early July. I’ve had the good fortune to have attended a webinar this past week sponsored by the International Alzheimer’s Institute. They had a panel of professors, physicians and even a biostatistician discussing the “data” on Lecanemab. The first important point raised was simply to lay out that the amyloid plaque that lecanemab helps remove isn’t the source of Alzheimer’s. It’s the result of what Alzheimer’s does to the brain. It’s like rheumatoid arthritis in that the inflammation which swells joints is not the disease, but a result of the disease. And how much amyloid does Lecanemab eliminate? The 18-point scale used to measure the effect against placebo showed those who had received the Lecanemab injections had .45 units less amyloid at the end of the trial…2.5 percent less amyloid. The trial also used a cognition scale that could show no statistically significant difference between the experimental group and the placebo group. Clinical trials are also required to track any side effects reported by participants during the trial as well as after the trial is closed. The Mayo Clinic has a list of more than 30 side effects associated with Lecanemab, and one of the panelists on my webinar, a neurologist at Northwestern University Hospital, reported a macrohemorrhage in an otherwise healthy patient. She subsequently died. I won’t pass judgment on a new medication…above my pay grade…but I will continue to look for treatments that actually address cognition or can work upstream from the plaque accumulation that Alzheimer’s leaves in the brain. I would rather hire a contractor who can build a great house that the critics call brilliant than one whose only claim to fame is how tidy they leave the site when their work is done. I would encourage you all to follow other trials for a way to address Alzheimer’s as well as those therapies that target other neurodegenerative conditions like Parkinson’s or Huntington’s. I’ve got a number of start-up companies that I am following, and we’ll updte you when new information becomes available. Meantime, let’s see what the final word from CMS on lecanemab is." Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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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There is much talk recently about “grade inflation” which rather diminishes the formerly exclusive appeal of a report card with A’s on it…or better yet, straight A’s. But this is a metaphorical discussion about the vitamins your body needs and what your body may actually be getting. So, we can thank Vitamin A for helping our immune systems and our body’s growth in our early years as well as visual acuity. Vitamin D also is an immune-booster, and you probably also know that it is a key ingredient for bone and joint health.
As scientists have delved into our body’s functioning, they have found more that 3,000 gene-regulatory functions in the body where vitamin D is key, and for 15 cancers or other life-threatening conditions that can be prevented or mitigated. Your mental health will also thank you for an extra dose of vitamin D. So, we’ve checked off bones and joints, but vitamin D also works to protect the largest organ in your body – your skin, but it doesn’t stop there. Those same endothelial cells that Vitamin D protects on your surface also branch out to protect your blood vessels and organs as well as your urinary tract. It’s like one of those players that make the defense and the offense of the team shine. I had mentioned mental health. You’ve all heard of Seasonal Affective Disorder. Vitamin D helps mitigate that seasonal downer as long as you use the right spectrum of light to activate it. And now that we’re seeing more sun with every day as we crawl out from winter, you can use the real deal: sunshine. As you become more able to “catch some rays,” do take note to expose yourself to no more than 10 to 30 minutes a day…and it helps to set aside your sunglasses during that time. Set a timer, because too much sun can be very bad for your skin and all the rest of you that is packed inside your epidermis. There’s a fairly long list of foods rich in vitamin D to include on your regular menu: cheeses and milk, eggs and mushrooms, and cod liver oil. (I put the fish oil last, because it may be everyone’s least favored source of vitamin D, but you can buy it as a capsule with a well-controlled odor.) What more can I say except: “THINK SPRING.” Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, LLC, 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.
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Roadmap to Alzheimer's Learn what to expect when you're caring for someone with Alzheimer's. Inside find tips for detecting dementia, how to best communicate with a loved one with Alzheimer's, and more.Download