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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
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September 15, 2020
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That’s Not A Senior Moment
We all hear the phrase used as an excuse for a bit of memory lapse … that it’s just...
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September 1, 2020
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Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
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August 18, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 2020
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Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
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July 21, 2020
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Just the Facts – About COVID Today
For a pandemic and quarantine that has lasted about 18 weeks, it is safe to say that most of...
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July 14, 2020
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Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
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July 7, 2020
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While Quarantining, Prevent Alzheimer’s
We’ve heard Doctor Fauci say it many times…that we have to deal with this pandemic on the virus’ terms,...
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June 30, 2020
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Abuse Thrives in Pandemic
Guest post author Gregory Peebles is a team member at CCM whose work focuses on helping aging adults and...
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June 16, 2020
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In the Caregiver's Words

Recent Client Praise

In past postings I have talked about the very difficult conversation caregivers can have with their older parents or loved ones who are no longer safe behind the wheel. The rate of per mile casualties for drivers 75 and over escalates rapidly, approaching and then exceeding that of under 20 year old male drivers. How does one tactfully and sensitively talk with an older adult into giving up the keys of that four-wheel machine that is so entwined with their sense of independence. But should we feel safer after that awkward conversation and our older loved one is back to curbside as a full-time pedestrian? Not necessarily. According to recent national statistics, fully 19 percent of all pedestrian traffic fatalities involved adults 65 years of age or older. Translated, a 65+ year old's chances of being killed in traffic while walking is fifty percent higher than other younger pedestrians. Some of you may see that and jump to the conclusion that well, that is an urban problem...not a suburban or rural one. Not so. The data show that pedestrians in small towns are more likely to be killed or injured than those in more urban or metropolitan areas. And a majority of all pedestrian, auto or cycle fatalities occurred in rural areas. Every two hours a pedestrian in America is killed. There is an initiative in both national houses to introduce new legislation to address the issues in an law known as the Safe Streets Act. It is all about smarter planning of American's streets and sidewalks so that at least the new road or walkway construction will be safer for older adults. And there are new safe street policies being embraced by more than 600 city and county governances across the United States. While there are national and local governmental moves afoot to make streets and sidewalks safer for pedestrians, that alone may not make your older loved one safe enough. If you are a caregiver to an older loved one who is a full- or part-time pedestrian, you should not feel that you need to take your loved one off the sidewalk to protect them. But you can help them to improve their "pedestrian fitness." For starters, have their hearing checked as part of a regular physical exam. If your loved one can hear something coming from a roadway, they will have a much better chance of finding safe ground than if not. By the same token, have their visual acuity checked yearly to make sure the glasses they may wear are sufficient to see the number of seconds left on the crosswalk light. Finally, your loved one does not need to go through training to be an Olympic runner or walker, but they need to have the best gait possible. As adults age, they point decline from a slow walk to a shuffle which is an accidental fall waiting to happen or an inability to get out of the way of oncoming traffic waiting to happen. See if their physician can write a prescription for physical therapy. 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@creativecaremanagement.com.
We all know that an object at rest tends to stay at rest, and that is as true of older adults as it is younger ones if you look at the frightening statistics on the obesity epidemic in America. Habits developed over the long run tend to be harder to break, but the fact is that appropriate exercise for older adults can get easier and easier just by the simple fact of dong it. Because the corollary to my first scientific law is that objects in motion tend to stay in motion. And exercise gets easier. Doubtful?

Here are nine reasons:
1. Starting a new exercise routine may feel clumsy at first, but so did dancing, riding a bike and a lot of other physical work we have all gotten better at with time. Muscle memory will help, because your body will make new nerve pathways to make your exercise easier with time.
2. Blood flow improves when you exercise at any age. The smallest vessels actually can increase in number fueling all parts of your body as your heart rate routinely increases with practice.
3. We all have seen body builders grow muscles into sculpted works of art. Well, we do not see the heart, but it gets stronger also with workouts that are even modestly strenuous. This is true of older adults as well as college athletes.
4. With the muscle memory and greater cardiac capacity comes increased confidence among elders who exercise. Physical confidence, in turn, creates greater overall confidence and a sense of “can do.” Older adults with a regular workout routine also will sleep better.
5. We have heard from too many fanatics about “no pain-no gain.” The opposite is, in fact, true. As an older adult works out over time, the body raises its threshold for working. With time, an older adult can do more and more without that shortness of breath or even the soreness afterwards.
6. Take that last one to a higher level, and if the older body begins a regular regimen of moderate exercise, the body’s hormone system will reward it with cocktails called endorphins. Endorphins are basically a homemade version of morphine to help the body feel better and better.
7. The power plants in your cells also will begin to grow in number with exercise over time. You cannot see them, but the mitochondria, as these power plants are called, become more numerous so that your body can burn more carbohydrates and fat to create more energy.
8. Exercise will encourage better eating habits. It is true, because a lot of those bad habit foods – comfort foods – are linked to stress, anxiety or even depression. Since exercise works against these negative emotions, some of the craving for the junk food will ebb as well.
9. Exercise actually makes a person happier. Tied to some of what I mentioned in #8, exercise really lifts the spirits, and it does it in part through releasing chemicals called serotonin, dopamine and norepinephrine. These chemicals can be as effective as some of the drugs often prescribed for depression.
Before you exercise or encourage an elder to exercise, see a doctor to sign off on your fitness to exercise.

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.,geriatric care manager Chicago, geriatric care Chicago

Copyright ©2011
When we as geriatric care managers talk about memory loss and aging, it seems inevitable that the discussion turns to Alzheimer's Disease or some form of dementia. The truth is, however, that nearly everyone's brain will begin that slippery slope to losing track of the keys, names or other details of our daily leaving. The part of the brain that forms memories and then helps us retrieve them is called the hippocampus, and it just degenerates with age. Scientists tell us that the hormones and proteins that rejuvenate and protect brain cells decline as we grow older. The reduced blood flow to older brains contributes to this decline as does the ability of older adults to absorb the nutrients that bolster the brain. If you are a caregiver to an older loved one whose mental function you want to help, take heart. Here are some tactics you can implement to help keep their brain as healthy as possible:
1. Eat Well. Nutrition is as important to older adult brains as it was when they were youthful and just beginning to grow their bodies. Focus on fish, white meats and all the most colorful vegetables to enhance nutrients.
2. Keep Learning. There is so much that can be exciting to an older brain if only they expose themselves to the world. Encourage your loved one to read new books, travel to new places, go to museums, listen to different music, take a different way home from the grocery store.
3. Work it. If your elder's body is working, the brain is benefiting. Increasing the flow of oxygen and blood through physical exercise will, in turn, flood the brain with oxygen while also releasing agents in the brain that enhance learning.
4. Don't Multitask. Even for a vigorous, youthful brain, multi-tasking simply divides the attention that can be devoted to any one task and diminishes recall. For an older, challenged brain any reduction in distractions will allow greater focus and better ability to retain.
5. Use Associations. If your older loved one meets a new person, encourage them to use an association with a feature of that person that may make it easier to remember their name. If they are visual people, use a visual assist; if they are aural people, ask them to repeat the new information or name as a way to remember.
Throughout any exercise along these lines, help your loved one to appreciate that we all forget some things at least some of the time. And we all have heard the phrase that we should "forgive and forget." Maybe we should turn that around and encourage our older loved ones to "forget, but forgive" themselves. 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@creativecaremanagement.com.
The rest of the oft-quoted phrase is a pejorative about how “Nobody’s Home.” And we know it’s supposed to connote low wattage of an intellectual sort. Well, burglars who may be watching for when your mom and dad go on the vacations with which retired folks are supposed to be frequently indulging themselves are also watching to see if the lights are on. According to law enforcement they take the lights on as a sign that, in fact, nobody’s home. So what can one do to safeguard home? Well, the same bad guys also look to see if the lights go on at the same time a couple nights in a row, so timers are about as effective as letting the house stand all lit up all the time. Technology has a better answer…actually a couple of them that involve “smart lighting” that can be a safeguard both indoors and outside. Smart lighting outside can use motion detectors that sense anyone approaching the house and flood them in conspicuous lighting that burglars like to avoid. And these particular smart lights can be “trained” to respond to only larger disturbances, so that pesky moths do not have your porch flashing all night like a pinball machine. The sensor outside could also be set up to turn on a light or two inside the house to make it appear as if someone inside is alert to anyone approaching the house. You will want a sensor that also is “outdoor rated” to be sealed against moisture. Smart lighting inside can be a real safeguard against night time falls for an older loved one who may make the middle of the night run to the powder room. A small light can be a big assist for someone just starting to awaken, but already in motion down the hall. And both indoor and outdoor sensors can be set to turn themselves off after a desired lapse of time, again looking more real life. And there is a whole line of smart devices that connect home indoor and outdoor lighting to an app on a smart phone. And you don’t have to ask Siri to attend to the lighting for you. It is all literally in your hands. Of course, if you’re trying to be helpful to an older loved one you will want to confirm specifically when they are and are not home so that you don’t unsettle them with an unannounced light show. 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 have all heard the phrase and it usually is a reference to someone who is just a little less on top of their game. Just last week, however, The New York Times released data on staffing in nursing homes that showed a tremendous variance in staffing levels on their units based on time of day and time of week. These staff levels are not inconsequential, because when we talk generically about “nursing homes,” we may be making reference to assisted living or skilled nursing or other supportive living facilities. This is all a way to say that the residents need help with any number of their key activities of daily living like toileting, dressing, bathing, eating and walking, etc. The New York Times reported variances from fully staffed to the understaffed weekends to be as much as a 100 percent difference. That is to say that the number of nurses or aides covering the residents on weekends was as little as half the number as during weekdays. Before the Affordable Care Act, nursing homes self-reported their staffing levels to the government watchdog agencies. Whatever they said was what was on record, so less ethical organizations could easily game a system where no one was minding the store. Since the ACA in 2010, these numbers are now verified. While ACA now more closely monitors staffing, there can still be day to day variances that may elude detection. Some defenders of the status quo claim that on weekends more family are visiting their loved ones allowing thinner staff to keep up with what is alleged to be lower demand. Maybe? How many visiting sons are comfortable helping mom to the toilet? If your older loved one is one of the 1.4 million Americans who are a resident in a nursing home, you can check on their staffing variances. The New York Times actually published a map on line that allows you to hold your cursor over a specific facility on the map to see how they rate from “much above average” to as low as “much below average.” They also will note for you the low and high resident to staff ratios of both nurses and aides. I have in our inset a picture of a facility in Nebraska as an example. So, do three things if you are helping a loved one move to, or have one already in, a nursing home…or may have one moving anytime soon:
1. Go to the map to get the data and also those of competing facilities around the region where your loved one may move;
2. Get references on facilities from care managers or other health care professionals from your locale; and
3. Once your loved one moves in, drop by as frequently as you can, but do so at different times of the day or week.
Consider all of these as steps toward catching a facility in the act of doing things right. If not, don’t be afraid to make a change of venue and a change for the better for you and your loved one. 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.
Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best lives. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte Since one of the primary uses of the Internet is to find things, it was inevitable that we would turn to it when looking for love. The “market” responded, and these days it seems thereare as many web sites and apps as there are people looking to date. Older adults, not wanting to be left out of any opportunities, now have match-making services that cater exclusively their cohort’s desire to connect, or to reconnect after loss. What advice can we give to aging adults and those who support them in living their fullest lives?
1. Be ready. Trying to start a relationship at any stage in life is complicated. It’s especially tough to get “back in the swing” after profound loss. Even caregivers and family should leave space for lots of complex feelings, staying ready for extra conversation. If you or your loved one is experiencing more difficulty than is comfortable, talk therapy can be of great assistance working through grief or even into “learned loneliness.”
2. Get creative. A good profile shows personality and flair, while also being honest and accessible. Anyone looking to create an online persona should ask friends to take new, current pictures, brainstorming with confidantes about what makes the relationship-seeker unique. We know only the subjective portion of ourselves. Outside perspective can really help us understand what others experience when they encounter us.
3. Avoid clichés. Lots of people like “long walks on the beach,” but if someone has a special knowledge of tides, or shells, that’s a point of connection or interest. Potential dates know then that the walk won’t be just aerobic awkward silence.
4. Stay safe. Online dating isn’t dangerous, but successful users of the service know that precautions are necessary. They start by having conversations on a mobile device, as landlines can be traced to an address. When it’s time to meet, they make sure to do so in a very public space - best for coffee or lunch - transitioning to more privacy or less daylight only once trust has been established.
5. Stay safe, the sequel. If the relationship becomes physical, intimacy should be safe. (Please note that if you are the adult child to an older loved one that intimacy can span everything from holding hands, so be sensitive, and don’t assume.) That said, the numbers regarding disease transmission among older adults continue to rise at alarming rates. Yet, intimacy is natural, and everyone has a right to enjoy it. You thought “that talk” was awkward when you were an adolescent child to your parent! Appreciate that everyone also has a right to stay healthy through conversation and proper precaution.
6. Remain positive. It would be great to meet Mr/Ms Right immediately, but the old saying about kissing frogs remains true at any stage of life. It’s also true that a positive connection of any kind—even if not potentially romantic—is preferable to self-isolation. Meeting folks with open-ended mindset is a healthy way to begin any relationship any
Charlotte Bishop is a best-selling author , 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.