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

A Good Habit Missing for Most Older Adults
Even among those older adults who dodged COVID, “gymnesia” may be a lingering effect. Please let me explain… What...
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May 24, 2022
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When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
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May 17, 2022
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HDL Graduates from “Good” to Better
You may have had the conversation with your physician about your cholesterol levels during your annual physical; there are...
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April 26, 2022
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Heavy Drinking Helps?
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: ...
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April 19, 2022
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When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
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April 12, 2022
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Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
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April 5, 2022
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Consult Your Lifestyle Physician
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral...
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March 29, 2022
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Gaining More than Birthdays
We’ve all heard someone explain…typically referring to that paunch around our middle…that their “metabolism has slowed” from what it...
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March 22, 2022
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When the IRS Calls…
How about a show of hands regarding the Internal Revue Service (IRS)… Have you ever filed a tax return...
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March 8, 2022
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Dementia from a Pet’s Point of View
Fetch! Come! Sit! Stay! Remember! So, I’ve given away that I’m a dog owner rather than a cat or...
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March 1, 2022
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In the Caregiver's Words

Recent Client Praise

Caregivers to loved ones with any of the many forms of dementia deal with their loss quite poignantly on special holidays like the one on our calendars for this Friday. While a loved one who is suffering from dementia may not remember what calendar date it is, they likely will have at least some distinct memories of past Valentine's Days just the same. So, if you are a caregiver to a loved one with one of the forms of dementia, there are ways to still share a special moment...even special memories with your older loved one. You doubtless have photo albums of moments shared with your loved one, and some of those photos may evoke a genuinely positive emotional response from your loved one. A walk down that memory lane can be surprisingly positive for both of you. Staying in the moment also can have its rewards. You can make it a point to bake festive cupcakes or cookies with a Valentine's look, or if your loved one is willing and able, you can even arrange flowers for the date. And maybe the flavor of chocolate will evoke "taste bud memories" in your loved one? Because more distant memories will be clearer than what has happened even earlier today with some patients, you can make Valentine's Day an opportunity to talk about first meetings, first kisses or first dates. And if you have special memories of a specific romantic movie that you had enjoyed with your loved one, you may find that a viewing now will evoke some of those good feelings again. Or at the very least, even if they do not remember the film, it may elicit similar positive feelings now just as it had back when you both first viewed it. In a similar vein, you and your loved one may have had "your song" or a number of songs that you enjoyed in an earlier time. If the song is one that you all learned the words and tune, you may find that your older loved one still remembers enough to sing along with certain refrains. Finally, in the spirit of Valentine's Day, hugs and gentle touch are every bit as important to an Alzheimer's patient now as they would have been before the onset of the condition. Alzheimer's patients also will respond to gentle talk as well as good humor...just as long as they do not feel they are the object of a joke. And while we are talking about caring for your loved one who may be wrestling with a fading memory, please remember my cardinal rule. You will do a better job of caring for your loved one if you also are caring for you, the caregiver. 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 don’t often get a chance to use the words “good news” and “Alzheimer’s Disease” in the same sentence. That may be about to change. You may recall that I have reported on numerous studies here as well as in Europe that have tried to combat the cognitive decline that is the hallmark of Alzheimer’s. Even those therapies that have been approved by the FDA have shown very little impact on the disease, and most of what we have seen clinically is just a modest slowing of the decline. As we said in our book last year:
“Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed.”
Chinese scientists now offer us something worth following. A Shanghai-based company called Green Valley Pharmaceutical Company presented phase 3 clinical trial data at the Alzheimer’s Disease Conference just this past week in Barcelona. In the topline results, researchers reported a rather substantial effect from their treatment, called GDV-971. They randomly sorted a bit more than 800 50 to 80 year old mild to moderate Alzheimer’s patients from 34 different sites across China into experimental and control groups. The experimental group received the 450 mg formulation of GV-971 twice a day for 36 weeks, and the control group received a placebo over this same period in the same dosing. Using the Mini-Mental State Examination, a standard test for cognitive ability, the researchers saw an effect as early as four weeks into this nine month trial. The separation between the cognitive capabilities of experimental and placebo patients continued through the duration of the trial. Patients had scored between and 11 and a 26 on the scale at the outset of the trial with placebo and experimental group patients manifesting the same mean score. By the 36^th week, the experimental group averaged a score 2.54 points higher than the control patients. Statisticians rate this a statistical significance of p<.0001, or in lay terms something that could happen by random chance only once in 10,000 tries. The active ingredients in the therapy operate in a number of ways that evidently slow the progression of Alzheimer’s. And there were no differences in the numbers of patients reporting any adverse effects in either the experimental or control groups. A company spokesperson suggests that they are cautiously optimistic…a bit understated we suggest. But it is true that additional studies need to be conducted across more sites to “clarify and confirm its promising biological and clinical effects.” The Chinese equivalent of the FDA has the company’s data under review now at the same time there are plans for more worldwide drug trials soon. Stay tuned! 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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Over the years I have devoted a lot of space to talking about what a Geriatric Care Manager (GCM) does. And that is because we as a profession have a long way to go before people know what we do as clearly as they know what a doctor, lawyer or accountant do. In this post, I am going to give two examples of when to call a Geriatric Care Manager, because unfortunately we often get the call later than we could. The call comes after a family crisis instead of before a crisis when we could have been the professionals who help avoid the crisis. Here are two examples of when... The Big Fall. After age 65 approximately one in three older adults will take a fall, not just a stumble or a trip, but a fall where they hit the ground hard. Beyond the age of 80 the chances increase to fifty percent. As geriatric care managers, we certainly can be part of the team who helps your older loved one recover, rehabilitate and get safely back on their feet. Much of that process will be in the hand the medical providers who may repair the broken hip, arm or other bone. And the physical therapists will do a wonderful job of helping to rehabilitate your loved one back to full or nearly full recovery. What a GCM can help with is putting together the lifestyle recovery plan with the family. We assess not just the individual, but also the home in which they live. We help the family to get everything for the recovering loved one that they perhaps used to do for themselves. We also help to make home a safer place for getting about, eliminating further fall hazards and helping everyone to navigate the path to recovery. But, what if the family had called when they first noticed that their loved one's gait had eroded from a stride to a shuffle, and what if the GCM had received the call to come by your loved one's home and help make it safer for getting about and avoid the fall? Dementia. Older adults fear losing their mental capacity more than they fear dying itself. As geriatric care managers we can certainly be called upon to counsel the family in how to manage a crisis once your older loved one has actually wandered away from home and given everyone the big scare. We can give family members by coaching in how to deflect instead of confront a confused older loved one during conversation. And much more. But we can be more effective if we get the call before your loved one has walked aimlessly into the night. We can help the family to make your loved one's home safer against "breaking out" just as you would want security from burglars breaking in. There are also ways to sharpen mental acuity at the first signs of confusion through social engagement and other intellectually challenging therapies. Working toward social engagement in meaningful ways is a high priority. The list is longer than just these two crises to which GCMs respond. How is your older loved one's driving? How safe is home from fires? How safe is your older loved one from scam artists? Is your older loved one getting the best medical care and support for a chronic medical condition? and much more. I would be remiss if I did not also add where you can find a professional Geriatric Care Manager. There are a lot of people who offer services to "help older people," but many lack training or certification. The best place to find a GCM is at the professional association's web site. Click on the button that says: "Find a Care Manager" to locate a professional near you. 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.
The most common question I hear after "What is a geriatric care manager?" is, "When do I know that we need a GCM?" It may actually be more accurate to frame the question as 'When would my family benefit from a care manager working with us?" And that is when I usually respond with a question of my own, "What is it that encouraged you to reach out to me now?" Usually there is an event or a culmination of events which encourage a person to look for a solution to a problem, an answer to a question or just plain help. Here are five of the common circumstances people with whom I speak talk about:
1. There has been a sudden event in your older loved one's health, and you are wrestling with what to do. This can be a stroke, a heart attack, a fall or just the most recent trip to the hospital with a condition that has been worsening. It represents one of those forks in the road where it seems that keeping on with the way things were will not be adequate, and the caregivers need to know their alternatives. GCMs have answers.
2. The caregiver in your family seems to be approaching "burn out." Caregiving usually falls to one of the adult children in a family, typically the daughter or the one who lives closest to mom or dad. This lead caregiver wants to do all they can, but there may not be enough hours in the day, and the guilt about not delivering may keep them from asking for help until you see the signs: fatigue, forgetful ness, irritability, depression or other signs they are overwhelmed. GCMs help the older loved one, to be sure, but they also are there for the caregiver.
3. It may be clear that something needs to be done on behalf of your older loved one, but the family does not know or cannot agree on what to do. A GCM has answers, because this is what they do. Think of a GCM as a "wedding planner" for getting older. A GCM does not bake cakes or cater meals, etc., but they can lead you to the best professionals who do. A GCM also can be a helpful mediator to help get everyone back on the same page for mom or dad.
4. If your older loved one does not seem to be getting the benefit from their care providers or they seem anxious around the care attendants, follow your instincts. A GCM can spot elder abuse and respond with the advocacy necessary to assure your older loved one's safety and well-being.
5. Your older loved one may just be confused, but it may also be signs of a more serious deterioration of their faculties. A GCM will help by finding a diagnostician to assess your older loved one's capabilities. A GCM also will help to assess if your loved one would benefit from social activity, better nutrition, exercise, etc.
These are just a handful of the kinds of first conversations I often have with those who reach out to us. You will find much more on the web site for the national association who accredits us as geriatric care managers. If you are a caregiver to an older loved one and you have questions, visit: CareManager.org 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.
Nearly a million people in America have a heart attack each year, and for two-thirds of these people it is their first episode. Beyond heart attacks, there are many more individuals who may suffer from some other form of heart disease or may have any of a number of surgical and other interventions involving their hearts. Older adults are more at risk for all "cardiac events," but for those who get a second chance following a cardiac episode, improving heart health should be a priority. Improving heart health is what cardiac rehabilitation is all about.

Who can benefit from cardiac rehab? The simple answer is everyone, but people who have had a cardiac episode may need the support of family and their health care provider to gain the confidence they need to exert themselves and get into better shape. Those who would benefit include anyone who has experienced:

·         a heart attack, or myocardial infarction - this results from one of the blood vessels which feed the heart being so clogged that it starves a portion of the heart muscle;

·         heart conditions such as angina, congestive heart failure (CHF) or coronary artery disease (CAD); or

·         any of the cardiac surgical interventions like heart bypass, percutaneous coronary intervention (balloon angioplasty), stent implants, valve replacements or implanting pacing devices or defibrillators.

            What does cardiac rehab look like? Cardiac rehab can be adapted to patients of any age, and it starts with:
- medical evaluation to determine where to start and how far to take rehabilitation;
- medical monitoring throughout all activities as a patient rebuilds their cardiac fitness and aerobic health;
- counseling on one's condition as well as how to cope with some of the psychological aspects of a cardiac event like depression or anger;
- education on better diet, smoking cessation, stress reduction and simply being "normal."
What are the benefits of cardiac rehab? Very simply put, most people can achieve more than just recover from a cardiac event; they can improve their health to an even higher level. Such as:
- regular physical workouts to improve your heart health as well as the strength and fitness of your entire body;
- cardiac fitness which lifts the spirits with a boost from the endorphins, a byproduct of working out;
- cardiac counseling which helps the heart patient learn more of what they can do to avoid future events.
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.