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

GOOD NEWS FOR CHRONIC CARE
Associate Care Manager Gregory is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and Medicare Counselor, whose work...
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August 6, 2018
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Long-Term Doesn’t Mean Put It Off Until Later
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and trained Medicare Counselor, whose work focuses...
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June 24, 2018
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Medicare Doesn’t Cover WHAT?!
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP) and trained Medicare Counselor, whose work focuses...
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June 18, 2018
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Understanding Medicare as Easy as A, B, D?
Associate Care Manager Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and trained Medicare Counselor,...
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June 11, 2018
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Do You Sea a Hero in Yourself?
Associate Care Manager Gregory is a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on...
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June 4, 2018
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What May Flowers Bring
April showers are supposed to bring May flowers, but what does May bring? It brings Mental Health Awareness Month…among...
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May 28, 2018
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Singing is a Breath of Fresh Air for Caregivers
Associate Care Manager Gregory is a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on...
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February 12, 2018
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Five Tips for Winter Because It’s Not Spring Yet
There is a lot of advice that goes around for older loved ones in our orbits when we see...
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January 16, 2018
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Is This Normal?
As we age, our bodies give us feedback we’re not used to. Activities that never required a second thought...
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October 23, 2017
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Insta-Gram: It’s a Date!
Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both a Certified...
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September 23, 2017
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In the Caregiver's Words

Recent Client Praise

There were 39 million injury-related visits to the emergency room last year according to the Centers for Disease Control and Prevention (CDC). And 300,000 of those were hip fractures in 65+ year old adults that resulted in a hospital stay, and a good share of these were because the dog’s bark may have been worse than its bite! The older adults who have been walking their “best friends” are prime victims for fractures – mostly hip fractures – owing to an overly-exuberant four-legged friend. Researchers from the University of Pennsylvania looking at the causes of the injuries. While still only a bit more than one percent of all fractures nation-wide, the number of hip injuries caused by Fido pulling too hard on the leash have nearly tripled between 2004 and 2017. And this is just the first step, if you will, toward diminished health and quality of life for older adults who make the fateful fall to the sidewalk. Picture the recovery trajectory of a “normal hip hospitalization.” By normal I mean that a patient has the relatively common wearing of the bursa of the hip which leads to pain that can only be relieved by surgically replacing the head of the hip. It takes anywhere from one to six months and physical rehab to fully recover from hip replacement surgery. But other research shows that at least one in four who have a fractured hip will die within one year of the event. It is not the fracture so much as the incapacity and loss of one’s ability to do an array of normal activities of daily living like walking, sitting and rising, reaching to high places and more. But you can help your older loved one, especially if mom or dad has a dog:
1. Encourage your older loved one to talk with their physician at the next appointment to evaluate their risk for imbalance problems and perhaps encourage a vitamin D supplement to strengthen bones.
2. Get your loved one screened for bone density and risk for osteoporosis. Even before adding the canine, brittle bones are a risk factor.
3. Sign your older loved one up with a balance and strengthening class like Thai Chi. No way mom will do that, you say; so sign up with them.
4. Have your loved one’s vision checked to be sure they are not an accident waiting to happen, because they cannot clearly navigate their surroundings.
5. I add this “non-medical” suggestion. Pets can be extremely good therapy, so by no means should you discourage an older loved one from adopting a furry friend. Take the next step, however, and have a professional help train that loyal companion to work with mom or dad.
Please also do a keyword search of my blog to find more suggestions on how to help your older loved one get and stay fit. This one is an example of how to help with a better walking gait as a basic approach to better health. Then, just add the dog! And yes, the one in the picture belongs to our household. 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.
As a geriatric care manager, I have the chance to work with all manner of caregivers and the elders or others with special needs for whom they care. Sometimes a caregiver becomes significantly more than the person who may help a loved one with shopping, cleaning or other personal needs. There are occasions when that individual becomes sufficiently frail or mentally compromised that they need the support and control of a guardian.

I recently spoke with an attorney, Gordon Gault, who specializes in trusts, wills and probate among other legal areas. We talked about what a guardianship means and when it is appropriate as well as how it comes about. Gordon first explained that a guardian is substantially different from just a caregiver in that a guardian must be appointed by a circuit court judge. That appointed guardian is then able to act on behalf of the individual who is either under the age of 18 or is deemed disabled in some other way.

How can a guardian be useful? I have talked about elder abuse and fraud in another blog posting. A guardian can be appointed when it is concluded that the individual is giving away money or other assets to individuals who may be manipulating to their own ends. This appointment is intended to protect the individual and only happens after a court hearing complete with a physicians’ or other professionals’ opinions being weighed.

I have talked about powers of attorney for health care and for finances in an earlier blog posting, but a guardianship clearly takes this up a notch. But it is important to recognize that not only must a judge be convinced that the individual in question is unable to take care of themselves, but that judge also will oversee the guardian’s activities. As you can see, a guardianship pretty much takes control of an individual’s affairs, but this whole process does not all have to be left to attorneys. Gordon highly recommends that anyone who has a family member growing incompetent, get the powers of attorney signed as a first step. Anyone over age 60, he says, should sign these POA papers so that they can be available should a need arise. And later if you have to get a guardian appointed, you may be able to do it on your own if it is just the individual and their care. If it is an estate worth more than a couple thousand dollars, according to Gordon, you will need an attorney for the paperwork.

If you have questions, please feel free to reach out to Gordon Gault using this link. Gordon is a Chicago-based attorney.

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
I get asked a lot of times what we do as geriatric care managers, and you can go to our national association's web site (caremanger.org) for their answer. But since we most often get called in to address a life crisis or other life-changing event in the life of an older loved one, I thought it would be helpful to offer what it looks like in action to be a geriatric care manager (a GCM) when the call comes in. As a GCM, what we do best is assess a situation, make a plan and then assist in executing the plan. Most of the caregiver calls we get, however, leave very little time to assess and plan, because it is a family emergency when our phone rings. Mom or dad has fallen with a resulting hip fracture or mom or dad has had a stroke or a heart attack or some other medical emergency. A geriatric care manager is not the first responder, but we are the second responders who help the older loved one's support system find their options and recover some sense of normalcy. Sometimes it becomes a new normal, because life has changed for everyone. Caregivers may not realize how "normal" has changed so instantly at first, because the hospital providers have done a remarkable job of stabilizing the patient and averting a life-ending disaster. And even the course of the hospital trajectory seems normalizing. A discharge planner comes to the older loved one's room and explains how home health will be prescribed or how physical therapy will be ordered and the road to recovery seems pretty clear. At this point, please do not mistake what I am saying for a criticism of hospital discharge planning, but look closely at what they call the process. They do not call it normalizing planning, they do not call it the new normal planning, they do not call it life planning; they call it discharge planning. Their major focus is on getting the patient safely out of the hospital and into the next level of care - it may be a rehab center in the case of a broken hip or a nursing home in other cases or home with a provider coming to them for their care. But who is looking to help create a plan for regaining and optimizing quality of life? Who is there to help make home a safe place for an older loved one with some new physical or health deficits that were not there before? I have just given the job description for a geriatric care manager. GCMs are the people who help make home safer...or if not home, then help to offer the options for a safe place for your older loved one. We are the people who help to find and coordinate the services or physical assists for a person whose life-changing event will not allow life to go back to what it once was. As I tell our clients, we are the option-makers for the decision-makers, and "quality of life" is our goal not just for the older loved one, but for all the caregivers as well. We also are the voice of the caregiver and the older loved one. We are the advocates who will speak up when a referral is not to the appropriate medical specialist or when something in the medical record does not make sense. One of my clients once observed that we "translate medical speak" for the family. And we even go one beyond that by asking questions not every lay person would think to ask. We also recognize what a tough path an older loved one's care trajectory can be for the caregiver. We are there to help care for the caregiver as much as for the older loved for whom they called us in the first place. 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.
Scientists have long known that Alzheimer’s Disease has a hereditary component, but new research suggests the predisposition is more often passed on from the maternal side than from the dad who has had Alzheimer’s. This, according to research reported in the March 1, 2011, issue of the journal, Neurology.

One of you who are following my blog had asked about Alzheimer’s recently, so the timing could not have been better. As a geriatric care manager, I often counsel sons and daughters of elder parents who have been diagnosed with Alzheimer’s. I now will tell them that in addition to age of onset, gender of the older parent also is a factor when considering one’s own future. But I can also report that there is very good reason for hope.

The researchers whose work was published studied 53 mentally healthy individuals, some of whom had a mother diagnosed with Alzheimer’s, some with a father diagnosed, and most with no history of the illness in their families. These patients had a baseline MRI at the start of the study to measure how much brain atrophy they had in the key areas of the brain associated with memory, areas that Alzheimer’s compromises. The same individuals also had MRIs two years later, despite the fact that none of them showed any outward signs of cognitive impairment at either time point. The researchers found significantly more brain atrophy among subjects who had a family history of the disease, and particularly if it was from the mother’s side of the family.  The researchers admitted that they had to depend on their subjects’ own reports of parents’ medical conditions, and they also acknowledged that they need larger studies to have greater confidence in these results.

So, what does a person with a mother with Alzheimer’s do? Well, with all the research presently focusing on Alzheimer’s these days, the person in this position should be optimistic. The same researchers who suggest a maternal link to Alzheimer’s have reported on the positive effects of cardiovascular exercise on affected patients. Regular exercise, they report, is associated with less atrophy in the areas of the brain most affected by Alzheimer’s. It does not have to be really strenuous exercise to see this benefit, and regular cardio-respiratory exercise is better than the “weekend warrior” version exercise. The researchers also reported that people already diagnosed with dementia had fewer falls and improved quality of life when they followed a caregiver-directed home exercise program.

Results like this and others are promising. They show that clinicians are getting a bit better at predicting and diagnosing Alzheimer’s as well as slowing and limiting the frailty so much associated with Alzheimer’s Disease. I encourage you to go to the Alzheimer’s Association web site for more useful information if you or someone you know is a caregiver to an older adult with Alzheimer’s.

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.

Copyright ©2011
The Boomers are aging, and that means the percentage of adults 65 years of age an older has now surpassed 13% of the population and growing. It also means that the number of older adults who suffer from physical, financial or mental abuse along with neglect is rising with this tide. But there is a second level of elder abuse that will also be rising, and it provides the added insult to the injury of abuse of those older adults less able to care for themselves. The second level is comprised of those who see abuse and don't report it as well as those who receive the reports of abuse but fail to act. In research conducted by the National Center on Elder Abuse, 45% of patients in nursing homes report being abused in some fashion and 95% report being neglected or seeing another resident suffer from neglect. Yet, we do not see this prevalence in any of the other "official" statistics, because it is either not reported or not acted upon. If you are a caregiver to an older loved one, you can do something about it. 1. If you see something, say something. I am borrowing this one from the TSA, but it works here also. Regardless of the age of the older adult whom you know, if you suspect active abuse or passive neglect, report it to a health care provider, social worker or law enforcement professional. These are what are termed "mandatory reporters" who must file, but sometimes they do not. Medical providers may not wish to be seen as violating the confidence of a patient, but that is patently wrong. Keeping silent only allows the perpetuation of this predatory behavior. 2. You do not have to see it to ask about it. Especially neglect may be incredibly subtle, and the abused victim may be hesitant to report a caregiver or even a spouse who is abusive for fear of reprisals. But inquiries have become part of the standard procedure for a lot of health care providers these days. I recall being a bit taken aback when on a doctor's office visit my older parent was taken out of my earshot by the provider and queried about whether she felt safe at home. That provider was doing her job. 3. Make sure there is action. Reporting abuse or neglect is the first step, but the professional to whom the report is made needs to act on the information. This is where it can get a bit murky, especially if this report is about a nursing home facility or chain that carries weight in political circles. The state of California has passed what has come to be known as the Elder Abuse Act which is intended to counter the potential obstacles to protection that political clout can create. Closer to home, the state of Illinois last year passed a law prohibiting anyone with a history of violence against older adults from holding a job in a position of care for an elder. Legislative changes are certainly important steps, but it also comes back to my rule about the village. It takes a village to support a senior just as it takes a village to raise a child. It is part of everyone's job description. 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.