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

Your Flight to Nowhere is Boarding
You have probably put off a vacation or most any travel for more than a year with the threat...
Read more
July 22, 2021
0
0
The Side Effects Physicians Don’t Talk About
You all have heard about the side effects of FDA-approved medications that make their sales pitches on your television. ...
Read more
June 29, 2021
0
0
Breaking News for Alzheimer’s … part 1
The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of...
Read more
June 15, 2021
0
0
If You’reOnly as Old as You Feel?
We’ve all been asked a question like “How are you feeling?” And we probably didn’t take but a moment...
Read more
May 25, 2021
0
0
To B or Not to B12?
I have written a lot about dementia over the years as well as other issues that can mimic the...
Read more
May 11, 2021
0
0
Three Milion More Victims…
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably...
Read more
April 27, 2021
0
8
Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
Read more
April 20, 2021
0
0
Not Just Spring…
We’ve heard of Spring Training for those who follow baseball teams like the CUBS or the SOX, and we...
Read more
April 13, 2021
0
0
Three Steps to the Now Normal
Yes, it has been a long year, maybe in part because it has been more than a year of...
Read more
April 6, 2021
0
0
As If COVID Were Not Enough
We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the...
Read more
March 30, 2021
0
0

In the Caregiver's Words

Recent Client Praise

Please consider what I am sharing with you here to be the raw material side of recommending some recipes for your upcoming Thanksgiving feast. By raw materials, I mean that these recommendations are not recipes, strictly speaking, but I am recommending your feast this week have ample quantities of vitamins D and E. In fact, you might carry these doses over into your regular diet after this week. If you are like most folks who have been following advice on healthy eating, you already appreciate that vitamin D is very important for bone health and vitamin E is central to heart health. But what you may not have seen is that both of these also are important to brain health. Separate studies have shown that vitamin E can help to keep Alzheimer's at bay and vitamin D can lower the risk of cognitive decline. Starting with the case for vitamin E, researchers at New York State University have studied the effect of regular quantities of walnuts (rich in vitamin E) on what they termed "Alzheimer's-susceptible mice." Granted, these are animal studies, but the nutrition needs of mammals can be generalized to some extent. And their results published just this month were quite striking. The group of mice in their experiment who consumed regular doses of walnuts showed statistically significant improvement in learning, memory, motor skills and even anxiety levels over the mice who received no walnuts. (How do they measure anxiety in mice?) No surprise that walnuts contain Omega-3 fatty acids as well as other antioxidants which have been proven in other studies to ward off cognitive decline. And then there is vitamin D. This was a study among older Italian adults rather than mice. The researchers tracked vitamin D levels of nearly 2,000 adults whose average age was 73.9 years for over four years. They found that those individuals with vitamin D deficiency or insufficiency (measured by their serum 25OHD) were more likely to have declining cognitive skills as measured by a standard test called the "Mini-Mental State Examination." This was compared to their baseline test at the outset of the study which showed all participants to begin at comparable and robust levels of mental ability. It is important to note that this second study simply noted the differences among individuals based on their blood serum levels and did not control what they ate. More testing will be needed to see if vitamin supplements can make a positive difference versus in mental capacity. And, of course, the first study was on mice, so it would be helpful to move this up to humans. And by the way, the amount humans would consume to give the equivalent dose for what the mice ate would be only about 1-1.5 ounces of walnuts daily. So, if you are a caregiver to an older loved one this holiday, these two studies may not include any recipes, per se, but they do suggest what you may wish to add to your Thanksgiving spread as well as the dinners that will follow. And you don't have to choose between these two vitamins; cover your bets by adding a bit of D and a bit of E. 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.
I have had the good fortune to connect with Julian Hills, a content writer and blogger for a great website and resource, Drugwatch.com. When I asked about the latest on diabetes and treatment, she offered these things to consider when it comes to elder care at home.

Diabetes is the seventh leading cause of death in the United States. Controlling the disease can save lives, but it’s also important for caregivers to know that controlling it can also come with its own set of consequences. Diabetes occurs in people who have high blood sugar because their body cannot move sugar into fat, liver and muscle to be stored for energy. The pancreas either does not make enough insulin or cells do not respond to insulin.

There are two common forms of the disease. The first, called type 1 diabetes, can be diagnosed in people of any age. The cause is unknown. These people need daily injections of insulin. The second, type 2 diabetes, is becoming more prevalent in the United States due to high obesity rates. Teens and young adults are now among many of the people developing type 2 diabetes. The Centers for Disease Control estimates that more than 8 percent of Americans have diabetes. Controlling diabetes is important because if untreated the disease can cause heart disease, stroke, hypertension, blindness and kidney disease. With nearly 26 million estimated cases in this country alone, an entire drug industry has blossomed, and caregivers need to be aware of the complications that have arisen from this group of drugs. While many of the medications on the market have helped patients control their condition, there are also a number of complications being reported.

As more and more people depend on these drugs, more and more lawsuits associated with their usage are arising. Here are some examples of conditions associated with these drugs:
- • Actos helps patients with type 2 diabetes by making their cells more sensitive to Insulin. But studies show extended use of the drug has been linked to an increased risk of bladder cancer. Patients taking Actos need to watch for painful or bloody urination, and unusually severe back pain.
- • Byetta is an injectable drug for type 2 patients. The drug controls blood sugar, but has been linked to damage of the pancreas, kidneys and thyroid. These complications can be fatal.
- • Januvia works in tandem with other type 2 diabetes medications to increase their effectiveness. It’s not for type 1 patients. Pancreatic cancer and pancreatitis are closely associated with the drug. In 2011, the Food and Drug Administration received nearly 200 reports of acute and chronic pancreatitis linked to the drug.
- • Victoza is another drug aimed at fighting type 2 diabetes. It has been linked to thyroid tumors, as well as pancreatitis and kidney failure.
Not all patients will suffer from these complications, but drugs may not be the only option. Adopting a healthier lifestyle may help people depend less on medication and avoid the potentially dangerous effects of these medications. Caregivers need to remember that helping people with the condition develop better diet and exercise habits is a great way to control the effects of type 2 diabetes.

SOURCES: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/
http://www.cdc.gov/diabetes/pubs/factsheet11.htm
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

Julian Hills is a content writer and blogger for Drugwatch. His journalism career has taken him from newspapers to local television news stations and even a 24-hour cable network in the Southeast. Julian is a graduate of Florida State University.

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 who need help with elder care at home in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a prevailing topic of our discussion. I have asked Gregory Peebles to talk about this topic from the vantage point of his experience. 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 life - at home. An Associate Care Manager, Gregory has been a part of my team for over a decade. - Charlotte
Home. There’s no place like it, but it’s also very conveniently located wherever you hang your hat. As nice a thought it is that “home” is a physical place we can go, when we look at that thought more closely, it turns out to be not nearly as nice as we first imagined. Our insistence on home being an actual place isn’t just silly misstatement; it’s a false belief that can easily get in the way of our ability to discover new happiness. We imagine “home” existing as it always has in our memories: strong, immovable, untouched by time. It holds us safe inside, protecting us while we watch the world transform at a dizzying speed into a place we no longer recognize. It’s easy to see why we yearn for such a harbor against change. That place doesn’t really exist, though. Even if there remains a physical house from childhood where parents still live, “home” is not a physical building: it is a mental place, constructed not of wood or stone, but of our memories and feelings. Consequently, when we visit the mental place we call “home”, safety is usually one of the first feelings to come to mind. When folks say, “I want to go home,” what they’re really telling us is that they want to feel safe again. We feel safest when we know. Not surprisingly then, where we once lived for a long time feels the safest. But, like the false idea that “home” is a literal place, is it possible that we could also be wrong about being safe in our own homes? Absolutely. In case you can’t tell yet, this post is gently getting us ready to talk about denial: denial that change is a necessary part of living; denial that our circumstances are ultimately beyond our control; denial that we are at last, mortal. As we age, inconveniences in the home can turn into safety hazards. As we watch our parents age, we begin to feel deeply our own mortality and—if we’re not careful—to slip into a pattern of denial, the manifestation of which is the attempt to keep life as it exists in our memories perhaps longer than is advised. However, while this may feel psychologically safe, it may also be physically the most dangerous choice to make on behalf of our loved ones. Yet we rightly want to keep our lives free of disruption for as long as we can. So how can we strike the balance and keep our loved ones safe and in that special place we call “home”? In our next blog, we’ll talk about what makes a home a safe place for aging adults, including how to continue to ensure protections for the loved ones who depend on you. Be sure to come back and we’ll give you what we know. 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.
I have written about Alzheimer’s disease…a lot, its warning signs and caregiving probably more than any other topic. Even in this time of COVID, I still come back to it. This time it is about the warning sign that may be COVID causing confusion instead of Alzheimer’s disease. If you are a caregiver to an older loved one, you probably have become very astute about listening for signs of the onset of this virus: changes in taste or smell, persistent cough, fever, all the usual suspects. A study recently published by health care providers at Northwestern University Health System has reported that a disproportionate share of 65+ year old COVID patients also had what they refer to as “altered mental function.” In short, these COVID patients may be confused or have some difficulties performing some activities of daily living. This may not be surprising, because delirium also has been a harbinger of infections. And what is COVID, except a life-threatening infection? The doctors who authored this study explain that this confusion is a result of inflammation that has spread to the brain causing encephalopathy. It may happen in the disease’s early stages, so this another warning sign for caregivers, and it is a serious sign, because the COVID has spread to the brain. And even patients who do not show these signs prior to hospitalization may develop the cerebral inflammation once they are in the hospital. And encephalopathy makes for a poor outcome in the course of COVID’s infection. Patients with encephalopathy stayed three times as long in the hospital and were seven times as likely to die from COVID. It’s always important to watch for any changes in our older loved ones as potential alerts for COVID, but now delirium is also one of those signs. So, how does one know? Here are some warning signs according to the experts:
1. Misplacing the keys…Misplacing the keys or other “forgetfulness” may be signs of potential delirium; get your loved one checked for COVID.
2. Losing longstanding skills…The loved one who was always good at math forgetting how to multiply should be concerning.
3. Just plain confusion…look for smaller signs as basic as their steps begin to more resemble a shuffle as this may be a sign of a more fundamental uncertainty.
4. Changes in personality…The loved one who used to be the animated conversationalist, but now is more subdued may be responding to their own confusion in trying to follow what everyone is saying.
5. Agitation…in a person who was once a cheery individual a short temper also can be a sign of changing mental abilities.
Caregivers should be alert to these, but not jump to the wrong conclusions. Take a temperature, offer hydration, ask about taste or smell capacity, and all the rest. So, raise your awareness, and then be prepared to raise your hand. 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.
It isn’t always a surprise or a “bolt out of the blue”. It can be a gradual awareness that “things aren’t quite right” or “something is off” with your older loved one. Trust your instincts. Follow the “little voice” that tells you to act. You may not see the unexpected coming, but you can prepare for the unexpected. You can be ready for the life altering events as your loved ones age and their needs and capabilities change.

A Geriatric Care Manager is educated and certified to deal with these life changes. With or without the help of a GCM, you can help identify a problem in the making and develop a strategy and plan to address it. Crises can and will occur. By taking the steps establish a dialogue with your loved one you will lay the groundwork for the more difficult conversations and decisions that will follow in the future.

My experience with elders and my years as a parent, a daughter, and a daughter-in-law, have helped me to understand that the ways you communicate with your loved one will influence how easy it will be to address life’s challenges. It is essential to be patient, loving and receptive to the range of emotions that may be present. Aging and its related changes can be scary and threatening to everyone. Do your best to listen and identify and prioritize your elder’s major (and minor) concerns. If there is resistance from your loved one or a difference of opinion among family members a Geriatric Care Manager is trained to offer an objective perspective and serve as a resource, counselor and mediator.

I had a client who very recently had a stroke that doctors call a transient ischemic attack (TIA). When I arrived on the scene the look a terror on her face told me that she was entirely dependent on me to make good decisions when she couldn’t even form the words to respond. The listening part I already had done in the meetings before a decision was needed, and the empathy part kicked in. I reassured her that I knew whom we were to notify about the stroke and that her pet at home would be attended. It was therefore our collective job to work with the health care providers to get through this first part of the stroke. No one had expected a stroke, but my client and her caregivers were prepared for the unexpected. And she did recover fully.

The role of “caring family member” has a lot of responsibility. Yet this can be managed with the right planning. You can provide a listening ear and a loving heart as you walk alongside your loved one in their journey. Remember that there are services available to assist you and your loved one.

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
Remember the ads that started with a plea: “Help, I’ve fallen and I can’t get up?” That is so twentieth century. Today, it is Alexa, please turn off the lights in the living room. Alexa, please play Guns and Roses…you get the point. Now, Alexa is making house calls for your older loved one. This past week, Amazon rolled out new software tools that are Alexa-compatible to help people at home communicate with their providers. Think about mom or dad now able to let their doctor know that they are able to get up and about at home following their surgery. Or they can report that they are having very little post-op recovery pain or that the infection seems to be under control today. That is all well and fine, others would say, but that patient feedback is strictly confidential. The good news is that Alexa communicates with your loved one’s health care provider … just like a healthcare provider. That is, the communications from home to hospital are HIPAA-compliant. The software developers have built in protections so that what is communicated by way of Alexa or Siri or Amazon or Google stays confidential. Amazon specifically is keeping tight control on who can use the platform with only six companies so far having received access. It used to be that “telemedicine” was via phone connectedness…and then via computers, but now it is just a voice away with an in-home set of ears sharing everything with a health care provider. Soon enough, those who cannot ambulate as easily or drive can order their prescription refills through Alexa. Developers are also at work to develop software that can understand medical records as well as ask the right questions of patients at home to help keep medical status current for the humans at the clinic who wish to check up on patients in their homes. There is more:
- Cigna has a system available to its large national clients so that they can better manage their health and wellness goals;
- Express Scripts allows for prescription renewal as well as tracking progress as the pills get delivered home.
- Another health system enables a home device to enable residents to identify the nearest provider with appointment availability when needs arises.
- Another digital health company interacts with people in their homes to manage chronic conditions like diabetes.
I cannot help but imagine Alexa helping that diabetic patient at home by monitoring their cookie and ice cream purchases…maybe tech gone too far? 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.