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

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...
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May 11, 2021
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Three Milion More Victims…
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably...
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April 27, 2021
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Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
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April 20, 2021
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Not Just Spring…
We’ve heard of Spring Training for those who follow baseball teams like the CUBS or the SOX, and we...
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April 13, 2021
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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...
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April 6, 2021
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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...
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March 30, 2021
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Diseases that Mimic Dementia…But Are Treatable-part 3
As you can tell from now a third installment about other medical conditions that can mimic dementia, it’s not...
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March 22, 2021
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Diseases that Mimic Dementia…But Are Treatable – part 1
Dementia is the condition that adult Americans fear the most, and tragically there are conditions that can give a...
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March 9, 2021
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Can I Have A Hug?
I doubt there is anyone who does not have something that they have not been able to do during...
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March 4, 2021
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A Game Where Everyone Wins
Pick your metaphor. If you want your knife to slice easier, you sharpen it. If you want to improve...
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March 2, 2021
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In the Caregiver's Words

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Learn How to Avoid 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. We also discuss other warning signs people should look out for when buying prescription or over-the-counter drugs.

Inside "Caregiver Advice about Bad Medicine"

Learn about polypharmacy and how to protect elder loved ones from it.

Discover the potential danger of some over the counter drugs

Dive into many of the ways in which some drugs do not cooperate well with food.
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What human organ weighs about half a pound and pumps about 2.4 liters per minute and is indispensable to the body's circulatory system? It is not the organ I have pictured here; it's your kidneys. And the older we become, the more important it is to take care of this "other" pumping organ. Not to mention March is National Kidney Month. So what can you do to promote the healthiest kidneys possible? The following are recommendations from the American Kidney Fund help us to understand how to take care of our other vascular organ. 1. Less Salt and Fat Intake. Steer clear of processed and fast foods. When cooking, don't add salt to give flavor; add new herbs. Eat fresh fruits and vegetables. 2. Stay Physically Active. Exercise helps to flush the system as well as relieve stress which in turn lowers blood pressure. High blood pressure is as hard on the kidneys as it is on the heart. 3. Maintain a Healthy Weight. Speak with your health care provider about your target weight. Added mass around the middle is the worst place to put your excess. IF your weight is stressing your heart, it also stresses your kidneys. 4. Manage Your Cholesterol. Watch what you eat so that your overall cholesterol will be under 200, your "bad cholesterol" (LDL) is less than 100 and your "good cholesterol" (HDL) is over 40. 5. Take Medicines as Instructed. Talk with your provider to be sure they know everything you take, even over the counter medication. And just because you don't feel your blood pressure does not mean you can ignore your medicine. 6. Reduce Alcohol Consumption. The limits are different for men versus women, but stay to two drinks if you are a guy and less if you are a woman. 7. Don't Smoke. That goes for chewing tobacco as well, because any amount of tobacco use elevates your blood pressure. Tobacco use also is a risk factor for certain types of kidney disease. 8. Limit Your Sugar. If you are a diabetic, sugar makes your blood sticky and begins to shut down the micro-vascular system within the kidneys. Even if you are not diabetic, too much sugar intake will either make your kidneys work harder or add to fat deposits. 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.
Some of us are “older,” but we ALL are aging. And there is no time like the present to take better care of ourselves. Here are physicians’ top eight recommendations: 1. Heed your Scale: Three out of four adults over 60 are overweight or obese, and this predisposes them to type 2 diabetes, cardiovascular disease, hypertension, gall bladder disease and breast and colon cancer. Limit sweets and alcohol. 2. Exercise Regularly. Arthritis may affect more than half of people as they age, but it can be minimized with regular exercise and with weight control. In one study losing just 11 pounds was associated with a fifty percent reduction in the risk of arthritis in the knees. 3. Consume more Calcium. Osteoporosis is not inevitable, but it affects as many as 44 million Americans over age 50, most of them women. Take calcium supplements, don’t drink carbonated beverages and stop smoking to minimize your risk of osteoporosis and deadly falls. 4. Stop Smoking. I know I said that already, but lung cancer causes more deaths than prostate, breast and colon cancer combined. Smokers will see the added benefit of reduced heart disease and lower blood pressure as a reward. 5. Moderate your Lifestyle. Heart healthy is key as cardiovascular disease affects one in three men or women between ages 45 and 54. All of the above will make a huge difference in lowering the risk of heart disease. 6. Lower the Volume. Audio that is. Hearing preservation starts even earlier on the prevention side, if any of you recall the concerts you may have attended when you were younger…and it extends to the ear buds that can channel overly loud sound directly to the ear drum. 7. Brush Twice. The best way to preserve oral health is to brush twice daily using toothpaste with fluoride. And did you know that teeth health is a strong predictor of heart health and longevity? 8. Multi-task Less. The brain really only manages tasks one at a time, so when you distract your brain’s focus with multiple demands, you only increase your stress or anxiety and fall prey to what seems like memory loss. It is not. And all that promotes heart health – because the brain is dependent upon healthy circulation – also promotes brain health. Charlotte Bishop is an Aging Life Care Professional and 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.
Steve Steiber, Ph.D., our vice president for senior services, completes his two part posting about how time of day of dosing can impact the effectiveness of a care receiver's medications. Steve has more than two decades experience in pharmaceutical consulting prior to joining CCM about 8 years ago. He reports: In the first installment on this subject, I had written about some of the general rules regarding when to take medications that are dosed once a day. In general, once a day doses should be taken at night. Let me get down to the differences across certain classes of drugs and the conditions they treat.
- Cholesterol - If your older loved one is taking any of the statins (e.g., Zocor, Lipitor, Crestor, etc.) to lower their cholesterol, they should be taken before retiring at night. Oddly, while much of the body is shutting down a bit, the liver produces more cholesterol after midnight than any other time of the day.
- Asthma - This condition is an early riser with a real spike in attacks between 4 a.m. and 6 a.m. Given how long it takes the inhalers to max out, it is recommended that the inhaled dose be taken in the afternoon in order to cover the early morning risk interval.
- Allergies - Allergic reactions will climb through the night and peak in the morning, so help your older loved one to take the single dose (for once a day) or one of the doses if the medication is a twice daily dose before retiring for the night for best coverage.
- Osteoarthritis - Dosing for this one should be dictated by when your older loved one is most active and will therefore be most pained. Read the label to see at what intervals the NSAIDs may be taken and back off from the high pain point by two to four hours.
- Reflux - There are two kinds of medications: proton pump inhibitors (PPIs) and H2 antagonists. PPIs are longer acting but slower to build up; once your loved one has reached an effective level, be sure that they dose before dinner so as to keep up the dose during the last meal of the day and through the night. With H2 blockers, have them dose as much as an hour ahead of dinner in order to cover the meal and night time. Why night time? Two to three times as much acid is produced in the stomach between 10 p.m. and 2 a.m. than at any other time.
- Hypertension - This gets more complicated with age. Have your older loved one take at least one of their medications before bedtime to cover their sleep time and the early morning spike. Younger individuals will have a natural lowering of BP at night, but older individuals with high BP may not have this dip, thereby exposing themselves to a greater risk of a cardiac event overnight.
As I emphasized in the first part of this series, be sure that you or your older loved one consults with their doctor before making any changes in their medication dosing. Be prepared also that older physicians simply may not be aware of some of this more current research on medicine and the body's clock. Please let Steve know if you have any questions about drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: Steve Steiber.
When I say there is no ‘D’ in dementia, it is not that I am Deficient in spelling. Medical research has been accumulating that people with low levels of vitamin D in their bloodstreams are more likely to experience cognitive decline and even develop Alzheimer’s Disease. When I say cognitive issues, it is not all aspects of brain function. The declines associated with vitamin D deficiency are focused on episodic memory loss and deterioration of executive function. Researchers from University of California, Davis and Rutgers University studied 382 adults whose average age was 75.5 years old. These adults received cognitive assessments which categorized them as having dementia (17.5%), having mild cognitive impairment (32.7%) or as cognitively normal (49.5%). Vitamin D levels were lowest for those diagnosed with dementia, but there was only very nominal difference in vitamin D levels for those who were mildly impaired and those who were classified as cognitively normal. All of these adults were studied for nearly five years and then assessed again. During that time the magnitudes of decline in episodic memory and executive function were greater in adults who had been diagnosed as vitamin D deficient or vitamin D-insufficient. The investigators found that regardless of their baseline cognitive assessment, their ethnicity or a range of other risk factors, those who had been vitamin D deficient at the beginning of the five year period were at greater risk of developing Alzheimer’s Disease. Scientists continue to study the association between vitamin D levels and dementia. While there are no studies that suggest taking vitamin D supplements can prevent Alzheimer’s, doctors in practice are not waiting. They are prescribing D for their older patients, especially those who are already at low blood levels of the vitamin. We who live in northern regions should be particularly on top of getting enough sun to activate our natural vitamin D, consuming more dairy products and green leafy vegetables and augmenting our diets with vitamin supplements. Charlotte Bishop is an Aging Life Care Professional and 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.
Everybody eventually learns to accommodate the “empty nest” that inevitably follows the busy days of child-rearing and child-launching. And then – maybe after a rather substantial wait – there is, once again, the prospect of more little ones in the house. This time, however, they are grandchildren, and as much as everyone who raises kids knows how not to drop a baby, the world has changed. It translates into a new kind of child-proofing different from a generation ago. This is advice for seniors who may be hosts to little ones for the first time in a lot of years.

1.    First, it is important to start with an open mind. It is too easy to slip into a mindset of “what was good enough for my kids,” but times have changed and so has safety. So, some of the old toys may still be considered safe, but the old car seat, play pen or infant swing may not be just outdated; they may be dangerous. Defer to the new mom and dad for advice on what will still work and what needs to be replaced by the next new thing. This approach is also politically helpful in empowering the new mom and dad.

2.    Remember also that when you raised your own children, you may not have had any of the chronic conditions you now have. And you also would not have the medications associated with those conditions, so develop a plan to store medications safely and out of reach of kids. While you may not want the nuisance of those safety bottles, you really need to be certain that medications that will be attractive nuisances to little ones on the prowl are locked up. This is especially true if one of the older grandparents uses the “day of the week” pill reminders that often are stored in the kitchen as a reminder for prescription schedules.

3.    For an add layer of safety, go to the source. The Consumer Product Safety Commission has a twelve-step approach to fully kid-proofing your home, and a number of their recommendations like smoke alarms and carbon monoxide detectors which are great safety measures for everyone. They have a downloadable two page brochure to walk you through the steps (click here for brochure).

4.    This last one is making the grandparents house safe from what the toddlers or young children will bring with them. Falls among seniors are often caused by the unexpected, and there is nothing so unexpected as the little dolls, cars or a myriad of other items that you will buy for the kids or that they will bring with them. Make it a habit of picking up after play time, because you may not see the little hazard on the floor…especially after sunset.

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. Read more about Our Story and Charlotte's mission.