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

Too Good to Be True
With over 300 clinical trials on vaccines for COVID19, it perhaps is not a surprise that at least two...
Read more
December 1, 2020
0
0
The Other Global Health Crisis
Wearing a face mask is the new front line of defense against the spread of the war on COVID-19,...
Read more
November 17, 2020
0
0
One More Sign of COVID?
I have written about Alzheimer’s disease…a lot, its warning signs and caregiving probably more than any other topic. Even...
Read more
October 6, 2020
0
0
None of the Above…
While everyone is awaiting the next vaccine to prevent COVID-19 or help in the treatment of the condition among...
Read more
September 29, 2020
0
0
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,...
Read more
September 22, 2020
0
0
It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
Read more
September 15, 2020
0
0
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...
Read more
September 1, 2020
0
0
Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
Read more
August 18, 2020
0
0
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...
Read more
August 11, 2020
0
0
Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
Read more
July 21, 2020
0
0

In the Caregiver's Words

Recent Client Praise

It is not just because of the housing collapse that many seniors have decided to stay in their existing homes instead of moving into a senior community in recent years. It also is because it is easier to make home changes to keep up with the needs of older adults who wish to "age in place." In this two-part series, I am going to take you on a walking tour of an older adult's home with an eye to how to make life a bit easier and safer. If you are a caregiver to an older adult or someone else with special needs, think of it as a checklist room by room.

Front Door. Don't think of those few steps that lead up to the front door as a stairway; think of them as barriers to entry and exit. Recall from an earlier post that osteoarthritis becomes increasingly common with age, and what used to be four easy steps can now become a big challenge. Then, add an armful of groceries or a dark night when things are not as easy to see clearly, and you have an accident waiting to happen. Consider as alternatives either a no-step rehab to the entry way or a long ramp; I say long ramp, because it is important to keep the grade modest to accommodate a wheelchair, a walker, crutches or a cane. And get rid of the threshold - that strip of wood or molding that rises up between the outer wall of a house and the inner wall.

Garage Entry. For the older adult who still drives or is a passenger to someone who drives, getting from the garage to the house can be as daunting as those stairs in front of the house. Consider a hydraulic garage lift, especially if someone requires a wheelchair to get about.

Halls and Floors. Once in the home, turn on the light. Especially at night an older adult will find the abrupt transition from the bright porch light to the dark interior will make it hard for one's eyes to adjust, an invitation for trip or fall. For ease of use consider also replacing old light switches with rocker switches that are much easier for older, less facile hand to manipulate. Then, look at the floor surface as a potential obstacle. Throw rugs are just waiting for an older adult with unsure footing, and a fall is the outcome. Of if the carpet has been aging with the resident in an older home, there may be edges coming loose or seams that may trip the older adult who treads there. For any longer corridors or internal stairways, also consider hand rails for both walls. These rails can be the first line of defense for an older adult prone to slipping or tripping.

In the next installment, I will continue with a room by room walk through as you consider how best to refit your older loved one's home. I'll also add a web site that is full of useful resources for anyone looking to make it easier for older adults to remain at home and independent.
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.
In the first of my present series of postings on recent Food and Drug Administration (FDA) warnings, I had talked about new evidence of long term health risks from some pain medications that are available both in prescription and over the counter (OTC). In this posting, I am going to share with you another FDA warning, this one for prescription medications that lower cholesterol. The “family” of medications is commonly called statins and includes some very well known brands that many of you have seen advertised on television and in magazines. Others of you or the people you care for may also be taking these medications.

All Americans have been alerted to the risks posed by increasingly high levels of cholesterol many of us have in our bloodstreams owing to eating foods high in fats or just plain eating too much. One way to address the elevated “bad cholesterol” or low density lipids (LDLs) is through diet and exercise. But for people with persistently high LDL, a physician may also prescribe one of the many statins available. These go by names like Crestor, Lipitor, Zocor, Levacor and Pravachol, and when taken as directed, they do help to reduce LDL levels. Research published in the June 22-29, 2011, issue of the Journal of the American Medical Association looked at a number of individual studies which had showed a link between high-dose statin use and diabetes as well as a risk for cardiovascular events.

The researchers pooled the findings of five different and large clinical studies of moderate- and high-dose statin use among patients. These studies followed patients for a number of years and the results over time were pretty compelling.

When the researchers compared the moderate and high-dose groups at the end of the nearly five years of the research, the high-dose group had 12 percent greater chance of developing type 2 diabetes than the moderate-dose statin users. But the high-dose users of one of the statins, Lipitor, experienced a 16 percent lower likelihood of having some sort of cardiovascular event like a heart attack, stroke or even death. The other statin studied did not offer any cardiovascular benefit. It is not clear how other statins fared in terms of heart health. The diabetes link was the most consistent across medications.

As with a lot of modern medicine, the devil is in the details. It seems that high-dose statins pretty uniformly put patients more at risk than moderate-dose statins for diabetes. It is important to appreciate that these are significant differences, but even then, the numbers of patients who may expect an issue to develop will be quite small. As always, consult with your primary care physician or cardiologist about your medications of those of the elder for whom you provide care.

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.
Yes, you are supposed to ask why being male and over 65 is a medical condition; so what do I mean by cure? The best "cure" at any age is appropriate prevention, and I would like to offer some prevention guidelines for any of you who have a loved one over age 65. I offer 65 because as we all age, what we should be screening tends to change along with the frequency of screening. I am starting with men in this posting, but I will offer a parallel "cure" for women in my next post. Blood Pressure - everyone should have their blood pressure documented annually, and hopefully by the same provider so that they can track any trends. If your older man already has diabetes or heart disease, this monitoring should be at much shorter intervals. Oral Hygiene - a cleaning and an exam once a year is the minimum, and most dentists recommend a cleaning twice a year. Appreciate that oral health is correlated with heart health, so consider your trip to the dentist to have more benefit that just a great smile. Cholesterol Levels - if your cholesterol have been within normal ranges in the past, you may need to check them only about every five years. As with blood pressure, however, if your older male has heart disease or diabetes, this should be more frequent. Colon Health - guidelines suggest annual stool sample screenings, but a flexible sigmoidoscopy is suggested only every five years and a colonoscopy every ten years. The U.S. Preventive Services Task Force has recommended talking with a provider after age 75 and no invasive testing after 85. All of this is much more aggressive for anyone with colon issues or cancer or who has a family history of any of that. Eye Health - a vision exam is generally recommended every other year as a screen for glaucoma or visual acuity, unless the older patient has diabetes. More frequent testing for a diabetic is recommended to watch for diabetic retinopathy. Immunizations - keeping current is the important part of immunizations. For pneumonia vaccines, every five years is recommended. Flu shots are an annual regimen given the variation in strains that are considered the biggest risks. A shingles vaccination may be a one shot matter, but ask your doctor, and a tetanus booster every ten years is recommended. For other immunizations or other infectious diseases consult a physician. Prostate Health - most doctors will test the size of the prostate during an annual exam, and the doctor also is the best one to advise on how often a patient should take a PSA test. Bone Density - although women are more at risk for osteoporosis than men, the risk increases appreciably after age 50. Taking in calcium and some vitamin D along with aerobic exercise will go far in maintaining bone health, but a physician may recommend how frequently to measure bone density. Everything else - annual exams are a great time to assess weight, height and hearing. It also can be a good time to check your 65 year old for signs of depression as well as go over all medications and any possible interactions or contraindications. 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.
…and when to not say anything…read further. It seems like such a waste of talent…the energy and brains that scammers invest in finding new ways to bilk people of their money, and older adults are more susceptible than others. Let me start with that part first. Older adults more often get scammed, because they answer their phones, they tend to be more trusting and they have more liquid assets. Let me share the short version of a number of relatively new scams targeting seniors. For more details, please also go to the U.S. Federal Trade Commission web site (https://www.consumer.ftc.gov/scam-alerts ). 1. A Government program that will pay bills. The scammers have been selling this “government program” at places of worship. The scammers at first appear legitimate as they take enrollment information from enrollees. The first bills appear paid, but the scammers cancel the transactions and keep the funds. When the bill comes the next month, it will have late fees, and the scammers will have the credit card and personal identification and financial information of the enrollees. 2. The “good-looking” bad check. This one actually seems to go back to the faxes that used to come across from a Nigerian prince, but it is still being used. The scammer asks you to deposit a check for a substantial amount of money because they do not have access to their own local bank. But could you please write a check for a much smaller amount in the meantime? Well, by the time the check bounces, so does the scammer. 3. More taxing issues. With the tax filing deadlines approaching, some people will be approached by email or even conventional snail mail with notices that the government demands more. If the email has a link, do not click it; it may have malware or worse. If the written letter asks for a wire transfer, prepaid debit card, gift card or other form of payment than a check, it also likely is a scam. If the request is to make payment to I.R.S., that also is a scam, because Uncle Sam asks for checks to be made payable to the U.S. Department of Treasury. 4. I cannot hear you now. Sprint used to famously ask, “Can you hear me now?” Well, there are robocalls going out with the same question…do not say yes! Scammers will be recording your answer to be used later as confirmation in what may sound to be a legitimate solicitation that has your “yes” answer as the reply and that now will have a price tag associated with it. Don’t say anything! How do you help protect your older loved one? Well, for phone callers, you can still request that their numbers be placed on the “no call” registry: 888/382-1222. To report suspicious activity, the Federal Trade Commission can be reached at the site I listed at the top of this post or called at 877/382-4857. 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.
Who doesn’t love indulging during the holiday season? Rich food, delicious drinks, and decadent desserts make every gathering something to look forward to. This is a time of year to celebrate, but it’s not a time to stop thinking about how we can still encourage healthy behaviors from our loved ones and from ourselves while enjoying the season you celebrate to the fullest.
1. Waist Watchers – This seems the one time of year when no one’s worried about what’s on anyone else’s plate—unless it’s to note something delicious missed on a buffet. A happy holiday is a healthy holiday, and most Americans, not just seniors, would benefit from limiting their intake of red meat. Make sure to have leaner versions, like turkey and salmon, available as alternatives. Similarly, make sure some sweets are heavy in fruit instead of processed sugar. Dark chocolate, rich in antioxidants, is an excellent choice for the conscious party planner.
2. Walk It Off – It’s especially easy to ignore exercise after a heavy meal when it seems impossible to move. If this is you, plan ahead and get a walk in before you eat. Grab a buddy, a light jacket in this unseasonably warm weather, and go looking at decorations. For those with limited mobility, or even those temporarily immobilized by calories, seated stretching is a great way to keep moving or get moving again.
3. Riddle Me This! – Research continues to show that mind consistently challenged is less likely to suffer significant cognitive decline. Puzzles and skill-based games and crafts aren’t just fun that everyone can enjoy; they’re also ways for your loved ones to stay sharp. Just remember to keep the competition friendly for everyone, and no slamming the table when Aunt Viv puts a hotel on Boardwalk.
4. Ritual and Remembrance – As adults age and lose independence, some seniors may become homebound, meaning that holiday celebrations might be the only significant interaction they get through the season. Helping to making sure that a senior’s holiday is special and celebrated in a way that they find familiar and comfortable, either by co-attending a religious service, or just singing a favorite holiday song together, helps the senior and caregiver alike, fostering good will and cross-generational relationships. It might be the most inexpensive gift you give all season, but it also might be the one that is most cherished.
“Charlotte was incredibly helpful to me yesterday and more so today. I'm delighted to have such a competent, caring partner. Also, Charlotte was instrumental in finding a new primary care physician for Margaret.”
Harriet Brandt, Faith in Action Evanston