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

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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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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A House is not a Home (Unless You’re There)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 5, 2017
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In the Caregiver's Words

Recent Client Praise

We have all heard that we Americans are living longer, and that is a good thing generally speaking. It seems, however, that living longer also exposes those with greater longevity to medical conditions that don’t affect younger adults. One of them is within the category of dementia with a long name that they abbreviate to LATE (Limbic-predominant age-related TDP-43 encephalopathy). You can see why the abbreviation. You have heard of the telltale deposits of beta-amyloid that are the hallmark of Alzheimer’s disease. LATE has TDP-43 protein deposits on the brain that impair cognitive function, and among people 85 years of age and older the odds are one in four that they will develop this neurologic condition. Okay, you might say, it is just another of the nearly one hundred kinds of dementia. It is important, in no small part, because before physicians identified this unique dementia it was just one more chance for a misdiagnosis, and where there is a misdiagnosis, treatment is going to be wrong also. All the more reason to get a specialist to diagnose any cognition issue your older loved one may be manifesting. One of our team shared that his mom had been diagnosed with “organic dementia.” It was a diagnosis by her primary care physician who promptly prescribed Namenda. Follow this now. First, Namenda is approved by the FDA to treat Alzheimer’s disease. Second, it is meant to be used in combination with the first line medication, Aricept. Third, it turns out she did not have Alzheimer’s…she had vascular dementia. Never mind that this would have been medications that together would cost between $500 and $900 per month…and have absolutely no effect on his mother’s condition. So, misdiagnosis leads to more problems than just not addressing the medical condition properly. It is about not getting the right treatment and not helping caregivers to the patient understand what part of the brain is compromised so that they are attentive to the unique needs a patient will have based on their condition. When our team mate pointed out the discrepancy with the “organic dementia” and the Alzheimer’s meds, the doctor sneered, “So, it’s the cost of the medicine?” You can see where misdiagnosis can go. The need to reliably identify what type of dementia is clear. If it walks like a duck and quacks like a duck, it still is only walking like and quacking like a duck. Ask an ornithologist what type of fowl it is! Or, in this case a neurologist. 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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1 New contact form submission received from CreativeCareManagement.com - A Caregiver’s Guide Toward a Healthier Senior Heart [fullname] <[emailc]> info@creativecasemanagement.com, lynda@llvirtual.com From: [fullname] <[emailc]> Phone: [phones] Message Body: [question] -- This email was sent via the contact form on the Creative Case Management website, http://www.CreativeCaseManagement.com. Your message was sent successfully. Thanks. Failed to send your message. Please try later or contact the administrator by another method. Validation errors occurred. Please confirm the fields and submit it again. Failed to send your message. Please try later or contact the administrator by another method. Please accept the terms to proceed. Please fill the required field. The field is too long. The field is too short. Date format seems invalid. This date is too early. This date is too late. Failed to upload file. This file type is not allowed. This file is too large. Failed to upload file. Error occurred. Number format seems invalid. This number is too small. This number is too large. Your answer is not correct. Your entered code is incorrect. Email address seems invalid. URL seems invalid. Telephone number seems invalid.
Therapy dogs work, because we all – as the saying goes – get by with a little help from our friends. It may be a cliché and it may be a good basis for a song, but it also works. Moreover, recent research shows that those who happen to have the companionship of furry friends have better medical outcomes. The research among chemotherapy patients demonstrated that patients who had the benefit of a dog with them during their treatments scored statistically higher on measures of “social well-being.” In my experience companion animals in assistive care settings make a difference for all the residents who get the benefit of a pet or a stroke of the furry worker dog. On my son’s campus, they also bring therapy dogs on the rounds during finals week. But do not just take the scientists’ word for it; dogs are mammals, and mammals emote. I know you can talk to some people who claim their pets know what they are thinking or when they are having a “bad day.” We don’t want to project too much intellectual capacity to our four-legged friends, but mammals emote. Reptiles and amphibians don’t. I understand that it has something to do with the physiology of their brains. If you have a pet these holidays – and it is well-behaved around strangers – don’t hesitate to share the warmth…even if the warmth also brings a bit of residual fur along with it. Everyone benefits when you share that love…and I believe even the dog will benefit. Speaking of which…the picture that accompanies today’s post is of a Jack Russel mix. The reason is that we have an orphan within our service community. Her name is Annabelle, and she was orphaned just this week after a number of years of faithful service to her master. She is only seven years old, and if you or someone you know could give her your love, she promises she will return the favor. She is only 15 pounds and she runs on regular fuel, so you will get lots of great miles per ounce. Please reach out to me or click on the link for info@creativecaremanagement.com . What better time of the year than now to share the love? Have a great holiday season and a very happy new year! 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.
Elders have more health care issues and have more doctors’ office visits and more hospitalizations than their younger counterparts. Where about one in four 18-44 year olds report no visits to a health care professional in the past year, two out of three 75+ year old patients have seen a health care professional four or more times in that same time. More than a quarter of 75+ year olds report in excess of ten visits a year. What may not be as obvious is that seniors also require more and different recovery help from their medical episodes, especially those that have required hospitalization.

Hospitalization can be the “perfect storm” for older patients, because they have potentially more medical issues in the first place. Second, everyone is discharged as soon as possible from hospitals these days, because insurance typically pays for the condition, not the days. Some in the hospital business refer to this kind of logic as “discharging sicker quicker.” A third factor can also be added, and that is the mental processing ability of an older patient is more challenged by the assault of a hospitalization, especially the discharge process. In a study recently published in the Journal of General Internal Medicine, and reported by UPI, a researcher named Lee Linquist and colleagues followed a group of 200 patients 70 years and older. Although all these patients lived independently in their own communities and none had been diagnosed with dementia or other cognitive medical issues, fully one-third were diagnosed with low cognition post-discharge. The good news is that with special post-discharge care, nearly three-fifths of these same patients improved in the areas of orientation, registration, repetition, comprehension, naming, reading, writing and calculation.

There is further good news. The researchers suggested that screening all seniors while still in the hospital could have helped to flag those in need of transitional care once they were discharged. This would help bridge the time between not being sick enough to still be in the hospital and being fully able to take care of themselves at home. In the past (and present) there has been no insurance that would pay for any of this, but a new bill has been proposed in the U.S. Congress. It would make it easier for patients already receiving Medicare benefits to also receive an “observational transition” that would determine if they should have more skilled nursing care at home care once discharged. The bill was introduced by Senators John Kerry (D-Mass.) and Olympia Snowe (R-Maine) and Reps. Joe Courtney (D-Conn.) and Tom Latham (R-Iowa). The bill has the backing of AARP, and you can read a bit more about it in Modern Healthcare.

If you are a caregiver to an elder, be attentive to any changes you may notice in your loved one not just as they are recovering from the illness, but also as they are being prepared for the transition home. The general rule of thumb for physical recovery is that for every day a person is in a hospital bed they will need at least two days to get back to normal. As much as being able to stand on their own be mindful of how they are interacting with you and others around them.

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 Charlotte Bishop
When I talk to people about advocacy and geriatric care management, they get that part of what we do in our professional role is look out for older adults and guard against abuse of a variety of sorts. One of those kinds of abuse is financial abuse in the form of scams that target older adults. Scammers target older adults in part because, as a group, older adults can be more vulnerable, but older adults also are the ones who will have accumulated some amount of money over their lives - their nest eggs. But did you know that more than 90% of reported financial scams targeting seniors are perpetrated by their own family members? If you are a caregiver to an older adult or just a concerned person in the orbit of a senior, here are some of the common scams going around.
1. Meet you at the Funeral - Believe it or not, some scammers will go to a complete stranger's funeral claiming to the family or widow that money is owed for some prior contract or other obligation. But that is not all. Beware of the "add-ons" that some funeral homes may try to railroad at this vulnerable time in a family's loss. It is a really good reason that we all should make our own funeral arrangements before the time comes.
2. Boomers don't Age - With the boomers starting to fill the ranks of the over 65 cohort, there is a host of anti-aging products to assist those who feel 70 is the new 50. Help your senior to see through the false claims as well as the fake products posing as the brand names like Botox. And remember that if it is not fake in the case of Botox, that it Botox made from a deadly toxin; be certain of the recipe.
3. Fake Drugs - With pharmaceutical prices still a large part of any senior's budget, the lure of non-U.S. pharmacies is still there. Be sure that the distributors actually offer the real deal. FDA has been reporting an average of 20 major investigations of fake manufacturers every year.
4. Just Bill Medicare - Anyone over age 65 will qualify for Medicare to pay part of their medical costs. Some providers working the system, however, can purport to offer services and then bill Medicare. Since they can use your elder's personal information for a direct billing, the older patient will never be the wiser.
The list, of course, goes on. The reason why some of these frauds may happen is that they take advantage of a senior who is not as tech savvy on the web as younger web surfers may be. And at any age, we all can be victims of the deal that sounds too good to pass up. So, if you are a caregiver, lend an eye and an ear to that older adult in your orbit. Your vigilance will benefit them, and it also will give you the benefit of advance learning for when you are there one day. 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.
In my last posting I shared geriatric care management services for caregivers communicating with a loved one who may be suffering from dementia. If you have a loved one who has Alzheimer's or one of the other types of dementia, you know all too well that they are not the same person they once were. But have you actually spent some time trying to understand who they are? Have you tried to understand what it is like inside dementia? Try this hypothetical situation. As you awaken tomorrow morning, you make note of the time, and you know that the dogs need to be walked because they have been in their crates all night. You have just enough time to walk them and then have breakfast and get to work. As you go downstairs to the kitchen, the crates are not there, the dogs are not there. In a minor panic, you turn to your wife who is there and ask where on earth the dogs and their crates are? If your wife of many years tells you the dogs have been dead for six years and that you have dementia which is making you confused, how do you feel? ...probably confused, anxious, frightened, and then sad - very sad. That used to be what professionals recommended to caregivers of individuals with dementia - a bit of reality-grounding, but today, the more accepted approach is one of empathy or what therapists call redirection and validation. So, this kinder approach to the situation might be to apologize for not letting your loved one know that the dogs are being groomed and that if they wish you can prepare a breakfast for them. A patient with dementia may suffer from delusions or hallucinations, and these can be intense and stressful events. So, affirming their feelings and then helping them to shift to something more soothing can be very helpful. This older adult who just happens to suffer from dementia still is the person with feelings who is just behaving in what they perceive to be a rationale manner. By validating their feelings and then redirecting their behavior, you are helping them to cope with the world as they see it. Some therapists even suggest that this helps to restore a sense of self-worth that will be helpful in avoiding some future episodes or anxiety:
1. First, ask questions that will help you understand what has triggered the response. I had a client who saw little people around the perimeter of the room painting the baseboards. Once we understood that these people did not speak or harm him, we could incorporate them into his world while still interacting with him.
2. Don't think that it all has to be logical. It is more about how your loved one feels than it is about if it makes sense. Just go with it.
3. Especially if your loved one is upset, try to gently find out what makes for the upset. Then, validate by agreeing that you would be troubled also if its happened to you. You will find that the anxiety for both of you will subside.
4. The bottom line for all of this is to gently give your loved one an out and a chance to save their self-esteem.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends who provide geriatric care management services to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.

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Singing is a Breath of Fresh Air for Caregivers

A House is Not a Home (Part 3)

A House is not a Home (Unless You’re There)

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