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

Listen to an Astronaut about COVID-19
A small percentage of us may be coping with symptoms of COVID-19 or we know someone who is, but...
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March 24, 2020
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Trusted Voices on COVID-19
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a...
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March 17, 2020
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One is Number One Threat to Seniors
We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to...
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March 10, 2020
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Helping Your Older Loved One – AND You – Avoid COVID19
All of us here know how to prepare for a blizzard, people in the South know how to prepare...
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March 3, 2020
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Part 2: Five Important Tips for Caregiving and Self-Care
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000...
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February 18, 2020
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Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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Five Things You Need to Know about Coronavirus
Okay, there may be more than five things you want to know about the coronavirus, but these five basics...
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January 28, 2020
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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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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

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.
I was asked today about the “mitten test.” It was one of our colleagues who had remembered something I had said about how to use mittens to facilitate a better test of how well home is still working with their older mom…not against her. Most of us look at our childhood home and our parents’ present home as the same place we grew up, but the difference is that mom or dad have grown older and maybe less able to negotiate the same space as they used to do. I call it the “mitten test.” If you live in the upper portions of the U.S., your winter mittens may just about be ready to come out of the storage closet. Besides keeping you warm, your mittens have another useful purpose that can help you make home an easier place for your older loved ones. You can use them to identify spots in your loved one’s home that can be adapted to fit their changing capabilities. As our bodies age, certain of our nerve pathways begin to fail, and the human anatomy uncannily reroutes many of the circuits as they stop firing. But with age, more and more of those pathways may slow or fail for a variety of reasons, and it just makes it harder for older adults to do the simple manual tasks they used to do without even a thought. Turning a door knob, turning on a lamp or taking the lid off a jar become challenging, maybe even impossible. It is hard for those of you who may be in the prime of your lives to really get this, no matter how empathetic, so I recommend an easy exercise to help you experience what this erosion of manual dexterity and fine motor skills feels like. In doing so, you can also help identify challenging hardware or activities that can be more easily managed with a bit of creative help. With a pair of mittens, walk through each of the rooms in your elder loved one’s home and go through the normal activities of the person who lives in those rooms. As you enter a room, it is may be more challenging to flip a light switch or twist the switch on a lamp with your hands in mittens. These can be remedied by retrofitting wall switches with the larger rectangular switches that one merely presses on and off. Likewise, the lamp twist switches that are challenging with mittens can be replaced with wider winged grips. And even before you enter a room, the door knob may be your undoing if the knob is too small or too slippery. Handles may be an appropriate replacement. The mittens are effective barriers to everything from opening the ketchup bottle to a twisting the lid on a jar of apple sauce or beverage bottle and more. And if a key itself is hard for an older loved one to grip when opening a door, hardware stores have over-sized sheaths to make gripping easier. With your mittens still on, try tying your shoe laces or buttoning a shirt or blouse. It may be time to get creative with Velcro-equipped shoes or other substitute hardware for buttons. And go through the motions of other self-grooming activities to determine what challenges are manageable and which are just out of reach. The number of what are called “assistive devices” will amaze you as you look to television remote controls, computer access and more. Check out the Department of Health and Human Services Assistive Technology site. 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.
Did you have a great Thanksgiving Holiday or do you find yourself totally exhausted from all the preparations and clean-up and dreading (at least) four more weeks of the same? If you can see something of your experience in that description then you may be a caregiver who has not followed my "prime directive" for caregivers: You will always take better care of others if you are taking care of the caregiver first! I have said it somewhat differently on numerous occasions, but those charged with taking care of an older loved one along with everyone else in their orbit also need to care for themselves. Don't burn the proverbial candle at both ends.

So you agree in concept. It seems easy to say, but how does a caregiver start taking better care of her or himself? Here are three simple guides that you may find helpful in getting through the rest of the holidays. I think you actually will find that you better enjoy the opportunities for family and friends when you are in better shape yourself.

1.    Delegate! Recognize that when ten people (or more) gather at your house to dine for the holidays that there will be a lot of food to prepare. Don't go it alone. Request the two vegetable dishes from two of the guests, the rolls from another and the dessert from someone else. You may reserve the special dish that only you do for yourself, but share the opportunity to prepare the feast. And keep sharing after the meal. Those who cannot cook will clean! If you find yourself alone in the kitchen with a sink full of dishes after dinner, you did not delegate.

2.    Designate! Set up a schedule with "rest stops" for your days leading up to and including the day of the event. Set aside time for yourself just as you would set aside a break from a long drive in order to get out of the car and stretch your legs. Get out of the house for a nice walk in the crisp air or sneak away to your room with a magazine or book.

3.    Disengage! Don't compare yourself to anyone else. It is easy to set the bar way too high by thinking that "if mom or dad could do all of the work," then so should you. And that goes for recipes also. Be prepared to enjoy the meal in which everyone has a hand in preparing. In fact, it may even taste a bit better if you did not prepare all of the meal. (Refer to rule #1 above.)

      Enjoy the rest of our holiday season, and remember to take care of the caregiver.

      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.
At the point in life when one of the family steps up to be a caregiver to an aging parent, all the "children" have already grown and flown the nest. But as siblings begin to communicate and delegate to help mom or dad, there can be a lot of the same sibling issues that may have been there when everyone was a lot younger and lived under the same roof. The result can be inequity in the duties expected of each of the siblings and a lot of stress for everyone. But it does not have to be that way if the family can set up some rules for communicating and sharing the caregiving load. Here are some useful "Do's" and "Don'ts":
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. Visit our For The Caregiver page for more information and resources.
While speaking with Matt Margolis (Elder Law attorney with Heartland Law Firm) recently, he mentioned a common question he receives often: “Why do I need a Health Care or Power of Attorney?” The short answer, he offered, is because only YOU can make a health care decision on your behalf or sign your own name. And he offered to expand on this in our blog with this post:

It is important to differentiate between a Power of Attorney for Health Care (HCPOA) and a Power of Attorney for Property (PPOA). If a doctor or other medical professional cannot communicate with you about your health care needs, whether it is because you are mentally incompetent or physically incapacitated (i.e. in a coma), a HCPOA allows someone else that you appoint to talk to the doctor and make a decision on your behalf. This authorized person is called your “agent.” A key component of the HCPOA is that the agent is making YOUR decision for you. It is not the agent’s decision or based on how the agent feels about a certain situation; rather, it is based on what you noted in your HCPOA and what you discussed with your agent (hopefully) prior to your incompetency or incapacitation.

A perfect example of what can go wrong when not having a HCPOA in place is the Terry Schiavo case from Florida. In 1990, Schiavo suffered major cardiac arrest, and a few months later was declared to be in a permanent, vegetative state. In 1998, Schiavo’s husband petitioned the court to remove her feeding tube, which was opposed by Schiavo’s parents. After many court filings and appeals to the Florida and US Supreme Court, the court’s decision to remove the feeding tube was upheld in 2005, and she died shortly thereafter. The problem was that Schiavo did not have a HCPOA in place. Therefore, no one had the legal authority to instruct the doctors on what to do without court supervision.

A PPOA allows your legally appointed agent to sign your name on your behalf and to handle your financial affairs. If you were to become mentally incompetent or physically incapacitated, who would continue to pay your monthly bills on time so your mortgage is current and your gas and electricity aren’t shut off? If you do not have a PPOA in place, there is NO ONE else that has the legal right to access the proper accounts and take care of your financial matters for you.

If you do not have a HCPOA or PPOA, a legal guardian will need to be appointed by a court to allow someone to make health care decisions for you or to be able to legally sign your name. A guardianship is a costly and time-consuming process. An attorney must appear in court a minimum of three times before the permanent guardian is appointed. Once appointed, the guardian must file an annual accounting with the court every year showing what money has come in to the estate and what money has been paid out from the estate. This can be a very arduous process when the person whom the guardianship is being sought for is not agreeable (typically due to their mental incompetency). This is called a “contested guardianship.”

To avoid the potential of any costly and unnecessary court proceedings, you should consult with an attorney to ensure that you have valid Powers of Attorney for Health Care and Property in place. This will not only protect you, but will save your loved ones a lot of aggravation and expense in the future.

Heartland Law Firm is a holistic elder law and estate planning firm. Heartland Law Firm concentrates in assisting seniors and those in transition with understanding the landscape they are in and what protections and benefits are available to them and their loved ones. Visit their web site at: Heartland Law Firm.

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.
I have a suggestion for the perfect gift for those of you who may be visiting with family during the holidays, perhaps with family members whom you may have begun to notice have cognitive abilities that are slipping a bit. I joined a group this past weekend who annually goes holiday caroling to those who are unable to get out or who are in memory units at a number of facilities here in our home town. It really helps me each year to share a bit of joy with those who are no longer able to just jump in the car and head out to a holiday show or a family gathering. It also reminded me of a significant therapy for people with many types of dementia. It is not a therapy that restores memory, but it is what is termed “reminiscence therapy,” and it restores a calm to people with cognitive impairment by “taking them back” to a place in their memories that they can still access…a place that is a good memory to savor. Therapists in the Netherlands have created small villages as settings for people with dementia so that they can return to some of the familiar looks, smells and music of an earlier time that is still within reach in their minds. It takes them back. There has been success with this concept in a village called the Glenner Town Square outside Baltimore as well. It is complete with pictures of a generation ago on the walls, period music emanating from the speakers and even a vintage Ford Thunderbird parked outside a vintage diner. Think of such places as comfortable and safe environments which are structured to be soothing memories of a time that becomes clear in their minds. And as with all pleasant sensations, the mind rewards the body with a boost of “feel good chemicals.” It brings a smile to participants’ faces and a better night sleep following. All of that makes their tomorrow a bit better as well. So I thought about this while we sang to people who immediately beamed when they heard our familiar refrains…and yes was even in a room playing a rerun of It’s a Wonderful Life…but who doesn’t do that during the holidays? And as we sang another old standard, I watched many of them singing along without using the songbooks we were provided. No troubles with their memories as I followed the words in my own book rather self-consciously. So here is something you all can take home for the holidays in the form of a little experience that will be a real “feel-good.” Bring along some classic music, add to that some of the vintage photos you may have and follow where your older loved one wishes to go. Please don’t correct them if they happen to talk about the older relative who died ten years ago as if they just couldn’t make it to the family dinner. Go with their flow and you all will get to a happier place that will have some really nice memories for you along with the “feel good” for you all. 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.