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

Your Older Loved One’s Greatest Health Risk?
As our loved ones grow older, we probably are more acutely protective of their health and well-being, especially if...
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September 14, 2021
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Nursing Homes Still a Risk for COVID-19?
It has been a tough pandemic for everyone, but it has been especially difficult for residents of nursing homes...
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August 31, 2021
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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...
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August 10, 2021
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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. ...
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June 29, 2021
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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...
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June 15, 2021
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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...
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May 25, 2021
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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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In the Caregiver's Words

Recent Client Praise

Associate Care Manager Gregory is 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. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte Lots of people play simple games on their phones while waiting. On this blog, we’ve often mentioned that any game play encouraging cognitive and spatial orchestration is great for the player’s cognitive future. But what if there were a fun game whose results also helped doctors learn more about dementia? That would be especially helpful, keeping our own brains sharp while we contribute to research. That sounds like double duty! Well, set sail at full mast, because that game exists. At first glance, “Sea Hero Quest” [iOS/Andriod link] is a fun mobile game like any other. It is special, however, because it exists to provide researchers with more data on 3D spatial cognition, often a first casualty to a dementia diagnosis. In the game, the child of a parent suffering from dementia sets out on an odyssey to recover their parent’s lost memories. On the path to discovery, there are navigation, orientation, and chasing adventures. The ways that the players advance levels is precisely the kind of valuable information hoped for; and the more people that play the game, the more information to help. Alzheimer’s Research UK is a major player in supporting the data obtained from gameplay, and it is hoped that the information gathered will make inroads towards early detection and consequent treatment. In addition to the regular mobile version, there is also a Virtual Reality (VR) release which combines the game with scene immersion. It tracks head movement and provides even more data to researches about how players obtain information about their environment. So, if you’re a mobile game player of any sort, consider the introductory video below, download, and start gaming! You just might have a great time helping your future self.
The Covid-19 pandemic and quarantine are receding in our collective rearview mirrors, but there are some lasting and devastating effects that remain…and they aren’t health-related. We have talked about how isolating the pandemic was, especially for older adults who may have been single during this quarantine. Beyond the unfortunate older adults whose communities may have been ravaged by the virus, the number of older adults who have been and may continue to be exploited financially has seen a sharp upturn. In a recent survey reported by The American Journal of Geriatric Psychiatry, the incidence of financial abuse among older adults has doubled during the pandemic. More than 21 percent of older adults reported some form of financial abuse or scamming during the quarantine which is double the one in ten rate of reported financial abuse in the period before the COVID-19 outbreak. What is all the more troubling is the fact that these are just the individuals who reported being scammed. Given that many financial abuse cases go unreported or unrecognized, we may now be in a continued pandemic of a financial sort among older Americans. Many older adults are relatively easy prey to those who will exploit their social isolation and the prospect that no one is looking out for their well-being while we were all maintaining distance to avoid spreading the virus. It could be a long lost school classmate of mom or dad, or maybe another individual whose work brought them in contact with a lonely senior. If you have an older loved one with whom you are now reestablishing contact, it is important that you help with a financial security check up. If you are not a legal power of attorney, you will have to be delicate about questions, but you can still look for signs of abuse:
- Have their been any changes to estate planning documents?
- Any purchases that seem unusual by their dollar amount or nature?
- Has your loved one been making more trips to the ATM for withdrawals?
- Have any bills gone unpaid?
- Any new credit cards arriving in their mail?
- Has your loved one talked about time spent with a “new friend?”
- Are their any pieces or art or family heirlooms missing?
With all of these, it may not be a stranger who is perpetrating the fraud on your older loved one; it may be a niece, nephew, child or grandchild or neighbor. Be prepared for your loved one to be perhaps indignant if you suggest anything, and be prepared to reach out to a community department of Senior Services. You also can find an accredited Elder Law Attorney by way of their National Association. Elder abuse is an epidemic for which there is no vaccine. Local law enforcement departments also have community outreach offices to help. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health experts have been reporting? Or how about the just, plain negative feelings that enforced quarantine, less social connectedness and social isolation or loss of a job can cause? We have heard from a number of studies over time that depression and anxiety contribute to a person’s likelihood of developing Alzheimer’s disease. Well, some recent research from University College London, McGill in Canada and the French National Institute of Health and Medical Research suggests that even negative thinking can increase the chance of developing Alzheimer’s disease. Over a four year study time frame the researchers followed one group of 292 people in what was called the PREVENT AD study and another smaller group and a group of 68 people in another study all over the age of 55. During those two years the researchers asked about people’s experiences, their anxieties, and their depression. They were looking for patterns that could tie in to what scientists call Repetitive Negative Thinking (RNT). They also measured cognitive abilities like attention, memory, spatial awareness and language and more than a third even had PET brain scans. The scans were used to chart any build-up of the amyloid and tau deposits on the brain. They sorted the people into groups and found:
- Higher RNT people had more cognitive decline;
- Higher RNT folks also had more deposits of amyloid and tau;
- Higher depression and anxiety people may have had more cognitive decline, but not necessarily beta and amyloid deposits.
If you tie these together it suggests that it is repetitive negative thinking that may cause the dementia, not depression or anxiety alone even though RNT can predispose people to depression and anxiety. It is well-established that mental health and physical health are linked, but these researchers get more specific about what mental health can do to physical or cognitive health. If you have an older loved one in your orbit, there is a distinct likelihood that they have had a lot less social contact during our extended quarantine. As you have been in communication with them have you noticed negative comments…and not just one negative comment, but a pattern? A short period of negative thinking is not going to cause Alzheimer’s disease, but it can begin a pattern of negativity. Make it part of your mission not just to call and see if mom or dad need groceries or help with their internet. Make it a point to be part of their regular – maybe daily - “positive fix.” Maybe it’s a humorous anecdote, an inspirational quote or a cool Netflix comic segment. Every positive boost to your loved one’s mental health is a boost to their long term cognitive and physical health. Protect your loved ones from not just the COVID, but also from the toll that negativity can take. And while you are at it, protect yourself also. Just because the researchers focused only on 55+ year-olds does not mean that RNT is not bad for anyone of any age…get positive. 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.
I have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about a concept that is gaining more attention these days, especially among health care providers caring for older adults. It is all about what time of day is best for your care receiver's medicines. Steve has more than two decades experience in pharmaceutical and medical device consulting prior to joining CCM about 8 years ago. He reports: If you are a caregiver to an older loved one, you probably have seen all the medications in their cabinets, and part of the label of each of those is a clear statement of how often to take them. Prescription medicines used to have abbreviations like B.I.D., T.I.D., Q.I.D., Q.D. of less commonly Q.O.D. which translate into twice a day, three times a day, four times a day, once a day or once every other day, respectively. Thankfully, prescriptions now say things in plain English so caregivers or the care receivers do not need to know medical shorthand to understand when to take their medications. One element that has been conspicuously absent from the labels, however, has been any mention of when to take the medications, and that is getting a lot of attention in some circles. Very simply put, your body does have a clock that works pretty much on a 24 hour cycle which is why most people have a typical time to go to bed, a time to rise and fairly regular times for their meals throughout their daily cycle. The new focus, of course, has a name, and this research into when is the best time to take a given medication is called "chronotherapy." The focus of chronotherapy is on optimizing the timing of medications to give the best clinical effect with the fewest side effects. In very general terms, the best time of day to take a once a day medication most often is at night time. Treatment for certain types of colon cancer, for instance, work better at night because the body's normal cells are resting and less sensitive to the agents while the cancer cells are more vulnerable. And for medications with a drowsiness side effect, why not take them at night to actually benefit from the side effect instead of fighting it. For certain blood pressure medications, it is important to take them at night time so that they are at their best in the morning. That is because when the heart is just starting to "wake-up," there is a spike in body hormones that can stress an unhealthy heart. Cardiac events are much more common early in the day versus any other time of day. Drugs that are part of a category called "narrow therapeutic index" (NTI) drugs are most effective when taken at the same time every day because their doses typically are measured in micrograms instead of milligrams. Small changes in dosing can make a big difference in effectiveness. For any medications, make sure you also are paying attention to whether it should be taken with or without food. And, of course talk with your physician before you may any changes in your medication schedule. In the second part of this two-part series, I am going to get into some specifics of certain classes of medications and how to use your clock to maximize their benefits. And just so I say it again, please do not make any changes in your care receiver's medication regimen without first talking to their physicians. 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. And check next Tuesday for part 2.
I have shared this statistic before, but in America someone is diagnosed with Alzheimer’s disease every 67 seconds. And Alzheimer’s is just one of the approximately one hundred types of dementia. Scientists do not have a cure for any of the dementias yet, and even the medications that are indicated for Alzheimer’s are only modestly effective in slowing the progression of this condition. But scientists are getting more and more data every year on the conditions or genetics that help to predict a person’s likelihood of manifesting some form of dementia. From physicians in London we learned recently that air pollution and dementia are linked. Among older residents across areas of London, these scientists found that those who lived in parts of the sprawling metropolis whose air was more polluted residents were more likely to be diagnosed with dementia. This adds to what researchers have been finding for years about polluted air contributing to cardiovascular disease, pulmonary disorders and even some kinds of cancer. It’s traffic pollution, manufacturer exhaust and other airborne byproducts of urban living. The researchers admit that preexisting levels of air pollution and subsequent diagnoses of dementia are not sufficient grounds for establishing causation of the latter by the former. They are one more reason, however, to underscore the need to minimize humans’ exposure to air pollution. The researchers calibrated the association between air pollution and dementia diagnoses by tracking individuals and their postal codes. Nitrogen dioxide and ozone levels in these post codes, in turn, were measured starting back in 2004. Patients’ health data confirmed the dementia diagnoses from records forward to 2013, and the statistical association was confirmed. They tracked both Alzheimer’s and vascular dementias (the Alzheimer’s was more common). The relationship between Alzheimer’s and pollution was more consistent that with vascular dementia, but both were statistically significant. The scientists admit that some of the findings may be specific to London, but similar findings have seen corroboration in Canadian research. And it seems unlikely that this is specific to just Commonwealth nations… What can one do? Scientists offer two recommendations, and I offer a third:
1. Where possible avoid heavily trafficked areas during rush hours, and avoid being outside during rush hours.
2. If possible, reside in locales away from traffic and industry to avoid the prolonged exposure to pollutants that location represents.
…and my third:
1. Vote for policy makers who will work to tighten air pollution standards.
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.
As geriatric care managers, we provide advice, counsel, advocacy and support for older care receivers or other people with special needs of any age. Care managers, however, also provide support to the front line caregivers to these care receivers by adding our CMs eyes and ears when the caregiver cannot be present, our advice based on the experience we have that first time caregivers just cannot have and support for the caregivers themselves. This last is important, because the person most often neglected by the caregiver is they, themselves. They do not sufficiently care for themselves while they are involved in caregiving. That said, there are different kinds of caregivers, and the care they need will be different. We can make a lot of distinctions about kinds of caregivers, but one important dimension that I see a lot very simply is defined by the relationship to the care receiver. By that I mean, the difference between intra-generational caregiving and intergenerational caregiving. Let me explain. Intra-generational Caregiving. According to all the surveys I have seen, one of the most common caregiver relationships is that of one spouse caring for the other. But it also can be siblings who care for one another as one falls ill, or it can be friends, cousins, neighbors and more. These intra-generational caregivers could benefit from the greater knowledge of community resources that GCMs have, the correct questions GCMs can ask at a medical appointment, the help GCMs can bring to the caregiving to avoid harm to the caregivers. This last is especially true when both the caregiver and the care receiver are older and frail. I have seen cases in which the caregiver is injured in a fall while trying to attend to their fallen care receiver. Yet, such accidents can be avoided if a care manager is brought in to "leverage" the good intentions of a caregiver. But a caregiver may feel guilty about asking for help when they perceive they should be taking care of everything. The family needs to talk about helping the caregiver. Intergenerational Caregiving. The other common caregiving relationship is the son or daughter (most often the daughter) who is trying to be the caregiver for mom or dad. This same daughter or son, however, are also responsible for a spouse, or their own children or a job. These are the truly stressed caregivers who would benefit from a trained care manager to attend the medical appointments and to ask the right questions that will get the best care for mom or dad. They also would benefit from a very subtle form of counsel on just how to establish the new ground rules for caregiving. I hear some caregivers say something to the effect that the roles have been reversed, and now mom (or dad) is the child and they are the parent. Wrong! The roles have changed, but they have not reversed. When a child to an older parent steps up to the caregiving role, there need to be some difficult conversations about everyone's expectations and about the older loved one's dignity. A third party like a GCM can be an invaluable arbitrator, not to mention a great resource about all the options in the community that can make caregiving much less stressful and much more rewarding. As I have said in other postings, just as it may take a village to raise a child, it also takes that same village to care for all our older loved ones! 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.