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

What’s Your Complaint?
If you grew up in a family as I did we were taught not to, or shown role models...
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June 11, 2024
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If It’s All in Your Head, Are You Out of Your Mind?
You know what makes a real difference between grade school children and adults over the age of forty? We...
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February 6, 2024
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Why D is More than a Passing Grade
There is much talk recently about “grade inflation” which rather diminishes the formerly exclusive appeal of a report card...
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January 29, 2024
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Questions and Answers to Live Well
Many of you have heard me talk about having a Live Well Blueprint as an anchor component to being...
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December 5, 2023
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The High Cost of Wellness
Once in a while “yesterday’s news” is also tomorrow’s news. Earlier this year you probably heard or read that...
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August 15, 2023
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Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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A Viral Trifecta?
To get to the question in the email first, the Spanish flu of 1918 did not get its start...
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December 13, 2022
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Saying “No” May be the Right Answer
Saying “yes” when someone asks you to do something can be like eating candy. It feels right or good...
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November 15, 2022
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Doing Your Homework on Medicare Coverage
If you or an older loved one are at that age in the magical transition – otherwise known as...
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November 8, 2022
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Planning for the Holidays is More than a Menu
The latest news reports suggest only about 10 percent of American Adults have received their seasonal booster for COVID. ...
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October 24, 2022
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In the Caregiver's Words

Recent Client Praise

COVID 19 was not in my calendar for 2020, and I strongly suspect it was not in yours either. I often have said that family life crises don’t make appointments; they just show up. And I am usually talking about how to be prepared for the inevitable call from or about an older loved one in your orbit…AND how to be prepared for your and their next steps. Well, this time, preparing for a crisis could be closer to home, because all of us need to be prepared so that the people who may get the call that we have taken ill can be prepared. What do you need to do to make a Plan? When I have spoken in the past, some people back off from talking about a loved one in a crisis. This list is about you, so please forgive me for getting “personal.” Here is my “short list” of the documents you need to have and make them available to your partner, your kids or other close friend … sometimes with no notice:
- Medical Release – the document you need so your medical providers to speak with your loved one’s about your health status, medications and prognosis.
- Power of Attorney (POA) for Finance - a legally binding document that gives a person (referred to as the “agent” or “attorney in fact” permission or power to act on your behalf in matters of property or finance.
- Power of Attorney (POA) for Healthcare - a legally binding document that gives a person power to act on your behalf in matters of medical treatment. The “power” typically is in force when it is deemed the person in question can no longer act for themselves or if they are not conscious.
- Practitioner Orders for Life-Sustaining Treatment (POLST) – a document (varies state by state) that specifies in advance what measures you wish to have in the event you cannot expressly grant permission yourself. These orders typically revolve around life-saving measures; they are sometimes referred to as advanced directives and are placed in your medical files. The forms are downloadable at your state’s web site.
- Health and Life Insurance Policies – the health policy will help everyone involved understand what is covered and which physicians and other providers are available to you. The Life insurance policy should be in a safe place so that it can be readily accessed should that become necessary.
- Estate Plan – is (potentially) a wide-ranging document that let’s everyone know how any real estate or other holdings are titled and what the “plan” is for when your will is executed.
- Trust documents – help to identify how your estate is to be transmitted to beneficiaries. Trust names need to be consistent with life insurance, will and holdings in order to be in effect.
- Last Will and Testament – the legal document by which you express your wishes of how property is to be distributed at death, and names one or more persons, the executor, to manage your estate until its final distribution.
- The Grab and Go – This is a list that typically is sealed in a plastic bag. It includes your medical insurance documentation, a list of allergies, a list of medications, primary care physician contact details and in case of emergency (ICE) contact information.
Please email (info@creativecaremanagement.com) me with any questions on any of these…as well as how to take the next steps which is your plan. Do yourself a favor…don’t wait. 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.
It is sadly ironic that it was former president Ronald Reagan who designated November as National Alzheimer’s Awareness Month in 1983. Reagan’s efforts and his own personal experience with Alzheimer’s disease did much to bring this mysterious and stealthy condition to the nation’s attention. But it did nothing compared to the attention that the nearly 6 million Americans today who have been diagnosed with Alzheimer’s and the 16+ million caregivers who support them lend. The number with diagnosed Alzheimer’s is expected to double in the next ten years, and experts are concerned that there may not be enough family caregivers to meet the needs. Everybody knows someone whose family knows Alzheimer’s. The number of assisted living centers as well as new types of facilities is increasing, but there also has been a revolution in the on-line resources available to families confronted with the challenges Alzheimer’s brings. Here are four that I recommend to meet needs from early stage diagnosis through to the rest of the trajectory families will face:
1. The Alzheimer’s Association offers a searchable “library” called the Green-Field Virtual Library. It offers searchable content and e-books on a range of topics from the range or neurological conditions of which Alzheimer’s is one to caregiving patient health.
2. The Alzheimer’s Association also hosts a number of independent sites with their own searchable, relevant content: Caregiving Fundamentals, Clinical Trials, Alzheimer’s Research and Alzheimer’s Stages.
3. The Alzheimer’s Association recognizes that the burning question for every caregiving family centers on finding a cure. We are not there yet, but for those of you who follow my blog, you know that a lot is being done to advance the effort toward an Alzheimer’s Cure.
4. On a more local and global front a group based originally at Northwestern University has created a digital platform for caregivers called June Care. June Care is a digital care platform that empowers families to support their relatives diagnosed with Alzheimer's. The June Care team has built an online therapeutics program made to manage and change behaviors around caregiving. June Care is partnered with the Alzheimer's Prevention Registry and is actively enrolling caregivers in Illinois — Ideal participants are full-time family caregivers who care for persons with dementia and are looking for support. Because these are pilot studies, there is no cost to participants.
So, while there is not yet a cure, there is both hope and help. Please feel free to search our Blog as well as the other resources we work to make available to families who have been thrust into the caregiver role to a loved one with any form of dementia. Also, please let me know your questions at info@creativecaremanagement.com. 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.
With a lot of talk these days about children moving back in with parents and intergenerational homes, it is easy to overlook the huge growth in “distance caregiving” in America. In 1997 the number of distance caregivers - family who are caring for an older parent in another location – was about 7 million; it has since doubled to an estimated 14 million today. I came across a study on distance caregiving by a nurse oncologist, Polly Mazanec, that addressed a lot of the issues I see as a geriatric care manager with my own clients.

We often get a call from a son or daughter (and yes, it is more often a daughter), because they are concerned about some life issue of an older parent who still resides here where we work. It can be a change for the worse in a chronic medical condition, a sense that the parent is “confused,” a progression of a cancer, a fall or a home security concern. But almost without exception, the distance caregiver clearly sounds stressed. When I talk about “distance,” there is no magical number of miles to be distant, if it is perceived as distance then that becomes stressful. Distance can be measured in miles, but if the caregiver has a strenuous workload or is the sole wage earner in this recession or has family obligations in their own home, the ability to make frequent trips to help mom or dad is limited.

Caring for an older parent from distance is stressful, because there can be a long interval between visits or a most recent visit has shown visible changes in mom or dad or there has been a change in treatment regimen that the distance caregiver does not understand. And the medical change actually can be more stressful for the distance caregiver than for the patient. The stress comes as much from anxiety and guilt than it does from concern for the elder’s well-being, a stress owing to having “not been there to help."

Based on our experience, I offer some suggestions for long distance caregivers:
1. Help with the things that can be done at distance - arrange for meals to be delivered, housekeeping details to be attended, a checkbook balanced, in-home help to be present, or a neighbor to look-in at intervals.
2. Appreciate that being an adult yourself may not release you from the way you related to your parents back when you were a child at home - give yourself permission to help as you can without feeling guilt about not being there.
3. Enlist the help of a local advocate - this can be a nurse clinician at the doctor’s office or a geriatric care manager, but it is helpful to have someone to monitor and manage and then inform you.
4. Acknowledge that hands-on is not the only kind of care; distance caregiving can be a very important part of the village it takes to care for an elder or other person with special needs.
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.
If you are a distance caregiver who will be home with an older loved one during these holidays, it is a great chance to have great conversation and to do a caregiver check up with your older loved one. You may beneficially find it helpful to raise some questions in your catch-up conversation to get a clearer sense of how well your elder is caring for themselves. Try these: 1. How are you sleeping? It is common knowledge that as we age, we simply need less sleep, but there is a real health difference between needing less sleep and actually suffering from insomnia. Consistent loss of sleep can be a real health risk in itself. Medical researchers find that as the hours of lost sleep pile up, blood pressure also rises. With rising pressure, there is rising inflammation or even weakening of blood vessel walls. People with genuine insomnia have twice the chance of suffering a stroke. Recommend end of day habits that will be less stimulating...like less television and more reading. It may be helpful to even suggest a white noise machine or some sound devices that mimic wave action or light rainfall to soothe your loved one to sleep. 2. Do you enjoy a good cup of coffee? At the opposite end of the sleep continuum, don't discourage your older loved one's coffee during the day. At the same time you can encourage decaf or a switch to non-caffeinated teas after the lunch hour to avoid stimulation that can fuel sleeplessness. But coffee actually imparts measureable health benefits. It has been demonstrated to reduce the risk of type 2 diabetes, heart disease and even some forms of cancer. 3. Do you have a place for safe walking? Walking just half an hour daily - or even six days out of seven - has had a demonstrably beneficial effect on reducing belly fat. And the effect is more than cosmetic. Walking or even jogging can reduce the middle and at the same time lower the risk of the three above: diabetes, heart disease and cancer. With any exercise, always encourage your loved one to consult their physician and to get comfortable and supportive footwear. 4. How are you feeling? This sounds like a vague question, but it is a chance to talk about anything that has changed lately. Research shows that unusual chest or arm pain are common precursors for heart issues in men. In women, it is not so clear. In fact, fewer than a third of women report discomfort before a cardiac event. But nearly all women have symptoms like indigestion, pain, anxiety or other cues before a heart attack. Listen for what may be brushed off as "nothing." If you are a caregiver to an older loved one, enjoy family and the holiday, and take the conversational opportunity to make it a healthy holiday and 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.
It is November, and for most of us that means gearing up for the holidays, family and memorable events. The first two are true of almost everyone, but the third one - memorable - can be a huge challenge to caregivers and patients with Alzheimer's Disease. Caregivers to a loved one whose mental faculties are declining from Alzheimer's Disease can face a lot of challenges, not the least among them the guilt that can come from hosting a holiday get together when things just cannot be the way they used to be. Here are some tips for caregivers to a loved one with Alzheimer's or any of the dementias that may affect memory:
1. Take care of the caregiver: The person whose needs most often are at the bottom of the list is the caregiver to an AD patient. Do something for you, and it will make it easier to do all those other things for all those other people.
2. Be realistic: We all tend to have a notion about what the "holiday is supposed to be." That may not be feasible when a loved one has Alzheimer's, so work within the capabilities and the comfort zones of all concerned.
3. Include everyone in the plan: If you talk over plans for the holiday with all the family, it can help all to enjoy the event. Everyone will have had a say in what happens and expectations will be better met.
4. Avoid over-doing the alcohol: There is a great deal of loneliness in being a caregiver to a loved one in decline, so avoid the inclination to self-medicate. If you as a caregiver already feel melancholy, alcohol will only fuel the depression.
5. Let visitors know: If visiting family does not know exactly what to expect from a loved one with AD, they probably will not act appropriately. Help them to understand about talking and living in the moment.
6. Let your loved one know: For patients with early onset AD, there can be moments of lucidity as well as confusion. Help them to also be in the moment and not lapse into the sadness or even the angry outbursts that can come from AD's confusion.
7. Manage the environment: AD can be confusing enough without exacerbating the challenge with a noisy environment. Helping your loved one to engage people in quieter surroundings can help everyone communicate better.
As you navigate through the holidays, appreciate that they may not be as they once were before the intrusion of Alzheimer's, but you are making new memories for you and the rest of the family. With attention to some of these tips, you will find that the new experiences will help everyone's holidays to be their own new memories to cherish. 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.
“A friend told me how valuable the information [that Charlotte gave her] was!”
Catharine J. Jones, Diplomate Analytical Psychoanalyst