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

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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What’s Scarier than Halloween?
The short answer to this question is cybersecurity breeches. First, how do you know if that spam in your...
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October 18, 2022
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Treatments for Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the third of four posts we’ll offer on the subject. I...
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September 20, 2022
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Diagnosing Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the second of four posts we’ll offer on the subject. A...
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September 13, 2022
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Dementia, Distraction, Delirium and Depression
September is Alzheimer’s Awareness Month, so we’re going to be sharing four posts that will help everyone with what...
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September 7, 2022
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Food Fight
When you hear the word cancer a lot can come to mind such as “cancer survivor,” “living with cancer,”...
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August 23, 2022
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In the Caregiver's Words

Recent Client Praise

Earlier this month, Kaiser Health News published an update on what the Centers for Medicare & Medicaid Services (CMS) is doing to reimburse for more services that may not be strictly medical…but offer a health benefit. With Kaiser’s permission we are releasing their summary of these changes here. Air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals may be among the new benefits added to Medicare Advantage coverage when new federal rules take effect next year. Earlier this month CMS expanded how it defines the “primarily health-related” benefits that insurers are allowed to include in their Medicare Advantage policies. And insurers would include these extras on top of providing the benefits traditional Medicare offers. “Medicare Advantage beneficiaries will have more supplemental benefits making it easier for them to lead healthier, more independent lives,” said CMS Administrator Seema Verma. Of the 61 million people enrolled in Medicare last year, 20 million have opted for Medicare Advantage, a privately run alternative to the traditional government program. Advantage plans limit members to a network of providers. Similar restrictions may apply to the new benefits. Many Medicare Advantage plans already offer some health benefits not covered by traditional Medicare, such as eyeglasses, hearing aids, dental care and gym memberships. But the new rules, which the industry sought, will expand that significantly to items and services that may not be directly considered medical treatment. CMS said the insurers will be permitted to provide care and devices that prevent or treat illness or injuries, compensate for physical impairments, address the psychological effects of illness or injuries, or reduce emergency medical care. Although insurers are still in the early stages of designing their 2019 policies, some companies have ideas about what they might include. In addition to transportation to doctors’ offices or better food options, some health insurance experts said additional benefits could include simple modifications in beneficiaries’ homes, such as installing grab bars in the bathroom, or aides to help with daily activities, including dressing, eating and other personal care needs. “This will allow us to build off the existing benefits that we already have in place that are focused more on prevention of avoidable injuries or exacerbation of existing health conditions,” said Alicia Kelley, director of Medicare sales for Capital District Physicians’ Health Plan, a nonprofit serving 43,000 members in 24 upstate New York counties. Even though a physician’s order or prescription is not necessary, the new benefits must be “medically appropriate” and recommended by a licensed health care provider, according to the new rules. Many beneficiaries have been attracted to Medicare Advantage because of its extra benefits and the limit on out-of-pocket expenses. However, CMS also cautioned that new supplemental benefits should not be items provided as an inducement to enroll. The new rules “set the stage to continue to innovate and provide choice,” said Cathryn Donaldson, of America’s Health Insurance Plans, a trade group. “CMS is catching up with the rest of the world in terms of its understanding of how we keep people healthy and well and living longer and independently, and those are all positive steps,” said Ceci Connolly, chief executive officer of the Alliance of Community Health Plans, which represents nonprofit health insurance plans. Some offer non-emergency medical transportation, low-cost hearing aids, a mobile dental clinic and a “grocery on wheels,” to make shopping more convenient, she said. 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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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.
We are all too familiar with the alarming death rates of those who contract COVID, and the hyper-transmissibility of the omicron variant especially among those who have not been vaccinated. Researchers at the University of Colorado have been studying what happens to patients after they have had a bout of COVID, and some of their findings suggest COVID may not be the worst of what happens to these patients. Studying a large cohort of recovered COVID patients, these scientists have documented that more than one in three of these recovered patients have been diagnosed with a subsequent psychiatric or neurological issue. Although there has not been time to follow all these patients to see what their long term health will be, there is strong suspicion that the ongoing effect of COVID is in the central nervous system. Neuroinflammation is never a good sign, but neurodegeneration that is a consequence of another disease … or of head trauma can yield downstream conditions like Parkinson’s Disease. These scientists also have found that in animal studies the COVID virus has been able to cross the blood brain barrier and the ongoing inflammation can cause sustained inflammation of the tau and consequent tangles and neurodegeneration. These scientists point back to the parkinsonism that was documented during and after the pandemic of 1918. Their estimate is that as many as 10,000 to 100,000 cases of this kind of inflammation could result for every 100 million cases of infection. This appears to include all the strains of COVID up to and likely beyond omicron. Who has not had the conversation…and likely many times…about getting through this pandemic and getting back to “normal?” The researchers don’t get into the new and yet to be discovered strains of COVID and their consequences, but it is pretty clear that even once we are all out of the woods we will need to be vigilant. The researchers suggest a substantial timeline for this vigilance…at least a decade for recovered patients, particularly those who have shown acute or subacute neurological symptoms. (These are not just one thing, so ask your personal physician what to be looking for.) What are the takeaways? One, please don’t let your guard down yet. Take the advice bout upgrading your mask very seriously and watch for when you are advised to again get “boosted.” Two, we have seen, and will continue to see, anxiety in recovering COVID patients. That’s not necessarily part of these “neurological issues.” Three, know that we are all on the learning curve, and this includes the health care workers and researchers. Know that we haven’t heard or seen it all yet, so stay tuned. There are optimistic public health suggestions that by summer we may be emerging from our pandemic. Until they can say that for certain, please stay masked and stay optimistic. 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.
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.