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

Too Good to Be True
With over 300 clinical trials on vaccines for COVID19, it perhaps is not a surprise that at least two...
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December 1, 2020
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The Other Global Health Crisis
Wearing a face mask is the new front line of defense against the spread of the war on COVID-19,...
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November 17, 2020
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One More Sign of COVID?
I have written about Alzheimer’s disease…a lot, its warning signs and caregiving probably more than any other topic. Even...
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October 6, 2020
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None of the Above…
While everyone is awaiting the next vaccine to prevent COVID-19 or help in the treatment of the condition among...
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September 29, 2020
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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
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September 15, 2020
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That’s Not A Senior Moment
We all hear the phrase used as an excuse for a bit of memory lapse … that it’s just...
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September 1, 2020
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Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
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August 18, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 2020
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Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
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July 21, 2020
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In the Caregiver's Words

Recent Client Praise

When you consider the place a typical senior calls home, it has not changed a lot since it was full of kids and a much younger family. But what may not have been a fall hazard back in the day might become one as parents age in place. This is a list of just some of the senior care precautions one should take to make home as safe as possible for an older adult whose feet just are not as nimble as they once were. Throughout the home:
In the bath:
In the bedroom:
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. Learn more about What We Do and how we can help you support your loved one.
Eating healthy should be a priority no matter what your age or health condition. Of course, during Thanksgiving, we are all tempted to indulge a little more than we would on a normal basis. Imagine if we were to reverse that thinking and made a more conscious effort to eat better during the holidays? If you’re preparing this year’s big feast, think about serving a mix of foods that align with a more healthy diet. For instance, if you’re caring for an elder adult, or an Alzheimer’s patient, you might want to consider a Mediterranean diet.

Studies have shown, as reported by ABC news, that a Mediterranean diet is great for preventing stroke and dementia. In general, the diet has exceptional nutritional value, with benefits that keep the body healthy and improve mental cognition at the same time. The American Academy of Neurology studied brain scans of those who exhibited various degrees of commitment to the Mediterranean diet. Those who stayed with the diet were 36% less likely to have infarcts – strokes in the brain that usually don’t produce any symptoms.

Another study by the American Academy of Neurology shows that the Mediterranean diet can improve the long-term health of Alzheimer’s patients. A focus on high fruit and vegetable consumption as well as low meat consumption seems to create benefits for mental and overall health.

So how do you infuse a bit of Mediterranean in your thanksgiving meal? First, if you’re a caregiver for a loved one, give them a few options and ask them what they prefer. It could be as simple as adding a salad to the meal, or trying a new and healthier way to prepare the stuffing. A quick search online will offer new ideas for side dishes and entrees. You may find that your efforts will encourage healthier eating habits for everyone at the Thanksgiving table, including yourself!

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.
We've all used the expression, "Don't lose any sleep over it." Turns out that losing sleep is one thing that can happen a lot more frequently as we age and it often is associated with other serious medical conditions.   The common causes of older adult insomnia are dementia, heart disease, kidney disease, heartburn or reflux, asthma, diabetes, thyroid disease or even prostate issues. So if you are a caregiver to an older adult who has been having trouble sleeping, it is worth paying attention.

And at the same time, insomnia is not always just one kind of condition. Some older adults have trouble falling asleep initially and some have trouble staying asleep. Some insomniacs may wake up several times a night, perhaps because they need to make trips to the bathroom, and some just cannot seem to feel rested in the mornings because they do not get a quality night's sleep.

As we grow older we need less sleep than we did as children or teenagers. Although we as a nation seem to deprive ourselves of sleep by getting up early, staying up late or both, the average adult needs about seven to eight hours of sleep a night to function well. People who say they need less may just have grown accustomed to getting by with less sleep, but they may also have a difficult time focusing during the day or may be cranky or irritable.

Sometimes it may simply be consuming caffeine, nicotine or alcohol, or it can be nutritional supplements or even vigorous exercise too close to bedtime that get in the way of good night's sleep. If you know someone who has trouble getting enough quality sleep, here are some tips that may help without resorting to the pharmaceutical sleep aids we have seen advertised a lot:

1.    It may be the afternoon nap that has to be taken out of the day's schedule in order to feel sufficiently tired to sleep at night...or the dozing off in front of the television after supper.

2.    Make sure the bedroom is dark enough and quiet enough, and move the clock out of sight so that there is not the temptation to keep checking what time it is.

3.    Don't use the bed as place where you eat, watch television or read so much that it is no longer that restful haven at the end of a day.

4.    Try to go to bed at the same time every night, and have some real physical activity each day so that the body will have something from which to be tired.

5.    Encourage your older adult to make a written list of the things they will do the next day so that the mind does not get caught up in the mental list-making that keeps the body awake.

6.    Above all, relax before bed time; it can be helpful to have a calming time that helps to really separate the day's activities from the night's surrender to sleep.
            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.
It was the extended family that took care of the children as well as mom and dad as they aged during much of the last century. Today life is both different and complicated. The family has changed in numerous ways to challenge the old models of caregiving. Everyone lives anywhere but “here,” the rates of divorce approach 50%; intimacy lasts well into older loved ones lives and non-traditional families have earned their rights. Consider:
1. Who takes care of mom or dad when they are divorced. Appreciate that when one of your parents cannot be there for the other once they are divorced. That may mean that your role as a son or daughter caregiver may come into play earlier than otherwise would be the case. Be alert to home safety issues as well as how well mom or dad ambulate, how fresh the food in the fridge is and either attend doctors’ visits with them or engage the services of a care manager to help with any of these.
2. Will residential care options be welcoming for gay families. New options to accommodate all lifestyles are becoming available every day, but be aware of old biases that can persist. If the care you need does not accommodate the individuals you are or your gay parents are, then take your business elsewhere. Consider the places that have been welcoming for your younger needs will have connections to similarly welcoming places for aging needs. Many cities have devoted directories of such vetted services. In Chicago, it’s the Pink Pages for the LGBT community.
3. How do we address intimacy among older adults as they age? Remember the “awkward conversation” you may have had with mom or dad as you were coming of age? Well, now it’s your turn to be the intimacy advocate for your older loved one. You may have to ask the tough questions of their caregivers or the facilities to which they move once they leave their homes. Today’s 80 may be yesterday’s 60 in more ways than you had considered, so be prepared.
4. Distance caregiving is the stress of anyone with older parents and a family, or job, or a life of their own. Based on our experience, distance caregivers need to focus on the things that can be done at distance. Arrange for what can be delivered by a third party, like meals; help by becoming a signer on mom or dad’s account to help pay bills and balance the check book; or find a local care manager who can be your eyes and ears when you can’t be around. And keep in touch with neighbors and friends.
I will be coming back to these themes in future postings, but I also strongly encourage you to attend a caregivers’ forum addressing these issues this Thursday, November 19 at St. Matthew’s in Evanston, Illinois. It will be an ecumenical program in the main Parlor at 7 p.m. CST. Enlarge the map on this page or go to: http://stmatthewsevanston.org/. Two of CCM’s staff will be co-hosting the event. Bring your questions…and contact us if you need help with respite care because you are caring for an older loved one and need that help to get to the event! Charlotte Bishop is an Aging Life Care Professional and 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.
Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both 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 Back in 2007, when the Internet was still being settled, I was in one of those lines that stretched around the block to ensure that the day it came out, I had a brand new first generation iPhone in my greedy little hand. Once acquired, friends and family were all amused by the machine, but saw little use for it in their own lives. The revolutionary, all-in-one device was an expensive fad that they imagined would calm down. Life had changed though, and I knew it was just a matter of time before what was in my pocket was the norm instead of a curiosity. Five years later, my retired mother, more than a little bored, adopted a smartphone baby, shortly thereafter becoming an excellent texting conversationalist, casually sharing with me links to favorite YouTube finds. She blossomed online and is currently the Facebook page administrator for one of her social groups. My mom is a special case. She’s very curious and took to virtual reality like a duck to water. Not everyone is as interested. It takes all kinds. In 2017, more than 2/3 of adults over 65 have cause to be online, with well over half of that number identified as being active Facebook users. That means that chuckling over technology-challenged grandparents has an expiration date, and it’s now! The cohort we call “oldest old” (85+) still tends towards pencil-and-paper or maybe typewriter modalities (and that doesn’t look likely to change), but aging boomers have rushed online in droves. Some overeducate themselves regarding proper safety, locking their identities down in privacy settings to the point that “social media” loses meaning. Meanwhile, others prefer to bleed important personal information to anyone listening. At CCM, most of our Internet discussion to-date has been dedicated to sharing with you the ever-changing scams Internet predators use to prey on vulnerable users of all ages. (We’ll talk some more about those, too.) But for the next few sessions, we’ll focus instead on the ways aging adults are using the Internet socially to enhance the quality of their lives. From best practices in social sharing to recognizing bots in chat, we’ll be engaging in eye-opening discussion about the real online lives of your older loved one and answering questions like:
- What can seniors expect from online dating?
- Where are seniors online?
- What services or sites have engaged them as a group?
- What does a secure and social Internet experience look and feel like for aging adults?
We hope you’ll join us for this topic each Monday for the next four weeks, commenting and sharing this important, somewhat unusual conversation with your own corner of the Internet.
Until quite recently there were rules governing what Medicare will reimburse if a qualified adult was prescribed physical therapy, occupational therapy or speech therapy. Patients needed to show documented improvement if Medicare was going to continue to cover their therapy. As with all insurance rules, a patient or the patient's families could pay out of their own pockets for any services a provider may prescribe, but until this year, the government was not going to pay for therapy without an improved health status. All that has changed now with a federal ruling that it is no longer necessary to show improved status to get reimbursed. If you are a caregiver to an older loved one or someone else with special needs who is covered under Medicare, therapy now will be offered to maintain a patient's present condition or to prevent "backsliding." Translated, Medicare now must recognize and support a patient who is attempting to stay as well and as active as they can be. As a geriatric care manager, this is very gratifying as a large part of what we do is to help our clients to maintain a quality of life, because beyond a certain age improvement is simply not realistic. Many of the old rules are still in place regarding where therapy may be received. It can be received at an outpatient center, a therapist's private office, in a nursing home or in a patient's own home. Authorization simply requires a doctor's order, so make sure your physician knows about the change. The same dollar caps on how much Medicare will cover still remain, and that is $1,900 a year. And even residents of nursing homes who have used up their 100 days can still get coverage for therapy, so long as they do not exceed the cap for the therapy. This, too, can be challenged , in certain cases, so be sure to check in with a local office of the Centers for Medicare and Medicaid Services for the terms. And claims for patients who may have been denied before this year may still be honored retrospectively back to the date when the lawsuit was first filed January 18, 2011. For more information on:
- the outpatient therapy cap limits,
- getting exceptions to the cap limits,
- who can give therapy services under the rules,
- where therapy services can be received, and
- how to find out what the therapy services will cost,
go to http://www.medicare.gov/Pubs/pdf/10988.pdf or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. To find a resource in your own state, just visit: http://www.Medicare.gov/contacts. 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 ccbishop@creativecasemanagement.com.