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

The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
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January 25, 2022
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It’s Not a Resolution – It’s Self-Care
A caregiver to an older loved one or other person with special needs takes care of everything, right? A...
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January 13, 2022
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If It’s Not Happy or Merry?
I explained in an earlier post about why we refer to Holidays in the plural, and how we are...
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December 14, 2021
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Making Your Holidays Happy Again
Yes, “holidays” is a plural word here. Please allow me to digress on this plurality and simply point out...
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November 16, 2021
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Password Protected?
I often offer advice on how to help your older loved one with challenging tasks or how to protect...
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October 26, 2021
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Can You Hear Me Now?
From 2002 to 2011, actor Paul Marcarelli was the voice for Verizon pitching their cellular communications with the simple...
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September 28, 2021
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What Does It Mean to Age Gracefully?
I think I can say with high confidence that your parents taught you how to walk…or what the kinesiologists...
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September 21, 2021
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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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In the Caregiver's Words

Recent Client Praise

New research recently reported sheds some light on what we need to know about Alzheimer's as well as what we may not want to know. Please allow me to explain. You likely have heard of some of the genetic advances that now allow labs to identify certain individuals who are more likely to develop Alzheimer's disease (AD) based on the apolipoprotein E ( APOE) ε4 allele risk factor for AD. Very simply, those who have this gene are at a higher risk of developing late-onset Alzheimer's, but how this happens is not yet fully understood. Scientists conducted a study among people with this genetic expression by dividing the individuals into two groups based simply upon whether they knew they had the gene or not. All individuals had the gene expression, so if they were randomly divided into groups one would expect that any person would have the same chance of having cognitive problems as any other individual. What the scientists found was quite remarkable. These study subjects were asked to rate their own memory performance and mental processing on a number of tests. Their actual performance was also quantified by the scientists. At the end of the testing, those people who knew they had the gene performed the same as those who did not know on the objective tests. When they scored themselves, however, those who knew they had the gene did worse than those who were unaware they had the gene. So, a person has to ask whether they will be better off knowing that they have a predisposition to AD or not? In a more upbeat bit of clinical research among Alzheimer's patients scientists offer a glimmer of hope for even those who may be predisposed to AD. It is a federally funded study and the largest and longest duration study of this type. Over a period of five to six weeks the experimental subjects were exposed to a number of hour long sessions in either reasoning, memory or processing speed, cognitive abilities that often decline as individuals age. All individuals were tested for cognitive ability at intervals up to five years from their initial training, and those who had been trained did better than those without the training. Even ten years out, there was a positive difference between the two groups, but the trained group did tend to decline somewhat from where they had been. So, if you are a caregiver to an older loved one, you may have one question along with one certainty. First, do you want them to have the test if knowing can be its own down side? Second, you should know that you want to encourage them to be socially active and intellectually challenged. 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.
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As a geriatric care manager, we have knowledge of Alzheimer’s Disease and its progression, less about its causes and its treatment, but we cannot know Alzheimer’s like a patient with the condition can. I recently was introduced to the writings of an “expert” who has gained his insights by being an Alzheimer’s patient since he was first diagnosed with dementia which has been presumed to be Alzheimer’s at age 58. Now 65 years old, Richard Taylor, Ph.D., a psychologist, has written a book titled Alzheimer’s from the Inside Out, and he issues a monthly newsletter on the subject. The following is an excerpt from his most recent newsletter. For those who are caregivers or family members of a patient with Alzheimer’s, this may offer some sense of living with the condition from the patient’s point of view:

“I am Richard, an individual living with the symptoms of dementia, probably (maybe) of the Alzheimer's type. This is my monthly newsletter for February, the month of my birth (Chicago, Illinois/Jackson Park Hospital 4:30 PM), at least that is what my Mom told me. This really isn't a newsletter; it's more like a report of what's happened to me in the past 30 or so days. It is sort of like my book, Alzheimer's From the Inside Out, except this newsletter is free and without charge (at least for now). It will soon be published in five languages - the newsletter that is. Through it, I have made and maintained friends with kindred spirits all over the world.

We all share more than a failing memory and slipping cognitive skills. We all want to know as much about what we "have" as possible. We all want to understand the research that is going on. We all to a greater or less degree are hoping for a cure - whatever the hell that means to each of us- within our lifetime, affordable to our families, with side effects that are significantly less than the symptoms of dementia with which we now live, and oh, by the way, could it reverse at least some of the more intrusive symptoms of this or that form of dementia.

I have spent a lot of time this month thinking and writing about this. I am not a researcher; I am not a physician or a pharmacist. I am just, Richard, a tall guy with a beard who is living with the more and more intrusive and more insoluble symptoms of dementia with which I have to cope if I want to live a purpose full, joy filled, love filled, and complete life. Most times this is much harder than I want it to be. It's not fair, it's not right, it just is. So I most times try to cheerfully embrace today, live in it as fully as I can by myself, and live in it more fully as a result of the enabling support of my family and those who love/like me.

Welcome to my inner and outer world more and more defined by dementia, probably (maybe) of the Alzheimer's type.”

Richard

Please check out Dr. Taylor’s newsletter and more about his book on his web site Richard Taylor PhD

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.

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It may be just the first week of summer, but if you are a caregiver to an older adult it is not too early to be alert to the toll that summer's heat can take on your loved one. Working in geriatric care management, one of the factors that always figure into my assessment of a client's overall condition is the weather and how well-equipped they may be to cope with what nature sends our way. To avoid the dangers that heat can represent for an elder adult, follow these six tips: • Replace the water lost. Perspiring is the body's way to lower its temperature, but it will happen at a higher rate during the hot months of summer. It is imperative that an older person consume more fluids during summer to replace what is lost to perspiration, and that this is not caffeinated or alcoholic liquids which by themselves dehydrate a body. • Ask their physician. How one copes with the heat can be dependent on the medications they take. I have talked in past postings about the large number of medications older adults typically are prescribed, and many of them can place a person at higher risk for heat-related issues. Especially if they are on a diuretic for high blood pressure, they are losing fluids, a condition that will be exacerbated by the heat and perspiring. • Dress for success. Success in this case means clothing that will allow more ventilation. Encourage your older adult to wear loose fitting clothes, and choose lightweight fabric like cotton or synthetics. A hat will not only protect the skin from dangerous sun rays, but it also is portable shade to cool your older loved one. • Don't overdo it outdoors. Even a walk in the park may prove to be too strenuous in summer's heat, so help your older loved one monitor how severe the heat is and modify outside activity accordingly. If they will be active encourage them to do so early or late in the day to avoid the highest temperatures, and take more frequent water breaks. If they will be poolside, encourage them to actually get into the water to cool down. • Cool down. It is possible that your older loved one does not have air conditioning, so find other retreats for the really hot days of summer. Public libraries, shopping malls, public activities centers or other venues can provide a break from the heat and offer social engagement as well. Opening windows on most nights also will give a relief from summer heat along with regular cool baths or showers. • When all else fails. Even with all these preventive efforts, you may still find your loved one succumbs to the heat, so watch for signs of over-heating. If you see one or more of the following - muscle spasms, headaches, over-tiredness, nausea - get your loved one to a cool area immediately. Begin to rehydrate them as well as use cool, water-soaked cloths on their neck, head or wrists. Running cool water over a person's wrists also will have a more general cooling effect on the whole body as the cooler blood circulates. If symptoms become worse or are accompanied by disorientation, rapid pulse or seizures get them to medical help right away. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends providing elder care management needs to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
Lauren Weldon is a partner in Margolis Weldon, a law firm specializing in estate planning and elder law. We have invited Lauren to post on what we all need to know about Long Term Care. She offers this: Even the best of us can be overwhelmed when someone we love is in the middle of a stint in rehab due to a fall or coming out of the hospital for the third time in a short period of time. We often don’t think about the financial, legal or even practical considerations that are part of what can become a long term care crisis. Here are three things you need to avoid; you could call them the three “NOTS” that can tie you in KNOTS:
1. Not knowing who will pay for it: One of the most common misconceptions regarding long term care is that Medicare or private health insurance will pay for it. To be fair, this is true to a certain extent, in some circumstances. Medicare pays for up to 100 days of rehab in a skilled care facility, provided the Medicare recipient meets certain qualifications. Any days after the 100^th day are not paid for by Medicare, nor are they paid for by a supplemental policy. For long term residents of nursing homes, their bills are being paid by Medicaid or privately (i.e., self-funded through assets, income or a long term care insurance policy). You and your loved one need to get schooled on Medicaid.
2. Not having a plan: Charlotte Bishop talks about “The Trifecta:” being old, sick and broke. Nobody wants to be any one of these things, let alone all three. The reality is, if we are lucky, we will get old. Yet, many of us will outlive our money - in part due to expenses related to chronic illness. Despite knowing these things, many people don’t plan adequately. They don’t inquire about or even consider long term care insurance until they are too old or sick to qualify. They don’t have an estate plan or the legal documents necessary to protect themselves, their loved ones and their assets from crisis.
3. Not consulting with an advocate: Unless you work in healthcare or senior care, chances are you have no idea how to go about finding the best rehab facility in your area. You don’t know how to negotiate the private pay period at a nursing home. You have no idea what to look for in a caregiving or caregiving company, and you have never heard of spousal impoverishment. In addition to an elder law attorney who can advise and guide you, geriatric care managers, patient advocates and private social workers can all represent your interests and provide unbiased feedback regarding your long term care choices.
There is a fourth NOT; do NOT put off planning. The best time to start planning is right now; don’t wait until a crisis occurs. In addition to giving you peace of mind, thinking through these issues and coming up with a plan now will save you significant time and money. 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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