Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • care managerChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 9

Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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Five Things You Need to Know about Coronavirus
Okay, there may be more than five things you want to know about the coronavirus, but these five basics...
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January 28, 2020
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Singing is a Breath of Fresh Air for Caregivers
Associate Care Manager Gregory is a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on...
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February 12, 2018
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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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A House is not a Home (Unless You’re There)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 5, 2017
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In the Caregiver's Words

Recent Client Praise

Who would say “yes” to cancer, you may be thinking, but saying “no” means you’re committed to the lifestyle changes that are different from the bad habits many of us have cultivated over the years. And the changes require some investment of time and effort and sweat. Yet, making changes could reduce people’s risk of dying from their bad habits by as much as fifty percent. It varies a bit by type of cancer, so let me share some insights from scientific research. Let’s start with some broad brush strokes. Quitting smoking, embracing a healthy lifestyle, regular weekly physical activity and a balanced diet all contribute to a longer life…and a life that is full of positives like being able to take that vacation that requires hiking or walking to the beach or simply keeping up with the friends with whom you could spend your time off from work. You’ve doubtless heard of the Mediterranean diet and its anti-inflammatory and antioxidant properties. Overall, this diet of fruits, fish, vegetables, olive oil and nuts reduces a person’s risk of mortality across the board, but it also lowers the risk of cardiovascular morbidity for cancer survivors by 58 percent. Moderate physical exercise at least four days a week or more vigorous exercise at least two days a week. Your return on investment is a 25% lower risk of mortality of death from all causes. And for cancer survivors the mortality risk is lowered by 28%. Quitting smoking at any time in life will decrease risk of cancer by 14% to 42%, and the younger one is the greater the reduction in mortality. For how many years has that Surgeon General’s warning been on the label of cigarette packages? And these benefits come to those who have embraced these lifestyles all along as well as cancer survivors. If you want to see the implications of lifestyle change across genders and categories or cancer go to the MedPage Today website and use the Search Assistant. Charlotte Bishop is an Aging Life Care Advisor, Retirement Lifestyle Coach and founder of Creative Care Management, LLC, 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.
The beginning of a new year is certainly a time for resolutions, but it also can be a time to take stock of the "big picture" if you are a caregiver to an older loved one. Your older loved one may be "doing well." But the following are brief descriptions with links to postings of their own on some of the dimensions you should track along with resources you may find helpful if you are family member or caregiver to an older adult.

8 Tips to Prevent Senior Home Fires. The question of how an older parent is doing physically is as much about their residence as it is about their personal health and well-being. Last year I devoted some time to talking about how to make an older adult's home safe from fires.

3 Tips to Avoid Scams Targeting Seniors. In the past I also have devoted some time to talking about the inevitable predators who may look to scam older adults and how to be financially vigilant on behalf of your loved one.

Making the Most of Medical Face Time. Caregivers are not expected to diagnose or prescribe unless they are a health care professional. But as caregivers, I have talked about ways to make productive use of medical face time to get answers to important questions about your loved one's health.

3 Elder Care Suggestions for Depression. And of course, health and well-being are not simply how well a person's body is functioning. It also is about their mental health. Rates of depression escalate as individuals age and they face losses and physical decline, and a caregiver should take note of how mom or dad may be doing psychologically.

Independent Living for Your Parents. While for some, being active is about physically getting out and about, being socially active can be every bit as important for aging parents or other loved ones. Caregivers may benefit from a two-part series I had posted last year about considerations in independent living.

Watch For Signs of Elder Abuse. Caregivers along with all the family members also need to be advocates on behalf of older adults who can be victims of physical, psychological or financial abuse. Here are some tips.

What is a Geriatric Care Manager? Finally, I had started this blog about two and a half years ago talking about what a geriatric care manager (GCM) is. Please check out that first post as it talks about GCMs as elder advocates and care coordinators, or as I like to describe the profession: "GCMs are the Option-Makers for the Decision-Makers."

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.
If you are a caregiver to an older loved one, you may find it a bit overwhelming to keep up with all the medications they take each day, and the times of day they take them. But have you thought about the potential side effects as well? The average older adult living independently is taking more than five prescription medications daily, and those in nursing homes may be taking at least seven prescription medications. We call this “polypharmacy.” We all have at least some sense of the side effects that many of these medications may carry, but what you may not know is that some of these medications have some unhealthy interactions with the other medications.
Recent research in the United States among older adults living independently found interactions between drugs in about 15% of the cases. In another study in Europe that tracked older patients being discharged from hospitals, as many as 70% were on medications with some interactions, and 24% were at risk for serious interactions among the drugs they were taking when they were discharged. What should you look for? Review the medications your older loved one takes looking specifically for these medications: • Statins – the drugs used to lower cholesterol • Proton Pump Inhibitors - the drugs that work against GERD or acid reflux • Antibiotics - the real offenders tend to be sulfa drugs or fluoroquinolones • NSAIDs - these are the pain relievers like Naprosyn, Motrin, etc. • SSRIs - these include the anti-depressants like Prozac, Celexa, Paxil • Calcium-Channel Blockers - like Norvasc • Warfarin – the blood thinner also known as Coumadin. This seems like a short list...no problem. The fact is that statins are the most commonly prescribed drug for older adults. More than half of those over age 55 are prescribed statins to lower their LDL. About one in five older adults in America take PPIs. And you can see with the number of medications your older loved one may take the likelihood of an interaction escalates. And some of these drugs also do not play nice with certain food groups or vitamins. If you see signs of muscle weakness, cramping or difficulty standing or walking, as well as fatigue or confusion, check in with your loved one’s doctor. But if you really want to be proactive take the list of the medications your loved one consumes regularly to your local pharmacist…and don’t forget to add the over the counter medications which can include PPIs or NSAIDs as well as an accurate assessment of alcohol intake. And next time you accompany your loved one to a physician’s office visit and the doctor recommends a new prescription, ask what can be taken from the list! 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.
The processed food consumption that has been linked to our global epidemic of obesity is also tied to the rising rates of Alzheimer's Disease world-wide. I don't mean to sound the alarm about sugar, but I came across an article recently that tied together a number of facts and trends that we all may have seen. And we all should be very alarmed! As a geriatric care manager, I often work with older adults who have developed medical conditions that reflect a lifetime of poor health and nutrition habits. We see the elevated blood pressure and the obesity that can arise from sedentary lifestyles and poor diet. One of the more common developments we see is the onset of type-2 diabetes resulting from a lifetime of too many sweets that have resulted in what doctors call "insulin resistance," the pancreas' inability to keep producing enough insulin to process the large doses of sugar it confronts. What you may not know is that the brain also produces insulin, and that when faced with a prolonged assault from more sugar than it can process, its ability to produce insulin may falter and then fail. The result is "type-3 diabetes." The research has been piling up. For instance, people who suffer from type-2 diabetes (type-1 is the form that people are either born with or develop as an immune response) have deposits of amyloid-beta in their pancreas. Sound familiar? Yes, amyloid beta deposits in the brain are the signature marker for Alzheimer's Disease. And this also begins to explain why type-2 diabetics are estimated to be anywhere from 50 percent to 100 percent as likely to also develop insulin-resistant Alzheimer's Disease. Now, it is important to point out that type-2 diabetes does not cause Alzheimer's Disease, but type-3 diabetes is caused by the same over-consumption of sweets that causes type-2 diabetes. This may begin to also explain why the rates of the two conditions both have tripled in the United States in the past forty years. This, along with a lot of other inflammatory conditions related to the heart and the circulatory system. You may have thought that the extra care required for the estimated 5.4 million obese Americans with type-2 diabetes was costing us a lot - $150 billion annually? It is estimated that care for that many Alzheimer's patients is even higher at about $200 billion, the reason being in part because the close supervision for the safety of a cognitively-impaired patient is so much higher than for an obese individual. This is probably one of the situations where I don't have to connect the dots for any of you who are caregivers to an older adult...or attending even to your own well-being. My advice can best be summed up with two words: diet, exercise. Ironically, these are considered first line treatment for people who are obese or who have begun showing the signs of type-2 diabetes. Of all the advice I have digitally-shared these many years, this may be the best for a whole host of reasons. Please pass it on. 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 all have heard report after report about how we should stay active, especially as we grow older. It builds endurance in general when we exercise for 30-45 minutes five times a week. It helps prevent body muscle loss if we exercise regularly – the “use it or lose it” notion. It can help stave off bone density loss if we exercise regularly, and we just feel better because exercise releases endorphins which are the “feel good” hormone of the body. While you are thinking about all of that, exercise will help … that is, exercise will help you actually think! Research recently reportedly by scientists from the University of British Columbia demonstrated that those who exercise just three times a week over a six month period scored substantially better on a measure call the Cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS). Notice I said “substantially” better on this scale. We see a lot of studies that make it to the popular press that show differences between people who do X or Y or Z versus those who do not. This study actually took the scientific approach and compared two different segments of a group of 70 people who already early signs of Alzheimer ’s disease. That is, they demonstrated an measureable improvement in the subcortical ischemic vascular cognitive impairment among people who exercised those three times a week versus the other segment who did not. The researchers point out that it would take a 3-point improvement on this scale to be statistically significant, and their measured difference was just less than two points. But the non-exercise group was also receiving an educational program to stimulate them mentally plus normal care and they still fell behind on this scale. Who would turn down a nearly two point improvement…not a slower rate of decline – an actual improvement. The exercise group, however, did show significant improvement in their “6-Minute Walk Test” and their blood pressure. So if you pick up the exercise program you can expect to be more fit, perhaps even lower your blood pressure medication needs. Consider the cognitive improvement to be a bonus. One of the researchers also comments on how exercise has “minimal side effects.” You cannot say that about too many medications. I also see another hidden bonus in that with the added exercise, I can maybe have a portion of dessert. Now that is statistically significant! 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.
This week I asked Gregory Peebles to talk about the topic of ridesharing from the vantage point of his experience. 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. An Associate Care Manager, Gregory has been a part of my team for over a decade. – Charlotte Ask any teenager in the US, and they’ll tell you when a person becomes a functional adult. The legal driving age in our country is 16, and the license signals independence, freedom, and increased responsibility, including driving to and from a new job. Conversely, it seems also that when it’s time to “give up the keys” we finally start to come face-to-face with the reality that our time as a sovereign individual is finite. Becoming a “rider” instead of a “driver” signals dependence, limited options, and isolation. Getting out of the driver’s seat doesn’t mean all the fun is over, though. The US is just a culture of drivers, and when we lose that one identity, if we don’t substitute another healthy vision of ourselves, we experience unnecessary loss and grief. For example, aging adults stop driving for all kinds of reasons. Because it’s a big conversation, at CCM, we have tended to focus on the cognitive decline aspect, but loss of night vision, reduced hearing, and prescription side effects are still among the top reasons that seniors become “riders.” That means that there are plenty of folks with a lot of life left who may be sitting at home trying to fill the day with meaning when they could be in the world connecting. Caregiver schedules are already often stretched to breaking, so asking for a ride from a caregiver to go to something “fun” is much less likely than securing the ride to a medical appointment. Ridesharing services continue to cover more ground, and in our Chicagoland area, Lyft and Über are the most visible brands offering service. Here are 5 things you should know as you consider ridesharing for your older loved one:
1. It’s safe. – While safety comes down to the specifics of the driver, vehicle, and driving environment, of the two main rideshare choices, Lyft “vets” drivers and vehicles most strenuously. Problems with either service provider however are statistically very low.
2. You don’t have to have a smart phone to benefit from ride sharing. – If you have a technology-loving senior in your care, that’s awesome, but many seniors balk at the idea of a smartphone. So how could they benefit from a service that requires the technology? Your smartphone. You can set the pickup and destination in the app.
3. You keep some control. – There’s a map to follow, so if you’re a worrier, there’s visual evidence of where the car is coming from, when it picks up your loved one, and when they have arrived at their destination. You can keep doing what you need to do while staying connected.
4. It’s usually cheaper than a cab. – Depending on the time of day and how in-demand drivers are (rush hours tend to trigger “surge pricing”), the cost can be as little as $8 for a significant distance. A line share (like a carpool) can bring that price down even to $5.
5. Client assistance is common. – Though it’s not in the contract, drivers are used to helping passengers with luggage or other inconveniences. Your loved one needing a little extra help probably won’t be a problem. However, if you’re truly worried about it, GoGo Grandparent (https://gogograndparent.com) is prepared to help more than Lyft or Über might be. They also make deliveries and will schedule a pick-up, where most rideshares are more spontaneous.
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.