Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • geriatric careChicago's Geriatric Care Manager Center of Excellence

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,...
Read more
September 22, 2020
0
0
It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
Read more
September 15, 2020
0
0
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...
Read more
September 1, 2020
0
0
Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
Read more
August 18, 2020
0
0
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...
Read more
August 11, 2020
0
0
Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
Read more
July 21, 2020
0
0
Just the Facts – About COVID Today
For a pandemic and quarantine that has lasted about 18 weeks, it is safe to say that most of...
Read more
July 14, 2020
0
0
Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
Read more
July 7, 2020
0
0
Abuse Thrives in Pandemic
Guest post author Gregory Peebles is a team member at CCM whose work focuses on helping aging adults and...
Read more
June 16, 2020
0
0
Dementia: We’re Not Post-COVID Yet
If you have a family member or loved one with dementia, this pandemic and its restrictions have been exponentially...
Read more
May 26, 2020
0
0

In the Caregiver's Words

Recent Client Praise

We’ve all seen the ads on television about the lawyers who will stand up for our older loved one if they are abused or neglected in a nursing home or other facility. A bruise, a bed sore or maybe loss in weight can be pretty conspicuous warning signs, but there is another pervasive abuse of older adults in America, an abuse that has no telltale bruises. We know from the statistics that one in nine older adults in America has been abused, but financial abuse specifically is substantially under-reported. Experts at the National Adult Protective Services Association report that only about one in 44 cases of financial abuse of seniors ever gets reported. Exacerbating this under-reporting is the simple fact that senior financial abuse doesn’t leave a mark on the abused victim. But it does raise a flag if you know what to look for. Look for telltale changes in your older loved one such as:
1. Sudden changes in a will or other document that now includes a new beneficiary.
2. The “live-in” caregiver who seems to be “living off” their client.
3. An unexpected increase in credit card debt or an unusually large line item.
4. Money spent that has a wild or outlandish explanation.
5. More frequent withdrawals on a bank account or new accounts with someone else’s name on it.
6. Vague explanations or complaints about a missing credit card.
7. Guarded talking or behavior around a new caregiver that may suggest they are being intimidated.
8. Missing items like jewelry, money, antiques, art or even furniture from their home.
9. That new girl or boy friend…maybe some significant number of years younger.
Older adults are prime targets because they have the money…their savings, retirement accounts, mortgage-free home or other assets. Older adults are also more vulnerable because they may live alone, they may have chronic medical conditions requiring assistance or they are simply weaker than their exploiter. Older women are particularly vulnerable for all of these reasons plus their upbringing was in a time when women were simply taught to defer, to be nice, to be polite. And nearly half of all abusers are family members or friends. Please remember also that the earlier you spot the flags, the easier it is to “fix the problem.” 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.
I had the good fortune to speak to a local Rotary chapter this morning. The question they had put to me was simply how does one plan with an older loved one for that moment that no one wants to plan? The answer is simple ... because for any conversation, you just need a place to begin. Here are five tips to BEGIN the work for your older loved one’s (or your own) future... Break the ice. Start the conversation with your older loved one…ask questions about their ideas regarding the ‘What ifs’ of life…ex: if you had to go to a hospital, which one would you like to go to? Does your doctor have my contact information if there were an emergency? Make a list of what those choices are; include them in a Living Will or POLST “Practitioner Order for Life-Sustaining Treatment”. Make sure that your family and your health care providers are aware of the choices. Evaluate the whole person. Use your powers of observation to assess your loved one’s situation and make notes. Think about what they have told you over time regarding their wishes, finances, housing situation, health. Plan follow up conversations to learn more about what they would want in the event of an emergency. Guard against abuse. Begin to gather legal documents including mortgage information, insurance information, bank account locations, account numbers, etc. Ask about finances, investments. Investigate the possible utility of Powers of Attorney. If there are any gaps or documents such as wills that are out of date or non-existent, get new ones drawn up. You don’t have to have everything perfect, but you will benefit if you start the conversations or the personal reflection needed to begin the process. Inside out. Make a list of you or your loved ones health history, get a medical release so that providers can talk to you about your loved one, consult current physicians and create a list of medications, dosing, etc. Nest. Think about the home as safe from the inside out, not just safe from the outside in...If they are living in the house you grew up in evaluate all the years of wear and tear on the infrastructure: stair railing, worn carpet. Take a look around the home for any obvious safety issues that can be easily addressed: since the majority of falls occur at home scatter rugs, poor lighting, expired food in the fridge, extension cords stretched under rugs or in walkways. Also, expired medication or medications that resemble each other…Safety first. 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.
Family crises don’t make appointments…they just happen whether you are ready or not. In fact, our clock is ticking: • Every 67 seconds another person in America is diagnosed with Alzheimer’s, and that is just one of the nearly 100 types of dementia; • Every three minutes an individual 65 years of age or older is taken to an emergency room; 14% of the subsequent admissions are for broken hips. The list goes on. You wish mom or dad could have the life they want…to stay in the home you grew up in … to stay independent. In fact, they may have made you promise that you would see to it. But dreams and promises can’t always come true. Are you ready? The clock is ticking. Do you dread the phone call that may come in the middle of the night- or during the work day? The call that tells you something out of the blue has happened to someone you love? I got that call- I was working full time with school age children at home when I got the call that my mother was diagnosed with cancer. Right then and there I had to deal with my mother’s medical needs, her health crisis, her finances while caring for my family and running my business. One of our employees got the call that his mom had to be out of her independent living facility within 30 days…she was no longer “independent.” How many of you have had a similar experience- or are hoping you never get the call? Well, hope is not a strategy for your inevitable family crisis - you need a plan. A plan starts with having the necessary documents for your older loved ones, and the basics are: a POLST, a Living Will, a Power of Attorney for Healthcare and a Power of Attorney for Finance. Some of our clients also have found that mom or dad wanted to lay out their plan for a funeral, but that may be getting a bit ahead of things. You also need to know their physicians – that’s right, it’s plural; there likely will be more than one. You also want to know their preferences…which hospital in the event they need to go to one, a document to inform any medical interventions. And, of course, where their health insurance card is, their will, and who their lawyer is. You may get some resistance, so just remember that resistance is just fear putting up a wall. Empathize with their fear. Imagine now your next step. Imagine what it would be like to have the peace of mind that a plan can give. The possibility of sleeping at night. The possibility of having more time with your family. The possibility of being able to do your job. The possibility of feeling more in control of all the chaos. Check out what I had to say about planning for the crisis that doesn’t make an appointment on ABC News. Watch it below (after a brief commercial).
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.
As a certified geriatric care manager I have written a fair number of posts about distance caregiving. With some of these posts, I have offered tips on the paperwork that should be in place in case of an emergency as well as how one can help prepare a loved one for a medical or weather emergency. Earlier this month, a national report was released that offers guidelines for an emergency I have not addressed yet: What should one be prepared to do in the event of a nuclear incident? In the spirit of helping any of you distance caregivers to make sure your loved ones are prepared for an improvised nuclear device (IND) or a dirty bomb, here are some suggestions from the people who study these things. First of all, an IND is an actual nuclear weapon stolen or illegally fabricated by terrorists to be detonated in a populated area. A dirty bomb is a conventional explosive that is used to disperse nuclear material over a substantial area. Both result in radioactivity being spread into the atmosphere, but the first also carries the added risk of the intense nuclear blast itself. As a caregiver, help your older loved one to understand that their first response should not be to evacuate. The first response following a nuclear event should be to get inside their homes and stay there. Since radiation exposure is the big threat, your loved one should listen to the news to get instruction on where to go, if anywhere. It is important to stay calm and wait while experts determine where the radioactivity will be dispersing so that any evacuations can actually take people away from - not into the path of - the fallout. This also will keep unnecessary traffic off the roads so that federal response teams can mobilize. Even if your loved one lives 100 miles away from the site of an IND, it will be important to stay inside and off the roads. Radiation will travel on the winds, and people who have been at the site of an event will doubtless be traveling to get to a safer location which could include your older loved one's community. As you can imagine, health care resources will be taxed to the limit by a disaster like this. In fact, federal estimates suggest that as many "worried well" will be lining up at hospitals as those with "moderate injuries." Encourage your loved ones to monitor their personal well-being and not over react. And the best way to keep calm in such an event will be to make a plan ahead of time. Check out what the Institute of Medicine says about preparation by clicking here. Charlotte Bishop is a certified 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.
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or had a cup of coffee after you turned out the lights for the night? No, you say, you have things turned around. You study before the test so that you will do better, you cook your meal before you can dine and coffee is how you start your day. Yet, we seem to do things backwards when it comes to the way we deal with surgery or injury or illness. After surgery we are prescribed a rehab program to get “back to normal.” After an injury we are prescribed a rehabilitation program to get our agility back or rehab to get “normal” after an illness. What if we were prescribed “prehab?” Among medical professionals it is called preventive rehabilitation, or “prehab” for short, and it is increasingly prescribe to better prepare a body for the recovery following a surgery. It also can be just the thing to help prevent injuries by strengthening the muscle groups that may be most prone to succumbing to breaking down. And I would suggest that prehab may be a great way to prepare for a healthier aging as well. But back to prehab before surgery…why do it if you have to do the recovery work anyway? Medical professionals say that the evidence suggests that prehab before a scheduled surgery has some concrete benefits; patients who prehab:
- Are better prepared both mentally and physically for surgery
- See more successful outcomes
- Have a shorter recovery time
- Stay less time in the hospital recovering
- Feel less post-operative pain and fewer complications
- Show less swelling and greater flexibility of the affected areas.
For patients preparing to undergo a surgical or other invasive procedure, providers can prescribe a prehab regimen specifically to address their existing weaknesses as well as the anticipated disruption that surgery will represent. I mentioned “healthier aging” as a benefit of prehab. Prehab can be individualized to a patient to help build up strength or flexibility where needed or range of motion or better endurance and physical function. I like to add to this list “nimble.” A physical trainer I know is a real prehab specialist, even though he does not focus on pre-surgical clients. What he focuses on with his clients is preparation for doing better and that applies to aging well with what he terms “muscle confusion.” He continuously changes up the physical routine so it is never the same stretches or the same conditioning. By giving the body new challenges each workout, he helps keep older clients on their feet instead of falling and successfully working out or just working without a strain or a tear or just that pain. You do not need to have an injury to visit a physical therapy facility. They can assess your present condition and work with you for better posture, better lifting, a stronger core and training for specific tasks and most important a better aging. 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.
November is National Alzheimer’s Awareness Month. We also shift from Daylight Saving Time to Standard Time…I hope you appreciated the “extra hour” you had over the weekend. But never mind setting your clock back by an hour when we made the change to Standard Time. Get a stop watch! The latest research shows someone in the world develops some form of dementia every 3 seconds. Giving that frightening statistic some local context, every state across the U.S. is expected to experience an increase of at least 12% in the number of people with Alzheimer's disease from 2019 to 2025. Alzheimer's is thought to arise 20 years before clinical symptoms are visible -- a point potentially amenable to lifestyle interventions such as diet. Current consensus is that eating a heart-healthy diet will benefit both the heart and the brain. That healthy food part gets a bit tricky in the 21^st century because so much of our food is processed food…some would say over-processed. Trans fats naturally occur in small amounts in some meats and whole milk. But through a process called hydrogenation many processed foods are infused with unnaturally high amounts of trans fats to make them more stable for longer shelf lives. It may be good for the shelf’s live, but not for yours. It has been well-established that trans fats are associated with an elevated risk of type 2 diabetes as well as cardiovascular illness, and there is a biomarker called serum elaidic acid that health care professionals have followed to assess who is at risk for a “cardiac event.” Researchers in Japan have recently reported that 60+ year olds who started in a panel - with no signs of dementia, but higher levels of serum elaidic acid - were 50% to 75% more likely to develop dementia of any type, including Alzheimer’s disease and vascular dementia in the decade that followed. But this serum concentration of trans fats can be reversed by shifting to a better diet. The first rule is to avoid sweet pastries, the strongest contributor to elaidic acid serum levels. But also steer away from margarine, candy – especially caramels, croissants, non-dairy creamers, and ice cream. But giving up these “bad foods” seems so negative. To make the transition away from trans fats, start with some fresh fruits, real milk in your coffee or something else that will be a delight. 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.