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

Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out...
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June 7, 2022
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A Good Habit Missing for Most Older Adults
Even among those older adults who dodged COVID, “gymnesia” may be a lingering effect. Please let me explain… What...
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May 24, 2022
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HDL Graduates from “Good” to Better
You may have had the conversation with your physician about your cholesterol levels during your annual physical; there are...
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April 26, 2022
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When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
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April 12, 2022
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Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
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April 5, 2022
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Dementia from a Pet’s Point of View
Fetch! Come! Sit! Stay! Remember! So, I’ve given away that I’m a dog owner rather than a cat or...
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March 1, 2022
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The “Other” Health Concerns for Older Adults
It was just two weeks ago that I underscored the fact that “older adults have a greater fear of...
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February 1, 2022
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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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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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In the Caregiver's Words

Recent Client Praise

We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to retreat periodically from the frenetic work pace, the demands of family or just the congestion of living in the 21^st century. But for older adults, being alone can become their way of life with the loss of friends or a life mate, no longer being employed, perhaps unable to move easily about, a lapsed driver’s license…and life becomes very, very small when it is just one. It’s a bigger problem than many people may think. The National Institutes of Health estimate that 28 percent of older adults live alone; that’s nearly 14 million people on their own. Living alone can lead to depression, poor self-care and ultimately an exacerbation of pretty much every other chronic condition that a person can have. A 2010 study found that socially-isolated older adults were 509% more likely to die prematurely. Being alone too much can contribute to other health issues, so much so that some health insurers are developing more comprehensive and holistic models for caring for our older adults. One of the major insurers of Medicare Advantage programs that will offer “enhanced” care, and they have come up with a model that can be imitated by all of us who may be caregivers to and older loved one. We all may look in on mom or dad, make a regular call or accompany our older loved one to their physician office visits, but there is more you can do. Consider:
1. Checking your loved one’s refrigerator for variety of food as well as expired products. Food insecurity is one of the big threats to health and well-being among older adults.
2. Ask about your older loved one’s friendship network, and get specific. Think about how often you make connections – probably daily – and help your loved one to do the same….be creative.
3. Be sensitive particularly to hospital discharges when an older loved one will be lest ambulatory. Help them even get to a “silver slippers” program at a local gym or to respite care so that they not only physically recover, but also socially recover.
4. Use tech. A Miami-based company called Papa connects older adults with local college volunteers that they sometimes refer to as “grandkids on demand.” Check it out to see if a campus near your older loved one can offer that support.
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.
In the first of this two part series on caregiving to Alzheimer's or other dementias I spoke to what kinds of people will have logged the nearly 20 million hours of caregiving to patients with these dementias during the year. And if you are one of those caregivers to a loved one whose mental faculties are failing, there may be some comfort in knowing you are not alone. In this posting, however, I would like to share some advice from the perspective of a geriatric care manager who helps to care for both the dementia patient AND the caregiver to the patient. Take Care of You. It has become something of a mantra for me, and I cannot say it too much: Take care of the caregiver. If you as a caregiver to a loved one with some form of dementia do not take care of yourself, you will not be able to take care of your loved one. This is what allows everything else to happen; caring for the caregiver is job one! Learn All You Can. You may have known your loved one for decades, but the dementia is a stranger to you. Everyone's journey with Alzheimer's or other dementias will be different, based in part on the personality they had when the symptoms of the disease first appeared. But the condition will make things progressively different. Get educated. Be Realistic. This is about you and knowing your loved one would not want you to give up your life to care for theirs. And it is about accepting the changing capabilities of your loved one as the condition progresses. Don't Isolate Yourselves. It may seem challenging to do what you used to do as a family, but don't retrench so far that you fear even venturing out of the house. Do all that you can do and simply accept the limitations on some of the activities. Prepare the Paperwork. End of life discussions are always at least a bit awkward, but they will not get easier with the passing of time and further erosion of mental faculties. Most everyone will have a will, but you will also want a living will, powers of attorney and Do Not Resuscitate (DNR) orders in place. Be sure that the living will and the DNR are in all your loved one's medical records in the event of an unexpected hospitalization. Don't Go It Alone. This is an extension of number one above. Throughout this journey you will benefit from having others with whom you can relate what you are feeling. This could be support groups of other caregivers like you or you may feel more comfortable talking with a counselor who will let you know that it is simply okay to feel as you do. We may not have any cures for any of the dementias yet, but science is getting better at understanding how to postpone the progression of Alzheimer's and some other dementias. Professionals in this are also are getting a lot better about helping people to understanding the conditions and how both the patients and the caregivers can cope with them. Some of my "go to" resources include http://www.webmd.com and the Alzheimer's Association (http://www.alz.org/). This latter has state and local chapters who can offer personal help to both caregivers and their loved ones where they live. 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.
If dementia were a foot race Alzheimer’s would be number one, but the first place finisher of this race might not even be able to see the runner-up on the track to the rear. The Alzheimer’s Association estimates that there are about 5.8 million Americans of all ages currently living with the second place condition. Lewy Body dementia, considered to be number two in prevalence in America, totals only 1.3 million people, to date, but researchers at the Mayo Clinic suggest that this number may be a profound underestimate because of the nature of the disease. The “Lewy Bodies” which are the hallmark of the disease of the same name accumulate in the neurons of the brain and affect both cognition and movement. As a result, it often is misdiagnosed as Parkinson’s disease. And the cognitive part of the decline often confuses it with Alzheimer’s disease or even vascular dementia. To make it more confusing, Parkinson’s disease has its own dementia manifestation. So, what does one look for that can be a clue that a loved one may have the onset of Lewy Body Dementia? First, this is a diagnosis for a neuro-psychologist, not a family member, but be aware of changes like the following so that your loved one who may have the second place dementia can get the best help as early as possible:
1. Hallucinations may be one of the early signs, and note that hallucinations can be more than just visual…like hearing what is not there or even smelling what is not present.
2. Movement issues that can be like Parkinson’s like rigid muscles or tremors, shuffled walking, etc.
3. Autonomic changes that can cause dizziness or falls and curiously digestive changes like constipation with no changes in diet.
4. Confusion and memory loss also come along with the package and account for some of the difficulty in distinguishing this condition from other dementias.
5. Difficulty with sleep such as intense dreams with associated physical movement or just plain drowsiness throughout the day.
6. Mood changes that show a clear downward trajectory like depression or apathy or even more aggressive behavior.
If you’re thinking that all of these symptoms look like other dementias or like Parkinson’s, then you can appreciate why Lewy Body Dementia can be misdiagnosed. So, it may be number two, but it may be a lot closer to the first place in this category than we know. 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 have written many times on the medical conditions that rob our older loved ones of their memories, and a lot of older adults fear a dementia diagnosis more than even dying itself. But there is a wave of activity that robs many of our older loved ones of something that can make their lives challenging for a different reason. The top two fears that older Americans voice more than the others are a fear of losing their mental faculties and a fear of running out of money before they run out of life. Well, it turns out that there are no “bad guys” inflicting anyone with dementia, but there are a fair number of criminals looking to take money from older adults in our country. We are growing a bit used to hyperbole in government reports these days, so let me allow the numbers to do the talking here. In March the Justice Department released figures that show reported cases of more than two million 65+ year old victims of fraud in which the individuals lost more than $750 million to “bad guys.” Federal officials are targeting ways to prevent the fraud instead of just apprehending the perpetrators. What can you do to follow-through?
1. To counter bogus “charities” - that may be Political Action Committees in disguise - from swindling your older loved ones, the Feds are making the federal registration of charities more rigorous. So, help your older loved one do the research at both the state and federal level before contributing a cent.
2. Everyone loves getting something for free and “health fairs” are an open market where older adults can get a free bag to be filled with free goodies. Warn your older loved one to not “sign up” at these fairs if the people with the sign-up sheets are asking for a social security number.
3. And of course, warn mom or dad that if they get a call to fix a purported problem or even if it is a household fixer upper that demands quick payment, it is almost always a sign of fraud being perpetrated.
And this is where I put on my counselor hat and caution that in order to be heard by your older loved one, you cannot sound like you are “parenting” them. You haven’t switched roles just because mom or dad is “of an age.” You are sharing a caution. We all know how to pass along a strong “for your information” to a friend or colleague, and that is the voice an older loved one will best hear. 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.
It’s not a new story that the internet is a potentially hazardous place to conduct financial transactions. You may have warned your kids and even your older parents. Beware of the companies who may be hacked and your older loved one’s (or your) credit card information is compromised…or the companies that ask for your mom’s or dad’s social security number and now someone has access to your loved one’s identity…an identity that can be used to build new credit requests, run up dollars of debt and more. Well, all of this has now gone from bad to worse. Think of the Web – the place we go to learn the stats on our favorite teams, what size shoes the presidents have worn or picking a gift that can be delivered in two days to our door. There is transactional activity here and some risk to our credit, but a lot is manageable. But there is a layer beyond this called the Deep Web. This is where social media like Facebook call home or where your bank hosts your information so that you can access your checking account, make recurring purchases and store really big files for sharing…DropBox and others. Bad guys can lurk around either of these levels of the Web, and they can hack your information. So, okay, they get your credit card details and go on a shopping spree – you can call your credit card company and contest the charges. It’s a headache, but it’s a one and done and you’re then back to business as usual. A lot of what is stolen on the Web and the Deep Web can be auctioned on the Dark Web. Why not take that credit card – and password – information that you just hijacked and sell it at an auction site on the Dark Web to anyone who can spend less than ten dollars for it…but there will be thousands of buyers? And even if the bad guys get just part of your loved one’s identity like their social security number, and they can go on-line and do searches for anything that matches that information. They soon can have a credit card number, a home address, a mother’s maiden name and more. You can help your loved ones and yourself with just three basic safeguards:
1. Monitor your loved one’s accounts. Ideally, they should be going on-line regularly to check their credit cards, investments or bank accounts for activity. Most accounts also allow for a feature that sends text alerts when there is activity…perhaps in excess of a certain dollar amount that your loved one can establish.
2. Place a security freeze on all your loved one’s accounts. They can do this by reaching out to one of the three credit reporting agencies. This will stop anyone from applying for a new credit card, securing a loan or otherwise misusing your loved one’s information.
3. Secure your passwords. Discourage your loved one from making everything tied to a sequence of numbers that are their birth date or anniversary. Even go so far as to use a secure online vault that will create really complex passwords and keep them secure. Passwords can also be changed quickly if security is suspect.
So, instead of buying grandma a new Chromebook or iPad for the next birthday or holiday, enroll them in a secure vault and work from there on steps they can take to be both tech savvy and safe! 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.
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.