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

What’s Your Complaint?
If you grew up in a family as I did we were taught not to, or shown role models...
Read more
June 11, 2024
0
0
Well, Don’t Do That
I have to believe that you’ve heard the one about the patient who shows up at the doctor’s office. ...
Read more
April 30, 2024
0
0
Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
Read more
February 7, 2023
0
0
Happiness is a Long-Term Investment
If I were to ask you to make a New Year’s Resolution for your own happiness, what would your...
Read more
January 17, 2023
0
0
Planning for the Holidays is More than a Menu
The latest news reports suggest only about 10 percent of American Adults have received their seasonal booster for COVID. ...
Read more
October 24, 2022
0
0
What’s COVID Going as for Halloween?
It’s been a year and a half since the COVID19 vaccines came on line to address the pandemic when...
Read more
October 11, 2022
0
0
The Will To Do the Right Thing
This whole idea to write up a legal document to give surviving loved ones clarity about how to take...
Read more
August 9, 2022
0
0
Why AND Is the Most Important Word
Do you recall the 1991 movie called City Slickers? It was another great role for Billy Crystal, but it...
Read more
July 19, 2022
0
0
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...
Read more
June 7, 2022
0
0
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...
Read more
May 24, 2022
0
0

In the Caregiver's Words

Recent Client Praise

I have shared this statistic before, but in America someone is diagnosed with Alzheimer’s disease every 67 seconds. And Alzheimer’s is just one of the approximately one hundred types of dementia. Scientists do not have a cure for any of the dementias yet, and even the medications that are indicated for Alzheimer’s are only modestly effective in slowing the progression of this condition. But scientists are getting more and more data every year on the conditions or genetics that help to predict a person’s likelihood of manifesting some form of dementia. From physicians in London we learned recently that air pollution and dementia are linked. Among older residents across areas of London, these scientists found that those who lived in parts of the sprawling metropolis whose air was more polluted residents were more likely to be diagnosed with dementia. This adds to what researchers have been finding for years about polluted air contributing to cardiovascular disease, pulmonary disorders and even some kinds of cancer. It’s traffic pollution, manufacturer exhaust and other airborne byproducts of urban living. The researchers admit that preexisting levels of air pollution and subsequent diagnoses of dementia are not sufficient grounds for establishing causation of the latter by the former. They are one more reason, however, to underscore the need to minimize humans’ exposure to air pollution. The researchers calibrated the association between air pollution and dementia diagnoses by tracking individuals and their postal codes. Nitrogen dioxide and ozone levels in these post codes, in turn, were measured starting back in 2004. Patients’ health data confirmed the dementia diagnoses from records forward to 2013, and the statistical association was confirmed. They tracked both Alzheimer’s and vascular dementias (the Alzheimer’s was more common). The relationship between Alzheimer’s and pollution was more consistent that with vascular dementia, but both were statistically significant. The scientists admit that some of the findings may be specific to London, but similar findings have seen corroboration in Canadian research. And it seems unlikely that this is specific to just Commonwealth nations… What can one do? Scientists offer two recommendations, and I offer a third:
1. Where possible avoid heavily trafficked areas during rush hours, and avoid being outside during rush hours.
2. If possible, reside in locales away from traffic and industry to avoid the prolonged exposure to pollutants that location represents.
…and my third:
1. Vote for policy makers who will work to tighten air pollution standards.
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 geriatric care manager, I am always alert to changes in people's eating habits and proper diet. As people age they naturally experience a decline in their appetite in part because their taste buds are not as responsive as they were when they were younger. Loss of appetite is also a potential sign of depression, and depression is one of the most common conditions older adults experience owing to the losses associated with their stage in life and aging. But if the diminished appetite leads to anemia owing to low iron intake, then there may also be a risk for dementia according to scientists. These scientists started with a group of over 2,500 mentally healthy women and men whose average age was 76. They then followed these people for 11 years testing them regularly for their blood counts and other mental function tests. At the outset of this study 392 people were clinically testing as anemic. By the eleventh year of this study 455 people had developed clinical dementia. These researchers also measured all study participants' age, gender, education, blood sugar levels (and diabetes diagnoses) and more than a dozen other biologic metrics. In statistical analysis they controlled for all these other variables and found that anemia still was a strong predictor of dementia beyond these other possible causes. In fact, of the people who started the study with anemia, they had a 49 percent greater risk of developing dementia during the 11 years of the study. What makes this study very compelling is that it is a prospective design. It is not one of the many studies we often see where scientists can ask questions about a person's background in an effort to explain a current condition. It also is a large panel of people for a study, so the chances a statistical error are reduced. What the study cannot tell us is what kind of treatment for anemia could "prevent" dementia. If you are a caregiver to an older loved one, what is the lesson to be learned from this research. At the very least it seems that caregivers should be watchful of their older loved ones' diet as a relatively easy way to rule out at least one potential cause of dementia. I have written about other steps that can be taken in other postings. Exercise and keeping mentally active are among those other steps that people of all ages can engage in to stave off mental deficits like dementia. 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.
If you’re old enough to remember 1969, then you are old enough to remember this bold addition to the packages containing cigarettes that year: “Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health.” It was supposed to alarm consumers enough to quit smoking, but it was reinforced even more with the 1984 rule that let potential consumers know more specifically what kinds of terminal illnesses smoking was known to cause. By the way, nicotine is addictive. What would your take be if you were to see this on your next frozen dinner or cereal box or other processed food product: “Warning: The Surgeon General Has Determined That This Processed Food Product Is Addictive.” The Surgeon General may or may not point to the poor nutritional value of many of these food products, but addictive? Well, that’s precisely what a number of recent clinical studies have shown. Clinical investigators in both Southport, UK, and the University of Michigan here in the states have demonstrated that highly processed foods and fat have the unique ability to rapidly metabolize leading to an addictive outcome in line with nicotine-based products. While the diet does not inexorably lead to bad outcomes, the addictive potential means that they become the slippery slope toward either obesity or diabetes or both. The rest of the story, the doctors note, are in step with addictive behavior:
- Poor control of intake among those who are addicted;
- Major cravings among those who are addicted;
- Continued use despite bad health outcomes;
- And all the other hallmarks of addiction.
When you consider what finally led to all the boxed warnings on tobacco products, you will see the parallels. Tobacco products, researchers found,
- Were triggers to not just continued, but compulsive, use;
- Were able to create cravings that were psychological; and
- Were repetitive behaviors that encouraged more and more.
Remember also that cigarettes used to be in the checkout lanes of grocery stores like…well, like the candies and other snacks that include highly processed carbohydrates. While there is no labeling of such commodities yet, that time will come. Don’t wait for the label to give a mindful consideration to the foods you label as your favorites when they may actually be your addictions. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
What takes 11 minutes and 18 seconds and sends you home with 10% of what the 11 minutes had to offer? The answer is in two parts. Starting with the second, this is why it can be very helpful for a geriatric care manager to attend a doctor's visit with your older loved one. First, the average patient accurately retains about 10 percent of the information that a health care provider imparts in an average medical visit. The 11 minutes and 18 seconds is the average length of a medical visit with a health care provider. These figures are from a recent health care survey conducted nationally. And there is more. The survey showed that an average of about 20% of what is said in a medical visit is retained following a healthcare visit, so the 10 percent figure I cited is what is retained accurately. This is the part that concerns me because it underscores not only how little of a conversation with a provider actually goes home with a patient, but also that half of it is just plain wrong. It also underscores why we as geriatric care managers find it extremely beneficial to the patient to actually attend the medical visit with them. Geriatric care managers bring along their pad of paper and a pen so that we can boost that percentage of information closer to 100%. And there is another piece of information that is interesting about the survey. It says that 63% of the talking in a medical visit is done by the doctor, and only 36% is from the patient. If you do the math there is 1 percent not accounted for. That is the average talking done by a typical caregiver accompanying a patient. When a geriatric care manager is involved with a caregiver and their loved one, we will strongly encourage that we attend any medical appointments. Some of our caregiver clients refer to us as their eyes and ears, but we also are the voice for them and for their older loved ones. We don't just work to make the percentage of the accurate information that goes home with the patient closer to 100 percent, but we also ask important questions that help to clarify why the provider is recommending the medicine or therapy that they do. What is the prognosis? What else can be expected in the way of side effects or other issues? And how can the team work toward better functional status and quality of life? Another important fact that is hidden in these bits of data about provider-patient interactions in the office: these figures are for a cross-section of all Americans. So what do you think the figures are for patients "of an age?" Do they retain more information and more of it accurately? If you are a caregiver with an older loved one anticipating a medical visit, consider giving them the advantage of getting a huge return on their investment of time with the doctor. Invite a professional set of eyes, ears and voice to accompany them. You will be pleased with what your loved one brings home from the doctor. 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.