Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • care managementChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 16

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 (Part 2)
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 12, 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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Respite Care – The Holiday Gift to Yourself
Be honest if you’re a caregiver and you can answer YES to more than one of these questions. Sit...
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November 23, 2015
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In the Caregiver's Words

Recent Client Praise

While it has been a fairly temperate season where we live and work, not all parts of the world have been spared the heat of summer. As we approach the dog days of summer - August - it may be helpful to offer a reminder on why older loved ones need some seasonal caregiver help in staying hydrated. A good place to start is in reviewing why older adults, as we have experienced in geriatric care management, are actually more at risk for dehydration than younger individuals. An older person’s abilities to retain water and recognize when they are being depleted of water are often diminished.
1. Just as with other sensory capabilities, an older adult’s sense of thirst may have weakened, so they just won't feel the warning signs as a younger person would.
2. On top of that, their sense of taste and hunger are both reduced, so they tend to salt their food more because that enhances taste, yet they will still eat less. This reduces fluid intake, because much of the water we ingest comes from the fruits or vegetables we consume.
3. Because we all tend to eat or drink around meals or at a table with other people, the isolation that many older adults experience takes away opportunities not just to socialize but also to hydrate.
4. As I have pointed out in other postings, older adults tend to have more chronic conditions such as diabetes, alcoholism or elevated blood pressure, and the conditions and/or their medications tend to deplete older adults of their body fluid.
5. If your older loved one has followed the migrations of many, they have left the colder northern climates for places like Florida, Texas or Arizona. However, they take their food and fluid intake habits with them. This exposes them to more dehydrating heat with similar historical water intake from their colder origins.
If you are a caregiver to an older loved one, be aware of how much fluid your loved one takes in on a daily basis. This is not about being the guardian of the water, but it is about asking good questions and offering gently encouraging words about fluid intake. Watch for signs of dehydration like frequent licking of the lips, infrequent toileting trips, lack of appetite or maybe even some amount of disorientation. But don’t overdo it. Older adults also can over-hydrate - although not as commonly - which can be as disturbing to their electrolytic balance as dehydration. And if you cannot be present, it may be helpful to have a hired geriatric care management professional make wellness checks, especially during the height of summer. If nothing else, it can be a time for social interaction which cannot help but spark their food and water intake as well as their intellectual and psychological well-being. Just as a coffee break most often is more than just about the coffee, a water break is more than just about the water. 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 a fair bit of controversy swirling around the Affordable Care Act - sometimes called ObamaCare, but what you should know If you are a caregiver to a Medicare-qualified adult is what services now are free as a part of some of the provisions of ACA. The Act has a number of initiatives that aim at improving the efficiency and reducing the cost of health care in America. One way ACA hopes to do that is to help prevent or detect early some of the more costly or more common illnesses among older adults.

       Here are services that will be covered entirely by Medicare:

·         Wellness visits - One wellness visit to a provider when you first enroll in Medicare and one every year after that.

·         Colorectal Cancer Screening - For everyone 50 years or older.

·         Mammograms - For all women 40 and older on an annual basis.

·         Pap Smears and Pelvic Exams - Biannually for all and annually for high risk women.

·         Prostate Cancer Screening - PSA tests for all men over age 40.

·         Cardiovascular Screening - Full screen cholesterol blood tests annually.

·         Diabetes Screening - Twice a year testing for all beneficiaries at risk.

·         Abdominal Aortic Aneurysm Screening - For men 65 to 75 who have been smokers and are therefore at risk.

·         Vaccinations - Includes, flu, pneumonia and hepatitis B.

·         Other Screenings - For depression, HIV and sexually-transmitted diseases.

       Medicare also covers a number of types of counseling such as smoking cessation, weight loss, medical nutrition counseling, alcohol and obesity counseling and cardiovascular risk reduction. The program also covers a number of other preventive services with relatively modest copays from enrollees. If you are a caregiver to a beneficiary, you can get the whole story at their site. (medicare.gov/share-the-health)

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.
I have to believe that you’ve heard the one about the patient who shows up at the doctor’s office. The doctor walks into the exam room and asks what has brought the patient in today. Patient says, “Doc, it hurts when I do this.” …Pause… The doctor replies, “Well, don’t do that.” Case closed. It seems that in many cases that approach to health and wellness has taken a backseat to more prescriptions for more pills. Yet, if you dig deep enough on line beyond all the classes of medications, you will find the following recommendations:
- Engage in at least 150 minutes of physical activity per week,
- Stop Smoking,
- Limit sodium and alcohol intake
- Enjoy a healthy diet with lots of vegetables and fruits
- Get to a healthy weight
- Manage your stress.
All of these are good ideas, but a person has to search for them with all the other medications that are available for a medical provider trying to see more patients per day. It’s not all on the health system. A majority of patients also seem to want an “easy pill” which may account for the high demand for the current wave of weight loss drugs originally intended for diabetes, but very much in demand for those who want to lose weight more easily than dieting may afford. And then there’s the Toby Keith song about a conversation he had had with Clint Eastwood about his “secret” to living well and long. The lyrics go like this: Don't let the old man in…I wanna leave this alone…Can't leave it up to him…He's knocking on my door And I knew all of my life…That someday it would end…Get up and go outside…Don't let the old man in Many moons I have lived…My body's weathered and worn…Ask yourself how would you be…If you didn't know the day you were born Try to love on your wife…And stay close to your friends…Toast each sundown with wine…Don't let the old man in Many moons I have lived…My body's weathered and worn…Ask yourself how would you be…If you didn't know the day you were born When he rides up on his horse…And you feel that cold bitter wind…Look out your window and smile…Don't let the old man in Look out your window and smile…Don't let the old man in But to get to the real point, if you really want to live longer and live well, don’t look for another pill or procedure. Look for a chance to take a walk, a chance to get up from your couch or to step away from your desk or to push back from the dinner table. This may take more than a day, but it will reward you with many more days and a happier life. It’s part of my “Live Well Blueprint.” 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.
Which of the following regarding what we know of dementia are true?
1. Adolescent personality traits predict later onset dementia.
2. Healthy lifestyle is an offset to genetic risk for dementia.
3. Mid-life anxiety is linked to later dementia.
4. The more mental activity, the lower the risk for dementia.
5. All of the above
6. None of the above.
I have written nearly fifty posts on dementia over the years, and I work to give you the latest information possible on the causes of, as well as ways to address, the cognitive thief we call dementia. This post brings a lot of that together in a more comprehensive summary. First, if you answered “5. All of the Above,” you are right…sadly. Let’s take the right answers in order:
1. You doubtless have seen research and through your own experiences that early habits around health are positive predictors of health in later life. Researchers have assessed personality traits of 80,000 youth in 1960, and found that those who rated higher on the “vigor” scale – calmness and maturity – were 7% less likely to be diagnosed with dementia 50 years later in life. Check it out.
1. A healthy lifestyle can offset the risk of developing dementia. Or flipping this around, researchers in Britain found that people who were at high genetic risk for developing dementia were three times more likely to develop dementia 8 years later than those with a more healthy lifestyle. Check it out.
1. Researchers have found that people with mid-life anxiety or even depression are more likely to develop dementia later in life. Researchers are still sorting out if these mental health conditions are simply leading indicators or are early manifestations of what will become dementia later in life. Check it out.
1. You have heard about the link between engaging mental activity and healthier cognition. Researchers have quantified the link: using computers in middle-age offers a 48% lower risk of later cognitive impairment; social engagement translates into a 20% lower risk of MCI; and immersing oneself in crafts reduces MCI risk by 42%. Check it out.
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.
A recent report from the Congressional Budget Office created a bit of a stir among geriatric care managers, because it predicted that the dollars spent on nursing homes and longer term care will amount to 3.3 percent of gross domestic product (GDP) by the year 2050. It is true that in the most recent year for which there is data, Americans spent $192 billion on these living environments, or about 1.3 percent of GDP. This past May, the National Association of Professional Geriatric Care Managers asked its members if we had an opinion on older adults moving into nursing homes in such numbers. However, there are alternatives:
1. The best thing older adults can do is make a plan. We all make vacation plans and maybe even retirement plans; we need to make plans around aging in place while still preserving quality of life.
2. Next in line is taking stock of home. It is easy to not see that the home in which parents raised a family just doesn't work as well for older adults who may have some mobility issues - hint: an elder care manager can help.
3. With an objective picture of the home layout, set about making home a safer and easier place to live than it is now. Grip bars in a bath room, extra lighting in the halls and ramps instead of stairs can be a start.
4. And it is important to remember who actually is going to live in the home. Well-intentioned children of older parents may want to come in and do a "home-makeover," but it is really important to help mom or dad lead the team.
5. And just as it takes a village to raise a child, there are resources and people in your older parents' community who can provide support. If you don't know what services or agencies can be brought in, again ask a professional. (We also have some listed on our "Support Tools" page of this web site.)
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 ccbishop@creativecasemanagement.com.