Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • care managementChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 5

Ain’t No Sunshine…
…When She’s Gone.” Or how about, “You are My Sunshine, My Only Sunshine?” or “Here Comes the Sun?” or...
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February 21, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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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...
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February 7, 2023
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A Defensive Game Plan for Dementia Outbursts
It’s not just about forgetting or being confused. If you have a loved one with dementia, it is also...
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January 31, 2023
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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...
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January 17, 2023
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To Sleep, Perchance to Dream
No, this isn’t a refresher course on Shakespeare and the famous Hamlet soliloquy. (Spoiler Alert – Hamlet was ranting...
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January 2, 2023
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A Viral Trifecta?
To get to the question in the email first, the Spanish flu of 1918 did not get its start...
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December 13, 2022
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One More BIG Addiction?
If you’re old enough to remember 1969, then you are old enough to remember this bold addition to the...
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December 6, 2022
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Would You Want to Know?
National Geographic has a new documentary series, Limitless with Chris Hemsworth, starring, of course, Chris Hemsworth of Disney’s Marvel...
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November 29, 2022
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Saying “No” May be the Right Answer
Saying “yes” when someone asks you to do something can be like eating candy. It feels right or good...
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November 15, 2022
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In the Caregiver's Words

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Many are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed. We also discuss other warning signs people should look out for when buying prescription or over-the-counter drugs.

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One of every three adults over age 65 will have a fall this year. This rate increases to one half of adults over age 80 who will fall during the year, some of them multiple times. On top of this, half of all falls occur in an older adult's home. With these alarming rates, it may come as no real surprise to those of you who may be caregivers to an older loved one that falls affect more older adults than heart attacks and strokes combined. As a geriatric care manager, I commonly get the call from a caregiver to an older loved one who has had one of these falls. And the fall often has resulted in serious injury, most often a fractured hip. One thing caregivers may not know is that unintentional falls result in death of the older adult in nearly 22,000 cases each year. We are not talking about just a bump or a bruise, and even more sobering is the simple fact that most falls are preventable. And, if not preventable, early intervention can make a huge difference in your older loved one's safe recovery from the fall. Here are some tips you can employ to help your older loved one be safer from falls:
1. Exercise. Yes, it is that simple. I have talked in other postings about "use it or lose it." It is not news that older adults tend to lose muscle mass as they age, and with this loss there is a proportional diminution of strength and endurance. There also is a loss in balance and coordination. Encourage your older loved one to take part in an organized exercise plan, perhaps with a fitness instructor who can teach safe exercise to improve balance. Research has shown that this can reduce fall risk by as much as 20% to 50%. And yoga or TaiChi can be a wonderful way to improve balance by strengthening and enhancing muscle coordination.
2. Home Safety. Do a search of my Blog for other postings devoted to "home safety" and you will see a lot more detail than I will give here. But safety at home starts with clearing floor surfaces of scatter rugs, worn carpets or electrical cords in trafficked areas. Go through your older loved one's home at night and look for dark or shadowy areas that may be fall risks. And be sure that a light is within easy reach of your loved one's bed so that getting up at night in the dark does not result in a fall. And be sure to have sturdy handrails in stairways as well as long hallways. Bathroom grip bars are also important as most falls in the home happen in that porcelain minefield we call the bath.
3. All of the Above. The most successful fall prevention efforts incorporate steps toward a safer home environment along with a more fit older loved one. To these I would also add a healthy diet high in protein and complex carbohydrates to help fuel the musculature that will prevent a fall. Although the evidence is not entirely clear yet, there is good reason to believe that vitamin D supplements also can be important as they help to maintain bone density and strength as well. Not sure how to implement these steps? If you are a caregiver to an older loved one, speak with their provider about appropriate exercise or a nutritionist about their diet. And reach out to a geriatric care manager about a home safety inspection. You may find that your older loved one may be much more willing to listen to an expert outside the family that to their son or daughter. We are here to help. 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@cr eativecaremanagement.com.
Associate Care Manager Gregory is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and Medicare Counselor, 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. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte Lots of folks are worried about the future of Medicare and Medicaid. In February, the Senate passed the CHRONIC Care Act which is called “Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care” in full, and is specifically designed to promote improved assistance to the millions of older adults with multiple medical issues. It expands care at the same level of funding and seeks to assist those whose chronic illnesses are not efficiently managed by the hospital model. As adults age, some health concerns can be resolved with treatment, but some, like dementia, emphysema, heart and kidney diseases, and arthritis, are permanent conditions that need a great deal of medical attention. For these conditions, though, hospitalization is not the best way to provide care. Still, many patients with chronic conditions find themselves in multiple, unnecessary office and hospital visits due to the current treatment climate. This legislation, which also seeks to end the lack of coordination between Medicare and Medicaid, will be a boon to folks living with chronic conditions, especially those whose chronic illnesses are auto-immune, as one of the primary objectives of the bill is to reduce hospital visits and provide more in-home care. What does the bill say it will do? What improvements can Medicaid or Medicare Advantage beneficiaries expect? The bill:
- Expands coverage for “non-medical” services and equipment– Funds are now freed for more in-home care for patients who need service, but do not need skilled nursing, and more funds are available for Durable Medical Equipment (grab bars, wheel chair ramps, etc) for the chronically ill.
- Expands telehealth coverage– Medicare Advantage members will have more access to telephonic health management and digital services where before barriers made these services more difficult to receive. This includes telehealth services for stroke no matter the geographic location of the call.
- Includes Telehealth with In-Home Dialysis– Kidney patients already on in-home dialysis will find it a great convenience to be able to use telehealth as a clinic visit.
- Frees Acountable Care Organizations (ACOs)– These organizations will be free to assign chronic status and utlilze their resources to provide care at a greater rate of their own discretion.
The bill, which will provide better care at the same level of funding, eliminate unnecessary hospital visits/stays for chronic patients, while drastically reducing cost of care provided, looks to be a win-win situation which will positively impact many aging adults. If you or someone you love is dealing with chronic illness and on Medicaid or a Medicare Advantage plan, your life just got a little easier, and your care just got a little better. Reach out to us at Creative Care Management or your providers and find out how this change in care model can best benefit your situation. 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.
About one in five adults over the age of 65 will fall in their homes during the course of a year, and for some this will be part of an inevitable decline in their abilities to care for themselves and stay in their homes independently. Because this is Home Safety Month, I wanted to share four geriatric care management perspectives with you that can help you to make home safer from falls, especially if you are a caregiver to an older adult or anyone else with special needs.
1. Gait and Balance. As an elder care manager, I am always assessing the health and well-being of our older clients, but this is not limited to their medical status. As a person grows older, they also become less nimble, their muscles are not as strong and their movement becomes stiffer. If you are a caregiver, you may not notice the subtle changes from day to day in your older loved one, but older adults progress from a walk towards more of a shuffle. The shuffle is what will increase an older adult's fall risk. Their shoes may catch the edge of a threshold or get caught in a worn patch of the carpet. Work with your older loved one to maintain a level of physical activity that helps keep their feet fit.
2. Household Hazards. In other postings, I have talked about the trip risks posed by footstools, worn carpet, slippery scatter rugs, uneven or wet surfaces, stairs, electrical or other cords and similar obstacles on the floor. While you need not become the interior design architect or housekeeper, it is helpful to do a periodic "environmental assessment" to identify and correct risks before they become a shattered hip.
3. Vision Issues. As your loved one grows older their vision inevitably becomes less acute, but sight also can be obscured by cataracts, macular degeneration or astigmatism. In addition to seeing that your older loved one gets their vision tested regularly, you also can help by installing higher wattage bulbs in areas of the house prone to shadows or in the entryways where your loved one may be coming in from a nighttime darkness or from the bright midday light into the darkness of home. Also have lamps within easy reach of bed for nighttime risings.
4. Medication Issues. Many medications have common side effects like dizziness, vertigo or blurred vision. Make certain you have a complete list of medications your loved is taking so that you can ask their health care provider about any side effects. You may have seen labels on drugs that caution against "operating heavy machinery," but there are a lot more side effects that are listed on the package inserts of these medicines. And probe the provider about the potential for interactions among the drugs which can cause their own added balance issues.
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.
I have a small pillow in my living room that speaks to me. In stitched letters it says, "What? Chocolate is not a food group?" My family knows that one of my favorite "food groups" is chocolate, and I don't mean because I am on a health kick looking for the benefits of dark chocolate; I just like good, old-fashioned milk chocolate. But let me tell you that when I have a chocolate craving, my body may really asking me for something more than my brown, sweet treat.

There is a growing body of literature that explains many of our cravings as our body's signals for what it really wants; we just don't speak the language. We fail to translate the cravings in quite the way our bodies are trying to communicate. This has real implications if you have an older loved one for who you are a caregiver. As one ages the taste buds become less sensitive, and appetite wanes. And if you are taking your older loved one's interest in foods or cravings too literally as you listen, you may think you are satisfying their body's nutritional needs when, in fact you are not. Let me start with my own craving.
1. Chocolate. If your elder expresses a craving for chocolate, they may really be translating their body's need for magnesium, a very important electrolyte in the human body. While chocolate can offer some magnesium there are better sources. Chocolate is okay - thank goodness - but your body will benefit from a variety of magnesium sources such as certain vegetables, nuts and seeds. So if your elder has a regular craving for chocolate, try offering legumes, nuts and seeds to avoid the sugar and fats that accompany the magnesium in commercially-available chocolate.
2. Potato Chips. I see this in our household where a certain family member would prefer a bag of potato chips rather than a handful or two. So much for portion control. Potato chip craving may actually be an expression of an iron deficiency. This kind of deficiency triggers a craving for crunchy foods, and potato chips -while crunchy - come up short. Iron-rich alternatives include dark meats, fish, poultry and darker green vegetables. And this overlooks the huge intake of sodium that potato chips offer and nobody needs.
3. All of the Above. This is where the psychology gets interesting. Let's say your older loved one can still smell the peanuts that you just had, but they had been disciplined and translated their craving into having a portion of raw carrots. But a half hour later, they still can all but smell the peanuts and they cave in and subsequently gorge on the peanuts. They should actually feed some of their craving when it expresses itself, but in moderation. That still leaves room for the healthy foods they will eat later and moderates the caloric intake that has become such a national epidemic.
At the end of the day, it is about balance and understanding what our bodies are telling themselves. If you are that caregiver to an older loved one, don't become the food police, but perhaps there can be a role for a food translator to help them understand their own bodies' language when cravings make their voices heard.
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@cr eativecaremanagement.com.
I have been hearing that the web resources I have been offering in my postings have been informative and helpful. I am regularly reminded that one of my principal roles as a geriatric care manager is to be a resource directing people to others. And that those “others” are not just health care providers.

In keeping with that notion, I have compiled some web resources here that may prove useful for elders and others with special needs who may also be on limited budgets.

These are just a few of the sites that you may find .useful, but may not always pop up in a web search engine when you are looking for answers to your elder law questions:

AARP has a program called Legal Counsel for the Elderly (LCE). You may wish to join AARP – if you have not already – to get full access to this program, but it has much to offer individuals who wish to understand their rights as well as how to get legal paperwork for an elderly family member or loved one in order: Legal Council for the Elderly.

For the latest legal perspectives on legislation affecting elders, legal-financial challenges facing elders and more, you can also go to the web site for the association that represents elderlaw attorneys, the National Academy of Elderlaw Attorneys (NAELA). Simply go to: NAELA Legal Affairs.

The National Senior Citizens Law Center is a non-profit organization whose principal mission is to protect the rights of low-income older adults. Through advocacy, litigation, and the education and counseling of local advocates, we seek to ensure the health and economic security of those with limited income and resources, and access to the courts for all. Go to:http: National Senior Citizens Law Center.

At all of these sites you will also find directions to professionals in your geographic area as well as other web resources that you will find useful.

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 throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.

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