Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • care managementChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 7

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...
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July 14, 2020
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Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
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July 7, 2020
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While Quarantining, Prevent Alzheimer’s
We’ve heard Doctor Fauci say it many times…that we have to deal with this pandemic on the virus’ terms,...
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June 30, 2020
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Abuse Thrives in Pandemic
Guest post author Gregory Peebles is a team member at CCM whose work focuses on helping aging adults and...
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June 16, 2020
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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...
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May 26, 2020
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Distance Caregiving Through a Wall
I’ve written numerous times about distance caregiving, and one of the observations I have offered is that distance is...
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May 19, 2020
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Caregiving During COVID: Four Tips for Reengagement
You may recall that I have recommended limiting your news consumption, because it really does add to our stressed...
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May 12, 2020
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COVID 19 and Stress
I heard a reporter talk about cases of post-traumatic stress disorder growing during this pandemic and quarantine. I admit...
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May 5, 2020
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Listen to an Astronaut about COVID-19
A small percentage of us may be coping with symptoms of COVID-19 or we know someone who is, but...
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March 24, 2020
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Trusted Voices on COVID-19
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a...
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March 17, 2020
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In the Caregiver's Words

Recent Client Praise

It has been a long time since we all first saw the television ad for “Help I’ve fallen and I can’t get up.” Technology has since evolved from a lifeline that a senior would wear around their neck to assure that help was just the push of a button away. Now, caregivers can equip seniors with motion sensors that can tell when a person has fallen and make the call before a button is pressed. Remarkable as these kinds of innovations can be – and there are a host of others – the best way to address the potential for older adults falling is to prevent the fall in the first place. In this first of a three-part series, I am going to first offer a checklist of fall hazards outside the home, and this will be followed by a parallel list for indoors and a final post that is about helping assure that your older adult is in the best physical condition to avoid falls. Starting with the outdoor list:
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. Learn more about What We Do and how we can help you support your loved one.
You can imagine that I follow a lot of clinical news feeds, and I keep files. I have files for dementia, files for residential living options and yes, I have a file for research that gives us insights into how people who live longer got there. There is no one secret to living longer, but there are some things that people who live longer do that can help us all: • An 80 year-long study that tracked people and their mental habits found that people who are more thoughtful and “plan-ful” live longer. • Multiple studies have consistently shown that people who have more friends or are more socially-active live longer. (They probably also have more fun…) • But choose your friends carefully, because their habits rub off…do your friends work out or do they smoke, do they make good food choices or eat junk? • In the “friends” vein, people who are married or have been married (divorced or widowed) live longer than those who have stayed single. • Napping is good for you; those who nap regularly have a 37% reduced risk of cardiovascular disease. • That extends to your overnight sleep also; people who get less than 5 hours of sleep a night are simply less healthy…if you snooze, you WIN. • Eat more fiber and fruits and vegetables; the end result is a much reduced risk for obesity … especially the belly fat that is the greatest risk. • Regular exercise to the tune of at least two and a half hours a week helps fend off heart disease, depression and some kinds of cancer. • If you drink alcohol – one drink a day for women and one to two for men; moderation reduces the risk of heart disease more than even than those who don’t drink at all. • Be chill – people who don’t carry a grudge or who are not always crabby or who are less stressed have lower rates of heart disease as well as other health issues. • Have a purpose in your life – you will live longer and reduce your risk of Alzheimer’s disease. These are the big issues to use as your guide to a longer life. As you read them, you may find that many of them make for a happier life as well. That probably is not a coincidence! Live well. 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.
You may recall nearly two decades ago a George Clooney movie came out that revolved around some men who made their living as fishermen. It was called “The Perfect Storm,” and the title drew upon what happens when not just one storms hits a ship at sea, but two storms. It was quite dramatic. Well, Alzheimer’s disease is like that Perfect Storm, but it is not just two storms. Those with dementia who are 65 years or older have not just two storms; they have an average of four chronic conditions – what doctors call comorbidities – along with the dementia. An average 65+ year old individual has about two comorbid chronic conditions. The most common comorbidities for Alzheimer’s patients are diabetes, urinary infections and depression, but there are also other cognitive aspects to dementia that impact more than memory. We often refer to the manifestations of Alzheimer’s disease as “cognitive impairment.” But cognitive impairment isn’t just about memory issues. If you have a loved one who has had the diagnosis, there is another facet to cognitive impairment called apraxia, and it is the most common manifestation of cognitive impairment. The healthy brain is a complex data processor that routinely connects things. It knows what a fork is and it knows food on a dinner plate when it sees it and it also knows how to use the fork to transport the food to the mouth. Rinse and repeat. But apraxia can put up a significant road block between those two cognitive processes. The brain sees the fork and it sees the food and the brain then comes to a halt…at least until someone helps to move the fork with the food to the dementia sufferer’s mouth. Clearly the apraxia can take on a number of basic forms, and understanding what your loved one is now unable to do can help in getting assistance as well as treatment for your loved one with dementia. Health care providers categorize apraxia along these three lines:
- “Ideational apraxia” describes the cognitive deficit of the person unable to process what an object is for…they see a car key, but don’t know how that enables driving a car.
- “Ideamotor apraxia” describes the kind of activity for which a person with dementia needs to be “primed” to do. They recognize a hair brush, but need to be prompted in how to use that brush for their hair.
- “Dressing apraxia” describes all the roadblocks in what used to be a taken for granted process. Think about seeing buttons, but not remembering how they align with button holes…or how a zipper zips, etc.
These are all important for the caregiver, because if you understand the deficit you can help your loved one and you to minimize the frustration of what have become mind boggling tasks. It will help you in asking for the appropriate assistance in respite or residential care. You can explain that “mom needs help dressing in the morning,” and the staff will understand and be proactive. Or “dad will need help with dinner and cutting meat,” and they can help dad do as much as possible on his own and with the least embarrassment. Within all of this it is about maintaining quality of life for your loved one with dementia, and that takes patience. And your patience can come from knowing what to expect and how to respond. Here are a couple resources on how to address apraxia: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341309/ https://medlineplus.gov/ency/article/007472.htm. 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.
Because I work in geriatric care, it almost goes without saying that I talk with a lot of people who have had a lot of birthdays. In conversations with these older adults and with their caregivers, I have learned some important lessons in elder care management about how to have a healthy brain. Much of what I am sharing here also is supported by the scientific literature; see what you think.
1. Healthy brains get out more. I hear older adults talk about how being active is important, and they don't mean hardcore exercise. They mean socializing. Having friends and a social life also exercises the brain as older adults engage others in stimulating conversation, remembering names and more.
2. Healthy brains are challenged. The older adults I meet who have the most "on the ball" minds also tend to have stimulating hobbies like doing crossword puzzles, going to the theater or reading books. While a bit of television or other visual stimulation is good, it can degrade into very isolating behavior that should be avoided.
3. Healthy brains are fit. Where the feet run (or walk), the brain will follow. Think of exercise as a chance to flush the brain with blood flow, and it will result in actually growing new brain cells.
4. Healthy brains need to be fed well. The foods that are good for your cardiovascular system like those low in cholesterol or high in phytonutrients will benefit the brain as well as the heart. And just as a healthy heart will do well with alcohol or caffeine in moderation, the brain also will benefit from the same.
5. Healthy brains chill out. No matter the age, there will be stressors in life. The key is to find ways to cope with and move through the stress. Some of the above - like physical exercise - can be part of the stress management that is important to being mentally healthy.
6. Healthy brains believe in something. While it is not one faith or one way of spirituality, researchers have found that people who believe in something greater or have a higher sense of life's mission also have healthier brains and live longer.
All of these may seem like a lot to juggle to achieve brain health, but not to stress. Think of all of these elements of brain healthiness to be incremental ways you can pay forward to your brain's longevity and your brain will return the favor by helping you to navigate a happier and longer life. Charlotte Bishop is founder of Creative Care Management, certified geriatric care management 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.
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP) and trained 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 key member of the CCM team for over a decade. – Charlotte This is the second installment in a three-part series to help clear up some common misconceptions about Medicare. Medicare isn’t intentionally confusing, but with all the cross-talk surrounding Medicare, even if understanding it isn’t as intuitive as “1,2,3”, it’s at least as easy as “A, B, D.” In the last post, I discussed the structure of Medicare, and its division into two main parts (A & B) and a supplemental part (D). In review, the major portions of the program look like this:
- Part A – “Original Medicare”, covers in-patient stays (including hospital stays, or stays in rehab facilities, etc.)
- Part B – “Original Medicare”, covers physician visits (including Primary Care Provider visits, or referrals)
- Part D – added under the Medicare Modernization Act of 2003, covers select prescription drugs.
Let me start with some of Medicare’s surprising omissions of coverage. Again, the way the public thinks that the service works and how the service functions in practice are not the same. For example, Part A is designed for stays in medical facilities, but not all stays, and not all facilities are covered. The same can be said for Part B, which does not cover all physician office visits. How does this work? While most traditional, scheduled physician visits are covered, you shouldn’t expect to be covered by Medicare Part B for:
- Most dental care
- Eye exams related to prescribing glasses
- Dentures
- Cosmetic surgery
- Acupuncture
- Hearing aids and exams for fitting them
- Routine foot care
Which facility stays are not covered under Medicare Part A?:
- Long-term care
- “Custodial” care
It may come as a shock to many, but Medicare does not pay any part of the cost for permanent residence in a Skilled Nursing Facility (commonly called a Nursing Home). Without long-term care insurance, many aging adults find themselves unsure how to manage to pay for extended, custodial care. Next week, we’ll talk about options to close the “gaps” in coverage and how folks covered by Medicare are planning for themselves with the help of Medicare Counselors. 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.
There is an epidemic going on, and it involves that butterfly shaped gland in the neck call the thyroid. Since 2002 the prevalence has doubled in the US, but this is not because twice as many people have developed hypothyroidism as it is that the professional society that represents endocrinologists established new standards. The new standards for defining hypothyroidism have reduced the TSH (thyroid-stimulating hormone) range to be .3 to 3.0 from the earlier standard that had been about .5 to 5.0. And this is not just a trivial matter of definitions when what had been about 15 million people with hypothyroidism suddenly becomes about 27 million Americans. This is about one in ten Americans, and the prevalence of hypothyroidism is about twice as high among women over 60 years as it is for their younger counterparts. (Just for what it's worth, this is more people than the number diagnosed as diabetic in America.) Hypothyroidism is important also because there is a big connection between the thyroid gland in your older loved one's neck and their brain and heart. For anyone whose TSH levels are out of range, the impact on the heart would be through the potential for significantly elevated cholesterol levels. It is estimated that this could be as many as 10 million Americans. So, for people whose thyroid condition has not been diagnosed, but they have been put on lipid-lowering agents like the statins, their cure may be even easier. By taking a thyroid supplement, suddenly cholesterol levels may become better managed. Yet, fewer than half the adults with diagnosed elevated cholesterol levels in a recent survey were aware if they had ever been tested for elevated TSH levels. I had mentioned the brain connection, and there are two significant brain manifestations of hypothyroidism. Patients who are out of range on their TSH levels may be depressed or they may display signs of delirium. The former may have led to treatment with antidepressants, treatments that may now prove unnecessary, and the latter may be confused with dementia if the delirium goes unchecked over time. And there are other symptoms of hypothyroidism that you should be looking for if you are a caregiver to an older loved one: • thin, brittle, dry hair or skin • increased sensitivity to cold • fatigue • muscle or joint pains • constipation. You don't need to remember all the signs and symptoms of hypothyroidism, but you should remember to ask your loved one's physicians at the next annual physical what your loved one's TSH level is. If the number is too high or too low, begin advocating for help to avoid the other conditions. Yes, your loved one may take home one new prescription, but they also may get rid of one or more existing prescriptions...and feel a lot better. 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.