Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • caregiver coachChicago's Geriatric Care Manager Center of Excellence

How to Say No to Cancer
Who would say “yes” to cancer, you may be thinking, but saying “no” means you’re committed to the lifestyle...
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July 23, 2024
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LIFE: What Are You Going to do About It?
I had the good fortune this past weekend to attend a Billy Joel concert, and he had a great...
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June 24, 2024
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What’s Your Complaint?
If you grew up in a family as I did we were taught not to, or shown role models...
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June 11, 2024
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Are Your Prepared?
Have you ever taken a trip that was planned by a third party… maybe a National Geographic voyage or...
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June 3, 2024
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The Synergy Between Seniors and Earth Day!
April 22 is Earth Day, a date that has brought together activists and celebrants since its inception in 1970. ...
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April 22, 2024
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Can’t Find Your Keys?
When I speak to some clients our conversation moves from their work lives and forward to their retirements now....
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April 16, 2024
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Are You in the First Half or the Second Half of Your Life
A philosopher/theologian whom I regard quite highly talks about the first half and the second half of life. Life...
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April 2, 2024
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Another Side Effect of COVID: SCAMS
Just when you thought you’d heard everything about COVID! We early on learned how to be vaccinated, and most...
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March 12, 2024
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If You Want to be More Fit, Don’t Exercise…
Just coming off Super Bowl Sunday, it’s easy to talk about who could run faster, who could pass more...
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February 12, 2024
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If It’s All in Your Head, Are You Out of Your Mind?
You know what makes a real difference between grade school children and adults over the age of forty? We...
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February 6, 2024
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In the Caregiver's Words

Recent Client Praise

Thanksgiving along with all the end of year holidays are great times when all the adult children of older parents get together to have the kids send time with the grandparents. It may also be the time when the adult children who may not live in their childhood communities or may just live in another suburb get their first real chance in a while to check in on mom or dad. As caregivers we may come with something of a "to do" list, and for some of us, it is a chance to sit with our parents to take stock of just how they are doing. In this first of two postings on the "holiday wellness check," I am going to offer some suggested items to have on your checklist as ways to make sure home is still as safe for your older loved ones as it can be. In the second, I will offer some mental and physical wellness suggestions to have on hand for your holiday trip. A home wellness checklist is mostly about preventing falls. Each year about one in three 65+ year olds will fall and half of those over 80 years old will take a tumble. Here is a short checklist to help protect your loved one:
- Front Door/Back Door - If your older loved one has developed more of a shuffle from what used to be a brisk stride, take a close look at the steps leading into the house. At the very least make sure the step[s have non-skid strips or other surfaces for sure footing, and also make sure they are well lit at night by considering installing motion sensors that trigger them in low light situations.
- Halls/Floors - At the very least get rid of an scatter rugs and replace them with nonskid mats or rugs. Look for heavily worn carpeting as another risk for falls. After sundown check for how well the edges and corners of halls are illuminated as older vision has greater difficulty gauging surfaces in low light or twilight. Handrails on halls and stairs are a plus!
- Kitchens - Even for older adults who may not use assistive devices like canes, walkers or wheelchairs, it is harder to reach those high shelves or stoop low enough to load a conventional dishwasher. If the kitchen is ready for an updating anyway, these can be useful upgrades.
- Baths - Grip bars and bath tubs than are easier to get in and out are great preventive improvements. The combination of the potentially slippery and hard surfaces of a bathroom conspire to make this room a real accident waiting to happen.
- Accessible Switches - With older finger joints, the old switches can be harder to manage and you may consider rocker switches for wall switches. All switches should be about 16"-40" off the floor. For the bedroom make sure that a light switch is within easy reach of the bed so that your older loved one is not trying to get out of bed in the dark at night.
- Declutter - Beware of the fall hazards that accumulations of newspapers, magazines or books can represent. Also important will be the lamps or other appliances whose cords may clutter walkways.
Now that you have gone through the checklist, you and your older loved one will have a happier holiday and a safer new year!
It may not be hard for you to remember when you had your last physical with your primary care physician. And you may even remember when you had your last tetanus shot, but I am willing to wager that you are not nearly as on top of when you older mom, dad or other loved one was last vaccinated, had their last mammogram or even vision exam. Yet you should have all of this and more at your fingertips, because knowing the stats could very well save your loved one's life. because they may not have all of that information readily available either. If your loved one is part of a health system that has all hospital as well as lab and doctors' records digitized and stored on a name and password-protected server, you may already have access to the vital statistics you will one day need. If not, here is how to get started. The categories of information you will want organized (consider an accordion file folder if you are more comfortable with paper or a file folder on your personal computer if you can digitize all information):
- Basic contact information, in case of emergency( ICE) and medical releases (If you need a form for this, please write to our info@creativecaremanagement.com -we will share one we use, powers of attorney (for medical), advanced directives, etc.
- Personal medical history of your loved one as well as relevant family medical history given that many medical conditions are genetically linked - "in the family."
- Current primary care provider information and predecessor providers if there has been any switch of providers.
- Other medical specialists whom your loved one has seen or continues to see, such as OB/GYN, cardiologist, endocrinologist, etc.
- Dentist contact information and a history of dental visits and any conditions of ongoing concern
- Alternative providers which may range widely from chiropractors to podiatrists, from acupuncturists to massage therapists and more.
- A record of all recent lab or other diagnostic tests and screenings.
- A history of all immunizations including the seasonal flu vaccines as well as less frequent TB tests, tetanus immunizations and beyond.
- A list of all medications (dose amount and frequency), over the counter medications (e.g., analgesics, sleep aids, etc.) and nutritional supplements.
- Insurance contact information as well as any forms or recent billing advice forms in order to track who has been reimbursed and who has not or even who has billed inappropriately.
- Allergies to foods or medications or other environmental risks (e.g., bee stings) of note.
- And, of course the "miscellaneous" category for everything else that may be relevant (e.g., pets and their food preferences, passwords, etc.).
At the end of the day, consider this to be one of your emergency kits should you get a call from medical or emergency personnel. If you have the answers to their questions, you also will be a life saver to your older loved one. 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.
Have you ever noticed how we all can get into a place where we are multi-tasking, we are reflecting on yesterday’s game, today’s meeting, the kids’ games, the weekend’s events and pretty soon we don’t just avoid stopping to smell the roses…we don’t even remember there was a rose along our path this morning. Scientists suggest that mindfulness is an alternative to the stress of multi-tasking. Mindfulness, they explain, is simply focusing on the present, not getting caught up in judging any aspect of it, and finding a calm within the chaos that seems to be ever-present in the 21^st century. Researchers at Harvard Medical School talk about readjusting how we view things in terms of mindfulness…that is being really in the present and just experiencing the present without judging it as bad or good…just experiencing it. It will take some practice because virtually all of us are really good at being stressed and overloaded. Yet, if we can learn this thing called mindfulness, we will have less stress, a better immune system and generally happier days. It may be even more important for our older loved ones. They have a lot more yesterdays about which they can have regrets and a lot more losses they can grieve. No wonder depression affects about six million adults over the age of 65 each year…but it is not just a normal part of aging. It is their points of view. The scientists tell us that mindfulness can improve gastrointestinal function, address heart disease, lower blood pressure, ease stress, enhance sleep, and moderate chronic pain. Practitioners are using mindfulness as part of the treatment for depression and anxiety, eating issues, alcohol and substance abuse and marital discord. They are even using it to address one of the big challenges of older adults – isolation and, yes, depression. Not being in the present also gives people way too much time to regret the past and fret about the future. Try this yourself…and share with an older loved one:
1. Sit in a comfortable, straight-back chair or on a cushion with crossed legs
2. Relax - slowly breathe in through your nostrils and out through your mouth
3. Focus on breathing…if you wander, bring your attention back
4. Take note of the rest of your body
5. After you establish this calm, then allow one thought at a time to enter
6. Gently guide yourself back to just breathing to keep from scattering
Try this for 20 minutes a day…and later expand to 40-45 minutes. Try to bring some of the method to how you handle the rest of your life by single-tasking, add moments of single-focused thoughtfulness. Rinse. Repeat. And share. 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 did not start out as a geriatric care consultant although I have been one for nearly 20 years. I actually started in care management helping injured workers, but it seems that life has come around full circle with an increasingly older work force. Larger percentages of workers are staying on the job beyond what had customarily been the "retirement age" of 65. Yet, today's older worker does not fit some of our historic expectations. The National Council on Compensation Insurance (NCCI) has offered some new research that may surprise a lot of people, especially those who claim that older workers will be more prone to costly injuries. The research showed, for instance, that workers under age 35 had more finger cuts than those over age 35. But workers over age 35 reported more cases of carpal tunnel syndrome or neck injuries than younger workers. This generalized to a lot of what are referred to as repetitive stress injuries like rotator cuff injuries. Even so, the differences were not very great in these latter categories. There also has been a pervasive notion that older workers' injuries will be more expensive than those of younger workers. Well, that depends on what you term "old." It turns out that workers under age 25 do have less expensive injuries with less time lost from work than those older, but it would probably be a stretch to suggest that a 30 year old employee is an "older worker." Moreover, once a worker hits age 35 and up, the costs of their injuries and the time lost from work are very much on par with much older workers. The researchers also found that the best way to reduce injuries and their costs is not to hire 30 year-olds, but to train workers in safety and to report injuries immediately when they happen. And there is one more similarity between the older worker and their younger counterparts, and it has to do with family responsibilities. We all expect younger, married workers to have family responsibilities they juggle with their workplace commitments, but older works are also jugglers. In their case, however, they are trying to manage caregiving responsibilities for older parents along with their maintaining on the job performance. And, of course, some of the "younger, older workers" are sandwich generation workers with kids at home or in college as well as parents who need help. No surprise, then, that an increasing number of our clients are not just the individual caregivers, but also the employers for whom they work who are looking to take some of the stress from their "older workers" by offering our services as a resource and support. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric care consultants, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
We all have been in desperate need for a ray of sunshine during this COVID-19 quarantine. Well, this week, we are told that a vaccine for COVID-19 has gone to phase 3 clinical trials. These are the trials in any FDA approval process where the company with the therapy specifies what they expect as the outcome of the treatment – in this case a vaccine – and increases the number of test subjects to the thousands so that they can be more statistically sure of the outcome and also vigilant about any negatives that may occur in very small percentages of people. A ray of sunshine? Good news, right? There is a bonus with this vaccine. Those who ultimately will become vaccinated not only will be virtually eliminating the chance of coming down with COVID-19, but they also likely will be reducing their chance of developing Alzheimer’s disease as well. Yes, those who receive this and some other vaccines will have a measurably reduced chance of developing Alzheimer’s if retrospective science just out holds up. Public health scientists have long worked to show that the anti-vaxxers shouting about an increased risk for autism and even Alzheimer’s are wrong associated with vaccines are just plain wrong. They did what honest scientists have always done, and that is … follow the data. What they found quite amazed them and continue to impress scientists. Just this week, two pieces of research presented at the Alzheimer’s Association International Conference that not only do vaccines prevent the diseases they are designed to prevent, but they also serve to protect memory and cognition. These are not just small scale studies. The first of the two from the University of Texas compiled data from millions of records in a national data base. The scientists were generally looking for any factors that would influence people succumbing to Alzheimer’s among other conditions. One of the factors with a measurable and positive effect was flu shots. The scientists found that a bit unexpected, so they looked more closely at medical records of about 9,000 60+ year old people. They compared those who had received flu shots with those who had not controlling for other factors like smoking habits, diabetes, obesity and more. People who had received at least one flu shot reduced their Alzheimer’s risk by 17%, and those who had regular immunization dropped their risks another 13%. More vaccines results in less Alzheimer’s! This was a bit surprising, because the conventional wisdom had been that vaccines do introduce some inflammation, and this had also been associated with Alzheimer’s disease. I had mentioned a second study. That one had looked at pneumonia vaccines. In that study, they looked at 5,000 65+ year olds who had been vaccinated for pneumonia before they were 75 years old. Those receiving the vaccine were 25% less likely to develop Alzheimer’s, although having a flu vaccine also did not add to this benefit. The jury is out on exactly why vaccines and Alzheimer’s have this relationship, and the scientists are look at what may actually cause what. They also are looking at other vaccines. I would have been on board for an anti-COVID vaccine already, but this added benefit just seems to be icing on a cake that is too long in coming. It is also gratifying to see that anti-vaxxers are on the wrong side of the longstanding debate about vaccines. 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.