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

The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
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January 25, 2022
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If It’s Not Happy or Merry?
I explained in an earlier post about why we refer to Holidays in the plural, and how we are...
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December 14, 2021
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Making Your Holidays Happy Again
Yes, “holidays” is a plural word here. Please allow me to digress on this plurality and simply point out...
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November 16, 2021
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Can You Hear Me Now?
From 2002 to 2011, actor Paul Marcarelli was the voice for Verizon pitching their cellular communications with the simple...
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September 28, 2021
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Your Older Loved One’s Greatest Health Risk?
As our loved ones grow older, we probably are more acutely protective of their health and well-being, especially if...
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September 14, 2021
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Nursing Homes Still a Risk for COVID-19?
It has been a tough pandemic for everyone, but it has been especially difficult for residents of nursing homes...
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August 31, 2021
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Your Flight to Nowhere is Boarding
You have probably put off a vacation or most any travel for more than a year with the threat...
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August 10, 2021
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The Side Effects Physicians Don’t Talk About
You all have heard about the side effects of FDA-approved medications that make their sales pitches on your television. ...
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June 29, 2021
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Breaking News for Alzheimer’s … part 1
The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of...
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June 15, 2021
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Three Milion More Victims…
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably...
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April 27, 2021
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In the Caregiver's Words

Recent Client Praise

I have really lost track of how many conversations and/or blog postings I have had about Caregiver Stress. As a certified geriatric care manager, we work with families, and a substantial part of my focus is upon the stress of a caregiver trying to both deal with a loved one's eroding health, but also the demands on them from the others who depend on them. I would like to devote a bit of space here to addressing the stress of the aging loved one and how a caregiver can help them to cope with what life throws their way. Retirement is a break from the stressors of a workaday world, to be sure. But as one lives to do what one wishes as a reward from a long career, there comes a time when new stressors emerge. There can be increasing physical challenges from a medical condition that is not going to get better. Many of these conditions like arthritis, cardiovascular or pulmonary issues just get worse with time. As a person becomes less and less able to do the things they used to do to take care of themselves, the stress mounts. Other very common stressors are those that come with needing an elder caregiver, a spouse or partner to help with every day tasks; it takes an increasing toll. With general changes in health status can come a profoundly diminished sense of well-being and just plain depression. So much for the Golden Years. As a caregiver, look for these warning signs of excessive stress in one or both of your older loved ones:
- signs of anxiety, undue worry or outright panic attacks
- irritability or angry outbursts
- sadness, melancholy or lethargy
- indecisiveness or difficulty focusing
- difficulty getting to sleep or staying asleep
- an array of aches, pains or other issues of nonspecific origin
- rashes, breathing problems or other "new" allergies
- drinking or eating too much or too little; or
- an increasing number of prescription or OTC medications on hand.
As a caregiver, you can help by helping your loved one to find a remedy for the stress. There is no absolute way to rid ourselves of all stress at any age, but the key is finding help to cope more effectively with the stress in our lives. For your older loved one, consider:
1. Gently and persistently encouraging your loved one to be more socially engaged with friends, clubs or outings in order to get a break from the stress cycle;
2. Help your loved one to find seek out talk therapy; it is not about getting another prescription nearly as much as "unloading" to a trained therapist;
3. Seeking a physical aid in the form of gentle massage therapy, exercise classes like yoga, relaxation therapy or just getting out for longer walks.
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@creativecasemanagement.com.
June is National Alzheimer’s Disease and Dementia Awareness Month. I will be having a number of postings on related news this month, and the good news is there is, in fact, good news on a number of fronts. Most of us have heard of the importance of using imaging of brains to identify the telltale beta-amyloid deposits and plaque in the brain for earlier diagnosis of Alzheimer’s disease. Researchers at Washington University in St. Louis, Missouri, are suggesting that Alzheimer’s protein tau may be a better biomarker of the disease than even beta-amyloid. Everyone develops protein tau in their brains as a normal part of the aging process. But these researchers have shown that it is not whether one develops protein tau, but where one shows it. When the protein spreads to the lateral temporal areas or into the parietal region, that is the trigger for Alzheimer’s symptoms. It also is when only mild cognitive impairment has begun to surface, and that early warning may work hand in hand with one other piece of promising news…actual treatment to stave off the progression of the disease. You may recall an earlier posting in which I discussed the brain’s response to excessive carbohydrate consumption as being “type 3 diabetes.” Qian Shi, a doctoral candidate at Tulane University, is analyzing Veteran’s Affairs data in a retrospective longitudinal study of neurodegenerative disease. Ms. Shi is reporting preliminary findings that link metformin use with a substantial reduction in neurodegenerative disease. Metformin appears to be having a similar effect on type 3 diabetes as it has had historically on type 2 diabetes. It reduces the inflammation that negatively affects both the pancreas and the brain. Until very recently, most research has found little support for the benefits of nutritional supplements or nutraceuticals in either preventing or slowing the progression of neurodegenerative diseases. But Jennifer Lemon, a research associate in the Department of Medical Physics and Applied Radiation Sciences at McMaster University in Canada, has conducted controlled studies using laboratory mice that show real promise. (Note: Animal studies, such as those using mice, are almost always the first step toward research that will move to human subjects later, and virtually all mammal brain functions are similar metabolically.) Dr. Lemon gave a mix of vitamins and minerals, along with nutraceuticals, such as beta carotene, bioflavonoids, cod liver oil, flax seed, garlic, and green tea extract to one group of mice. Relative to other mice receiving no nutraceuticals, the treated mice maintained better brain cell numbers and mass and cognitive function over the duration of the study. The treated mice seemed also to preserve their sight and sense of smell, two capabilities associated with neurodegenerative decline. Much research remains to be done, but we ought not be too hasty in giving up on the supplements you can purchase at the corner health food store. Charlotte Bishop is an Aging Life Care Professional and 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.
Who thinks it’s a good idea to just blow off Valentine’s Day? I am guessing not many hands will go up for that idea…some might even say that their spouse will kill them if they don’t bring forth at least a sentimental thought. Never mind the flowers, candy or sparkler. Just forget about the day later this week. Well, that probably is what some of us do every day … with our hearts…we just forget about our hearts. And that is why heart attack and stroke are the top two causes of mortality in the United States. So, what do you do to remember of your hearts? Earlier this decade the American Heart Association came up with seven habits to embrace to help avoid heart attack and stroke. You don’t have to wait until February 14^th to start:
1. Exercise - there is a new exercise program recommended almost every week, it seems, but the simple fact is that getting your body moving regularly and vigorously supports a healthy heart…and the rest of the body with it.
2. Eat right - we all know what the good foods are and what the bad foods are; make a healthy diet your Valentine’s Day resolution.
3. Lower blood pressure - you will need a medical provider to give you your actual numbers (not to exceed 12/80), and if your numbers are high stick to the prescription you will be given and follow #1 and #2 along with losing weight and cutting your salt or sugar intake.
4. Lower your cholesterol - focus your diet on fruits and vegetables along with fish, nuts and soy; your doctor can tell you if a statin is indicated.
5. Manage your blood sugar - sugar is not your friend, so limit its visits to your body in order to keep down your weight and not beat up your pancreas…your heart will thank you.
6. Maintain a healthy weight - losing weight should be an outcome of the first 5 instead of a goal in itself, but keeping your weight down lightens the workload for your heart.
7. Don’t smoke - smokers have double the risk of a heart attack and triple the risk of a stroke over nonsmokers; it is not just your lungs that suffer if you smoke.
So this list is the short version of a lot of material I have covered in other posts. If you have questions, you can use key words to search the blog for a related post or you can go to the American Heart Association web site. Make February your heart-healthy month! 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.
We are knowledgeable in a wide range of elder care services. Below you will find just some of the things we do to make the life of your elder loved one more complete and your life just a little simpler. If you are not sure what exactly you need, please don't hesitate to contact our Geriatric Care Management team.
Geriatric Care Plans
A direct product of a careful assessment, geriatric care plans act as a roadmap for health care options and living arrangements of an aging individual. Learn about geriatric care planning.

Assisted Living Consultations
Based on a careful evaluation of your loved one’s needs, we help review and select the ideal assisted living facility. We also assist with paperwork and legal matters. Learn about assisted living consultations.

Retirement Communities Consultations
We find the ideal retirement communities that match your aging loved one’s lifestyle preferences and then take care of the transition for you. Learn about retirement communities consulting.

Home Care Management
We manage the process of selecting and placing your loved one with the right kind of home care service from a reliable and trustworthy provider. Learn about home care management consulting.

Nursing Home Consultations
We evaluate healthcare needs of your loved one and assist in selecting the most appropriate nursing home. We then carry out periodic reviews of your loved one’s condition. Learn about nursing home consulting.

Senior Home Safety
Complete assessment of safety of your elder loved one’s home, and subsequent retrofitting to ensure comfortable and injury-free environment. Learn about senior home safety services.
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If you are like millions of folks in this country, you might be counting the days until Thanksgiving. Typically this creates a minor panic considering all the preparation most of us put into making the holiday happen. If you are a caregiver, it can be about more than meal preparations; it can also be about taking the opportunity for a "wellness check" on an elder mom or dad or other elderly loved one. I will talk about special food considerations in another posting, but let me offer some tips on what you can check to make sure the senior in your orbit is still in great shape.

            First, it is important to recognize that we all - and I mean all - forget some things some of the time. So this short check list goes beyond the normal slips that will affect us all, regardless of age. Here are six suggestions on what to note when you all gather for the feast:

If you are gathering at your elderly loved one's place, you have an opportunity to check out what is in their refrigerator. Look for items that are well beyond an expiration date or simply have become a science experiment.

If they still drive a car, you may volunteer to run some errands. Use the opportunity to see that the tires are fully-inflated, the oil has been changed, the brakes are in good working order, etc.

While I certainly don't recommend a white glove inspection, you will probably be able to see if the place looks as tidy and orderly as you remember it from last year and years gone by.

If your senior owns a pet, does the animal appear healthy and well cared for? You may want to check to see if the tags show current vaccines.

If you have a chance to talk with neighbors or friends who see your older relative throughout the year, try to enlist their help in looking out for that relative, especially since you may not be around but a few times a year.

Holidays are a time for catching up and sharing news. If your older relative repeats the same story within a single conversation, make note of it as short term memory loss is a sign of dementia.

Take note of personal hygiene. Seniors are entitled to hang on to a favorite sweater or other item because they simply are attached to it, but you will notice if hygiene is becoming a bit lax.

Finally, just ask. You can show your willingness to help in any number of ways and make a list. Keep in mind, they may feel comfortable just letting you know if they have not felt quite right lately.

With all of this, make sure you have a good line of communication with siblings or others in the family so that you all can compare notes. You want to be helpful, not alarming.

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.

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I often offer advice on how to help your older loved one with challenging tasks or how to protect your older loved one from outside threats, but once in a while the advice applies to us all. And it’s not about some complicated algorithms that the “bad guys” of the “dark web” may be using to hack users who stumble upon a site. It’s about your password or the password of an older loved one or other confidential information that has become the currency of the Internet. Notice I used the singular form of the word, password, because too many online users still resort to a single go to password for all the applications they may use on their computers or smart phones. #1 Threat. You may have been seeing new requirements for passwords in your more secure sites lately, such as no sequential numbers, a mix of numbers and letters and other characters for a password to qualify. The reason is simple – easy passwords are easy to hack, and some of us have been making it more than easy. The most common password, used by over 2.5 million on-line users in 2020 was “123456.” Seriously, and the second most commonly used password for nearly one million users was “123456789.” Really? #2 Threat. Or if you see a post that promises to give you “pictures you won’t find anywhere else on line.” Or even one of the news sites that promises to tell you if you’re a genius with just 12 questions or will show you what child actors look like now 40 years later. There is a host of different forms of these click bait sites, and they may seem relatively more innocuous, because they are just trying to get you to buy an over-rated facial crème or dog food, etc. #3 Threat. These threats are like Threat #2 on steroids, because they may give hackers access to your most important financial or personal information. Here are the twelve questions you should never answer if asked by an untrusted source or even a “friend:” • Where did you grow up, attend grade school, etc.? • What is your favorite color? • What was your childhood pet’s name? • What was the street you grew up on? • Who is your favorite sports team? • What is your favorite hobby or pastime? • What was your first car? • What is your favorite comfort food? • What was your mother’s name before she married? • Who was your first employer? • What was your favorite musical band? • Who is your best friend? You may be asked more than one of these by an untrusted source, and they may be the final keys that allow internet scammers to unlock your web-based safe – on-line bank account, investment funds, and more. Your parents may have cautioned you about talking to strangers when you were very young…that still holds for advice to your parents now. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.

Being a caregiver to an older adult or someone else with special needs requires a lot of care and attention to details. It also requires a lot of courage, because some of the conversations a caregiver has with their loved one delves into topics that we all may find difficult. Such a conversation confronts some of the casualties of aging like the loss of certain privileges and some subjects would be awkward to address with just about anybody. Let me start with the easiest of three: giving up the car keys.

       Driving. Talking with an older adult about whether they should still be driving can be most challenging if addressed head on. It becomes easier, however, if you try to take the role of the older adult and simply ask yourself how you would want to be approached. If you already accompany them to their physicians' office visits, you may discreetly ask the provider if there are any physical issues that detract from their capacity to drive. When you do address the issue directly, bear the physician's feedback in mind and ask about how traffic is on the days when mom or dad is out. Chances are that they may initially see it as all those other crazy drivers. Work into it by asking about how safe they feel on the road and be prepared with other transportation options that might be more comfortable and "safer" alternatives to driving themselves. This may take some time. Check out some of my other tips in one of my earlier postings.

       Funerals. What are your loved one’s plans for their funeral? This conversation may surprise you. Your loved one may have gone so far as to have prepaid for their funeral already and all those decisions might now be a thing of the past. But as with the car keys, it can be helpful to think about how you would wish to be approached on this subject before talking it over with your loved one. You may even introduce the subject about how you have recently given it some thought owing to someone whom you both know from the community who has died. And remember, it is not about you. It is about respecting the wishes of your loved one that you are asking, and if they do not wish to speak about it, that may just have to do.

       Intimacy. Finally, if this is your mother or father for whom you are a caregiver, you may remember how awkward that first conversation about the birds and the bees was when they broached the subject with teenage you. Now, if your older loved one is still living independently at home or in a senior residential community, you should not even broach the subject. If one of both require some level of assisted living, then you may ask the facility about their policies and be prepared to advocate on your loved one's behalf. No matter what age, individuals who are capable of making their own independent decisions ought be encouraged to decide about intimacy as well. It may even surprise you to learn that their desire for intimacy may be as basic as holding hands and sharing a quiet moment. All that said, the odds of an older adult being diagnosed with stress, anxiety or depression are lower if they are sexually active. This is one of those behind the scenes conversations where there may be a need for more education and a bit of advocacy.

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.

The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of a new Alzheimer’s treatment by the FDA. If you have been following any of the news on this new drug we have difficulty pronouncing, aducanumab, you may be scratching your head a bit. I’ve asked one of our senior people, Steve Steiber, Ph.D., to explain this new drug and what is going on in the “Alzheimer’s space” generally, because Dr. Steiber has over 30 years doing market research in the biopharma arena. He’s been published in JAMA, American Journal of Public Health, Public Opinion Quarterly and more and he has a book, Measuring and Managing Patient Satisfaction, in its second edition. He also is my co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. … I am happy to share with you my take on aducanumab, the Alzheimer’s treatments that preceded it, the controversy that surrounds aducanumab and also how much research into an effective Alzheimer’s treatment is still going on right now. Medical practitioners have been using biologic agents to treat conditions for a very long time if you count insulin, human growth hormone, thyroxine and other “naturally-occurring” body hormones. Aducanumab is a novel biologic, however, that works to interrupt the formation of beta amyloid plaque in the brain. You may recall reading about one of the ways that Alzheimer’s disease is diagnosed is by assessing the accumulation of plaque in the brain through PET imaging. But let me start with what we have had available to treat Alzheimer’s prior to the approval of aducanumab. Prior to aducanumab, FDA had approved five drugs to slow the progression – but not cure - Alzheimer’s:

Aricept (donepezil) is able to claim that it can slow the cognitive progression of Alzheimer’s and modestly improve confusion, memory and awareness.

Exelon (rivastigmine) claims to address the memory loss of both Parkinson’s and Alzheimer’s.

Namenda (memantine) claims to treat the moderate to severe confusion of Alzheimer’s disease, but it is to be used in combination with one of the other agents.

Namzaric (donepezil and memantine) combines an extended release form of Namenda as well as Aricept in one pill to address the symptoms each addresses individually.

Razadyne (galantamine) claims to improve the ability to think and even remember by increasing brain levels of acetylcholine, a beneficial enzyme.

None of these treatments could reverse or halt the progression of Alzheimer’s disease, and they really only modestly slowed its progression. The last of these was approved by the Food and Drug Administration in 2003. It had been a very long time since anything new has broken on the scene to address the ravages of Alzheimer’s disease when aducancumab and Biogen presented their case to the FDA committees seeking approval. It would be charitable to say that this new treatment offered mixed results at best in two Phase 3 clinical trials on patients with the disease. Phase 3 is the trial that builds on early research in animals and later humans to test against placebo whether a therapy can show a statistically significant improvement over placebo on specific predetermined clinical outcomes called clinical endpoints. Biogen halted both its phase 3 studies, called Engage and Emerge, early when they assessed that aducanumab was not likely to meet its clinical endpoints ("clinical endpoints" are the pre-established goals that a study proposes to meet in order to be deemed successful). In subsequent analysis, Biogen found that the Engage study, in fact, did not meet its endpoints, but Emerge showed some positive outcomes. Generally, this kind of analysis after the fact is not accepted by FDA, and FDA also takes a pretty dim view of one study’s success offset by another study’s failure. Nonetheless, FDA gave its conditional approval to Biogen. The condition was to be a phase 4 clinical trial to settle some of the questions on efficacy. You can go to your financial news feed to see that Biogen’s stock shot up 39%, so this is a big deal…but the deal is not over. In my next post to Charlotte’s Blog I’ll be sharing with you more of what FDA has demanded of aducanumab going forward, some of the organizational fallout at FDA, and also why we might still be hopeful. I’ll share with you some details on more than a dozen other companies who are moving forward with their clinical trials on therapies that show tangible promise in the fight against Alzheimer’s disease. I’ll also share the sites you can visit to gather more information on all clinical trials currently underway as well as where you can go to see how you can help your loved one apply to be part of some of these clinical trials that show promise if you are a caregiver to someone with Alzheimer's. It gets interesting. I encourage you to also send any questions you have to info@creativecaremanagement.com . I'll do my best to provide answers in my next post...part two. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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.

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We don’t often get a chance to use the words “good news” and “Alzheimer’s Disease” in the same sentence. That may be about to change. You may recall that I have reported on numerous studies here as well as in Europe that have tried to combat the cognitive decline that is the hallmark of Alzheimer’s. Even those therapies that have been approved by the FDA have shown very little impact on the disease, and most of what we have seen clinically is just a modest slowing of the decline. As we said in our book last year:
“Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed.”
Chinese scientists now offer us something worth following. A Shanghai-based company called Green Valley Pharmaceutical Company presented phase 3 clinical trial data at the Alzheimer’s Disease Conference just this past week in Barcelona. In the topline results, researchers reported a rather substantial effect from their treatment, called GDV-971. They randomly sorted a bit more than 800 50 to 80 year old mild to moderate Alzheimer’s patients from 34 different sites across China into experimental and control groups. The experimental group received the 450 mg formulation of GV-971 twice a day for 36 weeks, and the control group received a placebo over this same period in the same dosing. Using the Mini-Mental State Examination, a standard test for cognitive ability, the researchers saw an effect as early as four weeks into this nine month trial. The separation between the cognitive capabilities of experimental and placebo patients continued through the duration of the trial. Patients had scored between and 11 and a 26 on the scale at the outset of the trial with placebo and experimental group patients manifesting the same mean score. By the 36^th week, the experimental group averaged a score 2.54 points higher than the control patients. Statisticians rate this a statistical significance of p<.0001, or in lay terms something that could happen by random chance only once in 10,000 tries. The active ingredients in the therapy operate in a number of ways that evidently slow the progression of Alzheimer’s. And there were no differences in the numbers of patients reporting any adverse effects in either the experimental or control groups. A company spokesperson suggests that they are cautiously optimistic…a bit understated we suggest. But it is true that additional studies need to be conducted across more sites to “clarify and confirm its promising biological and clinical effects.” The Chinese equivalent of the FDA has the company’s data under review now at the same time there are plans for more worldwide drug trials soon. Stay tuned! 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.
Perhaps you have heard stories about people who are checked into a hospital and develop an infection while there. Or perhaps you have heard of the person with a minor infection that develops quickly into a systemic infection. All too often in these kinds of cases, the infection can move quickly to sepsis and ultimately even to death. Each year more than a million people develop sepsis, a multiple organ or systemic infection that causes the body to start shutting down altogether. In as many as half the cases of sepsis that develop, the patient actually dies because this runaway infection simply is not detected early enough. It is most common among adults over age 65, people with compromised immune systems and hospitalized patients.

            If you are a caregiver to an older person or someone with a compromised immune system, you may be the best person to see the warning signs. That is because the warning signs can be so subtle that a health care provider not familiar with how a patient is normally may not detect the small changes that can be the hallmark of sepsis. If your loved one develops an infection, be on the lookout for two of more of the following symptoms which may be the warning signs of sepsis:

·          Infection accompanied by a high fever or a very low fever, often accompanied by a chill or trembling.

·          Hypotension or very low blood pressure in a patient who has no history of low blood pressure.

·          Elevated heart rate - typically anything above 90 beats per minute.

·          General disorientation which may appear almost like a mild dementia or confusion about their surroundings or why they may be in the hospital.

·          Shortness of breath, rapid breathing or even hyperventilation which may be caused by fluid building up on the lungs.

·          Skin that is warm to the touch or what may appear as a heat rash.

·          A white blood count reported by the provider, but one that is unusually high or low.

       Most of these warning signs are what you as a caregiver can observe, but some may require you asking the nurse or physician charged with your loved one's care. And as in any case, you as a caregiver should be actively asking questions about anything you do not understand. Rarely will a patient identify their condition as sepsis, especially if the condition causes confusion.

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.