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

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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Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
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April 20, 2021
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Not Just Spring…
We’ve heard of Spring Training for those who follow baseball teams like the CUBS or the SOX, and we...
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April 13, 2021
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As If COVID Were Not Enough
We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the...
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March 30, 2021
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Diseases that Mimic Dementia…But Are Treatable-part 3
As you can tell from now a third installment about other medical conditions that can mimic dementia, it’s not...
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March 22, 2021
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Diseases that Mimic Dementia…But Are Treatable – part 1
Dementia is the condition that adult Americans fear the most, and tragically there are conditions that can give a...
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March 9, 2021
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Can I Have A Hug?
I doubt there is anyone who does not have something that they have not been able to do during...
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March 4, 2021
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A Game Where Everyone Wins
Pick your metaphor. If you want your knife to slice easier, you sharpen it. If you want to improve...
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March 2, 2021
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No Vaccine for the Other Plague
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine,...
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February 16, 2021
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What Tony Bennett Can Teach Us
Tony Bennet has arguably been one of those “one in a million” kind of musical talents, but sadly he...
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February 9, 2021
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In the Caregiver's Words

Recent Client Praise

Everybody eventually learns to accommodate the “empty nest” that inevitably follows the busy days of child-rearing and child-launching. And then – maybe after a rather substantial wait – there is, once again, the prospect of more little ones in the house. This time, however, they are grandchildren, and as much as everyone who raises kids knows how not to drop a baby, the world has changed. It translates into a new kind of child-proofing different from a generation ago. This is advice for seniors who may be hosts to little ones for the first time in a lot of years.

1.    First, it is important to start with an open mind. It is too easy to slip into a mindset of “what was good enough for my kids,” but times have changed and so has safety. So, some of the old toys may still be considered safe, but the old car seat, play pen or infant swing may not be just outdated; they may be dangerous. Defer to the new mom and dad for advice on what will still work and what needs to be replaced by the next new thing. This approach is also politically helpful in empowering the new mom and dad.

2.    Remember also that when you raised your own children, you may not have had any of the chronic conditions you now have. And you also would not have the medications associated with those conditions, so develop a plan to store medications safely and out of reach of kids. While you may not want the nuisance of those safety bottles, you really need to be certain that medications that will be attractive nuisances to little ones on the prowl are locked up. This is especially true if one of the older grandparents uses the “day of the week” pill reminders that often are stored in the kitchen as a reminder for prescription schedules.

3.    For an add layer of safety, go to the source. The Consumer Product Safety Commission has a twelve-step approach to fully kid-proofing your home, and a number of their recommendations like smoke alarms and carbon monoxide detectors which are great safety measures for everyone. They have a downloadable two page brochure to walk you through the steps (click here for brochure).

4.    This last one is making the grandparents house safe from what the toddlers or young children will bring with them. Falls among seniors are often caused by the unexpected, and there is nothing so unexpected as the little dolls, cars or a myriad of other items that you will buy for the kids or that they will bring with them. Make it a habit of picking up after play time, because you may not see the little hazard on the floor…especially after sunset.

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. Read more about Our Story and Charlotte's mission.
Do you have pain in your back, particularly your lower back - that area around your belt line or slightly lower? If not, please consider yourself lucky, but also just wait. According to some experts, about four in five Americans will at some point in their lives experience low back pain...chronic low back pain. What may be surprising is that most of these cases have no specific cause that can be diagnosed. As a geriatric care management professional, I hear about this a lot. And if you are a caregiver to an older adult, you may hear this from your loved one as well, or you may be experiencing the pain yourself. So, as a consequence, doctors are seeing more and more of these patients, and without having a specific cause to address they may be tempted to treat the pain. While surgery may be an option for serious spinal conditions, most of this low back pain does not reach such a level of acuity to justify surgery. A lot of doctors have started giving injections into the site with anti-inflammatories, opioids, or in some cases vitamin B-12. Injections would be great if they worked, but there is not much evidence to suggest that the injections are any more than a short term fix for the pain. A research commentary, reported earlier this summer in the Journal of the American Medical Association, says that there is almost no evidence in the larger literature that injections have any positive effect over the long term. Other reports suggest that they likewise do not substantially reduce the likelihood of surgery later. There was one research study published in February that actually showed the opposite; patients with pinched nerves in their lower back receiving injections showed less pain relief than a control group who received no injections. The JAMA authors are now recommending against injections. What are the alternatives? Here are :
1. For those with above average weight, especially belly fat, weight loss can be very beneficial.
2. Strengthen the back muscles with more exercise. It could be as easy as taking longer walks, swimming or riding a bicycle.
3. In a journal called The Clinical Journal of Pain, doctors recommend yoga or Pilates as a somewhat more aggressive approach that has showed good results.
It does not have to be confusing. According to some physicians, we seem to have made a symptom into a diagnosis. That is to say that pain is the result of something being wrong, and we ought to treat the source of a problem. Yet, most doctors do not like to prescribe long walks or losing weight, because patients ask for a "quick fix" to their problems. We have come to view pills as a solution to our problems instead of changing our lifestyles. I have talked in other postings about helping older adults to have more active lifestyles, because it will be helpful for their sense of well-being. Being more active, it seems, also will be good for addressing low back pain. Do it in small measures at first, but be persistent and grow the number of minutes, laps, blocks or other measure of investment in an active life. If you as a caregiver are walking with your older loved one, you also may find that the social activity of conversation is a health boost. Make sure their shoes give them solid support. The pain may not totally go away, but chances are that there will be relief at least during the exercise. And the relief can continue to grow. Charlotte Bishop is a Geriatric Care Management professional 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.
As a geriatric care manager, I have the chance to work with all manner of caregivers and the elders or others with special needs for whom they care. Sometimes a caregiver becomes significantly more than the person who may help a loved one with shopping, cleaning or other personal needs. There are occasions when that individual becomes sufficiently frail or mentally compromised that they need the support and control of a guardian.

I recently spoke with an attorney, Gordon Gault, who specializes in trusts, wills and probate among other legal areas. We talked about what a guardianship means and when it is appropriate as well as how it comes about. Gordon first explained that a guardian is substantially different from just a caregiver in that a guardian must be appointed by a circuit court judge. That appointed guardian is then able to act on behalf of the individual who is either under the age of 18 or is deemed disabled in some other way.

How can a guardian be useful? I have talked about elder abuse and fraud in another blog posting. A guardian can be appointed when it is concluded that the individual is giving away money or other assets to individuals who may be manipulating to their own ends. This appointment is intended to protect the individual and only happens after a court hearing complete with a physicians’ or other professionals’ opinions being weighed.

I have talked about powers of attorney for health care and for finances in an earlier blog posting, but a guardianship clearly takes this up a notch. But it is important to recognize that not only must a judge be convinced that the individual in question is unable to take care of themselves, but that judge also will oversee the guardian’s activities. As you can see, a guardianship pretty much takes control of an individual’s affairs, but this whole process does not all have to be left to attorneys. Gordon highly recommends that anyone who has a family member growing incompetent, get the powers of attorney signed as a first step. Anyone over age 60, he says, should sign these POA papers so that they can be available should a need arise. And later if you have to get a guardian appointed, you may be able to do it on your own if it is just the individual and their care. If it is an estate worth more than a couple thousand dollars, according to Gordon, you will need an attorney for the paperwork.

If you have questions, please feel free to reach out to Gordon Gault using this link. Gordon is a Chicago-based attorney.

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.,geriatric care manager Chicago,geriatric care Chicago

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It was the extended family that took care of the children as well as mom and dad as they aged during much of the last century. Today life is both different and complicated. The family has changed in numerous ways to challenge the old models of caregiving. Everyone lives anywhere but “here,” the rates of divorce approach 50%; intimacy lasts well into older loved ones lives and non-traditional families have earned their rights. Consider:
1. Who takes care of mom or dad when they are divorced. Appreciate that when one of your parents cannot be there for the other once they are divorced. That may mean that your role as a son or daughter caregiver may come into play earlier than otherwise would be the case. Be alert to home safety issues as well as how well mom or dad ambulate, how fresh the food in the fridge is and either attend doctors’ visits with them or engage the services of a care manager to help with any of these.
2. Will residential care options be welcoming for gay families. New options to accommodate all lifestyles are becoming available every day, but be aware of old biases that can persist. If the care you need does not accommodate the individuals you are or your gay parents are, then take your business elsewhere. Consider the places that have been welcoming for your younger needs will have connections to similarly welcoming places for aging needs. Many cities have devoted directories of such vetted services. In Chicago, it’s the Pink Pages for the LGBT community.
3. How do we address intimacy among older adults as they age? Remember the “awkward conversation” you may have had with mom or dad as you were coming of age? Well, now it’s your turn to be the intimacy advocate for your older loved one. You may have to ask the tough questions of their caregivers or the facilities to which they move once they leave their homes. Today’s 80 may be yesterday’s 60 in more ways than you had considered, so be prepared.
4. Distance caregiving is the stress of anyone with older parents and a family, or job, or a life of their own. Based on our experience, distance caregivers need to focus on the things that can be done at distance. Arrange for what can be delivered by a third party, like meals; help by becoming a signer on mom or dad’s account to help pay bills and balance the check book; or find a local care manager who can be your eyes and ears when you can’t be around. And keep in touch with neighbors and friends.
I will be coming back to these themes in future postings, but I also strongly encourage you to attend a caregivers’ forum addressing these issues this Thursday, November 19 at St. Matthew’s in Evanston, Illinois. It will be an ecumenical program in the main Parlor at 7 p.m. CST. Enlarge the map on this page or go to: http://stmatthewsevanston.org/. Two of CCM’s staff will be co-hosting the event. Bring your questions…and contact us if you need help with respite care because you are caring for an older loved one and need that help to get to the event! 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.
Dementia is one of the topics to which those of us who are geriatric care managers (GCMs) devote a fair bit of attention. In our day to day work and in my blog I have often talked about how caregivers can best communicate with, and care for, older loved ones who may be experiencing the cognitive deficits of Alzheimer's Disease or other forms of dementia. In this posting, however, I am going to share with you a bit of good news for caregivers and other individuals in their middle years who wish to take positive action to avoid dementia themselves. Yes, there are steps that a middle aged individual can take that will quantifiably reduce their risks of dementia, at least according to long term research recently released from the University of Eastern Finland. Very simply, what the Finnish researchers set out to do was study what kind of influence healthy diet could have among individuals from midlife as they aged. The researchers developed an index which helped them to quantify what constituted a "healthy diet" versus what they considered to be an "unhealthy diet." Healthy foods included unsaturated fats from milk products as well as fish, fruits, berries and vegetables. Unhealthy foods, on the other hand, included saturated fats, salty fish, sweetened drinks, other sweets, eggs and sausages. At the end of fourteen years, those who had eaten the healthiest foods had a 90% lower risk of developing dementia than those whose diets were the least healthy. These individuals started the program at about fifty years of age and the final assessment was in their mid-sixties. Those participants who had the highest consumption of saturated fats at the outset of the study were at higher risk of being diagnosed with "mild cognitive impairment" at the 21 year point in the study as well. This link between saturated fat consumption and incidence of cognitive impairment was consistent among the panel of participants. But there was another finding about coffee that may come as something of a surprise. They found that the "sweet spot" was three to five cups of coffee a day. That is to say the researchers found that those who consumed fewer than three as well as those who consumed more than five cups of coffee a day had higher risks for developing dementia over the courses of their lives. Something of a "happy medium." What should people in their middle years make of this study? The researchers had used this measure of a healthy diet based on the sum total of what a person consumes because they argued that there are a lot of interactions across foods and nutrients. That said, it also makes it difficult to point to a single food that is the miracle "dementia stopper." In reality, maybe it is just that...that there is no one food that is going to make us healthier or one that will make us inherently less healthy. If you want to make it to your later years without as great a fear of cognitive decline, should you eat less saturated fats and consumer more fruits, berries and vegetables along with an average dose of coffee. These researchers would probably say that it couldn't hurt. 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.
In a season with snow already blowing, we may think more about "winter-proofing," but I would like to continue with "fall-proofing." In my last posting, I wrote about how common falls among older adults are and some home improvements that can reduce the risk. I would like to take this conversation a bit further by talking about what are referred to as the intrinsic and extrinsic risk factors for falls. You will see that these offer two more "big picture" ways to both assess an older loved one's fall risk and to safeguard against those risks. Intrinsic Factors: The intrinsic risk factors are those that an older adult carries with them wherever they go, the most common simply is age. With more birthdays will come a decrease in muscle strength and tone, diminished vision and a decline in agility. And with age will come some chronic conditions that may not have been an issue when a person was younger. Increased age also translates into decreased bone density which simply means that the falls that a younger person can incur without complications now can become a hip or long bone fractures for a more mature adult. All of these risks conspire to create challenges to an older person's ability to maintain their balance. Extrinsic Factors: The extrinsic risk factors are those that are introduced to the older person. Many medicines or treatments can cause dizziness by either reducing blood pressure or by interfering with the inner ear's balance. I talked about loss of strength as an intrinsic issue, but a loss of muscle mass in the feet for an older person whose shoes therefore do not fit as snugly can pose its own imbalance and fall hazard. Alcohol consumption can be an extrinsic risk as older individuals' tolerance for alcohol is diminished. And the dehydration that can come from alcohol or any diuretic consumption may cause dizziness. So, if you are a caregiver to an older loved one, what can you do to address what seem to be the human forces of nature and aging? Here are some suggestions from the Centers for Disease Control. Encourage your older loved one to: • Exercise. Regular exercise strengthens muscles and bones for better balance and resilience. • Inventory the meds. Ask a local pharmacist or their primary care provider to review all prescription and over the counter medications for potential interactions or unwanted side effects. • Schedule a regular eye exam. What your older loved cannot see can hurt them, so have their vision checked at least once a year. • Rise slowly. Encourage your loved one to slowly get up from a chair or their bed to avoid the light-headedness that can result in a fall. • Wear shoes. Shoes will give a surer footing both inside and outside. Barefoot or slippers do not give the support or sure footing of properly fitted shoes. • Turn on the lights. Check throughout your loved one's house to upgrade where possible to brighter bulbs and add lighting to any dark or shadowy areas. 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.