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

Too Good to Be True
With over 300 clinical trials on vaccines for COVID19, it perhaps is not a surprise that at least two...
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December 1, 2020
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The Other Global Health Crisis
Wearing a face mask is the new front line of defense against the spread of the war on COVID-19,...
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November 17, 2020
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One More Sign of COVID?
I have written about Alzheimer’s disease…a lot, its warning signs and caregiving probably more than any other topic. Even...
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October 6, 2020
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None of the Above…
While everyone is awaiting the next vaccine to prevent COVID-19 or help in the treatment of the condition among...
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September 29, 2020
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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 2020
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Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
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July 21, 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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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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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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In the Caregiver's Words

Recent Client Praise

At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a frequent topic in our discussions. I have asked Gregory Peebles to talk about home safety from the vantage point of his experience. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping older adults and those who are less independent by providing resources and support to help them live their best life. An Associate Care Manager, Gregory has been a part of our team for over a decade. – Charlotte Home. Not only is there no place like it, conveniently located wherever you hang your hat, but it also fits--like an old, comfortable shoe. One of the things that makes “home” high on our list of favorite places is that home is where things work the way we expect them to work. Reach for it, and whatever it is will be their at your fingertips. We don’t have to think! (or so we (don’t) think…). We just do. But comfort can be a slippery slope, and it can get us into all kinds of unplanned trouble. As our older loved ones age, inconveniences in the home can turn into safety hazards. As we watch our parents age, we begin to feel deeply our own mortality and—if we’re not careful—to slip into a pattern of denial, the manifestation of which is the attempt to keep life as it exists in our memories perhaps longer than is advised, all to maintain comfort and status quo. Ironically, this attempt to maintain status quo may end up as a major catalyst to change in our lives unless we bring some consciousness to our scenario. So we need to look around, and I mean Really Look – not with the eyes we had when we were children in the house, or the eyes we had while we were rearing children, because those eyes both literally and figuratively no longer exist. What do we see? Here’s what I see most when I’m asked for advice: Stairs
- Steep stairs are not only difficult to manage for less-abled bodies, but they are a huge fall risk.
- Depending on where the family is in its journey, hand rails may be enough, but a stair lift may be necessary.
Cords
- The serpent of the salon, these may be “hiding in plain sight” ready to cause a fall.
- Make sure all floor surfaces are clear in trafficked areas, and, if carpeted, no holes worn through.
Mats
- Scatter rugs become “shatter rugs” if not well-secured to the floor.
- Use adhesives to secure in place, or get rid of any unnecessary rugs.
Washroom
- Water, rugs, and ceramic or steel surfaces all in one place make this the most accident-prone room in the house.
- Make sure it’s well-lit and that the shower has grip bars for balance, or even a chair for stability.
Kitchen
- Timers for appliances are a godsend in this room; auto-off coffee makers and the like will relieve fire anxiety.
- When cabinets are too high to reach, or too low, they may stretch an older adult’s limits. Make sure everything important is in easy reach.
If you’re all set from this list, but still unsure, call us! We’ll be glad to come out and give a look to ease your mind, or to begin the next conversation. In the next blog post, we’ll give you CCM’s best practices for when a change of address for a loved one may be imminent. 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.
How many times have we all seen the commercial with the plaintive actor on the floor crying, "Help, I've _____ and I can't get up." No one would ignore a plea for help from an older person who has fallen and cannot get up. But a lot of caregivers may be ignoring a similar plea with all of the health threat that a fall can represent. It is just that this fall is in slow motion. And it goes like this: "Help, I am so fatigued that I don't feel like getting up." Tired often does not get enough attention in medical circles, but it is a common symptom reported by people age 65 and older. We tend to discount fatigue, because we cannot accept that a person who has retired and now enjoys six Saturdays and a Sunday every week could not be well-rested. And if you are a caregiver to an older loved one, you may find it a bit challenging to muster the sympathy for your older loved one when you already are stretched across your responsibilities for your children, your partner, your job and... Yet, we should all pay attention to the subjective complaints of fatigue in our older loved ones, because tired can be a symptom of more serious medical conditions and because tired can lead to serious physical decompensation. Let's start with the other medical conditions for which fatigue can be a warning sign. Perhaps the most common clinical condition that presents with fatigue is depression, itself one of the most common comorbidities of aging. Depression often can arise from the hallmark aspects of getting older - loss, diminished physical capacity and social isolation to name a few. Chronic fatigue also can be a symptom of sleep apnea, restless leg syndrome, fibromyalgia, chronic obstructive pulmonary disease and any number of heart conditions. Poor quality sleep may also be indicative of musculoskeletal conditions or pain. If your older loved one is consistently tired, it may be time to accompany them on a visit to their physician for an assessment and a conversation. Sleepiness can also be just one more step along the slippery slope to frailty. Fatigue can be a strong disincentive for your older loved one to be as active physically as they once may have been. Fatigue also puts a damper on appetite which in turn reduces the quality of the fuel the body consumes to run the body's engine which leads to increased tiredness and low motivation for physical activity. And all of this translates into decreased mobility and frailty. Medical professionals refer to frailty as a "pre-disability." So, if the tiredness has gone on for an extended time, begin to look for signs of genuine frailty. No surprise, the signs include exhaustion ("hyper fatigue?"). Frailty also is predicted by weakness in grip and slower walking pace. And by weakness, we mean a quantum reduction in ability to grasp, and by slower we are talking a fraction of former strides. All of these point to diminished physical activity. Think of frailty as one step away from a permanent reliance upon a walker or wheelchair. The next time you are speaking with an older individual who reports being consistently tired, it may be time to wake up and take stock of their overall health. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@cr eativecaremanagement.com.
I left off last week with the first five (of ten) tips to healthy aging. Before I continue with the five that comprise the rest of the list, I want to point out that this is not meant to be an onerous list that no one can ever complete. It is about your loved ones doing their best on as much of the list as possible. And as with Rome, it will not be all done in one day. Picking up where we left off, here is 6 through 10:
1. Filling Out an Advanced Directive – In 1990 Congress passed the Patient Self Determination Act which allowed adults to have a say in how their life decisions would be managed if they were unable at a particular moment to have a say. Talk with your older loved one about “what they would want if.” Some states have the form on line, but an attorney can easily be consulted to help dot the “i’s” and cross the “t’s”.
2. Be active – Your older loved one does not have to join a gym, take a course in Pilates or run a marathon unless they wish to do so. But they do need to keep the parts moving so that they will work better. Regular exercise such as long walks or swimming also helps stave off high blood pressure, diabetes, arthritis and depression. Or if they say they would rather read a book, show them how to do that … on a stationary bike! It’s worth the sweat.
3. Input affects output – We all have heard that we are what we eat. It’s true. Steer your older loved ones to something new and delightful like fresh foods over processed foods or organic produce over the old alternatives. Encourage new recipes and portion control. Regarding portions, a rule of thumb is to target eating until we feel 80% full.
4. Active Applies to the Brain – Some cognitive decline is just part of the aging process, but encourage your older loved one to not just give up on their brains. And this is not limited to just doing the Sunday crossword puzzle. Anything that stimulates the brain is good for the brain. Think of the brain as a muscle that needs to work out to be its best.
5. Aging is Not a Solo Act – More than one in four older adults lives alone, but that does not mean that they need to consider their residential status to be some sort of “solitary confinement.” Getting out for coffee is not about the coffee, it is about the company they keep.
I said this last week, but please allow me to repeat myself when I say that all of these tips are great counsel for anyone at any age. 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.
Okay, there may be more than five things you want to know about the coronavirus, but these five basics are what applies to coronavirus as well as to all new cases of viral diseases. First, always take special precautions with older loved ones, especially those who may have pre-existing conditions that may weaken their immune systems. Also more vulnerable are those with respiratory conditions that make them particularly susceptible to any airborne virus. Second, coronavirus is a novel strain which means simply that no one will really have any inherent defenses built up like we do for measles or mumps or other well-known bugs for which we can get inoculated or have the benefit of having dealt with them when we were younger. And we have no vaccines as we do for the annual influenza seasons. It also means that we are still learning about how bad it can be ultimately be. Third, in the age of jet travel no one is really more than about 24 hours away from a carrier of a virus. With the condition’s relatively long incubation period, virtually anyone can become a host to the virus that can reach them from anywhere else. The “almost good news” is that Wuhan is in Hubei province, some distance of the other major cities, not really on the main thoroughfares of even Chinese travel. Fourth, the coronavirus does not yet constitute a public health emergency of international concern according to the World Health Organization. But, avoid contact with people who have the disease already as well as animals and animal markets. (None of these are real issues here.) Personal hygiene needs to be stepped up: aggressive handwashing, covering your face if you sneeze or cough, fist bumps over handshakes and the rest of the usual. Fifth, avoid all travel? No, says the CDC, unless you are specifically planning on going to China – that travel should be postponed. Exercise caution, and be vigilant about fellow passengers who may be coughing, etc. But also keep this in context; we have already seen thousands of hospitalizations and numerous deaths from the current flu epidemic. This is still small scale…so far. And keep all of this in perspective … that it is a “developing story.” None of the domestic cases yet have been contracted from a patient here. When that happens, the steps may change. Until then, consider all of the above to be steps to avoid infection of any new viral strain, but also take steps early with any signs in your older loved ones or yourself. If you or someone you love do develop symptoms and are planning a medical visit, phone ahead to tell them what you may suspect. Your providers need to be as prepared as you do. 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.
With this posting, I am introducing a colleague and guest blogger, Pamela Holtzman, who is a therapist I know locally. Pamela is an R.N and L.C.S.W. who combines her medical background with a combination of cognitive therapy, traumatic release with EMDR and EFT and integrative psychotherapy, to facilitate wholeness and wellness, in her clients. Her perspectives on being well while getting older are worth sharing:

“Have you had that birthday yet which made you suddenly realize that you really are getting older? I don’t mean older in a decrepit, breaking down way. I mean older in a wiser, stronger, and more mature way. I had discovered that I had reached that phase during my recent 60th birthday “initiation by storm” as I came face to face with IRENE, the Class 3 hurricane that wreaked havoc at the doorstep of our home in the Bahamas. What followed was a week-long power outage, and a chance to do a lot of soul searching.

As a result of a life-long practice of maintaining a healthy mind and body balance, I was able to remain calm, peaceful, and resourceful throughout this life altering and potentially devastating experience. How can you stay balanced through life’s unexpected challenges:

Be Present – learn and practice living in the here and now, don’t worry about the past or future. No matter what life is offering, take time to do a morning quieting practice. Good options are yoga, Tai Chi, meditation, or anything that includes a level of mindfulness.

Be Healthy – have regular medial check-ups, and use a preventative approach to health. A good place to start is by eliminating the four poisons from your diet: hydrogenated fats, high fructose corn syrup, processed foods, and sugar. Develop and maintain a routine of ample rest, and follow a Mediterranean diet (high in fruits and vegetables, whole grains and cereals, nuts and seeds, oily fish, and olive or avocado oil, keeping red meat and diary to a minimum.) Try some new grains like farrow and quin. Make sure to drink plenty of water, and, of course enjoy a daily treat of dark chocolate.

Simplify – let go of what you don’t need. Clear that which creates clutter and/or complicates your life. This includes identifying and spending less time with ‘maintenance friends’ who rely upon you, but don’t offer reciprocity in your friendship. Decrease or eliminate activities that drain your energy, as opposed to replenishing your reserves. Remember balance.

Get Moving – of course there’s the physical benefits of exercise (increased bone density, muscular strength, endurance, energy, and better posture), but exercise also provides stress relief and improves mood. I have learned as I age –if I want to move, I’ve got to keep moving! It’s fun to mix up your routine and keep learning. Try Zumba, Nia, Barre, go to a dance class, or water aerobics. Keep exercise fun and playful, and do it every day.

Have a Massage – many enjoy getting one. But you don’t need to pay someone to enable your body to relax, detox and stimulate the lymphatic system. You can do reflexology for yourself on your hands or feet (it’s as good as a whole body massage.) Or try “dry brushing” before your shower, which natural detoxifies and is very stimulating.

Embrace Change – and recognize that change is good. It keeps your mind active, challenges flexibility, and opens up new ways of being in the world. Remember to soften into life, rather than contract in fear whenever you’re not familiar with a situation or are uncomfortable in life. Let go of the need to be right, to be heard, or be acknowledged. As you mature, you can learn to be comfortable with who you are without the need for outside validation.

Fill Your Soul and Spirit – learn to have fun. Think about what fills your reserves, what feels cohesive to your sense of self. For me, it is being with my grandchildren, or doing anything in nature. For you, it may be travel, volunteering service work, or just being home with a good book. You will be able to tell you’re being true to yourself because you will feel happy, rejuvenated and renewed.

If you want to continue to improve and grow as part of your aging process, it is necessary to continue working on balance and integration as part of your daily healthy lifestyle practice. Then, no matter what life challenges you face – you’ll be ready for them. For more information and techniques on healthy living, refer to my book Healthy Lifestyle Path of Wellness."

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 Charlotte Bishop.
Most of us probably think of selling or buying a house as something best done in Spring. I recently spoke with a Specialist in Senior Relocation who is a broker at Coldwell Banker, and she had a lot of good advice about when an older person can productively start thinking about selling their house and move, perhaps to senior residential living. Her advice begins with a very simple observation about when is the right time to move. She says that "now is always the right time to move." If you are having conversations with an older parent about possibly moving this holiday season, read what Allyn Rawling (allyn.rawling@cbexchange.com) suggests to help the discussion along.

       "The best time to sell a house is when you want to or have to...a sense of urgency helps make the selling easier. When an older family member is waiting for the market to come around or for warmer weather, it simply makes the decision and transition harder. The fact is that the market has started to come back and most buyers have also come to the realization that prices are not going to go lower on homes that are priced right. The freefall of the recession is over.

       But it is even more important that you as a son, daughter or caregiver follow mom's or dad's lead about possibly selling the house that has been the lifelong home to the family. Older adults have taken responsibility for their actions their entire adult lives, and the process will work best and the older adult will 'own the process' if they 'own the decision.'

       What you can do in these discussions with mom or dad is help identify the reasons for the move. It can be something as basic as not wanting to mow the lawn or shovel the walk any more that starts them thinking. For other older adults, it also can be a concern for personal safely or for medical security. In the case of the former, older adults feel more vulnerable to strangers at the door or just getting out to do their shopping. And if your older parent has had a 'medical scare' or they have a friend who has fallen and broken a hip, they may be looking for the peace of mind that can come from a senior residential community.

       If mom or dad do not get out much, they may also feel isolated. A senior residential community may provide the answers. Moving to senior residential communities can provide a lot of opportunities for interaction that do not even require the older adult to go outside or drive somewhere.

       It also helps to have people involved in any move decision who actually do it for a living and can gain the trust of your older parent or loved one. A social worker can talk about life's transitions, a 'stager' can talk about getting a home ready for selling, and there are professionals who can simply declutter a home for sale. It is ideal to be as minimally disruptive as possible in a residential transition."

You can contact Ms. Rawling at her email address above or phone her at 847/425-3746. 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.