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

I Miss the Scams That Used to Be Easier to Spot
It was probably ten years ago that my husband’s mother was caught up in a telephone scam on her...
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September 26, 2023
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Lessons from Margaritaville
Jimmy Buffet has left a multi-faceted legacy…his distinctive musical style and lyrics, his upbeat and his laid back lifestyle...
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September 12, 2023
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The High Cost of Wellness
Once in a while “yesterday’s news” is also tomorrow’s news. Earlier this year you probably heard or read that...
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August 15, 2023
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It’s About You
This is personal! Yes, it’s about you! I’d be willing to wager, however, that most of you haven’t thought...
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April 18, 2023
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Follow Your Gut…You’ve Got No Choice
It was back in the sixties and seventies that so many folks embraced the mantra: “You are what you...
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April 11, 2023
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Another Side to the Story
It was just a year ago that Bruce Willis’ family disclosed that the actor would be retiring from acting...
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February 27, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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A Defensive Game Plan for Dementia Outbursts
It’s not just about forgetting or being confused. If you have a loved one with dementia, it is also...
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January 31, 2023
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Saying “No” May be the Right Answer
Saying “yes” when someone asks you to do something can be like eating candy. It feels right or good...
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November 15, 2022
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Doing Your Homework on Medicare Coverage
If you or an older loved one are at that age in the magical transition – otherwise known as...
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November 8, 2022
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In the Caregiver's Words

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Free White Paper: How to Administer First Aid for a Senior
It is no secret that caregiving can be an everyday challenge, especially when managing a full time job and other family responsibilities. As geriatric care managers, we help caregivers and their families through difficult transitions and provide options for tough decisions. We also aim to ensure a high quality of life for both the caregiver and the loved on in need of care. Discover tips about how caregivers can limit stress, boost energy, and stay positive in our latest white paper.

Inside "First Aid for the Caregiver"

Ways to stay positive and prevent reaching "the breaking point" as a caregiver

Tips on how you and your loved one can be prepared in case of an emergency

A self assessment to determine if caregiving demands may be taking a toll
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To answer your first question, Fisetin (pronounced fy-set-in) is a flavonol which is a class of flavonoids found in a number of plants and fruits or vegetables. They are antioxidants, and you may have seen some of the research on the flavonols in chocolate that are thought to help patients with mild cognitive impairment. Some other common sources of flavonols are onions, kale, lettuce, tomato, grapes, berries, tea and red wine. One of the rules of thumb is the greener the leaf, the more of the flavonols the plant will contain. Back to fisetin. Some researchers at the Salk Institute for Biological Studies have published some scientific work based on animal studies that show promise for fisetin's ability to protect the brain's memory from the inexorable degradation of Alzheimer's disease. They have done this in mice, and the scientists think that fisetin has a neuroprotective capability that helps the memories of mice in laboratory tests. The clinical test used three groups of mice. Two groups consisted of what are termed double-transgenic Alzheimer's disease (AD) mice. The third group was the control, and these mice did not have the Alzheimer's transgene. Mice in one of the first two groups were fed fisetin at three months of age until they were nine months old. The other group received no fisetin. Scientists use a water maze as a standard test of mouse learning and memory. The mice without the fisetin did not perform well in the mazes. Those who had been fed the fisetin, however, performed as well as the mice in the control group. Tests were repeated again at 12 months of age, and the results were very much the same with the fisetin mice doing as well as the control mice. Researchers are not prepared to jump immediately into human subject trials, but there is work underway to better understand at the molecular level how fisetin may be working on mouse brains. Ever hopeful, the scientists are also investigating whether fisetin offers any hope of actually reversing the neuro-degradation of AD. What do we take away from this research? Well, animal studies cannot provide a sound rationale for all caregivers to go out and stock up on fisetin rich foods to help an older loved one forestall Alzheimer's progression. But is it a good idea to encourage your older loved one to consume foods rich in antioxidants? probably yes, but as with any dietary, activity or medication change, always consult with your loved one's provider. 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.
According to research reported in the New England Journal of Medicine, approximately one in five Medicare beneficiaries discharged from a hospital will end up back in the hospital within thirty days. It usually is for the same reason they were admitted originally. This means that it not only is bad for the patient who has to go back to the hospital, but it typically represents an expense that could have been avoided. And it is these sorts of statistics that give me a chance to talk about a question I get asked a lot: “What is it that geriatric care managers do?” Let me explain.

The typical picture of an older patient who is readmitted is one without a lot of social support locally, and this older patient:
- May not fully understand their discharge instructions.
- May not be taking their medications as instructed.
- May have complications they cannot handle.
In most of these cases, if the patient had had someone to be the information processor, interpreter and implementer, the readmission would not have been necessary. A geriatric care manager would be available to make sure the discharged patient understands any limitations on activity that the medical professionals have stipulated or understands how active they should be to recover from being in bed for the number of days they were in the hospital. A care manager can help to make sure that all the patient’s medications are organized or that a new prescription gets filled and its dosing gets integrated into the daily regimen. (Remember that seniors are about 13% of the population, but they represent about 30% of all the prescriptions written.

The National Transitions of Care Coalition offers a checklist your care manager or you as a caregiver can use with an elder for whom you are responsible as they leave the hospital:
1. Have a method in place to assure safe use of all medications.
2. Have a plan to facilitate the big change from hospital to home.
3. Engage all members of the family and personal network of the patient.
4. Share important information with all care providers and caregivers.
5. Find and read any educational materials about the patient’s condition.
6. Facilitate any follow-up provider visits, therapy, etc.
As a caregiver (or through your care manager) advocate for the patient to physicians, discharge planners or other providers responsible for the continuity patient’s care.

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.
What is the most widely used drug by seniors? It’s the same one that is most widely used by all adults: caffeine. It’s estimated that about four in five adults world-wide consume at least one caffeine-containing beverage daily. I am going to share with you not one, but three quizzes on this go to “medication.”
1. Considering caffeine and some common medical conditions, which of these is true?
a. Patients with chronic kidney disease who drink caffeine have significantly lower mortality.

b. Caffeine improves motor function in Parkinsonian patients.

c. The risk for rosacea is dramatically increased with caffeine consumption.
Odd as this may sound, it is “a”. People with chronic kidney disease have a lower risk of dying if they consume caffeine. It was a study among 5,000 chronic kidney disease patients, and those who drank caffeine drinks had a 25% lower risk of dying. Drinking more caffeine did not get more benefit from the caffeine.
1. Which one of these is true about caffeine and heart health?
a. Consuming unfiltered coffee significantly increases the bad cholesterol and triglycerides in the blood stream.

b. Moderate caffeine consumption increases the likelihood of elevated blood pressure.

c. Regular caffeine consumption increases the deposits of calcium in the arteries.

Again, it is “a”. It is all about how the coffee is prepared, because unfiltered coffee can have some bad effects on blood cholesterol. The lesson here must be that filters good; no filters bad.
1. Although this may vary by individual, what is the “toxic level” of caffeine in the blood system of a healthy adult?
a. 400 mg per deciliter.

b. 600 mg per deciliter.

c. 800 mg per deciliter.
Okay, you may be on to me if you said “a”. There is variability across individuals, but 400 mgs is the limit, so more of a good thing can be a bad thing. And the very young have even lower threshold which is a bit scary with all the high caffeine canned beverages available to your people these days. By now, you have to be wanting to know how many milligrams in a cup of caffeine. The answer is about 95 milligrams, but of course, that may vary depending on who is making the coffee. Now, how did you do on the test? If you are satisfied with your score, figure out how much caffeine you have had so far today to see if you should reward yourself with a trip to the coffee maker. 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.
October 29th is World Stroke Awareness Day. We may not be hearing as much about strokes as we once did, because in the United States the incidence of strokes is on the decline. Just under 800,000 people will have a stroke this year, and three-quarters of them will be over the age of 65. The reason the incidence in the United States is on the decline is because Americans are doing a better job of managing their blood pressure and because fewer of us smoke. Because so many of the stroke victims are older adults, it is important for caregivers to help their loved ones to further prevent stroke. With the proper preventive measures fully 80% of strokes could be prevented. Here are some suggestions for preventing strokes:
- Know your loved one's blood pressure; this is a routine part of anyone's annual physical, but you also can get a screening at health fairs or even your retail pharmacy using a machine;
- Know the signs of atrial fibrillation, a condition in which the heart rate goes so high that it fails to pump blood effectively which can lead to pooling and clot formation;
- Stop smoking - this is just one more very good reason to kick the habit if your loved one has not already done so as smoking doubles a person's stroke risk;
- Monitor your loved one's cholesterol intake and blood levels - any total cholesterol count above 200 is cause for concern;
- Manage blood glucose levels in your loved one if they are a diabetic - one of the complications of diabetes is poor circulation which can lead to stroke;
- Diet and exercise are part of almost every approach to better health - boost your loved one's intake of fruits and vegetables (five portions a day) and reduce intake of trans-fats and salt;
- Manage alcohol intake - most doctors recommend limiting alcohol consumption to two or fewer drinks a day.
The good news about managing these risk factors is that not only will you as a caregiver be reducing your loved one's risk of stroke, but you will be adding to their quality of life as well. In addition, you may find that these healthy habits also are contagious which can results in a healthier caregiver. Stroke prevention can become a win-win! For more information, I recommend checking out the web site for the National Stroke Association (http://www.stroke.org/site/PageNavigator/HOME). 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.
Earlier this month, Kaiser Health News published an update on what the Centers for Medicare & Medicaid Services (CMS) is doing to reimburse for more services that may not be strictly medical…but offer a health benefit. With Kaiser’s permission we are releasing their summary of these changes here. Air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals may be among the new benefits added to Medicare Advantage coverage when new federal rules take effect next year. Earlier this month CMS expanded how it defines the “primarily health-related” benefits that insurers are allowed to include in their Medicare Advantage policies. And insurers would include these extras on top of providing the benefits traditional Medicare offers. “Medicare Advantage beneficiaries will have more supplemental benefits making it easier for them to lead healthier, more independent lives,” said CMS Administrator Seema Verma. Of the 61 million people enrolled in Medicare last year, 20 million have opted for Medicare Advantage, a privately run alternative to the traditional government program. Advantage plans limit members to a network of providers. Similar restrictions may apply to the new benefits. Many Medicare Advantage plans already offer some health benefits not covered by traditional Medicare, such as eyeglasses, hearing aids, dental care and gym memberships. But the new rules, which the industry sought, will expand that significantly to items and services that may not be directly considered medical treatment. CMS said the insurers will be permitted to provide care and devices that prevent or treat illness or injuries, compensate for physical impairments, address the psychological effects of illness or injuries, or reduce emergency medical care. Although insurers are still in the early stages of designing their 2019 policies, some companies have ideas about what they might include. In addition to transportation to doctors’ offices or better food options, some health insurance experts said additional benefits could include simple modifications in beneficiaries’ homes, such as installing grab bars in the bathroom, or aides to help with daily activities, including dressing, eating and other personal care needs. “This will allow us to build off the existing benefits that we already have in place that are focused more on prevention of avoidable injuries or exacerbation of existing health conditions,” said Alicia Kelley, director of Medicare sales for Capital District Physicians’ Health Plan, a nonprofit serving 43,000 members in 24 upstate New York counties. Even though a physician’s order or prescription is not necessary, the new benefits must be “medically appropriate” and recommended by a licensed health care provider, according to the new rules. Many beneficiaries have been attracted to Medicare Advantage because of its extra benefits and the limit on out-of-pocket expenses. However, CMS also cautioned that new supplemental benefits should not be items provided as an inducement to enroll. The new rules “set the stage to continue to innovate and provide choice,” said Cathryn Donaldson, of America’s Health Insurance Plans, a trade group. “CMS is catching up with the rest of the world in terms of its understanding of how we keep people healthy and well and living longer and independently, and those are all positive steps,” said Ceci Connolly, chief executive officer of the Alliance of Community Health Plans, which represents nonprofit health insurance plans. Some offer non-emergency medical transportation, low-cost hearing aids, a mobile dental clinic and a “grocery on wheels,” to make shopping more convenient, she said. 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.