Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • caregiverChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 5

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

Okay, "Grain Brain" is not something that immediately tells you what it is all about. Grain Brain is the phrase that neurologists and other brain scientists are using to describe a link between blood glucose levels from high carbohydrate consumption and dementia. A book by the same name is going into its 15th straight week on the New York Times bestseller list, so the concept is getting a lot of attention. But what does it mean for you or an older loved one in your orbit? In a scientific study recently published in the prestigious New England Journal of Medicine, researchers followed a large group of men and one of women for an average of almost seven years. During this nearly seven years they regularly measured the individuals fasting blood glucose levels. At the end of the study they found that people with higher blood glucose levels were more at risk for developing dementia that those whose levels were not as high. They found this to be true even with people who did not have diabetes. It is true, that this kind of study cannot say that increased blood sugar levels actually cause dementia, but the link is sufficiently clear that the New England Journal would publish the findings. Scientists also find that not all grains have the same negative effect on cognitive ability. Those with the highest gluten content seem to be the worst offenders. This is not the first research to show negative health outcomes associated with elevated blood sugar. Researchers have well-established proof that a high carbohydrate diet and the associated elevation of blood sugar poses a risk to one's heart and to the immune system. And there are other studies. in a 2012 study in the Journal of Alzheimer's Disease, researchers reported that risk for cognitive decline was 89% greater among those on a high carb diet; those on a high fat intake diet saw a 44% decrease in their risk for cognitive compromise. And researchers in another British journal, Lancet Neurology, estimated based on their findings that as many as 54% of the cases of Alzheimer's Disease in the United States could be avoided with exercise, weight reduction and steps to reducing blood pressure. This last study really drives home a great point. If you are a caregiver to an older loved one, you both will see great returns on a few basic investments of time and effort. Increase the daily amount of exercise, reduce the carb intake and the rewards will be weight loss, reduced blood pressure, a healthier heart, a more vigorous immune system and more acute cognition. Sounds like a really great return on investment to me. So, will you and your older loved ones be among those who avoid the "grain brain?" 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.
The most common question I hear after "What is a geriatric care manager?" is, "When do I know that we need a GCM?" It may actually be more accurate to frame the question as 'When would my family benefit from a care manager working with us?" And that is when I usually respond with a question of my own, "What is it that encouraged you to reach out to me now?" Usually there is an event or a culmination of events which encourage a person to look for a solution to a problem, an answer to a question or just plain help. Here are five of the common circumstances people with whom I speak talk about:
1. There has been a sudden event in your older loved one's health, and you are wrestling with what to do. This can be a stroke, a heart attack, a fall or just the most recent trip to the hospital with a condition that has been worsening. It represents one of those forks in the road where it seems that keeping on with the way things were will not be adequate, and the caregivers need to know their alternatives. GCMs have answers.
2. The caregiver in your family seems to be approaching "burn out." Caregiving usually falls to one of the adult children in a family, typically the daughter or the one who lives closest to mom or dad. This lead caregiver wants to do all they can, but there may not be enough hours in the day, and the guilt about not delivering may keep them from asking for help until you see the signs: fatigue, forgetful ness, irritability, depression or other signs they are overwhelmed. GCMs help the older loved one, to be sure, but they also are there for the caregiver.
3. It may be clear that something needs to be done on behalf of your older loved one, but the family does not know or cannot agree on what to do. A GCM has answers, because this is what they do. Think of a GCM as a "wedding planner" for getting older. A GCM does not bake cakes or cater meals, etc., but they can lead you to the best professionals who do. A GCM also can be a helpful mediator to help get everyone back on the same page for mom or dad.
4. If your older loved one does not seem to be getting the benefit from their care providers or they seem anxious around the care attendants, follow your instincts. A GCM can spot elder abuse and respond with the advocacy necessary to assure your older loved one's safety and well-being.
5. Your older loved one may just be confused, but it may also be signs of a more serious deterioration of their faculties. A GCM will help by finding a diagnostician to assess your older loved one's capabilities. A GCM also will help to assess if your loved one would benefit from social activity, better nutrition, exercise, etc.
These are just a handful of the kinds of first conversations I often have with those who reach out to us. You will find much more on the web site for the national association who accredits us as geriatric care managers. If you are a caregiver to an older loved one and you have questions, visit: CareManager.org 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.
In health care some basic rules apply, no matter what the medical condition. Number one is that prevention is better than treatment. Number two is that early detection is better than too late…especially too little too late. And now for the “breakthrough;” all of this is changing for the better in Alzheimer’s disease. At the most recent meeting of the American Neurological Association new research was shared that showed not only a very early way to detect Alzheimer’s disease, but the test itself is quite easy to administer. Physicians had been able to detect one of the key biomarkers of Alzheimer’s, a biomarker that identifies if a patient has amyloidosis forming in their brain, but that test required a lumbar puncture for the fluid needed for testing. And add to this PET (positron emission tomography) scanning to confirm the manifestation of the disease. Definitely not tests everyone would want as part of their annual physical, let alone afford to have done with any regularity. Scientists at Washington University School of Medicine have found a way to detect this Alzheimer’s biomarker in a simple blood test. So, it’s easy, but the best part is that the biomarker can be detected in the blood as much as 20 years prior to any other signs and symptoms of the disease. In fact, the researchers have found that an early positive blood test seems more accurate than the PET scanning. That is key, because once a person has the symptoms of the cognitive decline that is Alzheimer’s, the damage is done. None of the current treatments do any more than slow the progression of the disease that has already taken root, and even then only slightly slowing the progression. I’ve talked in the past about the medications currently available for treating Alzheimer’s disease. Three belong to a pharmacologic family of medications called cholinesterase inhibitors: tacrine, donepezil, rivastigmine and another is called memantine. Sadly, they merely slow the disease’s progression. But they have not been tried in really early stage Alzheimer’s disease. There is hope, therefore, that with a highly reliable and easy to administer early test for the disease that cognitive decline may be forestalled for much longer than when treatment was only introduced later in the disease progression. Wider availability of this blood test is still as much as four years out there, but for people who “have Alzheimer’s in their families,” this could be a great break through…and the beginning of a better chance in the fight. 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.
If you are a distance caregiver who will be home with an older loved one during these holidays, it is a great chance to have great conversation and to do a caregiver check up with your older loved one. You may beneficially find it helpful to raise some questions in your catch-up conversation to get a clearer sense of how well your elder is caring for themselves. Try these: 1. How are you sleeping? It is common knowledge that as we age, we simply need less sleep, but there is a real health difference between needing less sleep and actually suffering from insomnia. Consistent loss of sleep can be a real health risk in itself. Medical researchers find that as the hours of lost sleep pile up, blood pressure also rises. With rising pressure, there is rising inflammation or even weakening of blood vessel walls. People with genuine insomnia have twice the chance of suffering a stroke. Recommend end of day habits that will be less stimulating...like less television and more reading. It may be helpful to even suggest a white noise machine or some sound devices that mimic wave action or light rainfall to soothe your loved one to sleep. 2. Do you enjoy a good cup of coffee? At the opposite end of the sleep continuum, don't discourage your older loved one's coffee during the day. At the same time you can encourage decaf or a switch to non-caffeinated teas after the lunch hour to avoid stimulation that can fuel sleeplessness. But coffee actually imparts measureable health benefits. It has been demonstrated to reduce the risk of type 2 diabetes, heart disease and even some forms of cancer. 3. Do you have a place for safe walking? Walking just half an hour daily - or even six days out of seven - has had a demonstrably beneficial effect on reducing belly fat. And the effect is more than cosmetic. Walking or even jogging can reduce the middle and at the same time lower the risk of the three above: diabetes, heart disease and cancer. With any exercise, always encourage your loved one to consult their physician and to get comfortable and supportive footwear. 4. How are you feeling? This sounds like a vague question, but it is a chance to talk about anything that has changed lately. Research shows that unusual chest or arm pain are common precursors for heart issues in men. In women, it is not so clear. In fact, fewer than a third of women report discomfort before a cardiac event. But nearly all women have symptoms like indigestion, pain, anxiety or other cues before a heart attack. Listen for what may be brushed off as "nothing." If you are a caregiver to an older loved one, enjoy family and the holiday, and take the conversational opportunity to make it a healthy holiday and new year. 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.
In our book, How Do I Know You?: A Caregiver’s Lifesaver for Dealing with Dementia, we say: Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed. Stop the presses. New research suggests that there may be ways to slow the onset of the disease, if not prevent it. Let me repeat that. Some early results from a cognitive training regimen show that it may be possible to delay or slow the onset of Alzheimer’s disease. It may even be preventive, but that will take a very long term waiting game to see if the delays that are evident in the clinical studies can be sustainable. The results from this research show that a computerized cognitive training program in which patients were enrolled was able to reduce the risk for onset of dementia by 29% at ten years! In scientific jargon, that’s not nothing! Here is the other great part: those subjects who engaged in the most training got the most benefit. Does that sound like what we see in professional athletes …or professional anything? Those who put the most work into the program get the most out of it. Please let me tell you the rest of the story…Existing research has demonstrated that mental training that focused on retaining memory or processing did not reduce any risk for dementia. This present research was a study in Toronto among nearly 2,800 older adults whose average age was 73.6 years and who were living at home. They were assigned to three groups with three types of cognitive training: • memory, • reasoning and • processing speed. It was the processing speed groups which showed the results. Compared with a control group, those who went through this training had a 29% lower risk of developing Alzheimer’s. The memory training and reasoning groups were not different from their respective control groups after 10 years. All of this held true even after the investigators adjusted for any differences in other conditions or characteristics like gender, diabetes, depression or cardio-vascular health. Researchers are not sure why processing speed works this way, but it may be that working on processing speed builds up mental reserve. Maybe it’s like interval training for athletes. Mastering speed…bursts of work…grows their overall capacity. When the dementia erodes some of their cognitive capacity, they simply have more capacity on which they can draw. Clearly, a couple next steps will include following these people longer…but also trying to tap into what really is happening in the brains. That said, it stands to reason that if you can work on your “processing speed,” you will retain more ability over the long run. Get processing! 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.
This is not going to be a course in economics, but quite often caregivers of family members get more focused on how much respite care casts instead of on how much everyone benefits. Talking about costs first, there are three kinds of costs for respite care: dollars you pay, dollars someone else pays and what you can get for free. Starting with the dollars you pay, give careful consideration to the level of care you need for the older adult for whom you may be the caregiver. If the adult in your charge needs help with a whole range of activities of daily living such as eating or toileting, then there will be a higher hourly rate in order to get qualified respite care. If, you are closer to the other end of the continuum and mom or dad can get around quite well, but need to be watched so that they do not wander, then you may be able to save significant dollars by simply engaging the services of an aid or similarly-trained individual. Getting respite care for free? First, don't forget to consider other members of your own family. Even a brother or sister who has a day job can offer respite care in off hours or on weekends. Get to know other caregivers in your own circle of friends so that you can get some respite when one of them is willing to watch your mom or dad along with their own and vice versa. It is good for everyone when your respite becomes their chance to socialize. Check out resources for Chicago senior services, local community colleges or even high schools for students who either need to generate hours for community service or need hours toward course requirements in social work or other helping profession. And consider the following resources that may subsidize respite care:
Most important, don't forget the benefits of respite care. The most important of which is you will do a better job caring for someone else when you care for yourself.
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.