Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • caregiverChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 7

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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Trusted Voices on COVID-19
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a...
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March 17, 2020
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One is Number One Threat to Seniors
We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to...
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March 10, 2020
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Helping Your Older Loved One – AND You – Avoid COVID19
All of us here know how to prepare for a blizzard, people in the South know how to prepare...
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March 3, 2020
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Part 2: Five Important Tips for Caregiving and Self-Care
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000...
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February 18, 2020
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Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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There is an ‘I’ in Caregiver: 5 Tips to Avoid Burnout
We all have heard of coaches exhorting their players to work together by saying “there is no ‘I’ in...
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September 25, 2018
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Singing is a Breath of Fresh Air for Caregivers
Associate Care Manager Gregory is a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on...
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February 12, 2018
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Insta-Gram: It’s a Date!
Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both a Certified...
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September 23, 2017
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In the Caregiver's Words

Recent Client Praise

Any discussion of hygiene - whether in an older adult or anyone else for that matter - is an admittedly subjective discussion. It is not just about taking a daily bath or shower. In fact, in many other parts of the world, a daily cleansing is considered a bit excessive, and some people of earlier generations did not necessarily grow up on the daily dousing we call personal hygiene. Everyone potentially has their own take on how frequently they wish to bathe, but hygiene also can be an indicator that something else is not quite right in an older adult.

When I get a call from a client who is concerned about their older loved one's hygiene, I start by simply asking if this is a recent change from old habits or if it simply the way they always have been. If it is just the way the habit has always been, then it will not be easily changed...if, in fact, it even should be changed. Old habits are deeply ingrained. But a change in personal habits can be the sign of something else at work.

In an earlier post, I had pointed out that loss in appetite can be a warning sign of depression. The same holds for an older adult who has lost interest in how they look or how they smell. Depression is a bigger issue than hygiene, and in fact, if the older adult addresses the depression with talk therapy or medication, if indicated, they may find a renewed interest in self-care and hygiene.

And as with appetite as I addressed in the last posting, a change in hygiene can simply be a product of the older adult's diminished ability to smell what you as a caregiver may find offensive. Conversely, you may find that your older loved one has dumped excessive amounts of cologne on themselves, because they cannot tell that they have given themselves an overdose of the good smelling stuff. Regardless, any discussion you may have with the older adult about something as personal as how they smell should be a very sensitive discussion.

Your older loved one also may also be finding it difficult to navigate the bath like they used to because of their diminished agility. And modesty may preclude them from asking for help. So if this is the case, consider enlisting the help of third parties like home care aids who will not be as threatening to their sense of propriety.

Forgetting to shower or bathe can also be a sign of a larger pattern of forgetfulness, so try to assess hygiene against the "big picture." Does your older loved one also miss appointments or forget to pick up their clothes from the cleaners? Maybe suggesting a calendar with dates filled-in with the "things to do" can be an assist, because we all can forget things. If the forgetfulness, however, is part of a greater disorientation, be alert to early onset dementia. Even if this forgetting is part of a dementia, don't immediately push the Alzheimer's panic button. Mild dementia can be exacerbated by poor sleep or even a medication that has a side effect of confusion. Diphenhydramine (branded Benadryl), an ingredient in a lot of over the counter medications, can precipitate some amount of forgetfulness in a person of any age.
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.
Tony Bennet has arguably been one of those “one in a million” kind of musical talents, but sadly he now also is one of more than five million. Mr. Bennett has been diagnosed with Alzheimer’s disease, a condition that has robbed more than five million people in America of their abilities to understand or participate in the day to day activities that we call living. Mr. Bennett was diagnosed four years ago at age 90 as his family began to notice differences in his behavior, his speech and in how he related to friends and business associates. Would you know if a loved one in your orbit was developing Alzheimer’s disease? Here is what to look for, because early detection can mean better accommodation of the patient by protecting them from accidents of daily living. If you notice anything in your older loved one (older means most typically above 65 years of age, but there are early onset cases) that shows they are not interacting as they used to, talk to their family doctor:
- Difficulty processing information or content becomes difficult, and it is because the Alzheimer’s brain does not make memories as well or perhaps not at all in advanced cases.
- Facial changes or changes in facial recognition may give them a blank, uncomprehending demeanor or they may not as readily recognize when someone is joking…they may come to not recognize a friend at all.
- Difficulty concentrating or finishing tasks reflects their inability to cognitively keep up as they used to with reading, games, music and activities that used to delight them.
- Inability to multi-task, because their cognitive capacity becomes overwhelmed with more than one focus, and ultimately even single tasks become too much.
- Disorientation with both time and place may make them more anxious with familiar places or events, and unfamiliar places like restaurants or venues outside home can be absolutely overwhelming.
- Difficulty with word finding can make conversation increasingly difficult for the Alzheimer’s patient to understand what is said to them, and it ultimately may lead to withdrawal into silence.
But please don’t be alarmed at every instance of a memory lapse, because we all have lapses…but we typically remember the elusive name or date if given time. There is presently no cure for Alzheimer’s, but there are almost 1,300 clinical trials into therapies in the United States alone, so there is hope. And staying healthy is the best way to avoid Alzheimer’s: mental and physical exercise, low carb diet, low fat intake and don’t smoke. 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.
What do hearing aids, exercise, support groups and travel have in common? They all are ways that individuals suffering from Alzheimer’s Disease, specifically, or dementia, generally, can fight these diseases’ progression. Even more important, they help to fight the personal isolation that accompanies these frightening conditions.

We often associate dementias with older adults and the stereotypic confusion that can characterize the individuals with the diagnoses. But it is not just a condition of older adults as the recent public disclosure of The University of Tennessee women’s basketball coach, Pat Summit, highlights. Ms. Summit is just 59 as she goes public with her diagnosis, and it helps others to understand that it can happen as early as 30 and 40 years of age. Younger onset Alzheimer’s Disease technically speaking is the manifestation affecting those under age 65, and there are 250,000 new cases in America every year. Yet, there are ways to fight the downward spiral of dementia.
1. Hearing aids may seem an unlikely fix for dementia. Yet, it is simplybecause hearing aids enhance the clarity of communication and therefore the connection between dementia patients and others that they help alleviate the isolation and bolster memory. When dementia patients can hear more clearly, that connection also helps calm the anxiety that they may otherwise feel when living in a world that is confusing. Hearing aids cannot “cure” dementia, but they can help a patient navigate more confidently.
2. Exercise can be a helpful boost as well as it improves the blood flow and releases calming endorphin into the bloodstream. For a variety of medical conditions, health care providers often talk about the role that “performance status” plays in a patient’s ability to cope. Being more fit helps dementia patients cope just as being fit also helps cancer patients while they fight a tumor or surgical patients as they recover from a procedure.
3. I had mentioned the importance of being connected for a person with dementia of whatever sort. Support groups become the new circle of friends who can truly understand what it is like. This is common across a whole host of medical predicaments from grieving widows and family to returning wounded warriors or recovering cardiac or orthopaedic surgery patients. Somebody else who has been there understands what co-workers, friends or even family cannot quite fathom.
4. Travel is a bit of all these. It is a way to have fresh new experiences that challenge a patient cognitively. When a person experiences what should be familiar settings like home as frighteningly unfamiliar, it can be reassuring to share travel experiences to strange and different places that – well – everyone will find strange and different as well.
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.
You’re seated with your frail mother in a jet at about 28,000 feet, row 15. You had volunteered to fly out to meet her and fly her back to your home, and you just took off moments ago. Mom had been unable to use her right side to any good effect for some time, and you are bringing her to your home so you can better care for her. You haven’t made specific plans yet, but you’re certain it will be a good move for her and for your family at home. The plane suddenly lurches downward. The air masks drop from the ceiling. What do you do? If you had paid attention to the in-flight talk as you got settled before taking off you would know that you are to secure your own face mask first, and then help someone with you if they require any assistance. Anyone who has traveled with any regularity has probably heard this so many times that they could probably recite the pitch themselves. But who thinks to apply the same lesson to the rest of their lives? The New York Times carried an opinion piece this past weekend by an author named Lorene Cary. Her book has a title that pretty much tells it all: “Ladysitting: My Year with Nana at the End of Her Century.” She digs deep into the unsavory aspects of caregiving in the 21^st century. It’s often not just transporting a loved one to the doctor or picking up groceries and doing a load of laundry. Caregiving usually starts with no training and then quickly moves into bathing the family member, learning the nuances of adult diapers and all of the other assorted “Activities of Daily Living.” It’s hard, unpleasant and seemingly relentless. One person who came up to me after I had spoken to a gathering some time ago introduced himself as having “recently graduated from four hours of uninterrupted sleep to four hours of interrupted sleep a night caring for his mother.” And did I mention that most caregivers to family members do all of this without pay? Ms. Cary cites a figure that I still find staggering. According to AARP’s Public Policy Institute this cottage industry we call caregiving would total nearly half a trillion dollars in revenue if all the voluntary caregivers were paid just minimum wage. Ms. Cary also raises a point that can easily get missed if we just translate this “caregiver crisis” as some call it into dollars and cents and hours spent. She says, “Too many people have to reconfigure their lives around a loved one’s disability.” She goes on to talk about a different kind of national debt based on what she labels our “Gross National Happiness Index.” If you are a caregiver, try a little exercise. First, in one column list all the activities you have directed to your care receiver this past week….the trips to the store, the in home tasks…everything. Next, make a list of all the activities in which you have participated just for yourself? If that second column looks a bit wane, start today to rebalance your books and begin by caring for the caregiver. It will actually make you a better caregiver as it also makes you a healthier and happier person! 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.
September is Alzheimer’s Awareness Month, and this is the third of four posts we’ll offer on the subject. I have been hoping to post with a subject line like “First Cure for Alzheimer’s Disease.” I would settle for “First Effective Treatment for Alzheimer’s Disease.” Sadly, neither of these seem even close to what we can expect anytime soon. But as I noted in an earlier post, there are nearly 3,000 clinical trials in progress on various tests, predictors or treatments of Alzheimer’s Disease. And 172 of these trials represent 143 therapies under investigation. Tests and biomarkers are almost as important as treatments. These studies will help to identify the condition earlier in patients as well as help scientists to better understand the disease progression. They can then more effectively investigate a cure or a way to at least slow the progression of this diagnosis that most people fear more than death itself.
Thus far, the only FDA-approved therapies have been very limited in slowing the progression of Alzheimer’s disease, and the most recent approved therapy has been so ineffective that Medicare will not even approve reimbursement for its use. Here is a brief overview of what have been the approved medical treatments for Alzheimer’s:
- Aduhelm (aducanumab) claims to reduce beta-amyloid plaques in the brains of Alzheimer's patients, but the final conclusions from the clinical trials have been contested.
- 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.
So far, these treatments have not been very effective or effective for very long. Most of them tend to focus on beta amyloid and tau tangles, and this whole concept has come under fire, of late. The contention is that early research setting this premise for treatment may have been based on doctored evidence. More to follow on that controversy at some point, but other controversies have created their own firestorms. With approximately 6 million people already diagnosed in America, you can imagine how much is being invested in finding an effective treatment. When there is good news, we will get it to you as soon as practicable. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
Actually names can hurt you…sticks and stones can break your bones, but ageism affects the health of older adults. When older adults are at the receiving end of ageist comments they internalize what they hear, so much so that this lower self-concept results in a slower walking gait, brain changes of Alzheimer’s disease and even a shorter life span. Researchers with the World Health Organization and the Yale School of Public Health have demonstrated a negative link between ageist labeling and senior mind-set. But the good news is they have shown that a positive mind set makes a positive difference in health like walking speed, balance, memory and longevity. This last one comes from what one of the researchers says is a person’s “will to live” which actually results in longer lives. And the individuals who benefit may not even be aware of the positive or negative self-concepts they have developed; it’s often subliminal. In one study adults between 60 and 90 years of age were randomly divided into two groups, but all were first administered a memory test. One group was placed in front of computer screen that flashed positive words about aging and the other group was shown negative words. The words flashed faster than anyone could read, but they made a difference subliminally. Those in the negative exposure group were flashed words like “decline” or “decrepit” and more. The others were flashed words like “sage” and “accomplished.” Both groups then took a memory test again, and the first group showed a decline in ability to recall versus those in the positive group who showed an improvement in their recall. In a separate study in Ohio with about seven times more subjects over 20 years they showed that negative attitude participants died an average of 7.5 years earlier than those with a positive attitudes. Some explain this as part of an evolution of how we look at “seniors” in our culture. Language has become increasingly negative in our literature over the past 200 years and age has come to be viewed as a medical condition. So, what do you get for a medical condition when you visit a doctor…most often another prescription to add to what you already are taking? And what do most medications have? …side effects. Did he jump or was he pushed is a question that comes to mind. Back to the study with computer exposure to negative or positive language. Those who had been exposed to the positive language were interviewed again three weeks after the original experience, and they were significantly better still at the memory and physical tests. This is where it gets to be both a half empty and a half full glass. If through actions or words older adults are reinforced with negative language or behavior, they won’t let you down…they will go downhill in their abilities and their sense of themselves. Those who are exposed to positive situations and affirming language actually become happier…and healthier. So, please think about how you talk with your older loved one next opportunity you have…what you say…and how you act will have a measureable impact on their quality of life. 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.