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

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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Scamming as a Superspreader
We have all seen the advertisements for the on-line services that will help you find your ancestry by taking...
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February 2, 2021
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Until the Vaccine?
We have all been following the news on vaccine rollouts, and frankly you may have been as disappointed as...
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January 26, 2021
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Better than a Resolution
After nearly a year of a pandemic and its quarantine, we are all ready to get back to normal. ...
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January 12, 2021
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How the COVID Vaccines Work
If you’re like me, you have been following too much news on the pandemic, but hopefully you also have...
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December 15, 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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It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
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September 15, 2020
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In the Caregiver's Words

Recent Client Praise

We are knowledgeable in a wide range of elder care services. Below you will find just some of the things we do to make the life of your elder loved one more complete and your life just a little simpler. If you are not sure what exactly you need, please don't hesitate to contact our Geriatric Care Management team.
Geriatric Care Plans
A direct product of a careful assessment, geriatric care plans act as a roadmap for health care options and living arrangements of an aging individual. Learn about geriatric care planning.

Assisted Living Consultations
Based on a careful evaluation of your loved one’s needs, we help review and select the ideal assisted living facility. We also assist with paperwork and legal matters. Learn about assisted living consultations.

Retirement Communities Consultations
We find the ideal retirement communities that match your aging loved one’s lifestyle preferences and then take care of the transition for you. Learn about retirement communities consulting.

Home Care Management
We manage the process of selecting and placing your loved one with the right kind of home care service from a reliable and trustworthy provider. Learn about home care management consulting.

Nursing Home Consultations
We evaluate healthcare needs of your loved one and assist in selecting the most appropriate nursing home. We then carry out periodic reviews of your loved one’s condition. Learn about nursing home consulting.

Senior Home Safety
Complete assessment of safety of your elder loved one’s home, and subsequent retrofitting to ensure comfortable and injury-free environment. Learn about senior home safety services.
Get a FREE Consultation with a Certified Care Manager
CALL: 855-455-5118 x511 or just fill out the form. [contact-form-7 id="311" title="Contact form 1"]

Recent Client Praise

What do tennis, racket ball and soccer have in common? What do jogging, swimming and biking have in common? You may see that you need at least one partner for each of the first three, and the other three are pretty much solo activities. But the other point is that people who participate in the first three tend, on average, to live longer than the people who participate in the latter three. They are all good forms of exercise and all contribute to longevity, but the team activities just do a better job of giving us more birthdays according to a number of research studies. A 2017 study that followed 80,000 British men and women showed that those who played racket sports outlived those who were joggers. They originally had used this research to identify if the duration, strain or amount of jogging showed any differences in longevity, and the answer was yes those who were in the “happy medium” – not too strenuous and not too gentle - did live longer. On closer examination they further uncovered the greater benefit of racket sports over the solo sport of running. The researchers looked to even more data to see if this general pattern would hold in other populations, and they discovered that a Danish study that encompassed a greater number of activities that people had described in questionnaires showed that people who engaged in more social or team sports like tennis, soccer and even badminton lived longer than the more solo athletes. And they tracked these individuals for 25 years. No surprise, those who had reported relatively little or no exercise during their lives did not survive as long as their more active counterparts. Cyclists who bilked four or more hours a week, for instance averaged almost four more years of longevity than those who chose to “sit out” their lives. Running added about 3.2 years when compared with their sedentary counterparts. But tennis added nearly 10 years to players’ lives and badminton added 6.2 years. Soccer contributed 5 more years to players’ lives. Even when the researchers controlled for education, age and socioeconomic standing, this pattern held. It may be about the kind of cardiovascular benefit conferred by one sport over another according to the researchers, but they offered one more possible explanation. The sports that gave the greatest benefit in years also are team…or social…sports. Other research has often cited social isolation as one of the big detractors from both quality and quantity of life. Social engagement, they pointed out reduces stress at the same time one derives physical benefit from a sport. It seems to give new meaning to being “heart-healthy.” It is not just your pump that is healthier, so is your spirit, and both contribute to more birthdays. 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.
When we as geriatric care managers talk about memory loss and aging, it seems inevitable that the discussion turns to Alzheimer's Disease or some form of dementia. The truth is, however, that nearly everyone's brain will begin that slippery slope to losing track of the keys, names or other details of our daily leaving. The part of the brain that forms memories and then helps us retrieve them is called the hippocampus, and it just degenerates with age. Scientists tell us that the hormones and proteins that rejuvenate and protect brain cells decline as we grow older. The reduced blood flow to older brains contributes to this decline as does the ability of older adults to absorb the nutrients that bolster the brain. If you are a caregiver to an older loved one whose mental function you want to help, take heart. Here are some tactics you can implement to help keep their brain as healthy as possible:

Eat Well. Nutrition is as important to older adult brains as it was when they were youthful and just beginning to grow their bodies. Focus on fish, white meats and all the most colorful vegetables to enhance nutrients.

Keep Learning.   There is so much that can be exciting to an older brain if only they expose themselves to the world. Encourage your loved one to read new books, travel to new places, go to museums, listen to different music, take a different way home from the grocery store.

Work it. If your elder's body is working, the brain is benefiting. Increasing the flow of oxygen and blood through physical exercise will, in turn, flood the brain with oxygen while also releasing agents in the brain that enhance learning.

Don't Multitask. Even for a vigorous, youthful brain, multi-tasking simply divides the attention that can be devoted to any one task and diminishes recall. For an older, challenged brain any reduction in distractions will allow greater focus and better ability to retain.

Use Associations. If your older loved one meets a new person, encourage them to use an association with a feature of that person that may make it easier to remember their name. If they are visual people, use a visual assist; if they are aural people, ask them to repeat the new information or name as a way to remember.

Throughout any exercise along these lines, help your loved one to appreciate that we all forget some things at least some of the time. And we all have heard the phrase that we should "forgive and forget." Maybe we should turn that around and encourage our older loved ones to "forget, but forgive" themselves. 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.
By the time we ring out 2013 and welcome in the new year, caregivers to adults with Alzheimer's or some other form of dementia will have logged nearly 20 billion hours of unpaid care time this year. We all have heard the other statistics on the prevalence of Alzheimer's disease and other dementias, the cost of care in dollars and more, but we sometimes overlook the toll this disease takes on the loved ones who care for those with failing mental faculties. This is the first in a two-part series I will share on the topic of the 15+ million non-professional caregivers who help Alzheimer's and dementia sufferers with activities of daily living like bathing, feeding or dressing. If we were to place a dollar value on this unpaid care, it would approximate about half the annual revenue of Wal-Mart and approximately eight times the total 2013 sales of McDonalds. Who are these caregivers? Well, the majority are women, about 62% of the caregivers according to some surveys. About one in four is over age 65, and 70 percent are married to the person to whom they give this care. The care from these individuals is not remarkable in what they do to assist with the Activities of Daily Living, but their care is at once more extensive and more intensive. Where the difference is more stark is when the incidence of the care is twice the rate of other caregivers to loved ones who do not suffer from dementia...and more intense. For instance, 31 percent of caregivers to Alzheimer's or dementia patients help with toileting or diapers, only about 16 percent of other caregivers help with this. And 31 percent of Alzheimer's and dementia caregivers help with feeding compared with only 14 percent of other caregivers who help feed their loved ones. Dementia and Alzheimer's caregivers are also in it for a longer haul. About one in four will spend less than a year as a caregiver compared with more than one-third of caregivers to non-dementia loved ones who spend under a year. Yet, more than two in five caregivers to Alzheimer's and dementia caregivers will spend one to five years in this role, compared with one in three caregivers to other types of loved ones. This gap closes a bit with longer durations of care, but greater proportions of caregivers to Alzheimer's and dementia patients care for their loved ones 4 and more years. But how stressful is the caregiving of these two different groups of caregivers? There is a bit of a trade-off between emotioal stress and physical demands of the caregiving. Caregivers to Alzheimer's or dementia loved ones report about fifty percent more stress emotionally in the caregiving. But the physical stress of caregivers to other types of loved ones report about one-third more physical stress in their caregiving activities. 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.

I have written in earlier blog postings about dementia: “preventing” Alzheimer’s Disease, Alzheimer’s from the inside out, maternal genetic links to Alzheimer’s, and women’s predisposition to Alzheimer’s. I would like to share some research that shows dementia to be tied to a number of other chronic conditions we often find among the elderly. This posting is about monitoring and managing other medical conditions in order to reduce the chances of developing dementia, and it underscores one of the most important parts of geriatric care management specifically or caregiving generally.

Dementia is more common among people with diabetes than among the non-diabetic population. Diabetes seems to be more related to vascular dementia, but research shows also some risk for Alzheimer’s among diabetics. One study found that even a 1% rise in long term glucose levels (referred to as A1c) was associated with declines in three different measures of cognitive function.  Researchers have long known that poorly controlled diabetes is associated with renal and cardiac complications. These same micro-vascular issues associated with diabetes can lead to brain disorders, with some suggesting that Alzheimer’s disease could be considered “type 3 diabetes.”

Another risk factor associated with higher rates of dementia is elevated blood pressure, or hypertension. And the flip side is true as well with one clinical study documenting that well-controlled hypertension actually reduced the risk of dementia. And blood pressure registering above 140/90 evidently encourage Alzheimer’s or other dementias.

Finally, alcohol use taken to excess can lead to impaired cognitive function for anyone. For older adults, excessive alcohol consumption has been associated with dementias and also have been found to aggravate existing dementia or Alzheimer’s disease.

A care manager or caregiver should always be alert to any signs of impaired executive function in an older adult as this may mean that the diabetes or hypertension are not well-controlled, or that there may be alcohol abuse. Be alert to an elder’s:

poor organization,

loss of attention or train of thought,

poor judgment sorting good from bad ideas,

faulty short term memory, weak reasoning and even

lack of awareness of their deficits.

A medical provider can assist in administering a Mini-Mental State Exam to confirm any deficiencies as well as address these other co-morbidities. Acting early can save an elder from the slippery slope that is dementia.

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.

With all the talk of risk mitigation amid this COVID pandemic, home improvement may seem low on your list of things to do. But after we all have self-quarantined, maintained our “physical distance” (I don’t call it “social” distancing.) and stocked up on comfort food, please allow me to give you five insights into getting through this and coming out of this a better, more balanced and healthy person.

Start with You – It is not time to slink into the recliner chair with the remote in one hand and a bag of chips in the other. Take stock of what you eat, what you drink, how you exercise and how you are sleeping. Then choose one area for self-improvement, set a goal and work on it. Then another…all of these steps that make a better you will also protect you from a virus.

Reduce Stress – I know, easy to say, hard to do. Stress may have made our ancestors effective in defending themselves against predators, but they burn up our systems if we get stuck on “high alert.” There actually is a special web site designed around how to calm ourselves about COVID-19.

Socially Close while Physically Distant – I talked in an earlier post about ZOOM meetings with people who are important like family, friends and folks who just are isolated themselves. This last is important, because it can help us receive the calming benefit of extending our own empathy. (Key is to ask a lot of questions instead of “dumping” about ourselves.)

Use the Timer – This is not for the perfect three-minute egg, but for setting what I used to call with my kids “loving limits.” You may have your favorite newscaster or channel, but there is too much bad news if you let yourself get sucked into the endless news cycles. Use your Egg Timer or your app: 30 minutes is a good limit…and stick with it.

Attitude of Gratitude – I know it seems rather cliché, but you cannot tell the important people in your lives too many times just how important they are. You cannot stop to smell too many roses (I know I am rushing that season). You would be amazed at how cordial strangers can be if you extend the first courtesy.

We at CCM want you all to remain safe and follow the rules so that you all will get through this health crisis. And if you follow as many of these guidelines as you can fit into your day, you will be better coming out of this pandemic than you were going into it. Be safe and be healthier. 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.

I promised in my last posting to talk more specifically about what can be made safe for seniors who wish to age in place – room by room. I am going to start with the room in the home where most accidents happen, the bath. The bathroom for most elders represents the perfect storm of a confined space with potentially slippery surfaces. Nearly one-third of seniors over age 65 fall each year, and the majority of these falls happen in the bathroom. With basic planning and potentially some retrofitting, however, the bath can be made more safe and accommodating to an older person’s limited mobility and range of motion. Let’s start with surfaces.

There may already be a rug near the shower or bath area, but make certain it has a sticky, non-slip back to minimize falls when an elder enters or leaves the tub. If your older loved one uses a floor mat in the tub area when showering, make sure that the suction cups still offer good sticking poser. You may consider adhesive decals that stick to the porcelain tub surface with soft gripping rubber top surfaces. In the shower area itself, consider having a bath bench or chair with non-slip feet if your elder has difficulty standing for protracted periods or is at all unsteady on their feet. If your elder loved one is challenged by lifting their feet over the tub edge to step in for a shower, it may be time to refit their bath with a stall shower with a low or minimal curb in place of a tub/shower combination.

Having a non-slip, moisture-absorbent surface near the tub is a safety assist, but any other loose rugs should be replaced or eliminated. Look for uneven floor surfaces or thresholds and consider eliminating them, beveling surfaces or highlighting them with paint or tape. Loose cords from radios or hair dryers should be removed from walkways, and other floor level clutter like magazine racks should also be eliminated.

Just as in hallways, consider installing grip bars at strategic points in and around the tub or shower as well as either side of the commode. For seniors with difficulty getting up from chairs, consider also a raised seat for the commode as well as grip bars that flank the sides of the seat like arms on a chair. There even are hydraulic assistive devices that can be installed on the toilet seat with a lift that can help ease the senior into a seated position and then boost them slowly back up as they rise from sitting.

Lighting is as important in the bath area as it is in the rest of the house. If the present circuits allow, it may be as easy as upgrading to a higher wattage bulb in all the fixtures. In old houses, however, it may be safer to refit with new fixtures that can offer more lighting. And also as with other parts of the house, have a night light that automatically goes on when ambient lighting fades.

Finally, make sure that everything that your elder may need with any frequency while in the bathroom is within easy reach. Remove actual glassware or ceramics from the bath and replace with plastic, especially cups that have gripping texture on the outside. And while you are outfitting the bath, keep in mind bright colors and pleasant decoration. Just because your bath is now safe does not require that it look institutional. Next week, I will talk about what’s cooking in the kitchen.

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.

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Free White Paper: Caregiver's Guide for the Holidays
The holiday season is stressful for everyone but sometimes even more so for caregivers. This white paper provides essential resources to help you enjoy all of the holiday cheer and time with family as a caregiver.

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If you are a caregiver to an older adult, you may have noticed some of the changes in their bodies, like the wasting of their muscle mass. They may have lost some upper body strength, some of their former endurance in their legs and some of the spring in their step. Muscle cells simply begin to break down over time, but older adults who work out can preserve a much greater percentage of their strength and muscle performance than those who do not exercise. Well, your brain and nervous system run pretty much the same path as the muscle systems as a person ages. The neurons which comprise the nervous system also tend to atrophy, and some nervous pathways just don't work like they did in a younger body. But a person may maintain their mental agility by mentally working out just as physical ability can be preserved and enhanced by hitting the gym. Research shows that older adults who remain socially engaged do better mentally over time than more isolated individuals. Those who read or work crossword puzzles also do better than people who simply watch television or other less-engaging mental activities. There are, of course, factors that cannot be controlled by just more aggressively working out one's mind. Alzheimer's disease and some other forms of dementia will simply intervene and wreck havoc with one's faculties. Other hormonal shifts or chronic diseases also can be the culprits which rob a person of their intellectual capabilities. A person develops hypothyroidism during their career, for instance, is at risk for a whole host of unfortunate side effects if they do not maintain their balance with thyroid supplements. One of those side effects is dementia-like symptoms. Unchecked infections, particularly those of the urinary tract also can cause sudden onset of delirium, so it is important to track the big picture and to also look for other sides of such an infection such as frequent or painful urination. Also, the ability to intellectually process or aberrant behavior can be caused by out of control diabetes. Circulatory or lung issues may starve the brain of much-needed oxygen, manifesting itself in odd behavior or confusion. Mini-strokes - sometimes referred to as transient ischemic attacks or TIAs - also can manifest themselves as confused mental processing or language difficulties. And poor nutrition may impede the healthy function of an older person's brain and nervous system. So, if you are a caregiver, here are some useful steps that I as a geriatric care manager recommend you take to monitor your older loved one's mental health:
- be aware of how much real exercise your older loved one gets routinely;
- be alert to signs of isolation, social disengagement or depression;
- note regularly how well your loved one eats at family meals and how well stocked their pantry and refrigerator are; and
- notice how quickly any given change develops - chances are that the more quickly symptoms show themselves, the less likely the condition is to be dementia.
Remember, getting older is inevitable, but deteriorating is not. Keep a sharp eye for how sharp your older loved one is. 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.
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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.
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

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