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

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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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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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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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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In the Caregiver's Words

Recent Client Praise

The rest of the oft-quoted phrase is a pejorative about how “Nobody’s Home.” And we know it’s supposed to connote low wattage of an intellectual sort. Well, burglars who may be watching for when your mom and dad go on the vacations with which retired folks are supposed to be frequently indulging themselves are also watching to see if the lights are on. According to law enforcement they take the lights on as a sign that, in fact, nobody’s home. So what can one do to safeguard home? Well, the same bad guys also look to see if the lights go on at the same time a couple nights in a row, so timers are about as effective as letting the house stand all lit up all the time. Technology has a better answer…actually a couple of them that involve “smart lighting” that can be a safeguard both indoors and outside. Smart lighting outside can use motion detectors that sense anyone approaching the house and flood them in conspicuous lighting that burglars like to avoid. And these particular smart lights can be “trained” to respond to only larger disturbances, so that pesky moths do not have your porch flashing all night like a pinball machine. The sensor outside could also be set up to turn on a light or two inside the house to make it appear as if someone inside is alert to anyone approaching the house. You will want a sensor that also is “outdoor rated” to be sealed against moisture. Smart lighting inside can be a real safeguard against night time falls for an older loved one who may make the middle of the night run to the powder room. A small light can be a big assist for someone just starting to awaken, but already in motion down the hall. And both indoor and outdoor sensors can be set to turn themselves off after a desired lapse of time, again looking more real life. And there is a whole line of smart devices that connect home indoor and outdoor lighting to an app on a smart phone. And you don’t have to ask Siri to attend to the lighting for you. It is all literally in your hands. Of course, if you’re trying to be helpful to an older loved one you will want to confirm specifically when they are and are not home so that you don’t unsettle them with an unannounced light show. 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 have had the good fortune to connect with Jennifer Mesko, Managing Editor of a great website and resource, Drugwatch.com. When I asked about the latest on dangerous medications or medical devices for those who are caregivers or in geriatric care management, she offered these comments.
Nearly every senior in the United States relies on one or more drugs or medical devices to improve their lives. Most of the time, these drugs and medical devices help them deal with pain or a medical condition, and keep up an active lifestyle –and they can even save their lives. Sometimes, however, drugs and medical devices do more harm than good. When a manufacturer fails to disclose the risks of its products, people can end up getting much worse instead of getting better. As a caregiver, you likely play a key role in someone else’s medical care and may be responsible for making sure medicine is taken on schedule – or that surgery is scheduled when necessary. Here are a few products you should be aware of: Dangerous Drugs Just like prescription drugs, some over-the-counter drugs can be dangerous. Tylenol, for example, is taken by millions of people every day. Just recently, however, reports of serious liver problems have come to light. The problem occurs when someone overdoses on Tylenol, often by accident. If one of your patients is taking cold medicine in addition to Tylenol, for example, you need to check to make sure the cold medicine does not also contain acetaminophen (the active ingredient in Tylenol). If more than 4,000 mg of Tylenol is taken within 24 hours, the drug builds up in the body and can overload the liver and cause organ damage or even death. Carefully monitor your loved one’s medications to ensure he or she is not taking too much acetaminophen at once. Another drug that caretakers should be especially careful with is Pradaxa. The drug is a blood thinner that reduces the risk of blood clots. Unfortunately, because the blood is thin, patients can experience uncontrollable bleeding after a minor scrape or cut. There is currently no antidote to this bleeding, which can lead to death. Reports show that Pradaxa side effects such as heart attack and uncontrollable bleeding led to more than 500 deaths in 2011. More than 1,000 patients and family members have filed lawsuits after Pradaxa injuries. Talk to the patient’s doctor to discuss what to do in a bleeding emergency. Dangerous Devices Your loved one may require a joint replacement, just like hundreds of thousands of others do each year. Most of the time, this type of surgery helps relieve pain and restore mobility. Unfortunately, not all hip and knee implants are safe or effective. Before the surgery, talk to the surgeon about which implant will be used. Some hips, including the Biomet M2a Magnum and Depuy ASR, can create problems because they have two or more metal parts. As the components rub against each other during normal activities, the implant sheds metal particles into the body. This can lead to metal poisoning, which requires revision surgery. Knee implants can also be problematic. Patients have reported numerous complications from the Zimmer NexGen Flex Knee system, including loosening, dislocation, implant failure and intense pain. Artificial knee joints are expected to last 10-15 years, but Zimmer NexGen implants can fail after just a couple of years. Drugs and medical devices are an important part of everyday life for most seniors. As a caregiver, it’s vital that you find out as much information as possible before dispensing medications or agreeing to a medical device for your loved one. Do your research, talk to the doctor and make sure that the ones you love avoid these dangerous outcomes. Jennifer Mesko is the managing editor of Drugwatch.com, a consumer advocacy website. She keeps consumers informed about prescription drugs and medical devices that could put them at risk.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are senior care management professionals, geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
Eating healthy should be a priority no matter what your age or health condition. Of course, during Thanksgiving, we are all tempted to indulge a little more than we would on a normal basis. Imagine if we were to reverse that thinking and made a more conscious effort to eat better during the holidays? If you’re preparing this year’s big feast, think about serving a mix of foods that align with a more healthy diet. For instance, if you’re caring for an elder adult, or an Alzheimer’s patient, you might want to consider a Mediterranean diet.

Studies have shown, as reported by ABC news, that a Mediterranean diet is great for preventing stroke and dementia. In general, the diet has exceptional nutritional value, with benefits that keep the body healthy and improve mental cognition at the same time. The American Academy of Neurology studied brain scans of those who exhibited various degrees of commitment to the Mediterranean diet. Those who stayed with the diet were 36% less likely to have infarcts – strokes in the brain that usually don’t produce any symptoms.

Another study by the American Academy of Neurology shows that the Mediterranean diet can improve the long-term health of Alzheimer’s patients. A focus on high fruit and vegetable consumption as well as low meat consumption seems to create benefits for mental and overall health.

So how do you infuse a bit of Mediterranean in your thanksgiving meal? First, if you’re a caregiver for a loved one, give them a few options and ask them what they prefer. It could be as simple as adding a salad to the meal, or trying a new and healthier way to prepare the stuffing. A quick search online will offer new ideas for side dishes and entrees. You may find that your efforts will encourage healthier eating habits for everyone at the Thanksgiving table, including 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. Visit our For The Caregiver page for more information and resources.
I have written a number of blog postings on safety in the home, and most of them have focused on how to make the home environment safer for an older loved one or other person with special needs. But something we all may not think about as much is making home safer for the caregiver – especially in regards to health safety. As a certified geriatric care manager visiting clients in hospitals, I cannot avoid seeing all manner of hygiene steps that providers take so that they do not transmit disease. They will wash or use hand sanitizer each time they enter the hospital room, they will never sit on the patient's bed, and if they use gloves, they are very careful in how they remove their gloves when they complete an exam. If you are a caregiver to a loved one in the home, here are four tips for bringing that same hygiene to the home to make it safer for both you as the caregiver and your loved one:
1. Immunizations - This is not just the annual flu season immunization; it really covers a range of opportunistic bacteria or viruses that pose a risk to the health of your loved one as well as to you as the caregiver. Talk to your loved one's provider about the specific vaccinations you should have such as tetanus, pneumococcal vaccine, hepatitis B, measles/mumps/rubella and varicella (chickenpox). You want to avoid giving or receiving these bugs, and your loved one's provider will help you to identify what you need to do.
2. Hand Washing - You cannot see the germs, but you absolutely must wash your hands often and thoroughly. You should wash before and" hands-on" helping with your loved one and after. And, just as with restaurant workers, wash your hands after using the bath room as well.
3. Protective Gloves - As an extra precaution, consider using rubber or latex gloves as an extra layer between your skin and the skin of your loved one, especially if you are charged with assisting in bathing or toileting your loved one. And as you remove the gloves start with the wrist and peel them off so that they are totally inside out as you dispose of them. And wash your hands after for good measure.
4. Disinfecting - Cleaning surfaces or clothing and bed clothes that come in contact with your older loved one is a very good idea, and it is easy. Use some amount of bleach in your washer loads, and for surfaces one teaspoon of bleach per gallon water will make an effective disinfectant. This solution can be used in the kitchen as well as the bathroom. As with all cleaning products, read the label for any special precautions.
Charlotte Bishop is a certified 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.
We do a lot of postings on dementia, in no small part because adults rank it as their number one concern, just above running out of money or dying. I have again asked our Vice President, Steve Steiber, Ph.D., to talk to us about what we may not know - but should know - about the evolving science around Alzheimer’s disease and treatment options. Steve has over twenty years of experience as a consultant to the pharmaceutical and biologic industry prior to joining us at Creative Care Management. He reports in this post on what may be a "light at the end of the tunnel we call Alzheimer's disease. What is the first thing you learn when you are admitted to a hospital, and this can be for outpatient or inpatient procedures? ONE SIZE DOES NOT FIT ALL! That applies to Alzheimer’s disease as well. There has been no blockbuster fix for Alzheimer’s, to date, but on closer examination of how people with different genes or with different make-ups respond, scientists are finding they react differently to medications. We already have seen this in cancer treatment, and it is a broad and promising side of medical care called genomics…sometimes called pharmacogenomics when referring to medicines and nutrigenomics for foods or supplements. When physicians look to a person’s specific genes, they can find people who may respond a lot better than someone without those genes. They call it “personalized medicine,” and it is showing some real promise. Let's start with a clinical failure that may actually be something else altogether: tramiprosate (an antiaggregation of amyloid agent). Earlier this year results from a phase 3 clinical trial (this is the final phase for a drug to be up for possible approval by FDA) for tramiprosate showed no appreciable improvement, on average, for Alzheimer’s subjects in the trial versus those on placebo. I said, “On average.” When scientists later looked more closely at the genetic makeup of patients in the trial, they found that those patients with two copies of the APOE4-gene had markedly better results than those with only one or no copies of this gene. Scientists are reassessing how these patients and those with the APOE3 gene respond, especially since these latter are at greater risk for developing Alzheimer’s disease. Worth a second look, for sure. I also mentioned nutraceuticals. In a European study some time ago, there seemed to be some promise for vitamin D as a protective agent against Alzheimer’s. As scientists looked specifically at the patients with two copies of the APOE4 gene and taking vitamin D, they found those patients had better memory scores than those on placebo or without the gene. Vitamin D in the absence of the two gene copies did not seem to do as well. Scientists are also looking more closely at omega-3, what we sometimes refer to as fish oil (it is only in the fish oil, because that is where it is stored after fish eat the algae that contain the omega-3). And there are multiple types of omega-3, two of which are particularly “brain-healthy.” Scientists have a couple challenges here. One, the brain’s absorption of the healthy omega-3 takes a few years, and there also is a difference in the genes I mentioned above. This may take longer to get good evidence, but it also is promising. There also is research into limiting environmental risk for developing Alzheimer’s that is linked to both the APOE4 gene and the presence of pesticides like DDT and its metabolic cousin, DDE. While DDT has been banned in America for some time, its metabolite, DDE, is still around. Preliminary research suggests that it is not just the DDE or just the APOE4 gene, but the presence of both that is associated with higher incidence of Alzheimer’s. While these early findings will not tell you what to ask your physician about diet or medications, it is a cautionary note for all who live in or near agricultural regions. The lesson learned again is that we likely have just begun to tap the genotypic profiles that may lend themselves to less versus more risk or less versus more success. The oncology field has begun to get better and better results in their fights across a number of cancer types by paying attention to genes that can predispose individuals to either greater risks or to better outcomes. It just may be that Alzheimer’s disease can follow the same model. 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
While everyone is awaiting the next vaccine to prevent COVID-19 or help in the treatment of the condition among those who have contracted the virus, too many Americans already suffer from medicinal proliferation. Too much of a good thing happens to too many seniors who are over-prescribed. If you are a caregiver to an older loved one, you may find it a bit overwhelming to keep up with all the medications they take each day, and the times of day they take them. But have you thought about the potential side effects as well? The average older adult living independently is taking more than five prescription medications daily, and those in nursing homes may be taking at least seven prescription medications. We call this “polypharmacy.” We all have at least some sense of the side effects that many of these medications may carry, but what you may not know is that some of these medications have some unhealthy interactions with the other medications. Recent research in the United States among older adults living independently found interactions between drugs in about 15% of the cases. In another study in Europe that tracked older patients being discharged from hospitals, as many as 70% were on medications with some interactions, and 24% were at risk for serious interactions among the drugs they were taking when they were discharged. What should you look for? Ask one or more of these questions when you accompany your older loved one to their next medical appointment:
- Is the symptom the physician is about to treat a side effect of a medication they already are taking?
- Is there a safer drug to replace any of the medications your loved one is already taking?
- Can a lower dose of a prescribed medication be tried with any on the list?
- Does my loved one need to take any of these drugs at all?
And if you feel really bold ask how diet and exercise may be used to replace taking a drug. For instance, a balanced diet with enough vegetables and fruits can address diarrhea. Reducing consumption of sweets or other carbohydrates can alleviate pre-diabetic or diabetic symptoms. And getting up and walking can lower one’s high blood pressure and reduce weight as well. And all of the above can improve those feelings of melancholy that are far too common during this COVID quarantine. 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.