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

The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
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January 25, 2022
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Not Where You’d Expect Protection from Dementia
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there...
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December 28, 2021
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The Perfect Gifts for the Holidays
I came across a billboard this past week that offered a simple suggestion for those of us making lists...
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November 30, 2021
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Password Protected?
I often offer advice on how to help your older loved one with challenging tasks or how to protect...
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October 26, 2021
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What Does It Mean to Age Gracefully?
I think I can say with high confidence that your parents taught you how to walk…or what the kinesiologists...
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September 21, 2021
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Your Flight to Nowhere is Boarding
You have probably put off a vacation or most any travel for more than a year with the threat...
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August 10, 2021
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The Side Effects Physicians Don’t Talk About
You all have heard about the side effects of FDA-approved medications that make their sales pitches on your television. ...
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June 29, 2021
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Breaking News for Alzheimer’s … part 1
The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of...
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June 15, 2021
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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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In the Caregiver's Words

Recent Client Praise

Raise your hand if you ever had a disagreement with a brother or sister as you were growing up. It may sound like an odd question, but it highlights of the "iron rules" of family dynamics that I have seen in my years as a certified geriatric care manager. Most families tend to play out a lot of the family dynamics that had characterized them during the formative years of the family. They simply are older now that they were when mom and dad were raising them as children. We also still find that caregiving to mom or dad as they age generally falls to the daughter in the family and not the son. According to sources woman (daughters) caregivers outnumber men (sons) about two to one. SO what can one do to manage the family dynamics so that the caregiving actually is productive instead of combative. In part because caregiving can be demanding and stressful, it can bring out some of the family's old tensions or unresolved issues. Some siblings may be the optimists and others the pessimists, but quite often the tension that already exists is exacerbated because the duties are not seen to be shared equitably. Here are some guidelines that can help to diffuse a tense predicament and hopefully move things to a more productive plane:
- Make it a point to appreciate all points of view, and be open to compromise; as I often say, "Would you rather be right or happy?"Recognize that not all siblings can contribute equally; everyone comes from a different place with different abilities and different constraints.
- Don't forget "please" and don't forget "thank you;" show appreciation for everyone's contribution to caring for mom or dad.Make it a point to share all the information; if one of the siblings does not know their help or input is needed, it is not going to be forthcoming.
- Remember to frame your suggestions and actions around what mom or dad would have wanted, not what you specifically may want.
- You may not be required to "forget" a perceived wrong from a sibling, but you do have to "forgive" the slight so that you all can move forward.
- If you are the caregiver who is not getting sufficient help from the siblings, you still need to find professional (or otherwise) respite care.
- Be open to seeing when you need to call in help just to work together as siblings; seek the facilitation of a therapists, counselor, social worker other third party.
- Remember one of my other iron rules, and that is "Care for the Caregiver;" you cannot be an effective caregiver if you are not caring for yourself.
This may seem like a lot, but productive resolutions of issues will in the end be better for your older loved ones. The lessons you learn in working through your sibling tensions also can be tremendously illuminating as you look to prepare your own children for roles that they will one day face. Charlotte Bishop is a certified Geriatric Care Manager and founder of Creative Care Management, 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 like to report on medical research that shows that if a patient does what is directed by their doctor, they can avoid a problem or see a benefit in their lives. I like it even more when I can offer research that delivers a bonus or another benefit in addition to what a patient may have been expecting for paying heed to doctor’s orders. This is one of those bonus stories. Half of all adult Americans have high blood pressure. That’s more than 103 million people whose blood pressure is at unhealthy elevated levels. While many of these individuals can bring their numbers back under control with diet and exercise, the rest are prescribed one or more anti-hypertensive medications like an ACE inhibitor, a beta blocker, an angiotensin II receptor blocker, a calcium channel blocker or a diuretic. In some cases a person may be on more than one of these agents to bring their blood pressure down and preserve their cardiovascular health. Dementia researchers involved in analysis of large scale data are telling us that there may be an added benefit for these BP patients. They may also be preventing the onset of one or more types of dementia if they are adhering to their blood pressure treatments. The researchers have tracked more than 31,000 patients who had been dementia-free 22 years ago, and found that over time 1,741 developed Alzheimer’s disease specifically and 3,728 just developed some form of dementia (most typically vascular dementia). Among the adults with high blood pressure at the outset in this large panel and who used a blood pressure medication, they were statistically less likely to develop dementia of any sort than those not on a medication. In fact, the difference between those who would develop dementia and those who would not was statistically significant across all types of anti-hypertensives. And it was significant for Alzheimer’s disease specifically as well as the other dementias. (Vascular dementia, or mini-strokes as it is sometimes called, could understandably be linked to better controlled blood pressure, but Alzheimer’s has a different mode of acting.) Also noteworthy is the fact that there was no drug company funding for this research. While funding does not cause results of any sort, it is helpful to see that there is no suggestion of sponsorship in any financial way influencing outcomes. If you or a loved one are among the 103 million Americans with elevated blood pressure, staying with your blood pressure medications will be good for your heart and your head! 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 am sometimes asked why we have that phrase on our brochure and web site that says "Your Sister in Chicago." The Chicago part is not where the question arises, but some ask why we talk about the "sister." Well, we have discussed that among our own staff, but it really comes down to how roles sort out when it comes to caregiving. Aside from the fact that research shows that it is spouses who are more often the caregivers to one another than anyone else, it most often is the daughter than the son who is the caregiver to an older parent who needs the help. The University of Michigan collects data from Americans every two years in what they call their Health and Retirement Study. It's a survey of more than 26,000 adults over age 50 in America, and some of the recent findings shed some light on how caregiving sorts itself out by gender among adult siblings. The averages begin to tell the story. Daughters, the survey shows, perform 12.3 hours of caregiving to an older adult in an average month compared with fewer than 6 hours for the average son in a family. And when there are both a son and a daughter in the sibling mix, this sibling gender mix reduces the sons' average hours while it increases the hours the daughters will spend in caregiving. According to this survey, the pattern has remained essentially unchanged for more than two decades. There has been a consistent gender gap, and it is more pervasive that just elder caregiving. If you look to see who the stay at home parent is when families sort out responsibilities, women still outnumber men as the stay at home caregivers to children. The authors of the research suggested that it is not up to the daughters of America to more actively recruit their brothers to be involved in caregiving to mom or dad. They argue that the brothers ought to assert themselves into the mix as a remedy for the stress that daughters will experience as the disproportionate caregivers. Women may provide more care to the parents, but they also take on a larger share of the caregiver stress. Yet, this gender gap is not always because men do not step up. We see cases in our own sphere where it seems that the sons' voices do not get heard as much as the daughters, so maybe adult siblings of all genders need to do a better job of sharing the family caregiving responsibilities. But until we can proudly say that we are your "sibling" in Chicago, we will continue to be a sister to both the daughters and sons who are looking for a care navigator to help them with their care receivers. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@cr eativecaremanagement.com.
We as certified geriatric care managers all hear about older adults falling. Caregivers often do not expect their own loved one to have an accident at or around home. The simple fact is, however, that about 20 percent of adults over age 65 will have a fall in any given year. Sadly, most fall can be prevented with some simply safety precautions:
1. The Feet aren't Fit. Yes, it is true that a lot of falls happen because there are hazards all over an older adult's house, but falls are not inevitable. De-conditioning happens in older adults who do not really exercise their balance and their gait. They become less nimble, and you can see it in the "elder shuffle" many of them manifest. You may not be able to help them dance again, but you can get rid of worn carpet or what we call "shatter rugs," or scatter rugs. For an older person who does not lift their feet, these can be a fall waiting to happen.
2. Other Hazards. Anything on the floor and potentially in traffic can be a fall hazard. Look for uneven surfaces, footstools, electrical cords, stairs and similar clutter on the floor. You don't need to make your older loved one's home a sterile and barren place, but you can clear the traffic routes to eliminate risks before they become a broken hip.
3. Line of Sight. If they cannot see it, they will fall on it. Older vision inevitably becomes less acute, but sight also can be obscured by cataracts, macular degeneration or other conditions of older eyes. You can address some of this by seeing that they have annual vision tests and necessary upgrades in their eye wear as well as enhanced lighting throughout the house.
4. Medication Side Effects. Many medicines have side effects that cause dizziness or low blood pressure upon standing. While their main effect may be necessary, the side effects can make navigating an otherwise safe path incredibly difficult. Talk to the health care provider about any side effects and ask about reduced doses or a change in meds altogether.
Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
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Twenty two minutes. Every twenty-two minutes someone over age 65 dies as a result of a fall, and this is almost double what that figure was just ten years ago. These are called severe falls, and it is not that the individual dies at the time of fall as much as they will succumb to other complications subsequent to the fall. Because just as the incidence of falls has increased, the incidence of heart disease, stroke, arthritis, diabetes and other chronic conditions has increased among older adults. With the increasing numbers of medications that older adults take for their medical conditions, there also is an increased risk for confusion, delirium or imbalance as side effects of the prescriptions. We also are seeing an epidemic of severe - but not fatal - falls, nearly 2.5 million of which result in trips to the emergency room in America each year. This is fifty percent more than just ten years ago, and the incidence is double for women what it is for men, because women are living longer. So what can caregivers do to help their older loved ones living safely and independently? Take your cue from some innovative senior residential facilities around the country. In past postings I have talked about making lights within reach of bedside for older loved ones who may be getting out of bed during the night or in the early morning hours of darkness. There are now new ways to install floor lighting around the bed or along the usual paths from bed that are motion-activated. As your older loved one sits up in bed and their feet reach toward the floor, lighting strips like those on jet airline aisles are activated and light the way to a safe trip to the bath. In the bath, motion sensors turn on enough lighting to make navigating what can be the most dangerous room in the house much clearer and safer. One other innovation being introduced into senior residences is color contrast seats for the commode. Instead of the interior design rule of matching colors, some residences are making the toilet rings black against a white commode to provide an easier contrast for those whose eyesight may not be as sharp as it once was. And grab bars in the bath as well as along any halls and stairways to give a ready assist to older loved ones who may be sufficiently willful to ignore the doctor's orders to use a cane or walker. And who said floors can only be made of wood or tile? Interior decorators are coming out with attractive new floor coverings that absorb shock as a last line of defense against fatal falls. Consider also tasteful color contrasts to help older eyes distinguish step treads on the stairways as well as paths along halls. For anyone who recalls my "mitten test" for household door handles, switches, etc., you will like this suggestion. Get a pair of cheap sunglasses and rub Vaseline over the outside of the lenses. As you walk through the house you will have a much greater appreciation for what older vision - particularly vision impaired by cataracts - can literally look like. Add six pair of socks to your feet and you will be able to take a walk in their eyes, instead of a walk in their shoes. 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.