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

It Only Works If It’s YOUR Resolution
How many New Year’s Resolutions have you broken in your life? Be honest. Now ask yourself how many of...
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January 9, 2024
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A Happy – And Well – Holiday for All
It’s the season of holidays. We started with Thanksgiving and then Channukah, and we have yet to tackle Christmas...
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December 19, 2023
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Questions and Answers to Live Well
Many of you have heard me talk about having a Live Well Blueprint as an anchor component to being...
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December 5, 2023
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Ask the Doctor
Don’t ask just any doctor…and don’t just ask your primary care provider (although they may have some insight)…ask a...
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October 31, 2023
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Lessons from Margaritaville
Jimmy Buffet has left a multi-faceted legacy…his distinctive musical style and lyrics, his upbeat and his laid back lifestyle...
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September 12, 2023
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Update on Dementia – part 2
I had left you last week with what may have seemed to be an optimistic note regarding the latest...
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June 26, 2023
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It’s About You
This is personal! Yes, it’s about you! I’d be willing to wager, however, that most of you haven’t thought...
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April 18, 2023
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How (NOT) to Worry, Stress or Be Anxious
It’s not so much whether you’ll have worries, be stressed or feel anxious…it’s how you’ll manage your worries, your...
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March 21, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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In the Caregiver's Words

Recent Client Praise

You know what makes a real difference between grade school children and adults over the age of forty? We could go down an entire list of physiological and intellectual and stature differences, but there is one you may not have considered, because it’s in your head. Ask most kids in primary school how old they are and you’ll get a fair bit of “I’m going to be ## in whatever month their next birthdays are. Ask someone over forty a similar question as a group of Danish researchers did of 1,470 study subjects and it flips pretty dramatically the other direction. On average, these researchers got answers that were 20 percent younger that the subjects’ actual ages. Across all of these study subjects the age deflation was a fairly consistent 20 percent difference which led the researchers, and probably you as well, to ask, “Why a consistent twenty percent?” What age do you think yourself to be in your head? I attended a seminar a number of years ago, and one of the lectures was from a recently-retired university professor who introduced his session with a simple rule: “You have to get older, but you don’t have to act your age.” He promptly plopped a beanie on his head and proceeded to elaborate. I spoke with him on our break and asked him what motivated him to retire from his tenured position and his university and take his subject matter to other venues. I did not then know to ask him how old he thought himself to be, but his story suggests that he wanted to put a brake on aging. His best friend on the faculty had died in the past year which gave him pause to take stock and reroute his life. Or, did he refuse to get to be “that age” but changing lanes to a track that felt more vital, younger? This is not an uncommon story line for “aging adults,” although the details of each person’s story will be different from the others. Some of this phenomenon may also be that our society tends to discount what an older adult can bring to the table. Ask anyone who still wishes to stay on their career path into their sixties or seventies…until they report to that new 35 year old manager. Our society and most western societies tend to attach less value to older workers’ wisdoms. Yet, Asian cultures celebrate age for its place within a hierarchy where chronological age is correlated with prestige. Their brain age to chronological age gap is also smaller and smaller yet is the gap between how old an individual is and how old they feel in their minds in Africa. These latter also tend to be a bit more culturally homogeneous and socioeconomically more homogenous as well. All of this does underscore that age divide, but it should not stop you from enjoying the gathering for your next school reunion or the music they play that “takes you back” to your youth. At the end of the day we are all an accumulation of countless experiences across our years, and you should feel to travel back to whenever you want. To answer the title’s question, what’s in your head may be worth revisiting whenever you choose. Enjoy your trip! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, LLC, 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.
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a lot of voices and one for which we have no precedent. I will not add my voice this week, but I offer a couple of trustworthy voices from the last 24 hour cycle. Please consider this counsel from Dr. Asaf Bitton, MD, MPH, a healthcare leader from the Harvard University School of Public Health. He says: “So what does this enhanced form of social distancing mean on a daily basis, when schools are cancelled? I can suggest the following: 1. No playdates, parties, sleepovers, or families visiting each other's houses. This sounds extreme because it is. We are trying to create distance between family units and between individuals across those family units. It is uncomfortable, especially for families with small children or for kids who love to play with their friends. But even if you choose only one friend to have over, you are creating new links and possibilities for the type of transmission that all of our school/work/public event closures are trying to prevent. The symptoms of coronavirus take 4-5 days to manifest themselves. Someone who comes over looking well can transmit the virus. Sharing food is particularly risky - I definitely do not recommend that people do so outside of their family. We have already taken extreme social measures to address this serious disease - let's not actively co-opt our efforts by having high levels of social interaction at people's houses instead of the schools. Again - the wisdom of early and aggressive social distancing is that it can flatten the curve above, give our health system a chance to not be overwhlemed, and eventually may reduce the length and need for longer periods of extreme social distancing later (see what has transpired in Italy and Wuhan). We need to all do our part during these times, even if it means some discomfort. 2. Take walks/runs outside, but maintain distance (ideally 6 feet between people outside your family). Try not to use public facilities like playground structures as coronavirus can live on plastic and metal for up to 3 days, and these structures aren't getting regularly cleaned. Try not to have physical contact with people outside of your family. Going outside will be important during these strange times, and the weather is improving. Go outside every day if you can but stay physically away from others. Try not to have kids play with each other (even outside) if that means direct physical contact. Even basketball or soccer involve direct contact and cannot be recommended. If people wish to go outside and have a picnic with other families, I strongly recommend keeping distance of at least 6 feet, not sharing any food at all, and not having direct physical contact. Invariably, that is hard with kids, so these shared, "distant" picnics may be tricky. Do not visit nursing homes or other areas where large numbers of the elderly reside, as they are at highest risk for complications and mortality from coronavirus. We need to find alternate ways to reduce social isolation in these communities through virtual means instead of physical in-person visits. 3. Reduce the frequency of going to stores/restaurants/coffee shops for the time being. Of course trips to the grocery store will be necessary, but try to limit them and go at times when less busy. Consider wearing gloves (not medical - but perhaps washable) and of course washing hands before and after really well. Leave the medical masks and gloves for the medical professionals - we need them. Maintain social distance from folks. Take-out meals and food are riskier than making food at home given the links between the people who prepare food, transport the food, and you. It is hard to know how much that risk is, but it is is certainly higher than making it at home. 4. If you are sick, definitely stay home and contact a medical professional. If you are sick, you should try isolate yourself from the rest of your family within your house as best as you can. If you have questions about whether you qualify or should get a coronavirus test, you can call you primary care team and/or consider calling the Partners Health Care hotline staffed 8AM-8PM every day - 617 724 7000, or the Massachusettes department of public health at 617 983 6800. Don't just walk in to an ambulatory clinic - call first. Obviously if it is an emergency call 911. 5. We need to push our local, state, and national leaders to close ALL schools, events, gatherings, and public spaces now. A local, town by town response won't have the needed effect. We need a statewide, nationwide approach in these trying times. Contact your representative and the governor to urge them to enact statewide closures. As of today, 6 states had already done so. We should be one of them. Also urge them to fund emergency preparedness and make increasing coronavirus testing capacity an immediate and top priority. I realize there is a lot built into these suggestions, and that they represent a real burden for many people, businesses, and communities. Social distancing is hard and may negatively impact others, especially those who face vulnerablities in our society. I recognize that there is structural and social inequity built in and around social distancing recommendations. We can and must take steps to bolster our community response to people who face food insecurity, domestic violence, and housing challenges, along with the many other social inequities. I also realize that not everyone can do everything. But we have to try our absolute best as a community, starting today. It is a public health imperative. If we don't do this now voluntarily, it will become necessary later involuntarily, when the potential benefits will be much less than doing so right now.” Please also let me add some good news from FDA: "Aimed at ramping up testing capacity in the U.S., the FDA will now allow individual states to authorize the use of laboratory-developed tests by qualified in-state labs for the coronavirus causing the current outbreak. The labs do not have to engage with the FDA nor will they need to apply for Emergency Use Authorization (EUA).
1. Although states are not required to follow New York's lead, the Empire State's system may serve as a useful guide for others.
2. The FDA will also allow the distribution of commercially developed tests prior to Emergency Use Authorization under certain circumstances and only after the tests have been validated. The agency believes that a 15-period should be sufficient to prepare an EUA filing.
3. The agency will also allow the distribution of serology tests (tests that detect SARS-CoV-2 antibodies in the blood) contingent on the tests being validated, the FDA being notified and the inclusion of warnings that the tests have not been reviewed by the FDA and results should not be the sole basis for diagnosing or excluding COVID-19.
4. The FDA says more than 90 test developers have sought its assistance thus far."
Back to Charlotte here... A lot of you who read my posts are caregivers...if not to an older loved one, then to others within your orbits. My longstanding advice is perhaps more relevant than ever in a crisis. You will do a better job of caring for others if you also are taking good care of yourself! 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.
During this seemingly relentless pandemic, it may be difficult to think about longevity as the COVD virus has swept through all populations in all countries with some scary and mortal consequences. But let’s be aware of the miracle – seemingly overnight – that science emerged with not just one, but multiple vaccinations to protect us against the scourge. In similar fashion, science has been creating the opportunity to extend both quality and quantity of life for decades. There are some scientists who mathematically and medically argue that the first person who will live to 150 years old is already born and walking among us…some say the 200 year old is in the crowd also. Not all scientists agree…surprise, and they fall into two camps that are aptly named “pessimists” and “optimists.” It starts with the simple fact that in 1990 there were approximately 95,000 people in American who had hit their 100^th birthdays. By the year 2015 that number had climbed to 450,000 centenarians. The numbers of supercentenarians (110years+) have also increased dramatically across the globe – in Japan, for instance, they increased sevenfold from 2005 to 2015. The record presently is with a French woman who lived to 122 years of age before she died in 1997. Back to pessimists and optimists. Pessimists hold that risk of death increases exponentially with age so that the odds just require that a person hit a limit. Optimists talk about that exponential increase being true – up to a point. That point is 80 years old. Once people reach 80, the risk of mortality plateaus with the odds of survival being all of fifty percent each year starting with 80 and stretching to … who knows where. The argument between these two camps goes on, and the data are not entirely on one side or the other. But living to 80 gets you the ticket to the next level. Those who wish to live to 150 need to get to 80, of course, and then see which school is correct. How to make it to 80? Well, the French woman smoked a cigarette most every day, had a brandy and enjoyed chocolate, so maybe there is no one path that does not also include good genes and good medical care. But scientists suggest some simple recommendations to maximize everyone’s chance to reach the 80^th birthday:
- Eat fruits and vegetables as well as whole grains
- Consume lower fat yogurt and milk products
- Serve primarily skinless poultry or fish entrees
- Munch on a variety of nuts or beans
- Cook with olive, corn, safflower or peanut oils.
And exercise 30+ minutes at least three times a week; it’s important to keep an engine running periodically so that it doesn’t “rust out.” Oh, and the pessimists and optimists…one scientist from each camp wagered on this one. Each put $150 each into a growth fund in 2000 betting that whomever is right about a documented case of anyone living to 150 years old would claim the growing fund … in the year 2150. Recall I said that this future 150 year old may already be walking among us now…let’s be on the lookout. 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.
“She has confidence in you.”
A satisfied client
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000 foot perspective on distance caregiving. But even from afar caregiving is deeply personal and the caregiver needs to be as much a focus as the care receiver. You might call this my “do unto yourself as you do unto the other” post. I’ll start with the “other:”
1. Caregiving is a team sport – to be successful you have to be part of your care receiver’s team. Most health care providers, especially the residential ones, have what they call a “Care Team.” That could include a nurse, a physical therapist, a social worker, and a physician, and this last could include any number of specialists. You are part of the team, and you do not have to have power of attorney to be a team member…but you do need your care receiver’s written permission for the rest of the team to talk with you.
2. Successful teams bond with one another – you need to have a relationship with key members of the Care Team. And everyone needs to own their position on the team. Regular check-ins happen…well…regularly. Everyone keeps notes and lists of “to do” items. You also need to get into that habit.
Now, about you.
1. Take care of you - If you know anyone who is a therapist or social worker seeing clients in an office, they do not work all their hours in one-on-one therapy. They take time to process, and they take time to recover. In short, they take care of themselves. The lesson here is that self-care is very important to successful “other-care.” I recall an individual who confided in me that he had gone from six hours of uninterrupted sleep a night caring for his mother to six hours of interrupted sleep a night caring for mom. That is not good self-care.
2. Avoid burnout - When you have a call with your care receiver or members of the care team, set a time limit as you begin. Make notes following the calls, and these include assessing how you feel about what you have heard. Have the local care team take care of what happens locally…you cannot.
3. Set loving limits – I followed this advice when I was raising my children as well. You have to recharge your batteries. Some people workout, others write in a journal, some people go to the art museum, and some listen to their favorite music. Do what feeds your spirit so that your spirit will be there for both you and your care receiver.
In the end, everyone on the team wins. If you are a caregiver, it’s important to be part of a winning team. 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.