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

A Good Habit Missing for Most Older Adults
Even among those older adults who dodged COVID, “gymnesia” may be a lingering effect. Please let me explain… What...
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May 24, 2022
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When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
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May 17, 2022
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When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
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April 12, 2022
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Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
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April 5, 2022
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A COVID “Tech Boom” Among Seniors?
“Necessity is the mother of invention” is most often attributed to Plato, although he actually wrote, “Our need will...
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February 15, 2022
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The “Other” Health Concerns for Older Adults
It was just two weeks ago that I underscored the fact that “older adults have a greater fear of...
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February 1, 2022
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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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In the Caregiver's Words

Recent Client Praise

Career Opportunities at CCM

Open Positions:
Creative Care Management is looking for full- and part-time professionals to provide geriatric care management services to our clients. CCM was founded more than twenty years ago and is a team of certified professionals providing answers to older adults in Northern Illinois and their families.

Qualified applicants should have:

a nursing, social work or other degree in the helping professions

experience with older adults or others with special needs is a plus

GCMs will evaluate an older person's situation, identify solutions, and work with the family to design a plan for maximizing an elder's independence and well being. Geriatric care management involves an in-depth assessment, developing a care plan, arranging for services, and following up or monitoring care. A GCM can also assist in the medical management of a client and suggest potential alternatives not considered, and they assure a loved one receives the best possible personalized care and all the benefits to which they are entitled.
Please send a bio and credentials to:

Steve Steiber

ssteiber@creativecasemanagement.com

or call 847-869-5118 x 511.
Dr. Oliver Sacks explains neuroplasticity in his editorial, “This Year, Change Your Mind,” in the New Year’s Day editorial page of the New York Times. As a geriatric care manager, I have encountered clients whose injuries have induced deficits of some sort from which recovery plans are designed and executed. Physical injuries such as lost limbs, vision, hearing or others have fairly clear rehabilitation trajectories, and the injured individual can learn and work through them to recover as much of a productive life as possible.

Neurological injuries like those Dr. Sacks offers as examples require remolding an organ that we do not see from injuries that also may be invisible. As Dr. Sacks explains, neuroplasticity offers the means by which the brain can remold itself to overcome a deficit. For a geriatric care manager, the deficits do not have to be as dramatic as a spinal cord injury, the onset of blindness or even a stroke. We see every day the consequences of older adults’ inactivity and the cumulative deficits that can grow out of the under stimulated life. The brain does lose some of its pathways through natural attrition, and it is critical for a vibrant life for the aging individual to keep working in order to maintain the pathways they already have as well as to create new ones as some of those may become unavailable. A colleague likens it to commuting in the brain. There may be detours and rerouting, but an active individual will always find a route home.

There is a case of a 70+ year old client whose spouse is suffering from Alzheimer’s inexorable progression. While there is little to do to forestall that condition, he takes it upon himself to exercise at his facility’s gym three times a day, he is a voracious reader and he is an active participant in his wife’s care team so that he can be both physically and mentally able to care for his wife to whom he is entirely devoted. Or the 90+ year old woman who will keep up with her grandchildren when they come to visit – as exhausting as it may be. She is a brilliant conversationalist, she rarely repeats herself and she completes the New York Times crossword puzzle. What do they have in common? They both push the boundaries of the envelope.

They both are pushing the plasticity of their brains.

Dr. Sacks exhorts us to “change our mind” this year as part of our 2011 resolution. I would expand that to include all of those on whom an elder or person with special needs depends, and encourage those caregivers to help push the envelope for those in their care in order to effect a change of mind and a robust life in 2011 for all.

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.

Copyright ©2011
That depends on what you mean by “slow” motion. It was just a couple years ago that I noted in my book on dementia that a new case of Alzheimer’s disease is diagnosed in the United States every 67 seconds. I received a solicitation from my state chapter of the Alzheimer’s Association yesterday, and an opening sentence informed me that “every 65 seconds someone in the United States developed Alzheimer’s disease.” I paused for a moment, and then it really struck me. The train wreck is gathering speed. Two seconds less is no big deal, but that is three percent faster; three percent is higher than the current inflation rate. Would you invest in a financial instrument that guaranteed you three percent less each year? I think the takeaway is that we all need to be vigilant with our friends and loved ones when it comes to “forgetfulness.” The Alzheimer’s Association offers some very basic tips on the most common early warning signs of Alzheimer’s disease:
1. “Memory loss that disrupts daily life,” like recently learned dates or events
2. “Challenges in planning or solving problems,” such as recipes, paying bills, etc.
3. “Difficulty completing familiar tasks,” because familiar no longer is familiar
4. “Confusion with time or place,” is like having no clock, no map
5. “Understanding visual images and spatial relationships,” such as a clock’s hands
6. “New problems with words,” but it is not just “word-finding”…it’s sentence-making
7. “Losing the ability to retrace steps,” and then blaming someone for the problem
8. “Decreased or poor judgment,” like giving up on self-care or donating in excess
9. “Withdrawal from work or social activities,” because they just can’t keep up
10. “Changes in mood or personality,” like confusion, paranoia or depression.
The challenging part when we may take stock of a loved one is that all of these in some minor ways are simple products of just having more and more birthdays. I strongly encourage you to visit this page to see not just the warning signs, but also the “normal signs.” But I also add that the first steps one should take when the signs begin to seem real include getting specialized assistance in a proper diagnosis from a neuro-psychiatrist…and then, don’t go it alone. There are numerous resources in almost every community and on-line that help all of us with a loved one with “that diagnosis” … and to find the support that you as the caregiver need. You will do a much better job of caring for a loved one if you first take care of you! 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.
Elisabeth Kubler-Ross introduced her five steps of grieving for a loved one who has died four decades ago in her book On Death and Dying. A couple of new authors, Barbara Okun and Joseph Nowinski, have revised these five steps in light of our present day experience of dying which tends to be a more protracted process. As a geriatric care manager, I find myself spending more time helping caregivers prepare for the death of a loved one than helping them after death has occurred.

The very practical fact is that people simply do not die in the same way they did nearly half a century ago. We do not hear of folks just “dropping dead” as much as ultimately succumbing to a terminal disease from which they have been suffering for some time. Modern medicine has given us more warnings of life-threatening conditions and more tools to forestall the assault of terminal conditions like cancer or heart and lung disease. With that change in how we die has come a need to address the anticipatory trajectory of caregivers as they attend to an individual and as they prepare to say good bye.

Okun and Nokuski offer a psychological road map for caregivers anticipating the demise of a loved one in their book, Saying Goodbye: How Families Can Find Renewal Through Loss. The authors help readers to develop the communication skills to address the old family issues that will surface during the protracted caregiving a terminally ill individual will require. It is a self-journey handbook for the caregiver to address the inevitable emotional challenges they will face, and I recommend it.

An important counterpoint to the emotional navigation aid Okun and Nokusi offer is the guidance that Dr. Kevin Pho offers. In his blog posting, KevinMD, Dr. Pho offers advice on how to navigate what he calls the “medical maze,” how to interpret medical speak, ask the right questions, be proactive. For any of you facing these end of life passages, I strongly encourage you to check out both of these resources. We all need to be willing to “stop and ask directions.”

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.,geriatric care manager Chicago, geriatric care Chicago

Copyright ©2011
It seems that you cannot watch the evening news without getting a pitch on why older men should be paying attention to their potential for “Low T”, or low testosterone hormone levels. And a pharmaceutical company just happens to have a supplement to take care of it! This is why I have asked our Vice President, Steve Steiber, Ph.D. to talk to us about what we may not know - but should know - about “Low T” and the new treatment. Steve has over twenty years of experience as a consultant to the pharmaceutical and biologic industry prior to joining us at Creative Care Management: First, of all, it is important to understand what normal testosterone levels in men are before we can really talk about what has been described as “Low T.” Low ranges have been associated with decreased bone and muscle strength as well as lower fertility in men. But it gets a bit complicated, because the testosterone level itself is affected by obesity and by age and it ranges rather widely among men. Researchers from Harvard Medical School have recently compiled data on blood assays of testosterone levels in panels of thousands of men in eight European countries and the United States. Without getting into the specific metrics, they calculated the overall range from the normal low to the normal high end for men 19 to 39 years old. It was 264 to 916 on their scale. Adding the obese subjects lowered both of these numbers. Men ages 40 to 49 had a range of 208 to 902. What I find remarkable is that as they tracked all the way of up to ages 80 to 89, the range was 119 to 902. The upper bound was unchanged, but more men slipped lower. So that is “normal.” How to “naturally” improve testosterone:
1. Exercise regularly and add weight training
2. Eat a balance of protein, fats and carbohydrates
3. Supplement with vitamin D and some sun to activate it
4. Add a balance of other vitamins and minerals
5. Reduce stress which releases cortisol
6. Sleep well.
If that older man you may know wants to consider adding the hormone, there also are some cautions. In clinical trials against placebo, older men taking the hormone had twenty percent greater build-up of non-calcium plaque in their arteries than men who did not take the hormone. In other words, the improved testosterone levels came with increased risk of a cardiovascular event. Another study looking to see if there is improved cognitive ability in men taking testosterone supplements found no improvement in men who had started with Low T and moderately impaired cognitive function. There also is a demonstrable increase (63%) in risk of venous clots in men taking a testosterone supplement. It appears that this effect is transient, only lasting for the six months following the start of treatment. The lesson appears to be simply that anyone considering testosterone hormone supplements needs to talk with his physician…and perhaps consider the “natural aids” versus the hormonal supplement. 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.

See all Testimonials »

family caregivers

A Good Habit Missing for Most Older Adults

When Being in Demand Isn’t Healthy

When That Doesn’t Stink…

Respect and Inclusion

A COVID “Tech Boom” Among Seniors?

The “Other” Health Concerns for Older Adults

The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know

Not Where You’d Expect Protection from Dementia

The Perfect Gifts for the Holidays

Password Protected?

Career Opportunities at CCM

Open Positions:

Qualified applicants should have:

Please send a bio and credentials to:

Steve Steiber

ssteiber@creativecasemanagement.com

or call 847-869-5118 x 511.

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