Chicago's Geriatric Care Manager Center of Excellence – Since 1991 | Chicago's Geriatric Care Manager Center of Excellence

Alzheimer’s Disease State of the Nation
It is sadly ironic that it was former president Ronald Reagan who designated November as National Alzheimer’s Awareness Month...
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November 20, 2019
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There is an ‘I’ in Caregiver: 5 Tips to Avoid Burnout
We all have heard of coaches exhorting their players to work together by saying “there is no ‘I’ in...
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September 25, 2018
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Singing is a Breath of Fresh Air for Caregivers
Associate Care Manager Gregory is a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on...
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February 12, 2018
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What to Look for When Your Loved One Needs You But Can’t Ask
Associate Care Manager Gregory Peebles returns with a talk about hidden signals of aging that need our attention. Gregory...
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July 31, 2017
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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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Plug In and Light Up the Holidays
Who doesn’t love indulging during the holiday season? Rich food, delicious drinks, and decadent desserts make every gathering something...
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December 16, 2015
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Respite Care – The Holiday Gift to Yourself
Be honest if you’re a caregiver and you can answer YES to more than one of these questions. Sit...
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November 23, 2015
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In the Caregiver's Words

Recent Client Praise

Our vice president for geriatric care management services, Steve Steiber, Ph.D., brought some startling information to my attention recently, and it concerns the risk we don't often think of when we hear that an older loved one has been hospitalized. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM.
For older adults, who are admitted to a hospital intensive care unit, it would seem that discharge from the hospital means they are out of the proverbial woods. Not so, according to researchers affiliated with Vanderbilt University Hospital. They studied older adults who were discharged from the hospital after a stay in the ICU. What were they were looking for? Complications from what they termed Potentially Inappropriate Medications (PIMs) and Actually Inappropriate Medications (AIMs). Very simply, AIMS are medications whose side effects or likelihood of adverse events outweighed the potential benefits the medications were supposed to confer. PIMs were seen as medications where the jury might still be out. In short, they were looking to see what negative outcomes were associated with the patients' prescriptions separate from their medical conditions. This is a big deal if you are a caregiver to an older adult, very simply because drug-related admissions for 65 to 84 year olds have increased by 96 percent between 1997 and 2008. And approximately half of all drug-related hospital admissions are among adults 80 years of age and older. As we all know the over 65 age group is growing more rapidly than the population at large, so we can only expect this risk to grow. Getting back to PIMs and AIMs, about half of all older adults are discharged with at least one PIM, and four out of five of these older adults are discharged with an AIM. This is all the more exaggerated among patients who have been in the ICU, since 85% are discharged with at least one PIM and more than half are prescribed at least one AIM. The lessons the researchers learned is that some of the AIMs that patients were discharged with were appropriate and useful in the ICU, but should have been discontinued upon discharge. As a caregiver, be aware of the new medications that your older loved one was started on in the hospital ICU, and ask your attending physician if they should be continued at home. The most common AIMs that patients carried home with them on discharge were:
- anticholinergics (37%) - These drugs are used to treat asthma, COPD, incontinence, stomach cramps, and muscular spasms. They can be used to help patients sleep when they are hospitalized.
- nonbenzodiazapene hypnotics (14%) - These are almost always used as a strong sleep aid, but if a patient takes them home beware of their effect with alcohol.
- opioids (12%) - These are indicated for significant pain, most often associated with trauma or in post-surgical recovery. There is significant addictive potential, and these should not be maintained long term.
So, if your older loved one carries home any of these prescriptions, ask the provider why they are appropriate for use at home. If they are appropriate, also then inquire for how long the patient will be taking them safely or for what kind of side effects you should be looking. Please let Steve know if you have any questions about drugs or their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends who deliver geriatric care management services to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
Associate Care Manager Gregory Peebles returns with a series on the Internet and older adults. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte The Internet is a safe place if you know how to navigate is safely. It’s user-friendly if, like the youngest generation, you grew up using it all the time. Most, however, have not had that advantage. We learned on our own, and any self-taught amateur will tell you that without a teacher, you can learn a lot of things wrong. There’s no shortage of helpful information on scams directed at older adults who have ventured onto the Internet. At CCM, we try to feature this type of content as it becomes available. Today’s post, however, is about common, globally unsafe habits from which we’ve witnessed our clients and their families struggle to recover. Have these conversations with your older loved one before you have to clean up a digital mess or reclaim a stolen identity.
1. Passwords. Plural. There should be a different password for each online account, and they should change with some frequency. It’s annoying, but at least it’s easy. You know the “best practices” – upper and lower case letters, numbers and even the “other” characters (@, #, etc.).
2. The Not-So-Funny Joke Forward. Sometimes a dangerous link gets inserted into those joke message forwards. Anyone curious/unlucky enough to click on it gets a nasty surprise. Tell your loved ones Don’t click on links unless they are in a personally directed communication from a trusted source.
3. Oversharing. Social media encourage us to tell everyone everything, first among which is how we feel, where we are, what we’re doing. Older adults - not as fluent in the standard practices of safety - are most likely to fall prey to those seeking to benefit from oversharing, an example of which might include updating a status about leaving town for a while. Predators are looking for exactly this type of information, especially if they know their prey’s address already.
4. Oversharing: The Sequel. Similarly, older adults are much more likely to give out personal information casually in a public forum (as in a comment). Not only will it overwhelm your loved one with junk mail, placing them at higher risk for scams, but someone looking to take advantage can get an incredible amount of information from just a name, a phone number, and an email address.
5. Shopping the Black Market. Non-secure websites don’t even pretend to protect your information. How can you tell if a website is secure? Nothing is 100%, but if the URL you’re shopping at does not begin with [https:], leave immediately. The extra “s” is for “secured”, and without it, online shopping becomes a huge risk. Noting this one thing can save lots of money and trouble.
Internet safety could be its own series, but with these five tips, we’re confident your loved one will be safe exploring all the Internet has to offer. 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.
Count slowly from one to sixty-seven…one thousand one, one thousand two, one thousand three… By the time you reach 67, one more person in the United States will have been diagnosed with Alzheimer’s Disease. In fact, one in three Americans will die with Alzheimer’s Disease. I have talked in the past about new diagnostic breakthroughs and some pharmacological and nutritional and other ways to modestly stave off the progression of this disease, but the fact is that there is no cure for Alzheimer’s. Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed. But from the perspective of geriatric care management, it is not just the patient with the disease that requires help; it is their families and other caregivers in their orbits. To that end, I would like to share a brief overview of some of the resources available to support all the individuals who need help when this disease strikes:
1. Alzheimer’s Disease Alzheimer’s and Dementia Caregiver Center (http://www.alz.org/care/alzheimers-dementia-support-help.asp ) is an arm of the Association that has done the most to help patients with the disease as well. The Center provides training and other resources to caregivers as well las a 24-hour telephone hotline.
2. Family Caregiver Alliance(https://www.caregiver.org/national-center-caregiving) offers families resources at the local, state and national level. Not all locales may be covered, but their information and other resources at the national level can be a real asset to families.
3. Rosalynn Carter Institute for Caregiving (http://www.rosalynncarter.org) offers training and education going beyond basic pamphlets. They do peer-reviewed literature searches across a host of related topics as well as sponsorship of researcher into interventions that work.
4. Eldercare Locator (http://www.eldercare.gov/eldercare.NET/Public/index.aspx ) is funded by the U.S. government and provides a unique matrix resource approach to resources nation-wide. From their web site one can search a range of service types by zip code to find specific services in your own locale.
And, of course, the Aging Life Care Association (https://www.aginglifecare.org) helps visitors to their web site with a Care Finder down to the specific zip code level. If you reflect back on other public health challenges where cures ultimately have been found, they all started with building from the grass roots a support system that not only supported the patients and their families, but also the march to a cure. It takes a village. Charlotte Bishop is an Aging Life Care Professional and 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.
Back in May I posted about how May used to be called National Geriatric Care Manager Month, but with a change in our association’s name it has become National Aging Life Care Professional Month. People have asked me what has changed, and I am reminded of a columnist here in Chicago who used to write for the Sun-Times, but switched over to the Chicago Tribune when the Sun-Times changed ownership. When people asked him what he changed with that move, Mike Royko replied, “My socks!” Aside from the fact that “socks” are not my idea of a fashion statement, I would have to echo what Royko said those many years ago. Aging Life Care Professionals – you can still call us Geriatric Care Managers – still deal with the aging person and their families and the challenges of aging. I say families here, because almost invariably the person who gives us a call is the adult child of an older mother or father…or uncle or aunt…for whom they are a caregiver. And what weighs upon that caregiver most heavily is not just a medical diagnosis, but a quality of life issue. So we most often are focused on reducing the worry, stress and time the caregivers must take from their day jobs…or their family lives…or their personal lives. So what does an Aging Life Care Professional actually do? The short answer is: Whatever it takes. But let me elaborate; it is the same as we formerly did under the label Geriatric Care Manager: • Assess and Monitor-does the older loved one’s current home and their current capabilities work together, or are we seeing the kind of rehabilitation from a fall or illness that we should rightfully expect? • Plan and Problem-Solve-if home is no longer a good fit for the older loved one’s capabilities, what can be done to make it so or what are the alternatives to the current environment, or if an older loved one’s medical condition is not responding to current treatment, what are the options? • Educate and Advocate-when an older loved one does not feel they can ask their physician the important questions or when the living facility is not delivering appropriate care or service, who should be informed and who will stand up for that person? • Coach Families-this is most families’ first time down the path of aging, and a professional with training and experience can help everyone find optimal solutions and facilitate the best outcomes. • Option Making-and as I always tell our clients and our staff, we are not the decision-makers; we are the option-makers for the decision-makers. Charlotte Bishop is an Aging Life Care Professional and 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.
In a recent post, I shared what Allyn Rawling said about what to consider when mom or dad are moving out of the family home. Ms. Rawling addressed some of these factors, especially the benefits that assisted living can provide – eliminating possible isolation, ensuring safety, among others. Here are some other aspects to look for when you next visit your loved one.

First, you may notice and overall unraveling of your loved one’s quality of life. For instance, the home itself isn’t well kept and there are safety hazards that have gone unnoticed. You may find that your loved one isn’t taking care of themselves as well as they should, especially when it comes to grooming, bathing, and feeding themselves. Bills might be going unpaid. It is important to note however, that some of these factors may be fixable with some caregiving consultation and changes around the house. However, moving out of the home may be an option that your parents might have to consider.

Second, the family home may simply no longer be safe for your loved one. If the stairs are too steep or if help is not readily available when there is a need, a safer residence may be in order. If mom or dad show bruises, but do not admit that they have fallen - perhaps more than once - it may be time to talk to your parents about independent living. Remember to underscore the "independent" in the living option, because they may have images of the last generation's "old folk's home" or some other outdated stereotype.

Third, it is a tough topic to bring to your parents as they’ll want to keep their independence as long as possible, again a reason to emphasize the "independent" in independent living. Be patient. Start the conversation well before an immediate decision is required. Also, help to make it their decision, their process and their terms. If your older parent does not own the decision, guess who will own it, and that will be a costly bit of ownership for you as a caregiver.

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 my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved ones to find meaningful quality of life. In part, that may translate into helping a loved one to find social and age peers within their communities as their lives and perhaps even the meaning of quality of life may have changed. It also can extend to their desires for maximal independence, developing or preserving meaningful friendships, or even finding personal connections or intimacy. Intimacy? Yes, and you may have thought that your first talk with your parents about sex when you were an adolescent was awkward. Hold on.

As a geriatric care manager, part of the job description is about helping older clients with the challenges of aging, and part of it is about helping caregivers to appreciate their loved one's changing predicament and embrace those changes as well. "Mature intimacy" is one of those dimensions that call for equal portions of each.

If you have an older loved one who is single and wants to have a meaningful relationship, you likely need some guidelines:
1. The first thing you need to do is set aside the old "tapes" that may be in your head, your old beliefs about what intimacy is for you or was for your older loved one. Things are different now.
2. Now, turn that around and appreciate that your older loved one's early experiences will not guide their quest for a meaningful relationship now. The world has changed and age also has intervened. As a caregiver, you can gently help them to feel more comfortable with life's changes.
3. Appreciate that you may be asked about life and intimacy, and if you are not comfortable talking about it with your older loved one, encourage a conversation with the family doctor or a counselor or even sex workshops in some communities.
4. If you do break the silence remember that intimacy is more than intercourse. Just touch - as in holding hands - is something that older adults may long for. Try to set aside arbitrary expectations about what sex is that are based on what sex was. Encourage your older loved one to relax and enjoy the company.
5. Recognize your limits as a caregiver. A lot of parents had their children read books about intimacy before having "the talk." There are books available for mature sexual encounters as well (e.g. "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only).
6. Safe sex is critical in a time when STIs are potentially everywhere. There is a web site called SaferSex4Seniors. They also are on YouTube.
7. There are professionals who can help your older loved one. Check out the web site for the American Association of Sexuality Educators, Counselors and Therapists.
Now, that was not so bad was it?

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.