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

Part 2: Five Important Tips for Caregiving and Self-Care
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000...
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February 18, 2020
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Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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Five Things You Need to Know about Coronavirus
Okay, there may be more than five things you want to know about the coronavirus, but these five basics...
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January 28, 2020
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Alzheimer’s: A Cure at Hand?
I have posted before that the currently approved therapies for treating patients with Alzheimer’s disease are not really very...
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January 21, 2020
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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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In the Caregiver's Words

Recent Client Praise

How often have you heard comments like: “Oh, mom is just a bit blue;” or “Her husband died six months ago…she should just snap out of it;” or “He just likes his time to himself.” They are all ways to discount what is something of an epidemic among older adults in America today: depression.
If you are a caregiver to an older loved one, the symptoms may be slow to show themselves, but depression is a real medical condition to be addressed every bit as much as dementia or heart disease. Adults 65 years of age and older may only be just 13% of the population, but they account for 20% of suicide deaths. Older adults with depression have healthcare costs 50% higher than non-depressed adults. And depression is common – more than two million older adults manifest some degree of clinical depression. Where should you look for depression? I mentioned widowhood at the beginning. Well, one-third of widows and widowers meet the clinical criteria for depression within the first month after losing a spouse. And half of these are still depressed a year later. Depression also is a classic comorbidity of a number of medical conditions like Parkinson’s, Alzheimer’s and even cancer, arthritis and heart disease. But the prevalence of depression is really just an opportunity to take action. The data show that fully 80% of depression in older adults can be effectively treated with either medication or talk therapy or a combination of both. If you are a caregiver to an older loved one, however, encourage them to see a mental health professional who can offer the best of both medical and talk therapy. About 55% of older adults who do seek help for their depression reportedly go to their primary care physicians. While PCPs care prescribe, they are not schooled in talk therapy. If you suspect an older loved one in your orbit is depressed, don’t leave it to them to make their decisions on their treatment alone. The majority are likely to just “manage it” themselves which is not the way one addresses a genuine health problem. And don’t discount it as “just depression.” It’s bigger than that, but it can be addressed! 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.
New research recently reported sheds some light on what we need to know about Alzheimer's as well as what we may not want to know. Please allow me to explain. You likely have heard of some of the genetic advances that now allow labs to identify certain individuals who are more likely to develop Alzheimer's disease (AD) based on the apolipoprotein E ( APOE) ε4 allele risk factor for AD. Very simply, those who have this gene are at a higher risk of developing late-onset Alzheimer's, but how this happens is not yet fully understood. Scientists conducted a study among people with this genetic expression by dividing the individuals into two groups based simply upon whether they knew they had the gene or not. All individuals had the gene expression, so if they were randomly divided into groups one would expect that any person would have the same chance of having cognitive problems as any other individual. What the scientists found was quite remarkable. These study subjects were asked to rate their own memory performance and mental processing on a number of tests. Their actual performance was also quantified by the scientists. At the end of the testing, those people who knew they had the gene performed the same as those who did not know on the objective tests. When they scored themselves, however, those who knew they had the gene did worse than those who were unaware they had the gene. So, a person has to ask whether they will be better off knowing that they have a predisposition to AD or not? In a more upbeat bit of clinical research among Alzheimer's patients scientists offer a glimmer of hope for even those who may be predisposed to AD. It is a federally funded study and the largest and longest duration study of this type. Over a period of five to six weeks the experimental subjects were exposed to a number of hour long sessions in either reasoning, memory or processing speed, cognitive abilities that often decline as individuals age. All individuals were tested for cognitive ability at intervals up to five years from their initial training, and those who had been trained did better than those without the training. Even ten years out, there was a positive difference between the two groups, but the trained group did tend to decline somewhat from where they had been. So, if you are a caregiver to an older loved one, you may have one question along with one certainty. First, do you want them to have the test if knowing can be its own down side? Second, you should know that you want to encourage them to be socially active and intellectually challenged. 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.
Although Alzheimer’s disease is the most common type of dementia, there are over 100 different causes of reduced brain function and cognition…dementia. Although we are all hopeful for a cure...or should I say cures. So, it is huge when we begin to learn what factors predispose someone to reduced cognition and how we can modify behavior or the environment to reduce the risk and that cognitive outcome. Let’s take them one at a time:
1.Dementia has been statistically tied to high mid-life blood pressure
Longitudinal research recently reported in the British journal Lancet Neurology statistically linked higher and rising blood pressure in early to middle age with a higher incidence of dementia in later life. In this research “middle age” was defined as 36 to 53 years of age, and “later life” was defined as 69 and older.1.Dementia is linked to decreased brain size This is where it is all linked. The higher blood pressure or rising blood pressure in early life is also linked to a smaller brain volume. In the British study they followed people from birth to older age with 20 measurement points along the way. The link between brain size adjusted for early life cognition is not necessarily a direct one. We talk about “adjusted for early life cognition,” because people who have cognitive issues early in life tend to have more as they get older. But those with smaller cranial size have an even great incidence of cognitive impairment. The researchers speculate that it is the clear link between reduced brain mass and the development of white matter brain lesions that gives rise to the dementia, not just a matter of brain size.
2.White matter brain lesions are linked to the later onset of dementia
Here is where the link becomes really concrete. The researchers showed that a given increase in blood pressure yielded quantifiably more white matter lesions. Back to brain size, the same sort of trade off was demonstrated with brain size…more pressure yields smaller brain mass. The bigger the increases in blood pressure the greater the incidence of white matter and the smaller the brains.
3. 30% of dementia cases are modifiable
Yet, blood pressure alone was not directly associated with cognitive function at any given point in time. It was the early rise and sustained high blood pressure that created the brain size and white matter problems later. These were tied to diminished cognitive abilities. And this now gets back to modifying risk factors for dementia, and it is pretty clear. Everyone gets their blood pressure check early and regularly…and gets it under control if it is elevated!
4. All of the above
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.
We all have seen the news stories in which older adults who are in a senior residential facility or dependent upon caregivers who come to their homes are intimidated by the people charged with their care. It can be physical abuse, emotional abuse, abuse by neglect or theft of the older residents' valuables and money. But we do not often think of identity theft as an abuse targeting older adults. If you are a caregiver to an older loved one, you need to be a vigilant advocate and be prepared to report any suspicious behavior. How can identity theft pose a threat to an older adult? Because someone has to look the part to get away with that, right? A growing number of cases nationwide suggest that older adults are perhaps even more likely as targets of identity theft than other younger people, and the reason very simply is that the person using a credit card in any number of transactions will rarely be asked for photo identification as they use the card. Even so, there are just too many "faceless transactions" for photo identification to pose any kind of barrier to abuse. Filling the tank at a service station or making a purchase on-line or purchasing by phone order are just a few examples. But why target seniors? Well, that is where the money is. By the time one retires, the house typically is paid off and they have accumulated their nest egg for the "golden years." And seniors are not likely to be making those big purchases for which a credit check is necessary, so they are not vigilantly tracking their credit scores nor is a lender. They may also not be using their credit card daily, so if it goes misses from a purse or wallet, it may be days before the loss is discovered. There also are more interactive scams that can defraud seniors. There are fake phone solicitations by what seem to be worthy charities or the call from someone posing as a grandchild or other family member with an urgent need while in another town. There are investments for which they may be "prequalified" with rates that will always be above what the older investor is earning from bonds or other safer investments. And who has not had an opportunity to help retrieve prize or inheritance money from someone in western Africa? As a caregiver, how can you help protect your older loved one?
1. Warn your loved one to the possibility of this kind of abuse.
2. Be alert to caregivers in your loved one's home and limit their access.
3. Suggest a credit card statement audit by a money manager who can spot fraud.
4. If your loved one is already having difficulty keeping up with bills, step in to help organize their finances and give everything due scrutiny.
5. If not you, personally, there are daily money managers who can fill this role (check the top listing on our resource page). 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.
Last week, we talked about how to overcome depression and melancholy after the holidays as a caregiver. For some, the emotions and attitudes of those around them can affect state-of-being as well. If the person you’re providing care for is also feeling down, it might weigh down on you too. We’ve said previously that it is important to take care of the caregiver in order to provide the best for your loved one. However, sometimes assessing the loved one’s emotional needs might help everyone in the household survive post-holiday blues. Here are a couple of quick tips on how to approach a senior or loved one that is feeling down after the holidays.

Sometimes a little bit of rest helps. You may not have to do anything out of the ordinary other than be there for each other and take a break. After the holidays, everyone – including the person you’re caregiving for – is probably exhausted. This can contribute to being down and out for a while. Sometimes it’s best to just let those feelings live while allowing everyone to wind down and rejuvenate after an exciting holiday time.

Feelings of nostalgia of how things used to be can affect the person you’re caring for too. After the holidays is a prime time to reflect on year’s past and about how the holiday just doesn’t feel the same. Even without engaging in feelings of nostalgia, emotional stress regarding health and finances may take its toll. Providing a positive distraction for both you and your loved one might help with these feelings. For instance, taking them out for a relaxing stroll, engaging in some form of activity, or simply having a quiet meal together may help tremendously.

Above all, simply understanding you and your loved one’s feelings– recognizing it, and doing your best to overcome them will help get you through those tough times.

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.
I bet if I asked for a show of hands for any of you who have flown on a commercial airline within the past year, there would be only a precious few who did not raise their hands. Now, if I were to ask if you had made a plan about what you would do if one of the engines failed and the plane was forced to make an unexpected landing scarcely a hand would raise. And that’s okay, because all the airline professionals have logged hundreds of hours training so that they know exactly how to get everyone safely on the ground and off the plane under almost every circumstance. Now, if I were to ask how many of you have an older loved one who depends on you in some fashion, how many of you would raise your hand? It may be your aging parent, a spouse or partner with some medical challenges or the neighbor that does not seem to have family whom everyone on the block has adopted. Now, do you have a plan for next steps…the call that comes when you least expect it? Every 67 seconds, someone in America is diagnosed with Alzheimer’s, and that is only one of the multitude of cognitive issues that can affect aging people. Every 105 seconds a 65+ year old in the United States is hospitalized with a fractured hip. Eighteen percent of auto fatalities are among drivers 65+ years old, a rate 50% higher than the rest of the population. And then there are the other chronic health or simply accidental issues that can arise among our older loved ones, and the vast majority of those who will be caregivers to them are not prepared with a plan. Hope is not a plan! Let’s start with how you can make a plan. How about the talk no one wants to have with their older loved one…is it safe for them to drive? I was at a talk recently where the doctor who hosted the session talked about what I would call the “pre-talk” when it came to safe driving and aging. And the pre-talk also has a pre-plan. Consider this to be the small step toward a dialogue with your older loved one that will help prepare everyone for their healthier aging…and your older loved one gets the chance to buy-in. You can choose which path feels comfortable for you. One is called the Driver Planning Agreement and it simply is your asking your older loved one to read a sheet that they will sign if they agree that they will consent to talk about their safe driving with a person whom they will designate on the agreement. The other is about letting them begin to assess how they, in fact, are driving… It is a self-rating test that will give them an objective opportunity to rate themselves in a way that can open the door to a conversation they may not otherwise have had with you or other loved one. And they still get to control their lives and their plan. This is just one way to addressing the changes of aging, and it is just a start. But it also is the beginning of a plan! And you will find it is not so difficult after all. All conversations have to begin somewhere, and this just could be your “road map” to a better place for talking about driving as well as talking about everything else on the life path. 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.