Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • caregiversChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 3

I Miss the Scams That Used to Be Easier to Spot
It was probably ten years ago that my husband’s mother was caught up in a telephone scam on her...
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September 26, 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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Medicare’s Surprising Cost Savings
Medicare has been one of those political footballs where both sides of the aisle have had an entrenched position...
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September 5, 2023
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The High Cost of Wellness
Once in a while “yesterday’s news” is also tomorrow’s news. Earlier this year you probably heard or read that...
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August 15, 2023
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Three Words Are the Cure
Some have called it an epidemic. And it’s particularly virulent within the senior population. The epidemic leads to even...
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July 16, 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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Follow Your Gut…You’ve Got No Choice
It was back in the sixties and seventies that so many folks embraced the mantra: “You are what you...
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April 11, 2023
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Spring Tips for the Holiday Caregiver
We all know that that Spring in the Midwest isn’t on a straight line from Winter toward Summer, but...
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March 28, 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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In the Caregiver's Words

Recent Client Praise

It is November, and for most of us that means gearing up for the holidays, family and memorable events. The first two are true of almost everyone, but the third one - memorable - can be a huge challenge to caregivers and patients with Alzheimer's Disease. Caregivers to a loved one whose mental faculties are declining from Alzheimer's Disease can face a lot of challenges, not the least among them the guilt that can come from hosting a holiday get together when things just cannot be the way they used to be. Here are some tips for caregivers to a loved one with Alzheimer's or any of the dementias that may affect memory:
1. Take care of the caregiver: The person whose needs most often are at the bottom of the list is the caregiver to an AD patient. Do something for you, and it will make it easier to do all those other things for all those other people.
2. Be realistic: We all tend to have a notion about what the "holiday is supposed to be." That may not be feasible when a loved one has Alzheimer's, so work within the capabilities and the comfort zones of all concerned.
3. Include everyone in the plan: If you talk over plans for the holiday with all the family, it can help all to enjoy the event. Everyone will have had a say in what happens and expectations will be better met.
4. Avoid over-doing the alcohol: There is a great deal of loneliness in being a caregiver to a loved one in decline, so avoid the inclination to self-medicate. If you as a caregiver already feel melancholy, alcohol will only fuel the depression.
5. Let visitors know: If visiting family does not know exactly what to expect from a loved one with AD, they probably will not act appropriately. Help them to understand about talking and living in the moment.
6. Let your loved one know: For patients with early onset AD, there can be moments of lucidity as well as confusion. Help them to also be in the moment and not lapse into the sadness or even the angry outbursts that can come from AD's confusion.
7. Manage the environment: AD can be confusing enough without exacerbating the challenge with a noisy environment. Helping your loved one to engage people in quieter surroundings can help everyone communicate better.
As you navigate through the holidays, appreciate that they may not be as they once were before the intrusion of Alzheimer's, but you are making new memories for you and the rest of the family. With attention to some of these tips, you will find that the new experiences will help everyone's holidays to be their own new memories to cherish. 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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a common topic of our discussion. I have asked Gregory Peebles to talk about this topic from the vantage point of his experience. 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. An Associate Care Manager, Gregory has been a part of our team for over a decade. – Charlotte Home. Not only is there no place like it, conveniently located wherever you hang your hat, that fits--like an old, comfortable shoe, but it’s also a place that once we leave, to which we can never return. While most find this very stressful, some are secretly happy for a new chapter. Indeed, lots of people confirm they like adventure, but small is the number who enthusiastically embrace major residential change. So what’s the difference? Well, for one, the direction of action: people elect to go on adventures, but change just seems to happen to us. This is a major life change, and those inclined deserve the opportunity fully to grieve their loss of home sweet home. However, once the initial grief has been addressed, we’ve got work to do! Change isn’t the end, and there’s plenty of life and happiness yet to be found no matter the location. Where that happens is up to you. The diversity of the experience of aging can be exciting, and, with the number of Americans joining the group of aging adults, the kinds of communities that now exist will only become more varied. Right now the kinds of accommodations available generally fall into a few groups.
- Active Adult Communities – Often neighborhoods with individual bungalows, these communities are based on the model of so-called “snow birds” who opt to transition to such a residential community rather than maintain a larger space. Living in one of these communities requires a high level of independence (and income). Individuals or couples with highly social personalities thrive in this setting.
- Independent/Congregant Living – Facilities of this type, while slightly less luxurious than an Active Adult Community, feature many of the same accommodations with a denser population. In an urban setting, they are often high-rise apartments indistinguishable from nearby housing, with dining, health care, and leisure activities on the premises. If considering this type of facility, be sure to keep nearby entertainment and accessibility in mind.
- Assisted Living – A senior for whom it has become difficult to care for themselves either because of physical limitations or decreasing independence will often find an exciting new life in such a facility, either through public assistance or private pay, where skilled staff are present to provide diverse care. If the care receiver is also living with cognitive decline, such a facility with a “Memory Unity” may be advisable.
- Skilled Nursing – On average, aging adults who become residents within skilled nursing facilities – SNFs - are those who have health problems, who require 24-hour care, and whose ability to manage the Activities of Daily Living is severely impaired. Nursing home care, too, is expensive, but public assistance programs such as Medicare or Medicaid relieve the cost.
Change is difficult, but not unmanageable. New identities await us and are only limited by our willingness to embrace them and the imagination we bring to our experiences. Change is scary, and rightly so, but when we weather even the most difficult transitions together, and our lives are no longer recognizable from before, we may--if we choose to--learn that home is something that we take with us wherever we go, and that it is recognizable not by its address, but by the love shared and the people with whom we share it, common to both our memories and our futures. One final thought: This is when people often reach out to Aging Life Care Professionals to help smooth the transition to a new residence and to ensure ongoing care. CCM has helped countless families like yours succeed in this new chapter. Contact us today and let us assist you. 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.
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and trained Medicare Counselor, whose work focuses on helping aging adults and folks with limited independence by navigating resources and support to help them discover and lead their best life. Gregory has been a key member of the CCM team for over a decade. – Charlotte This is the final installment in a three-part series to help clear up some common misconceptions about Medicare that are more important for Caregivers than your older loved ones. We started our series with the structure of Medicare [link], and moved last week to surprising omissions of coverage [link], chief among which is long-term or “custodial” care. When folks discover that Medicare does not cover residence in a Skilled Nursing Facility (used to be called a “nursing home”), it can be startling. And if they are waiting until they need this residential care, it is too late to prepare. Managing the options available requires a little planning, though, and the sooner it starts, the more effective it can be. Several insurance companies provide long-term care packages, and some options are even provided through employers and may be available to you now —provided you know what to ask for. Individual policies are also available, but, if initiated later in life, premiums can be quite high. These premiums also potentially increase with age, and this can make the option less viable for some. Important to consider, too, in your planning, is that income typically goes down with age, and the premiums must continue to be paid so long as the beneficiary is receiving care. This means that the earlier you invest in long-term care, the more likely it is to be affordable for as long as you need it. Important services covered by long-term insurance usually include:
- SNF, or “nursing home” stays;
- Assisted Living;
- Adult Day Care Services;
- Home Care; and
- Home Modification.
As none of these services is covered by Original Medicare, the benefit of having a long-term care policy is clear. In fact, home care and home modification services increase the amount of time adults can age-in-place, which is the preferred option for most. So, wherever you are in your journey, consider putting methods in place that bolster the existing benefits of Medicare and increase your options for quality of life while maintaining your hard-earned savings. It is never too early to plan! 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.
You may have heard the noise about a new drug for treating Alzheimer’s disease and other dementias. It would make sense that there would be some noise, because we’re talking about a new treatment with a new target and new data on how well it works (or doesn’t). A lot of the noise, however, was not fanfare about a new drug as much as the red flags that Medicare (CMS) was raising about covering the new therapy's use. That, and it’s been since my book was released in 2017 that any new way to address the devastating effects of Alzheimer’s has come on line…and that's just about six years! I won’t go into the details of those “older drugs,” except to say they didn’t have anything close to the dramatic results that consumers or physicians wanted:
- Cholinesterase Inhibitors (Donepezil, Galantamine and Rivastigmine); and
- NMDA antagonists (Memantine, Memantine and Donepezil combination).
You can read more in Chapter Seven of the book if you want to understand their mechanisms of action as well as other healthy lifestyle habits that can make a difference in addressing both the progression of Alzheimer’s and how the medications work. I had mentioned the “noise” about a more recent addition to the inventory of FDA-approved treatments for Alzheimer’s. The new drug, Leqembi, was approved for treating AD, but there were a number of caveats imposed by the Food and Drug Administration from the get-go. When FDA gave its initial approval of Leqembi as “safe and effective,” the Centers for Medicare and Medicaid Services (CMS) placed some rather onerous restrictions on the use of this therapy. What restrictions? Patients can of course be prescribed Leqembi, but it will be “covered” by CMS only if their prescribing provider is part of a registry to monitor the use of the drug. This position has been a bit relaxed from their earlier restriction that patients could be prescribed this therapy only if they were involved in an extended clinical trial. And this is a first for CMS to require this sort of data-collection after FDA approval. FDA’s approval was based, it seems, on the therapy’s ability to reduce amyloid beta plaque in patients’ brains in a 79 week trial among 856 patients. The manufacturers of Leqembi had completed the trial with up to 93 percent reduction in plaque at Leqemi’s highest dose. CMS has made restrictions for drugs yet to complete an approved clinical trial, but Leqembi was already done with that. What’s missing in this picture? Since this is going to take a bit more space to unpack, I’ll leave with you a question to be answered in “part 2:” What about maybe judging a therapy based on measures of Cognitive Decline? Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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 short answer to this question is cybersecurity breeches. First, how do you know if that spam in your inbox is from the “dark web?” This is the last week of National Cybersecurity Month, so you’re just in time to help your older loved ones…or yourselves…shore up your protection from security threats on line. If you or your older loved ones did not shop or do business on line before COVID, you all are probably well on board by now. Here are the three main areas where the risks are the greatest for security breeches according to our own Cybersecurity professional, Bryant Wallace:
1. Health and Wellness -It’s no surprise that our older loved ones may have some health care concerns, and with those concerns come questions for which they seek answers. So, pop your/their question into the search bar and click, right? Beware of the sponsors of the site(s). There are some really slick sites that seem to be full of medical information, and pharmaceutical and biotech companies are very happy to share what they know about a medical condition. But they are also selling their product(s). In the industry they call this “pull-through advertising,” because they intend it to be a conversation that a patient will bring to the doctor to secure a prescription. To get more objective information look to the last three letters on the site; the .edu and .gov will have generally objective and non-sales content.
2. Banking and Finance – Be certain that your loved one’s computer and home internet are secure. Discourage your loved one from using a public computer or kiosk like one they may find at a public library. And also discourage their sharing of personal information like account numbers, birth dates or their social security numbers. Encourage your loved one to also type in a secure website when accessing sites…no click-through from an email or pasting from a browser search results.
3. Shopping – Begin at the beginning of the web site…double check for the ‘s’ in the https. It stands for “secure.” Look for the padlock icon on the site that will assure you and your loved ones that the site is secure. And as with banking and finance, don’t just click on a link or paste an address. Consider the charge limit on your credit card, and you’ll realize how much is at risk when shopping online.
I had mentioned Bryant Wallace at the top of this post, and you can reach him at this address or browse his company’s website here . Back to the dark web and spam…reach out to Bryant for some tips! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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 have had the good fortune to connect with Jennifer Mesko, Managing Editor of a great website and resource, Drugwatch.com. When I asked about the latest on dangerous medications or medical devices for those who are caregivers or in geriatric care management, she offered these comments.
Nearly every senior in the United States relies on one or more drugs or medical devices to improve their lives. Most of the time, these drugs and medical devices help them deal with pain or a medical condition, and keep up an active lifestyle –and they can even save their lives. Sometimes, however, drugs and medical devices do more harm than good. When a manufacturer fails to disclose the risks of its products, people can end up getting much worse instead of getting better. As a caregiver, you likely play a key role in someone else’s medical care and may be responsible for making sure medicine is taken on schedule – or that surgery is scheduled when necessary. Here are a few products you should be aware of: Dangerous Drugs Just like prescription drugs, some over-the-counter drugs can be dangerous. Tylenol, for example, is taken by millions of people every day. Just recently, however, reports of serious liver problems have come to light. The problem occurs when someone overdoses on Tylenol, often by accident. If one of your patients is taking cold medicine in addition to Tylenol, for example, you need to check to make sure the cold medicine does not also contain acetaminophen (the active ingredient in Tylenol). If more than 4,000 mg of Tylenol is taken within 24 hours, the drug builds up in the body and can overload the liver and cause organ damage or even death. Carefully monitor your loved one’s medications to ensure he or she is not taking too much acetaminophen at once. Another drug that caretakers should be especially careful with is Pradaxa. The drug is a blood thinner that reduces the risk of blood clots. Unfortunately, because the blood is thin, patients can experience uncontrollable bleeding after a minor scrape or cut. There is currently no antidote to this bleeding, which can lead to death. Reports show that Pradaxa side effects such as heart attack and uncontrollable bleeding led to more than 500 deaths in 2011. More than 1,000 patients and family members have filed lawsuits after Pradaxa injuries. Talk to the patient’s doctor to discuss what to do in a bleeding emergency. Dangerous Devices Your loved one may require a joint replacement, just like hundreds of thousands of others do each year. Most of the time, this type of surgery helps relieve pain and restore mobility. Unfortunately, not all hip and knee implants are safe or effective. Before the surgery, talk to the surgeon about which implant will be used. Some hips, including the Biomet M2a Magnum and Depuy ASR, can create problems because they have two or more metal parts. As the components rub against each other during normal activities, the implant sheds metal particles into the body. This can lead to metal poisoning, which requires revision surgery. Knee implants can also be problematic. Patients have reported numerous complications from the Zimmer NexGen Flex Knee system, including loosening, dislocation, implant failure and intense pain. Artificial knee joints are expected to last 10-15 years, but Zimmer NexGen implants can fail after just a couple of years. Drugs and medical devices are an important part of everyday life for most seniors. As a caregiver, it’s vital that you find out as much information as possible before dispensing medications or agreeing to a medical device for your loved one. Do your research, talk to the doctor and make sure that the ones you love avoid these dangerous outcomes. Jennifer Mesko is the managing editor of Drugwatch.com, a consumer advocacy website. She keeps consumers informed about prescription drugs and medical devices that could put them at risk.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are senior care management professionals, geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.