Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • crisis managementChicago's Geriatric Care Manager Center of Excellence

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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Can You Hear Me Now?
From 2002 to 2011, actor Paul Marcarelli was the voice for Verizon pitching their cellular communications with the simple...
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September 28, 2021
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Nursing Homes Still a Risk for COVID-19?
It has been a tough pandemic for everyone, but it has been especially difficult for residents of nursing homes...
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August 31, 2021
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Your Flight to Nowhere is Boarding
You have probably put off a vacation or most any travel for more than a year with the threat...
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August 10, 2021
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Breaking News for Alzheimer’s … part 1
The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of...
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June 15, 2021
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To B or Not to B12?
I have written a lot about dementia over the years as well as other issues that can mimic the...
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May 11, 2021
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Three Milion More Victims…
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably...
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April 27, 2021
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Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
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April 20, 2021
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Three Steps to the Now Normal
Yes, it has been a long year, maybe in part because it has been more than a year of...
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April 6, 2021
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As If COVID Were Not Enough
We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the...
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March 30, 2021
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In the Caregiver's Words

Recent Client Praise

I have talked in some of the recent blogs about when decision-making may transfer to another person from an individual whose own faculties may be failing. Such is the case with powers of attorney as well as guardianships. There also are decisions which need to be facilitated by a caregiver, but we need to know the difference between deciding for the older loved one or individual with special needs versus facilitating their own good decision.

In my role as a GCM I had a conversation with one of my clients recently about her car. She is an 84-year old woman who has been living on her own since her husband died about six years ago. Her husband had surrendered driving responsibilities to her some several years before his demise, and it was his initiative and his choice.

Recently, she asked me what I thought about her giving up driving. The fact that she brought it up suggested to me that there may have been a precipitating event for her question. She admitted that increasingly she had experienced vision difficulties driving at night, so she was limiting her driving to daytime.

On further probing she admitted, however, that she recently had lost control of her car and skidded off a road near the independent living facility she called home. It had frightened her. Her facility manager at the residence had suggested she consider selling her car and rely instead on their complimentary shuttle service to get about town for shopping and such. Simply put, she did not want to give up her independence. If you were the caregiver to such an individual what would you do?

The one thing you ought not do is immediately decide for the older individual under normal circumstances. You can, however, talk about the frightening moments the older individual may have had. In my case here, I used that experience as an opportunity to discuss what might have happened if her accident had involved another vehicle or worse, a pedestrian. I said "normal circumstances." If the individual is mentally or physiccally compromised to such an extent that it interferes with safe driving, you have a moral and legal obligation to deny them access to a vehicle. Check with your own state department of motor vehicles for the actual wording on the books in your locale.

On the positive side, it was also an opportunity to discuss how using the facility shuttle could be liberating. She would now have the benefit of transportation without the increasingly challenging responsibility of driving. In the end, I also encouraged her to talk with her adult children to discuss their opinions and what they could do to help. Although both her children lived at some distance from her home, they were in a position to assist in selling her car. That proved to be the last string for her to cut in order to part with her car and to move forward with “her own chauffer” as she came to call the shuttle.

In my next blog, I will talk about another big decision-point many older adults face – whether to move into a facility for elders and others with special needs. I also have spoken with elderlaw attorney Eric Parker, whom you may remember from an earlier blog on advance directives. He has some great advice on how to select a nursing facility.

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.

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It is no secret that we at Creative Care Management are all about what families can do to help older loved ones … as well as help themselves. I often have said that a caregiver can be their best caregiver if they also are taking care of themselves. I came across some research that may be suited to a caregiver’s loved one or to the older caregiver who may be “at retirement age” but still in the work force. A lot of folks are electing to work beyond the traditional retirement age of 65 years…give or take. There is ample evidence that we as Americans are mostly living longer, because we are healthier, and some just find that they need to anticipate a bigger nest egg because we are also, in fact, living longer. Running out of money is considered a “bad retirement plan.” Research published by some Health Economists from The Netherlands suggests that working may be detrimental to one’s longevity…or conversely that retiring earlier could prolong one’s life. These Dutch researchers took advantage of a temporary change in retirement eligibility among male government workers to compare those who had retired early versus those who waited. Five years after the early retirement they compared the mortality rates of the retired men who were at least 55 years old when they quit with those who worked longer before retiring. Those who worked longer showed a 2.6 percent higher mortality five years out than those who retired early. It is not a huge difference, and a person could argue that civil servants have a more stressful work environment…maybe. But studies ion the U.S., Israel, Germany, England and some other European countries had similar findings. Other research even shows that retirees are more socially active than once thought; so much for the social isolation and depression theories. We simply cannot overlook the fact that some jobs…maybe more than we had thought…are just stressful. Long hours get in the way of working out, and high stress can disturb good sleep or even lead to higher alcohol consumption. So, early retirement could be in the cards for us all, but with a few caveats. Work on a nest egg that will be sufficient so that finances do not become a post-retirement stressor. Be active, especially if your career job involved high activity. Stay active so that obesity does not become a challenge with a new sedentary lifestyle. Continue to be socially engaged. 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.
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A family crisis doesn't make an appointment. Therefore, you've got to be ready when it shows up. In excess of 8 million Americans have some form of dementia, As a caregiver to a loved one with dementia, it can wear you down, stress you, worry you and make you sad. It may create a financial hardship for you or your loved one. It can become your other full-time job. And it can burn you out! This book focuses on what we know that can be your lifesaver to ease your pain and help you find the best way to address your problems. It also will help you to care for you, the caregiver. There is no "one size fits all" plan, but we think you will find parts of your plan in the case studies we share in this short book. The key to peace of mind is to have a plan, even if you have to make adjustments along the way. Let us be your companion and guide as you navigate this challenging time…

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Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together at distance with friends and family in manageable numbers while maintaining distance, but there is no chatting around the water cooler or dropping by the grandparents or social hour at a local establishment like there once was. All of that is mostly lost, at least if you’ve been following the guidelines, and the isolation you and your older loved ones feel is not unique. Odd to talk about isolation and then offer that you are not alone, but… Research is showing that strangers may be every bit as important to your emotional well-being and your older loved ones’ well-being as the friends that you all may now be missing. If you’re like a lot of folks, you are walking more, perhaps with a dog in tow. Or you many be shopping for groceries in the less crowded grocery stores. Or you may be at home to have the mail delivered as your retired parents are and meet the letter carrier or the delivery person from those on-line purchases we all have been making in greater number. I am not exactly an extrovert, but I always make it a point to at least say hello to all of these people with whom I have casual contact. And my husband, the extrovert in the family, may spend minutes chatting up a neighbor we had not met until the recent months or the person from the pizza parlor who delivered tonight’s guilty pleasure or someone eight blocks from home on his long walks with our now physically fit dog. Well, those casual encounters may be helping his and my mental health in a way that we used to think only close friends or confidents could according to a book I came across. The book, titled “Consequential Strangers,” is co-authored by a psychologist and a science reporter who analyzed the importance of those “weak ties” that we all have on a daily basis. In fact, the authors contend, those strangers are as important as family in best friends in giving us a strong grounding in the world. And the authors further point out that the more ties we have with “consequential strangers” the less likely one is to become depressed. Some of the benefits also include better sleep patterns, more productive work effort and just about all of those parts of daily living we value. To truly be healthier during this extended break from normal, ask strangers how they are faring…and then how their family’s health is…and maybe what they have been bingeing lately. You will have primed the pump for your better health. Now, do the same for your older family members and friends and you are passing it forward. Remember, we all will get through this, and we will get through it in much better shape if we hold our strangers closer. 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.
I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights, this time about diabetes and some late-breaking news. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM.
More than 11 percent or, or nearly 27 million, Americans have either diagnosed or undiagnosed diabetes according to the most recent data. We include the "undiagnosed" in this figure, because anyone who has a consistently high A1C level (the measure of long term blood glucose) is creating an opportunity for other medical problems. For anyone who is a caregiver to an older loved one, this "diabetes epidemic" should be all the more alarming, because the prevalence of diabetes and what is termed "prediabetes" more than doubles to nearly 27 percent of those 65 years of age or older. The reason for the title of this posting is that diabetes is one of those medical conditions that seems to almost invariably be part of multiple diagnoses or medical conditions. So if your older loved one has been diagnosed with either diabetes or prediabetes, you need to help them to manage diabetes as well as the other companion conditions. For instance:
1. Diabetes is associated with higher levels of chronic fatigue. A recent study in the Netherlands found that these two conditions seem to go hand in hand, but they could not conclude that high blood glucose "causes" fatigue. It is just more likely to be there if a person runs "high" on a consistent basis.
2. Chronic kidney disease (CKD), a condition in which the kidneys progressively lose their ability to filter body fluids, is twice as common in people already diagnosed with diabetes. Scientists suggest it is the glucose that binds to red blood cells in the blood stream that block and break down the micro-vascular tissue of the kidneys leading to CKD.
3. High blood pressure and diabetes also tend to go hand in hand. For the same reasons that the kidneys suffer from high blood glucose levels, all the other circulatory system is adversely affected. And the negative synergy of poor circulation along with further hindrance to circulation create the potential for a real cascading of medical complications.
4. Retinal eye compromise and its ties to diabetes complete the circulatory issues caused by consistently high blood sugar levels. By blocking the tiny vessels that nourish the retina of the eye, diabetes effectively starves the eye causing a loss of vision or diabetic retinopathy.
5. People with diabetes have a higher risk of depression than those without. There is some speculation on how this happens,. but most professional agree that depression does not cause depression. A fair number, however, state that the feeling of the unfairness of the disease or the loss in control over their diabetes and the associated anxiety cascade into depression.
Please let Steve know if you have any questions about diabetes, drugs, 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 to older adults and their families who need geriatric care management services in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
No, it is not a typo. There are some new changes to insurance coverage under the Affordable Care Act that will have a big impact on one of America's often overlooked health care needs: hearing. Did you know that one in five adult Americans have some form of hearing loss according to the National Institute on Deafness and Other Communication Disorders. Yet, only about one in five of the one in five with a hearing loss actually have used a hearing aid in the past. That translates into about 40 million adult Americans go without a device that could re-engage them with the world, and it mostly is because hearing aids are expensive - about $1,000 to $5,000 - and last only about three to five years before a replacement is needed. The implications for the older population are staggering. Among adults between 65 and 75 years of age, the percent with some hearing lost, but this jumps to fifty percent of those 75 and older who have a hearing deficit. In past blog postings, I have talked about two of the major challenges of aging: loss and isolation. Picture those two amplified by the inability to hear the words of comfort from another person or to engage in social activities simply because one cannot hear well. But there are changes afoot. The Affordable Care Act stipulated a requirement for coverage for the ten "essential health benefits" (EHBs). Advocates for hearing health see number 7 of these ten as applying to hearing: "rehabilitative and habilitative services and devices." While this is not a done deal, there are increasing numbers of states and/or insurers who are getting on board with hearing health just as they had in the past with vision or dental health. UnitedHealth Group has introduced a hearing health option in 2011 that can be either a benefit or at least a discount. Closer to home, Blue Cross/Blue Shield of Illinois is now offering a discount benefit to their members through TruHearing. With these giant insurers in the lead, you have to believe that others will follow now that the playing field for health insurance has become more competitive. You should also check your AAA insurance or AARP membership for discounts. And Veterans Benefits and the Federal Employee Benefit Health Program have always included a hearing health benefit for their members. If you are a caregiver to an older loved one who is having hearing difficulties, give one of these entities a call. You may be very pleased at what you - and your loved one - hear. 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.