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

COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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Just the Facts – About COVID Today
For a pandemic and quarantine that has lasted about 18 weeks, it is safe to say that most of...
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July 14, 2020
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Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
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July 7, 2020
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Dementia: We’re Not Post-COVID Yet
If you have a family member or loved one with dementia, this pandemic and its restrictions have been exponentially...
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May 26, 2020
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Distance Caregiving Through a Wall
I’ve written numerous times about distance caregiving, and one of the observations I have offered is that distance is...
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May 19, 2020
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Caregiving During COVID: Four Tips for Reengagement
You may recall that I have recommended limiting your news consumption, because it really does add to our stressed...
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May 12, 2020
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In the Caregiver's Words

Recent Client Praise

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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a prevailing 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 - at home. An Associate Care Manager, Gregory has been a part of my team for over a decade. - Charlotte
Home. There’s no place like it, but it’s also very conveniently located wherever you hang your hat. As nice a thought it is that “home” is a physical place we can go, when we look at that thought more closely, it turns out to be not nearly as nice as we first imagined. Our insistence on home being an actual place isn’t just silly misstatement; it’s a false belief that can easily get in the way of our ability to discover new happiness. We imagine “home” existing as it always has in our memories: strong, immovable, untouched by time. It holds us safe inside, protecting us while we watch the world transform at a dizzying speed into a place we no longer recognize. It’s easy to see why we yearn for such a harbor against change. That place doesn’t really exist, though. Even if there remains a physical house from childhood where parents still live, “home” is not a physical building: it is a mental place, constructed not of wood or stone, but of our memories and feelings. Consequently, when we visit the mental place we call “home”, safety is usually one of the first feelings to come to mind. When folks say, “I want to go home,” what they’re really telling us is that they want to feel safe again. We feel safest when we know. Not surprisingly then, where we once lived for a long time feels the safest. But, like the false idea that “home” is a literal place, is it possible that we could also be wrong about being safe in our own homes? Absolutely. In case you can’t tell yet, this post is gently getting us ready to talk about denial: denial that change is a necessary part of living; denial that our circumstances are ultimately beyond our control; denial that we are at last, mortal. As we age, inconveniences in the home can turn into safety hazards. As we watch our parents age, we begin to feel deeply our own mortality and—if we’re not careful—to slip into a pattern of denial, the manifestation of which is the attempt to keep life as it exists in our memories perhaps longer than is advised. However, while this may feel psychologically safe, it may also be physically the most dangerous choice to make on behalf of our loved ones. Yet we rightly want to keep our lives free of disruption for as long as we can. So how can we strike the balance and keep our loved ones safe and in that special place we call “home”? In our next blog, we’ll talk about what makes a home a safe place for aging adults, including how to continue to ensure protections for the loved ones who depend on you. Be sure to come back and we’ll give you what we know. 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.
My mom died on March 9th with dementia. During the 4 years as her caregiver, I really valued your emails. I learned so much from reading them and tips made my life better.
A satisfied client
Perhaps you’re thinking about ways to make caregiving easier in the next coming year. You may have read tips and advice about caregiving and creating care plans, especially if you follow this blog, but don’t know exactly what care managers do on a task by task basis. An elderly care plan should encompass all facets of a senior’s life. In days of old, care plans merely addressed pressing health concerns. Today, caregivers design care plans that include health, lifestyle and social dimensions, improving their residents’ quality of life across the board.

As a care manager, one of the goals I try to instill through CCM is providing assistance within the context of a senior resident’s accustomed environment. If the resident lives in a nursing home or care facility, the care plans should allow for home-like routines. A reliable Chicago senior care provider must also encourage healthy lifestyles that fit the resident’s beliefs and personal preferences.

Before actually preparing a care plan, we first observe the senior resident’s daily routine. We try to find out if there are tasks the resident prefers to avoid, e.g., picking up clutter, cooking a meal or bathing, and why the person avoids them. We also might prepare an ADL (activities of daily living) questionnaire for the senior and loved ones to fill out. The resident’s daily needs, lifestyle choices, hobbies and interests will be explored as well. In addition, we’ll about activities the resident would like to pursue, but currently cannot, because of a constraining physical or mental condition.

Once we have all the pertinent data from observation and needs assessment, we’ll go over these findings with the senior resident. They decide whether certain devices would be of help, especially in the performance of ADLs. Identified care needs, however, should be administered in such a way as to preserve the dignity of the resident and promote his independence as much as possible. Appropriate ways to encourage the patient to engage in a hobby and interact with others are considered too.

When the assessment is completed, they start identifying together short and long-term goals for the resident to work toward. Goals are written by both the care manager and the senior, and should have the patient's strengths and needs in mind. Throughout the entire process of goal setting, the senior gets the ultimate vote over specific objectives he or she deems worth striving for. After all, a geriatric care plan helps ensure that an aging individual continues to enjoy life. This is why it is so important to find reliable Chicago senior services only from established managers. Creative Care Management also makes sure to link seniors and their families with the appropriate local resources in Chicago for care providers and other needs.

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 have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about some new research which studies what predicts cognitive decline. Steve has more than two decades experience in pharmaceutical and medical device consulting prior to joining CCM about ten years ago. He reports: "Keep you r friends close, but your enemies even closer," is advice that has most often been attributed to Sun Tzu, a Chinese military strategist of 6th and 5th century China. Maybe this is good advice for military matters, but researchers are finding increasing evidence that it is poor advice for mental matters. In fact having stressful friends as early as middle age is a statistical predictor of cognitive decline in later years. Scientists at University College London report that negative interactions with others - which they characterize as "unpleasant social exchanges" - lead to declines in cognitive test scores over the ten-year period of their study. They actually measured the cognitive profiles of nearly 6,000 British civil servants over this period, and those with more negative social relationships reported even more rapid decline in their mental capabilities. Those in the top third of "negative associations" aged cognitively as much as a year more than those in the bottom third. The differences, while small, were statistically significant. In parallel research recently reported by physicians at the Washington University School of Medicine in St. Louis, it is not just the "crabbiness" of others that can precipitate cognitive decline. These physicians were looking for leading indicators of Alzheimer's Disease in more than 2400 patients in 34 Alzheimer's Disease centers between 2005 and 2013. They tested patients for their functional capacity, general depression, a host of other neuropsychiatric conditions and dementia. The patients all started out "cognitively normal" on all these scales at the outset of the study. They found that irritability, depression and disturbances in nighttime sleep patterns preceded mental decline in these patients. But it got even more granular than that. It was like following a road map with first, irritability, depression, and nighttime behavioral changes; these were followed by anxiety, appetite changes, agitation, and apathy. Last came elation and motor disturbances which were followed by hallucinations, delusions, and disinihibition. Rather startling. What do we take away from these findings? First, we should not make any sweeping generalizations without more research to corroborate what these researchers have found. But at the very least, it suggests that if you have a loved one who is middle age or older, be aware of the people whose company they keep. It is not mentally healthy to immerse oneself or your loved one in the company of irritating people. (Maybe that is good advice for us all, regardless.) The second research suggests that we perhaps can seek professional help earlier with symptoms that may precede forgetfulness or other cognitive decline. The list is here. Take seriously the signs of melancholy or poor sleep patterns or changes in mood or appetite. And if a loved one shows consistent signs of irritability, it may be more than their impatience. At the most general, think of these bodies of research to be not unlike the research we have always seen about diet and exercise along with not smoking. The research here, however, is not about physical health; it is mental health we can safeguard with better vigilance. 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.
Anyone who has raised children in the 21^st century can probably remember helping their young ones learn how to stay safe while out of the house, and later while driving the car and in between while surfing the internet. If you also have an older loved one, you may now have to work with mom or dad to be alert to the new scams targeting the unsuspecting who have internet access. It is not just a matter of helping your older loved one install current anti-viral and anti-malware software. The new scammers are taking advantage of the perfect storm of technology, trust and assets.
Today more than three in five adults over age 65 have access to the internet, and nearly four of every five have a cell phone. According to Microsoft there is a new consumer scam taking advantage of these technologies and the trust of their owners to dupe an estimated 3.3 million individuals – many of them 65 years and older – of an estimated $1.5 billion. It starts with their phone when an alleged representative of Microsoft or Windows calls advising of a virus detected on their equipment. The consultant directs them to log on and go to a support web site that will double-check their computers for the trouble. Once logged on to the site, malware is installed that can hijack any personal or financial information your trusting loved one may have on their computer. But be aware that Microsoft does not make outbound calls. Or it may be just the phone alone that gives the bad guys access to your older loved one. Ask your loved one if they have received any calls where no one was on the line when they picked up. If so, they may be part of an automated system that is accumulating a data base of people who can be targeted for later scams. If your older loved one does not yet have caller ID, have it installed. Or the number one fraud presently taking advantage of people’s phone access poses as a representative of the IRS. This may be the one phone call everyone dreads, but the simple fact is that the IRS does not make outbound phone calls. That said, when an unknown caller invokes the name of the IRS and then proceeds to make demands, most people – elders included – can become very intimidated. Let your older loved one know about this, and if they ever receive a call like this or from any of a number of agencies or federal offices, simply look up the number of the nearest office by that name and call them yourself. Again, the IRS – or any other predator - does not call you; you need to call them. 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.