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

If You Want to be More Fit, Don’t Exercise…
Just coming off Super Bowl Sunday, it’s easy to talk about who could run faster, who could pass more...
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February 12, 2024
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The Risk Factors AND Ways to Prevent Alzheimer’s
Alzheimer’s Disease affects nearly six million people in the United States according to estimates from the CDC, and that...
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January 22, 2024
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How to Get All the New Years You Can
It’s not a magic pill or a quick transformation, but it’s not difficult either. The “it” is greater longevity,...
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January 17, 2024
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A Happy – And Well – Holiday for All
It’s the season of holidays. We started with Thanksgiving and then Channukah, and we have yet to tackle Christmas...
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December 19, 2023
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Memory Doesn’t Have to Decline with Age
Memory decline doesn’t have to be part of a person’s aging process. You may know that I have written...
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October 17, 2023
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Not Just Dark Chocolate…
If you’re like me, you may have had moments when you’ve looked at the latest clinical information on the...
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July 10, 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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Update on Dementia – part 1
You may have heard the noise about a new drug for treating Alzheimer’s disease and other dementias. It would...
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June 6, 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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Another Side to the Story
It was just a year ago that Bruce Willis’ family disclosed that the actor would be retiring from acting...
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February 27, 2023
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In the Caregiver's Words

Recent Client Praise

Have you ever noticed how we all can get into a place where we are multi-tasking, we are reflecting on yesterday’s game, today’s meeting, the kids’ games, the weekend’s events and pretty soon we don’t just avoid stopping to smell the roses…we don’t even remember there was a rose along our path this morning. Scientists suggest that mindfulness is an alternative to the stress of multi-tasking. Mindfulness, they explain, is simply focusing on the present, not getting caught up in judging any aspect of it, and finding a calm within the chaos that seems to be ever-present in the 21^st century. Researchers at Harvard Medical School talk about readjusting how we view things in terms of mindfulness…that is being really in the present and just experiencing the present without judging it as bad or good…just experiencing it. It will take some practice because virtually all of us are really good at being stressed and overloaded. Yet, if we can learn this thing called mindfulness, we will have less stress, a better immune system and generally happier days. It may be even more important for our older loved ones. They have a lot more yesterdays about which they can have regrets and a lot more losses they can grieve. No wonder depression affects about six million adults over the age of 65 each year…but it is not just a normal part of aging. It is their points of view. The scientists tell us that mindfulness can improve gastrointestinal function, address heart disease, lower blood pressure, ease stress, enhance sleep, and moderate chronic pain. Practitioners are using mindfulness as part of the treatment for depression and anxiety, eating issues, alcohol and substance abuse and marital discord. They are even using it to address one of the big challenges of older adults – isolation and, yes, depression. Not being in the present also gives people way too much time to regret the past and fret about the future. Try this yourself…and share with an older loved one:
1. Sit in a comfortable, straight-back chair or on a cushion with crossed legs
2. Relax - slowly breathe in through your nostrils and out through your mouth
3. Focus on breathing…if you wander, bring your attention back
4. Take note of the rest of your body
5. After you establish this calm, then allow one thought at a time to enter
6. Gently guide yourself back to just breathing to keep from scattering
Try this for 20 minutes a day…and later expand to 40-45 minutes. Try to bring some of the method to how you handle the rest of your life by single-tasking, add moments of single-focused thoughtfulness. Rinse. Repeat. And share. 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.
When I speak with clients about dementia, there are usually three kinds of questions that come up a lot. The first is whether there is a cure, or at least an effective treatment for dementia? The second is does my loved one have dementia? The third question is something along the lines of what are my or my loved one’s chances of developing dementia? The answer to number one is that the current treatments for dementia are modestly effective in slowing the progression of the condition, and there is no cure yet. But a lot of researchers are intensely at work on new treatments. For number two, MRIs and other imaging technologies as well as cognitive tests can give us clearer assessments of Alzheimer’s progressive erosion of the brain. And it turns out that there are good answers in the works for the third question with recent results from two teams of researchers. A doctor and his team from the Division of Cognitive Aging and Dementia at Albert Einstein College of Medicine, New York City have recently published their findings on tests for predicting what they refer to as “amnestic mild cognitive impairment” and dementia. The test is called the Memory Binding Test, and it can be done in a doctor’s office in only about ten minutes. The MBT measures what scientists call associative binding; that is how we link one event or thing with another event or thing. In a study with almost three hundred patients, researchers took a baseline measure of their associative binding with the test. They followed these people for ten years and found that people who did poorly on the test at baseline were twice as likely to develop dementia as those who did well on the test. The only other reliable tests up until now have been imaging tests for amyloid plaque, so this test could prove not only hugely less expensive, but also be more reliable even before dementia manifests itself in brain images. A second study was also recently reported, and it links adult-onset diabetes with dementia. You may recall an earlier posting on what some are calling type 3 diabetes…dementia. It turns out that developing type 2 diabetes may be also be a good predictor of the dementia that will follow, especially as they both have elevated cholesterol, hypertension and obesity in common. For this research, the scientists followed more than 200,000 individuals over age 65. They found that even after taking into account other risk factors for dementia that the presence of type two diabetes increased the risk of adults developing Alzheimer’s disease by one and a half times. The risk for vascular dementia was increased 2.5 times among those with type 2 diabetes over those without type 2 diabetes. The upshot from these studies may be twofold. For the first, it is a less expensive way to determine if certain patients who test positive cognitively should be more closely monitored so that they receive treatment that slows the progression of dementia earlier in the disease. In the case of the second study, we have one more very good reason to manage our cholesterol, blood pressure and weight. 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.
As a geriatric care manager, I am always alert to changes in people's eating habits and proper diet. As people age they naturally experience a decline in their appetite in part because their taste buds are not as responsive as they were when they were younger. Loss of appetite is also a potential sign of depression, and depression is one of the most common conditions older adults experience owing to the losses associated with their stage in life and aging. But if the diminished appetite leads to anemia owing to low iron intake, then there may also be a risk for dementia according to scientists. These scientists started with a group of over 2,500 mentally healthy women and men whose average age was 76. They then followed these people for 11 years testing them regularly for their blood counts and other mental function tests. At the outset of this study 392 people were clinically testing as anemic. By the eleventh year of this study 455 people had developed clinical dementia. These researchers also measured all study participants' age, gender, education, blood sugar levels (and diabetes diagnoses) and more than a dozen other biologic metrics. In statistical analysis they controlled for all these other variables and found that anemia still was a strong predictor of dementia beyond these other possible causes. In fact, of the people who started the study with anemia, they had a 49 percent greater risk of developing dementia during the 11 years of the study. What makes this study very compelling is that it is a prospective design. It is not one of the many studies we often see where scientists can ask questions about a person's background in an effort to explain a current condition. It also is a large panel of people for a study, so the chances a statistical error are reduced. What the study cannot tell us is what kind of treatment for anemia could "prevent" dementia. If you are a caregiver to an older loved one, what is the lesson to be learned from this research. At the very least it seems that caregivers should be watchful of their older loved ones' diet as a relatively easy way to rule out at least one potential cause of dementia. I have written about other steps that can be taken in other postings. Exercise and keeping mentally active are among those other steps that people of all ages can engage in to stave off mental deficits like dementia. 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.
In this posting, I have invited Julie Northcutt, President of Caregiverlist.com, a company that uses new technology to deliver objective and comprehensive information and helps families select the right senior care. I have asked her to talk to us about how those “summer family visits” can be productive times for families to lay the foundations for life decisions when there is an elder or other special needs individual in the family. Please give her a read:

“Do your parents live in another city, state or country? Do you only enjoy a lengthy visit with them during summer holidays? If this is the case, remember to take a complete assessment of their current care needs while you are visiting. This will allow you to prevent emergency senior care planning later and eliminate the added stress last minute planning can cause. It is also a good time to assess the home for issues which may be a safety concern due to changing mobility and vision loss. The Centers for Disease Control and Prevention reports falls are the leading cause of injury and death for Americans age 65 years and older. Every year, about 35% to 40% of adults age 65 and older fall at least once. Keep an eye out on your visit home for any areas which might be made safer by making a small adjustment to furniture placement or by adding a safety device. Check on the following areas for any necessary updates so you will have good information to assist you in managing senior care from a distance.
- Medical Conditions: Do you know all of their diagnosed medical conditions? Ask about the more common medical issues which can escalate as we age, such as high blood pressure, high cholesterol, hearing loss, weight gain, arthritis, forgetfulness. Remember that the earlier any medical condition is diagnosed, the better the chances of slowing the progression.
- Medical Providers: Do you know the names of all their medical practitioners, along with their contact information? If they are not seeing a geriatric medical doctor, find out if their doctor has discussed age-related diseases with them and conducted a mini-mental exam in the past year.
- Medications: Are the medications organized and are they taking them consistently? Taking medications at the proper time and as directed (with or without food) does impact the effectiveness of the medication. Find out if they have kept up on refills of all prescribed medications.
- Home Safety: If mobility or hearing or vision losses are becoming issues, find out what products you can purchase to make their daily activities easier. Is it time for a telephone with larger numbers and a louder ring tone? Is it time for an emergency-response bracelet or necklace? Do they have proper grab bars for their bath and toilet? Assess what areas of the home are becoming a challenge and find solutions.
- Driving: How is their driving ability? Ask the neighbors and take a ride with them yourself to find out. You can learn about the senior driving laws in each state at Caregiverlist.com and also learn about ways to address any driving safety concerns with your parents.
- Retirement Care Plan: Where do your parents want to receive care in the event they suffer a stroke, heart attack or fall? Usually Medicare will pay for short-term rehabilitation in a nursing home after a major hospitalization but find out if your senior parent would prefer to recover at home or in a facility.
- Guardians: Who has been assigned the Power of Attorney and the Power of Attorney for Health Care? Make sure everyone knows who will be in charge and where the family keeps these documents.
- Resources: Learn what care providers are available in the area, from nursing homes to senior home care agencies to assisted living communities. This way you will be familiar with the choices.
- Finances: What is the budget for senior care? Has a long-term care insurance policy been purchased? If not, what are the financial capabilities to pay for care privately? CaregiverList provides information on costs of care and ways to pay for care.
Being a caregiver can be daunting, but you can make it better by planning ahead.

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 Charlotte Bishop.
As a geriatric care manager, I speak with my older clients who wrestle with weight gain as much as anyone younger. No surprise, obesity has become a recognized, global epidemic in the developed world, and it shows little sign of slowing in its progression toward greater individual bulk and poorer health. Yet, recently reported research in the Journal of the American Geriatrics Society summarized in an article in Medscape on Aging and Obesity suggests that overweight older adults may have very similar mortality to normal weight older adults.

In a study of about 9,000 Australian men and women aged 70 to 75 years old, researchers tracked the mortality of individuals categorized by their Body Mass Index (BMI). BMI is a measure of the estimated body fat of an individual based on their height, weight and waistline. What they found shows that overweight individuals who are older do not seem to have worse mortality than their normal BMI counterparts. That said, being sedentary was associated with a greater risk of mortality. Being sedentary doubles the mortality risk among women, but it only increases mortality in elderly men by about 28%. Extreme obesity, however, was associated with significantly greater mortality.

While the researchers acknowledge that BMI is not a perfect indicator of body fat, per se, they did conclude that dieting among this age group does not offer any measureable mortality benefit. Losing weight among older adults may even be harmful to their well-being.

Given the mortality risk associated with extreme obesity and the ill effects of a sedentary lifestyle, the researchers further suggested that very high BMIs may discourage the activity which is beneficial to older adults.

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.,geriatric care manager Chicago, geriatric care Chicago

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I have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about a concept that is gaining more attention these days, especially among health care providers caring for older adults. It is all about what time of day is best for your care receiver's medicines. Steve has more than two decades experience in pharmaceutical and medical device consulting prior to joining CCM about 8 years ago. He reports: If you are a caregiver to an older loved one, you probably have seen all the medications in their cabinets, and part of the label of each of those is a clear statement of how often to take them. Prescription medicines used to have abbreviations like B.I.D., T.I.D., Q.I.D., Q.D. of less commonly Q.O.D. which translate into twice a day, three times a day, four times a day, once a day or once every other day, respectively. Thankfully, prescriptions now say things in plain English so caregivers or the care receivers do not need to know medical shorthand to understand when to take their medications. One element that has been conspicuously absent from the labels, however, has been any mention of when to take the medications, and that is getting a lot of attention in some circles. Very simply put, your body does have a clock that works pretty much on a 24 hour cycle which is why most people have a typical time to go to bed, a time to rise and fairly regular times for their meals throughout their daily cycle. The new focus, of course, has a name, and this research into when is the best time to take a given medication is called "chronotherapy." The focus of chronotherapy is on optimizing the timing of medications to give the best clinical effect with the fewest side effects. In very general terms, the best time of day to take a once a day medication most often is at night time. Treatment for certain types of colon cancer, for instance, work better at night because the body's normal cells are resting and less sensitive to the agents while the cancer cells are more vulnerable. And for medications with a drowsiness side effect, why not take them at night to actually benefit from the side effect instead of fighting it. For certain blood pressure medications, it is important to take them at night time so that they are at their best in the morning. That is because when the heart is just starting to "wake-up," there is a spike in body hormones that can stress an unhealthy heart. Cardiac events are much more common early in the day versus any other time of day. Drugs that are part of a category called "narrow therapeutic index" (NTI) drugs are most effective when taken at the same time every day because their doses typically are measured in micrograms instead of milligrams. Small changes in dosing can make a big difference in effectiveness. For any medications, make sure you also are paying attention to whether it should be taken with or without food. And, of course talk with your physician before you may any changes in your medication schedule. In the second part of this two-part series, I am going to get into some specifics of certain classes of medications and how to use your clock to maximize their benefits. And just so I say it again, please do not make any changes in your care receiver's medication regimen without first talking to their physicians. Please let Steve know if you have any questions about drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: Steve Steiber. And check next Tuesday for part 2.