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

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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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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No Vaccine for the Other Plague
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine,...
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February 16, 2021
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The Other Global Health Crisis
Wearing a face mask is the new front line of defense against the spread of the war on COVID-19,...
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November 17, 2020
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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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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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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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In the Caregiver's Words

Recent Client Praise

I like to report on medical research that shows that if a patient does what is directed by their doctor, they can avoid a problem or see a benefit in their lives. I like it even more when I can offer research that delivers a bonus or another benefit in addition to what a patient may have been expecting for paying heed to doctor’s orders. This is one of those bonus stories. Half of all adult Americans have high blood pressure. That’s more than 103 million people whose blood pressure is at unhealthy elevated levels. While many of these individuals can bring their numbers back under control with diet and exercise, the rest are prescribed one or more anti-hypertensive medications like an ACE inhibitor, a beta blocker, an angiotensin II receptor blocker, a calcium channel blocker or a diuretic. In some cases a person may be on more than one of these agents to bring their blood pressure down and preserve their cardiovascular health. Dementia researchers involved in analysis of large scale data are telling us that there may be an added benefit for these BP patients. They may also be preventing the onset of one or more types of dementia if they are adhering to their blood pressure treatments. The researchers have tracked more than 31,000 patients who had been dementia-free 22 years ago, and found that over time 1,741 developed Alzheimer’s disease specifically and 3,728 just developed some form of dementia (most typically vascular dementia). Among the adults with high blood pressure at the outset in this large panel and who used a blood pressure medication, they were statistically less likely to develop dementia of any sort than those not on a medication. In fact, the difference between those who would develop dementia and those who would not was statistically significant across all types of anti-hypertensives. And it was significant for Alzheimer’s disease specifically as well as the other dementias. (Vascular dementia, or mini-strokes as it is sometimes called, could understandably be linked to better controlled blood pressure, but Alzheimer’s has a different mode of acting.) Also noteworthy is the fact that there was no drug company funding for this research. While funding does not cause results of any sort, it is helpful to see that there is no suggestion of sponsorship in any financial way influencing outcomes. If you or a loved one are among the 103 million Americans with elevated blood pressure, staying with your blood pressure medications will be good for your heart and your head! 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.
If you are like millions of folks in this country, you might be counting the days until Thanksgiving. Typically this creates a minor panic considering all the preparation most of us put into making the holiday happen. If you are a caregiver, it can be about more than meal preparations; it can also be about taking the opportunity for a "wellness check" on an elder mom or dad or other elderly loved one. I will talk about special food considerations in another posting, but let me offer some tips on what you can check to make sure the senior in your orbit is still in great shape.

First, it is important to recognize that we all - and I mean all - forget some things some of the time. So this short check list goes beyond the normal slips that will affect us all, regardless of age. Here are six suggestions on what to note when you all gather for the feast:
1. If you are gathering at your elderly loved one's place, you have an opportunity to check out what is in their refrigerator. Look for items that are well beyond an expiration date or simply have become a science experiment.
2. If they still drive a car, you may volunteer to run some errands. Use the opportunity to see that the tires are fully-inflated, the oil has been changed, the brakes are in good working order, etc.
3. While I certainly don't recommend a white glove inspection, you will probably be able to see if the place looks as tidy and orderly as you remember it from last year and years gone by.
4. If your senior owns a pet, does the animal appear healthy and well cared for? You may want to check to see if the tags show current vaccines.
5. If you have a chance to talk with neighbors or friends who see your older relative throughout the year, try to enlist their help in looking out for that relative, especially since you may not be around but a few times a year.
6. Holidays are a time for catching up and sharing news. If your older relative repeats the same story within a single conversation, make note of it as short term memory loss is a sign of dementia.
7. Take note of personal hygiene. Seniors are entitled to hang on to a favorite sweater or other item because they simply are attached to it, but you will notice if hygiene is becoming a bit lax.
8. Finally, just ask. You can show your willingness to help in any number of ways and make a list. Keep in mind, they may feel comfortable just letting you know if they have not felt quite right lately.
With all of this, make sure you have a good line of communication with siblings or others in the family so that you all can compare notes. You want to be helpful, not alarming.

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.Learn more about What We Do and how we can help you support your loved one.
All of us here know how to prepare for a blizzard, people in the South know how to prepare for a hurricane, and folks on the Great Plains know how to prepare for a tornado. Maybe what is most challenging about the virus that is part of every news cycle these days is that it is a “novel” coronavirus. If you are a caregiver to an older loved one as well as looking out for your own health, let me address four major questions about the “new” virus:
1. What are signs and symptoms? The incubation period can be as long as 14 days, but is generally expected to be about five days. This virus does not initially differentiate itself from any other “bugs” going around. Initial symptoms likely include a cough or sneezing, but with or without an elevated temperature. Rarely is there diarrhea. Drinking lots of fluids is very important at this early and all stages of the disease. Milder cases can be treated at home, but if the condition persists or if the lungs become affected, seek professional help.
2. How is it transmitted? COVID 19 is not transmitted through the air we breathe, but it is transmitted through mucous droplets. If someone with the disease sneezes or coughs, they should cover their nose or mouth with a tissue or the sleeve at their elbow to avoid spreading the droplets. Be careful of surfaces on which a carrier has had contact (or their sneeze or cough droplets have had contact) as the virus may survive as long as several days. Those diagnosed with the condition should wear a face mask.
3. Who is most susceptible? This is where COVID 19 is similar to other flu viruses in that as many as four in five deaths will be among patients 60 years and older. It is not just the age of the patient, however. It is other conditions that weaken their bodies’ ability to fight the virus. Those particularly at risk will be those with high blood pressure, diabetes, heart disease or lung disease. Those who are immune-compromised may also be at greater risk, but it is wise to consult a family physician before sounding alarms.
4. How to protect your loved one / yourself? Stand at least three feet away from anyone with whom you are conversing which will lessen the chance of your receiving a stray droplet. Wash hands often according to the WHO guidelines (link is below), avoid touching your face and wipe surfaces with sanitizer materials with at least 60% alcohol content. The World Health Organization (WHO) does not recommend face masks for the general population, but patients are encouraged to wear a mask. And then there is the obvious precaution that one ought to avoid contact with COVID 19 patients or travel to geographic areas where cases have been confirmed.
To get answers to your other questions, please don’t hesitate to email me at: info@creativecaremanagement.com or go to the World Health Organization website. 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.
Creative Care Management invites you to browse our FREE downloadable white paper resources – offering both personal and professional geriatric solutions for those who care for the elderly or people with special needs.

Caregiver Advice on Bad MedicineMany are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed and how to spot warning signs.Get This White Paper

Caregiver Counsel on First Aid for the CaregiverIt is no secret that caregiving can be an everyday challenge, especially when managing a full time job and other family responsibilities. Discover tips about how caregivers can limit stress, boost energy, and stay positive in our latest white paper.Get This White Paper

Caregiver Counsel on Caregiving & the New NormalStatistically, more and more people will become caregivers to an older adult in their lifetime. Becoming a caregiver can be sudden and overwhelming as it is. We offer senior care options for preparing and reacting to different obstacles you may encounter.Get This White Paper

Caregiver Counsel on Taking the Old Out of AgingNo one argues that loss, isolation, or medical ailments may represent genuine setbacks as a person ages, but depression is a significant step beyond just feeling down or blue. Learn how to recognize symptoms of depression and how to be happy even at 100 years old.Get This White Paper

Caregiver Counsel on Senior Living OptionsFinding the best living options for your loved one can be tough. Whether it is picking the right senior living community or making your current family home safer, we help you to prepare for a productive conversation with your loved one about these transitions.Get This White Paper

A Caregiver's Guide Toward a Healthier Senior HeartHeart complications and disease are common issues that older loved ones face. Discover easy and practical ways to give you or the senior in your orbit a healthier heart.Get This White Paper

A Caregiver's Guide for Changes & AgingCoping with change can be difficult. It often involves tough decisions and conversations with the person you care for. Discover strategies to help you and your loved one feel more comfortable with transition.Get This White Paper

A Caregiver's Guide for the HolidaysHoliday stress is tough for everyone but especially for caregivers. Find out how to care for both yourself and your loved ones while managing these hectic seasonal times with friends and family.Get This White Paper

Roadmap to Alzheimer's Learn what to expect when you're caring for someone with Alzheimer's. Inside find tips for detecting dementia, how to best communicate with a loved one with Alzheimer's, and more.Get This White Paper

Making Home Safer Make sure your loved one can navigate daily activities as safely and independently as possible. Read about how to secure the most hazardous areas of the home and what action steps you can take to ensure your loved one is living comfortably too.Get This White Paper

Caring For the Caregiver Learn how to be as good for yourself as you are for your loved one. Are you becoming impatient with your loved one? Are you missing work or finding yourself easily irritated? If so, this white paper can help.Get This White Paper
We as certified geriatric care managers all hear about older adults falling. Caregivers often do not expect their own loved one to have an accident at or around home. The simple fact is, however, that about 20 percent of adults over age 65 will have a fall in any given year. Sadly, most fall can be prevented with some simply safety precautions:
1. The Feet aren't Fit. Yes, it is true that a lot of falls happen because there are hazards all over an older adult's house, but falls are not inevitable. De-conditioning happens in older adults who do not really exercise their balance and their gait. They become less nimble, and you can see it in the "elder shuffle" many of them manifest. You may not be able to help them dance again, but you can get rid of worn carpet or what we call "shatter rugs," or scatter rugs. For an older person who does not lift their feet, these can be a fall waiting to happen.
2. Other Hazards. Anything on the floor and potentially in traffic can be a fall hazard. Look for uneven surfaces, footstools, electrical cords, stairs and similar clutter on the floor. You don't need to make your older loved one's home a sterile and barren place, but you can clear the traffic routes to eliminate risks before they become a broken hip.
3. Line of Sight. If they cannot see it, they will fall on it. Older vision inevitably becomes less acute, but sight also can be obscured by cataracts, macular degeneration or other conditions of older eyes. You can address some of this by seeing that they have annual vision tests and necessary upgrades in their eye wear as well as enhanced lighting throughout the house.
4. Medication Side Effects. Many medicines have side effects that cause dizziness or low blood pressure upon standing. While their main effect may be necessary, the side effects can make navigating an otherwise safe path incredibly difficult. Talk to the health care provider about any side effects and ask about reduced doses or a change in meds altogether.
Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
We all know that an object at rest tends to stay at rest, and that is as true of older adults as it is younger ones if you look at the frightening statistics on the obesity epidemic in America. Habits developed over the long run tend to be harder to break, but the fact is that appropriate exercise for older adults can get easier and easier just by the simple fact of dong it. Because the corollary to my first scientific law is that objects in motion tend to stay in motion. And exercise gets easier. Doubtful?

Here are nine reasons:
1. Starting a new exercise routine may feel clumsy at first, but so did dancing, riding a bike and a lot of other physical work we have all gotten better at with time. Muscle memory will help, because your body will make new nerve pathways to make your exercise easier with time.
2. Blood flow improves when you exercise at any age. The smallest vessels actually can increase in number fueling all parts of your body as your heart rate routinely increases with practice.
3. We all have seen body builders grow muscles into sculpted works of art. Well, we do not see the heart, but it gets stronger also with workouts that are even modestly strenuous. This is true of older adults as well as college athletes.
4. With the muscle memory and greater cardiac capacity comes increased confidence among elders who exercise. Physical confidence, in turn, creates greater overall confidence and a sense of “can do.” Older adults with a regular workout routine also will sleep better.
5. We have heard from too many fanatics about “no pain-no gain.” The opposite is, in fact, true. As an older adult works out over time, the body raises its threshold for working. With time, an older adult can do more and more without that shortness of breath or even the soreness afterwards.
6. Take that last one to a higher level, and if the older body begins a regular regimen of moderate exercise, the body’s hormone system will reward it with cocktails called endorphins. Endorphins are basically a homemade version of morphine to help the body feel better and better.
7. The power plants in your cells also will begin to grow in number with exercise over time. You cannot see them, but the mitochondria, as these power plants are called, become more numerous so that your body can burn more carbohydrates and fat to create more energy.
8. Exercise will encourage better eating habits. It is true, because a lot of those bad habit foods – comfort foods – are linked to stress, anxiety or even depression. Since exercise works against these negative emotions, some of the craving for the junk food will ebb as well.
9. Exercise actually makes a person happier. Tied to some of what I mentioned in #8, exercise really lifts the spirits, and it does it in part through releasing chemicals called serotonin, dopamine and norepinephrine. These chemicals can be as effective as some of the drugs often prescribed for depression.
Before you exercise or encourage an elder to exercise, see a doctor to sign off on your fitness to exercise.

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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