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

Why a Flamingo Stands on One Leg
You’ve all probably heard the old joke about why a flamingo stands on one leg…and we have all seen...
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June 28, 2022
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What You Can and Cannot Change About Dementia
Let me start with the short answer to a question we raised in the email announcement of today’s post. ...
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June 21, 2022
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Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out...
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June 7, 2022
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Dementia from a Pet’s Point of View
Fetch! Come! Sit! Stay! Remember! So, I’ve given away that I’m a dog owner rather than a cat or...
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March 1, 2022
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If It’s Not Happy or Merry?
I explained in an earlier post about why we refer to Holidays in the plural, and how we are...
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December 14, 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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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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In the Caregiver's Words

Recent Client Praise

November is National Alzheimer’s Awareness Month, and that means it is a good time to talk about how to deal with this frightening condition. There has been ample press and research in recent months about how Alzheimer’s works, the damage it produces, as well as insights into how to arrest or cure the condition. However, the fact remains that an estimated 5.5 million people of all ages are coping with this degenerative condition. And more than 19 of every 20 of these individuals are 65 years of age or older. So, the question for caregivers to those people is how can we support their quality of life as they cope with the condition?

       A lot of research from around the world focuses on how to address Alzheimer’s and other dementias, and some of this has shown that there is a lot to be said for more than just the medical care these patients receive. Part of a growing body of work on “patient-centered” care has shown the benefit of modifying certain environmental factors for people with Alzheimer’s. A study of long term care facilities in Spain showed the positive impact of modifying such environmental factors like temperature, light and noise.

       Among samples of dementia patients from each of these facilities, the researchers took measures of quality of life either from the patients directly or by proxy indirectly from staff. Quality of life measures included patient mood, interaction with others, physical comfort and their relative abilities to manage standard activities of daily living. As researchers measured these factors, they also took measures of temperature, light and noise in areas the patients occupied during any given day – their own rooms, the living room, the dining room.

       They found that higher temperatures were consistently associated with lower quality of life among residents. Low lighting, they found to be associated with depressed moods among residents, and the greater the noise, the lower the social interactions among residents. To get quantitative, noise levels above 50 decibels were consistently associated with more negative quality of life for residents. In a positive vein, when day time hours had brighter light and evenings had lower light, sleep and mood patterns for residents were significantly improved. The researchers also found that higher daytime temperatures resulted in more demands from residents for care or attention from the staff.

       If you want to be an informed advocate on behalf of an institutionalized family member or loved one with dementia, please check out the rest of the findings. They can be found in the Journal of the American Geriatric Society.

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. Visit our For The Caregiver page for more information and resources.
May has been Geriatric Care Manager Month for 31 years. Now, with a change in how we refer to ourselves – starting with our national association – May has become National Aging Life Care Month. And we Geriatric Care Managers still are GCMs, but we are also referring to ourselves as Aging Life Care Professionals. I would be really interested in what you all think of the change in our “name.” Aging Life Care Professionals provide guidance and advocacy for families who are caring for older loved ones or disabled individuals…what we at CCM have always called “caring for elders and others with special needs.” With a specialized focus on issues related to aging, we assist clients with the challenges of aging, such as finding appropriate housing, in-home care, referrals to medical providers or elder law attorneys, as well as the advocacy and support that provides families peace of mind. In other words, Aging Life Care Professionals do what we as Geriatric Care Managers have always done. What do you think? Leadership within our organization did a lot of soul-searching along with a lot of asking people who have worked as clients with our members about what it is we all do. The answers from this journey showed that what we as GCMs do is pretty much valued by the clients whom we serve. We meet people who are going through the gradual changes of life and help make that path easier. We also meet people who have experienced sudden life-changing events within a family such as a fall, a sudden diagnosis or any of the crises that affect how independently an older member of the family is able to live. We are the people who help families to navigate these paths with sometimes a lot of “forks in the road.” As I like to explain to prospective clients, we are the option-makers for the decision-makers. And since we are daily navigating various parts of this path – a path that our clients typically are navigating for the first time – we can offer a lot of insight that comes from training and relevant experience. Let me get back to the forks in the road metaphor. We help with the road sign that shows you to slow your vehicle to 35 miles per hour on the curve coming up, because we have been down that stretch of road before. Most people appreciate that kind of navigational help when they realize what might happen if they maintained their 65 miles per hour going into that curve without some warning. Please let me reiterate that I would like to hear from you about what you think of our name change. Does knowing that we are the professional experts on Aging and Life Care give you any new sense of what we all do? Please send your thoughts to us at info@creativecaremanagement.com . We are still here to help you and your loved ones on their journeys. And with this blog, I will continue to keep you updated on the road conditions ahead. Drive carefully… 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.
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral to an orthopedic surgeon…a hip specialist, no less. …or have had shortness of breath and your primary care provider recommends you be checked out by a cardiologist. …have a generalized fever for a number of days, you’ve lost your appetite and you have general body ache and sinus congestion. After the COVID test, there may be a referral to an infectious disease specialist. Even the doctors sometimes complain about how “over-specialized” medicine has become. When did you last get a referral to a specialist who focuses on…well, lots of your body’s functions and their health? They are calling it lifestyle medicine, and it has a lot to offer almost everyone. One practitioner describes this emerging specialty: “it's the use of evidence-based lifestyle and therapeutic interventions to prevent, treat, and reverse chronic diseases.” (click here) What is the focus of “lifestyle medicine?” For those of you who are accustomed to a trip to your older loved one’s doctor as a lengthy review of existing prescriptions…and often getting one more added when leaving their provider’s office, this new specialty may seem a bit radical. But it’s radical in the right direction. The five pillars of lifestyle medicine include:
- A whole food diet with nutrition built around predominantly plant-based healthy foods;
- Sufficient quantity and quality sleep on a regular basis;
- Stress management…primarily achieved through eliminating the stressors that many of us take for granted as part of 21^st century living;
- Healthy relationships – get rid of that old idea about keeping friends close and enemies closer…just keep healthy friends;
- Avoid toxic substances like tobacco, excess alcohol consumption and such.
Do you see the real difference with this “new specialty?” It puts control back within the individual and works to avoid undue prescribing or tolerating unhealthy habits. And it’s guaranteed to improve cardiovascular function and minimize bone and joint issues. The key, however, lies within a patient who implements the changes. And this method has been largely “on the books” in medicine for years, but it’s been neglected…perhaps because too many patients are inclined to ignore, for instance, the first and second line treatments for heart issues…diet and exercise. If you are a caregiver to an older loved one, help them to this “new cure” perhaps by “being the change” yourself. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
I have a small pillow in my living room that speaks to me. In stitched letters it says, "What? Chocolate is not a food group?" My family knows that one of my favorite "food groups" is chocolate, and I don't mean because I am on a health kick looking for the benefits of dark chocolate; I just like good, old-fashioned milk chocolate. But let me tell you that when I have a chocolate craving, my body may really asking me for something more than my brown, sweet treat.

There is a growing body of literature that explains many of our cravings as our body's signals for what it really wants; we just don't speak the language. We fail to translate the cravings in quite the way our bodies are trying to communicate. This has real implications if you have an older loved one for who you are a caregiver. As one ages the taste buds become less sensitive, and appetite wanes. And if you are taking your older loved one's interest in foods or cravings too literally as you listen, you may think you are satisfying their body's nutritional needs when, in fact you are not. Let me start with my own craving.
1. Chocolate. If your elder expresses a craving for chocolate, they may really be translating their body's need for magnesium, a very important electrolyte in the human body. While chocolate can offer some magnesium there are better sources. Chocolate is okay - thank goodness - but your body will benefit from a variety of magnesium sources such as certain vegetables, nuts and seeds. So if your elder has a regular craving for chocolate, try offering legumes, nuts and seeds to avoid the sugar and fats that accompany the magnesium in commercially-available chocolate.
2. Potato Chips. I see this in our household where a certain family member would prefer a bag of potato chips rather than a handful or two. So much for portion control. Potato chip craving may actually be an expression of an iron deficiency. This kind of deficiency triggers a craving for crunchy foods, and potato chips -while crunchy - come up short. Iron-rich alternatives include dark meats, fish, poultry and darker green vegetables. And this overlooks the huge intake of sodium that potato chips offer and nobody needs.
3. All of the Above. This is where the psychology gets interesting. Let's say your older loved one can still smell the peanuts that you just had, but they had been disciplined and translated their craving into having a portion of raw carrots. But a half hour later, they still can all but smell the peanuts and they cave in and subsequently gorge on the peanuts. They should actually feed some of their craving when it expresses itself, but in moderation. That still leaves room for the healthy foods they will eat later and moderates the caloric intake that has become such a national epidemic.
At the end of the day, it is about balance and understanding what our bodies are telling themselves. If you are that caregiver to an older loved one, don't become the food police, but perhaps there can be a role for a food translator to help them understand their own bodies' language when cravings make their voices heard.
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@cr eativecaremanagement.com.
We are fortunate to have a new contribution from a good friend and colleague, Julie Northcutt of Caregiverlist.com. Julie offers a caution in this contribution about the scams that seek to prey on older adults, so please give her warning a read...

“Holidays are a magical time, but unfortunately they are also a time when law enforcement sees a spike in online and telemarketing fraud, especially directed against the elderly. According to the Federal Trade Commission, nearly 25 million Americans are victims of consumer fraud each year. Senior citizens continue to be a rapidly increasing segment of the population. Why are seniors especially vulnerable? Seniors are seen as easy marks with “nest eggs” that make them attractive to con artists. According to the F.B.I., “people who grew up in the 1930s, 1940s, and 1950s were generally raised to be polite and trusting. Con artists exploit these traits, knowing that it is difficult or impossible for these individuals to say "no" or just hang up the telephone.” In addition, because the elderly are sometimes socially isolated, the elder will stay on the line just to converse with another human being.

“Silver Surfers” are the fastest growing group of Americans using computers, recent studies have shown, using email as an essential way to keep in touch with loved ones. This makes them especially vulnerable to illegitimate “charity” organizations looking for donations, lottery scams and bogus product offers. Elderly victims are less likely to report the fraud because they don’t know who to report to or they are embarrassed to admit they have been scammed. One of the more popular schemes this season is the “grandparent scam.” In this scenario, someone calls a senior and poses as their grandchild or a friend of the grandchild. The caller claims that the grandchild has been in an accident or is in trouble and needs the grandparent to wire them money. The grandparent is also urged not to tell anyone. Once the money is sent, it is unlikely it can ever be recovered.

What is a senior to do if they suspect fraud? Seniors are urged not to reply to any emails offering “free” medical equipment, miracle cures, or lottery prizes that require up-front payment for processing. Never give out sensitive information over email or phone, including social security numbers and bank information. Verify charity information before donating. In the case of the “grandparent scam,” seniors are urged to call their grandchildren to see if they are really in trouble. Everyone is vulnerable to deceptions during the holiday season. None more so, it seems, then our senior population. If you or a loved one has been the victim of a scam or fraud, report it to your local Department on Aging. You may help prevent others from becoming victims as well.”

Julie Northcutt is founder and president of Caregiverlist.com. We encourage you to visit her website.

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.