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

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

As a geriatric care manager, I work with court-appointed guardians. You may recall from a blog last December, Caregiver or Guardian, we talked about guardianship. I had the really good fortune to speak with John Wank, President of the Illinois Guardianship Association. Mr. Wank also is General Counsel of the Illinois Guardianship and Advocacy Commission, a state agency. He answered a lot of the questions I have heard from our clients. This is going to take a few postings to get through them all. Here are some questions and his answers for a start.

What is a guardian?

A guardian is a person appointed by a court to make personal or financial decisions for another person who has been found by the court to be incapacitated (a disabled person, under the Illinois definition) and unable to make decisions. All guardianship in Illinois is governed by the adult guardianship provisions of the Probate Act of 1975, 755 ILCS 5/11a-1, et. seq. Other laws also apply.

Does the individual get to choose his/her guardian?

An individual may state a preference, but the final decision as to the choice of a guardian is made by the court. Under Section 11-a-6, "(a) person, while of sound mind and memory, may designate in writing a person, corporation or public agency qualified to act under Section 11a-5, to be appointed as guardian or as successor guardian of his person or of his estate or both, in the event he is adjudged to be a disabled person. The designation may be proved by any competent evidence, but if it is executed and attested in the same manner as a will, it shall have prima facie validity. If the court finds that the appointment of the one designated will serve the best interests and welfare of the ward, it shall make the appointment in accordance with the designation. The selection of the guardian shall be in the discretion of the court whether or not a designation is made." Illinois law creates no preferences or priorities as to whom is appointed guardian for a person with disability, other than the requirement that the court give due consideration to any preference of the respondent. Section 11a 12(d). The criterion used in selecting a guardian is the prospective guardian’s capability of providing an active and suitable program of guardianship for the ward. Section 11a 5(a).

Can the individual rescind the guardianship?

Only a court may rescind a legal guardianship. Guardianship is terminated when a person under guardianship (a ward) is restored to legal competency. Section 11a-20. Otherwise, the guardianship continues until the death of the ward. The court may also change the terms of guardianship, making it more (plenary guardianship) or less (limited guardianship) encompassing, or by appointing another person as guardian after the removal or resignation of a guardian. Section 11a-12 defines plenary and limited guardianship; Section 5/23-1 sets out procedures for removal and resignation of guardians.

We will pick up with more of Mr. Wank’s Q and A in the next posting.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management; please e-mail your questions to Charlotte Bishop.

Copyright ©2011 Charlotte Bishop
No surprise to anyone with a medical condition that drug prices continue to soar even during this past decade of near zero inflation. If you have a loved one 65 years of age and older, you need to know about coverage of these increasingly pricey drugs. The four things you should know:
- According to a recent Senate minority report, the twenty most commonly-prescribed brand name drugs for Medicare recipients have gone up in price ten times more than inflation over the recent five years.
- The brand names are: Diskus, Crestor, Januvia, Lantus/Lantus Solostar, Lyrica, Nexium, Nitrostat, Novolog, Premarin, Proair HFA, Restasis, Spiriva Handihaler, Symbicort, Synthroid, Tamiflu, Ventolin HFA, Voltaren Gel, Xarelto, Zetia and Zostavax.
- Half of these medications have a generic equivalent that can be substituted at substantially-reduced prices: Crestor, Januvia, Lantus, Nexium, Nitrostat, Premarin, Symbicort, Tamiflu, Voltaren Gel, and Zetia. (Synthroid has generic competition, but as a Narrow Therapeutic Index (NTI) agent, switches across manufacturers are a bit challenging; Restasis and Lyrica will have a generic competitor yet this year.)
- A Pharmaceutical Research and Manufacturers of America industry group spokesperson said the report was misleading, because companies “negotiate robustly” with Medicare Part D. Really?
If you are a caregiver to a Medicare-qualified loved one, it may be time to review their medications with their primary care physician. Physicians have the option of specifying that a generic alternative may be substituted. Aside from Synthroid, ask them if they would check the box to allow substitution. Diabetes treatments, for instance, may be bit more nuanced. Ask them to explain their reasons. And do your homework ahead of time so that you know the price differentials of brand versus generic. 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.
Okay, "Grain Brain" is not something that immediately tells you what it is all about. Grain Brain is the phrase that neurologists and other brain scientists are using to describe a link between blood glucose levels from high carbohydrate consumption and dementia. A book by the same name is going into its 15th straight week on the New York Times bestseller list, so the concept is getting a lot of attention. But what does it mean for you or an older loved one in your orbit? In a scientific study recently published in the prestigious New England Journal of Medicine, researchers followed a large group of men and one of women for an average of almost seven years. During this nearly seven years they regularly measured the individuals fasting blood glucose levels. At the end of the study they found that people with higher blood glucose levels were more at risk for developing dementia that those whose levels were not as high. They found this to be true even with people who did not have diabetes. It is true, that this kind of study cannot say that increased blood sugar levels actually cause dementia, but the link is sufficiently clear that the New England Journal would publish the findings. Scientists also find that not all grains have the same negative effect on cognitive ability. Those with the highest gluten content seem to be the worst offenders. This is not the first research to show negative health outcomes associated with elevated blood sugar. Researchers have well-established proof that a high carbohydrate diet and the associated elevation of blood sugar poses a risk to one's heart and to the immune system. And there are other studies. in a 2012 study in the Journal of Alzheimer's Disease, researchers reported that risk for cognitive decline was 89% greater among those on a high carb diet; those on a high fat intake diet saw a 44% decrease in their risk for cognitive compromise. And researchers in another British journal, Lancet Neurology, estimated based on their findings that as many as 54% of the cases of Alzheimer's Disease in the United States could be avoided with exercise, weight reduction and steps to reducing blood pressure. This last study really drives home a great point. If you are a caregiver to an older loved one, you both will see great returns on a few basic investments of time and effort. Increase the daily amount of exercise, reduce the carb intake and the rewards will be weight loss, reduced blood pressure, a healthier heart, a more vigorous immune system and more acute cognition. Sounds like a really great return on investment to me. So, will you and your older loved ones be among those who avoid the "grain brain?" 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.
One of my geriatric care clients, an 80-year old widow who lives in an independent living center, came to me with what she felt to be an embarrassing story. Since it is about fraud, I offer it now during a season when we all may feel the spirit of giving and we also can be duped by thieves. My client received a telephone call from “her favorite grandson.” At least that is how the caller introduced himself and my client inadvertently gave in to the urge to guess the caller’s name as her eldest of five grandsons. She readily admits she has no favorites, but she gave in to what seemed to be a tease from her grandson, a fully grown young man with a family of his own. Her “grandson” then proceeded to relate a story of a bit of partying with coworkers on a business trip to Canada that resulted in his incarceration. He desperately needed $3,000 for bail. He wished to avoid informing his wife or parents until he could return to relate the unfortunate events in person. My client agreed to this conspiracy and wired the funds. Only later did she discover it was a fraud and reported the caller to the police. Unfortunately, she could not recover the funds, but she did go on local elevision for a news segment to help others avoid her mistake. I am writing today as a geriatric care manager to offer a heightened alert to elders and others with special needs along with those who help care for them. It is not just telephone scams, but also identity theft or fraud of a variety of sorts that prey upon the elderly. It is estimated that as many as 9 million Americans have their identities stolen every year. Be on the alert to:
As you gather over the holidays with family, encourage your older loved ones to check their free annual credit reports as a way to identify suspicious activity. Help make certain your older loved one has current spyware and other internet security software. Make sure your loved one is not leaving important identity or password information lying openly on surfaces where anyone might steal them. Consider a locking mail box if incoming mail is not retrieved soon after it is delivered. And consider the Federal Trade Commission’s website , a useful elder resource on addressing victimization. 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.
For this week’s post, Charlotte asked Rebecca Bloomfield, partner at Jerry S. Pearlstein Insurance, to speak to caregivers about long term care insurance. She and Jerry head up a unique agency of trusted advisors, helping individuals and families to take control of their personal financial planning … and more. Please describe the concept of long term care insurance. “Long Term Care Insurance (LTCI) pays for services when more than 90 days of continuous care are required. It’s contingent upon an individual’s inability to do at least two of the six activities of daily living: bathing, continence, dressing, eating, toileting, transferring.” How early should a person look for coverage? “Most people come to us when it is too late. The lowest premiums are when one is youngest. You can start early with a progressive sequence of plans with upgrades along the way, many times without medical exams required. Most people look at life insurance when they start a family, and that is also a good time to look at the long term picture.” Sounds like it is for caregivers… What is the right level of plan a caregiver may need? “Traditional LTC insurance has been based on a person being in a nursing home. You anticipated how long you would anticipate be in a facility and how much that might cost. Today, 80% of people want to stay at home when they cannot do two of the ADLs. They want to stay in community. So, there are now plans that cover the cost to do that by paying caregivers, or adult day care centers, or drivers…and you stay out of a facility.” Can my older parents get covered? “Once you are over 70, it is tremendously expensive. …and then there are pre-existing conditions. When you are young and healthy is when to start. Care receivers cannot get new insurance…but it is the right time for the kids who are the caregivers to get their plan.” Anything else caregivers should know? “The biggest misconception of people who come to us is that Medicare will cover long term care. It is not designed to cover sustained care over 90 days. Medicare is diagnosis-based and is built on a plan of care for a person to get better. Long Term Care Insurance should be seen as a way to assure the ability to live a long and happy life without being a burden to the children. …and to preserve your choices.” 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.

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No Vaccine for the Other Plague

The Other Global Health Crisis

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Negative Thinking Causes What?

Distance Caregiving Through a Wall

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