Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Alzheimer’s diseaseChicago's Geriatric Care Manager Center of Excellence

Would You Want to Know?
National Geographic has a new documentary series, Limitless with Chris Hemsworth, starring, of course, Chris Hemsworth of Disney’s Marvel...
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November 29, 2022
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Become a Dementia Detective by “Talking the Talk”
Today we have a guest Post from Christina Padilla, a speech-language pathologist and Certified Dementia Practitioner living and working...
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September 27, 2022
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Treatments for Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the third of four posts we’ll offer on the subject. I...
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September 20, 2022
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Diagnosing Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the second of four posts we’ll offer on the subject. A...
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September 13, 2022
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Dementia, Distraction, Delirium and Depression
September is Alzheimer’s Awareness Month, so we’re going to be sharing four posts that will help everyone with what...
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September 7, 2022
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Burn Calories to Reduce Dementia Risk
We most often think about exercise as a way to work off the calories that we may have consumed,...
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August 30, 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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HDL Graduates from “Good” to Better
You may have had the conversation with your physician about your cholesterol levels during your annual physical; there are...
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April 26, 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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The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
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January 25, 2022
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In the Caregiver's Words

Recent Client Praise

November is National Alzheimer’s Awareness Month. We also shift from Daylight Saving Time to Standard Time…I hope you appreciated the “extra hour” you had over the weekend. But never mind setting your clock back by an hour when we made the change to Standard Time. Get a stop watch! The latest research shows someone in the world develops some form of dementia every 3 seconds. Giving that frightening statistic some local context, every state across the U.S. is expected to experience an increase of at least 12% in the number of people with Alzheimer's disease from 2019 to 2025. Alzheimer's is thought to arise 20 years before clinical symptoms are visible -- a point potentially amenable to lifestyle interventions such as diet. Current consensus is that eating a heart-healthy diet will benefit both the heart and the brain. That healthy food part gets a bit tricky in the 21^st century because so much of our food is processed food…some would say over-processed. Trans fats naturally occur in small amounts in some meats and whole milk. But through a process called hydrogenation many processed foods are infused with unnaturally high amounts of trans fats to make them more stable for longer shelf lives. It may be good for the shelf’s live, but not for yours. It has been well-established that trans fats are associated with an elevated risk of type 2 diabetes as well as cardiovascular illness, and there is a biomarker called serum elaidic acid that health care professionals have followed to assess who is at risk for a “cardiac event.” Researchers in Japan have recently reported that 60+ year olds who started in a panel - with no signs of dementia, but higher levels of serum elaidic acid - were 50% to 75% more likely to develop dementia of any type, including Alzheimer’s disease and vascular dementia in the decade that followed. But this serum concentration of trans fats can be reversed by shifting to a better diet. The first rule is to avoid sweet pastries, the strongest contributor to elaidic acid serum levels. But also steer away from margarine, candy – especially caramels, croissants, non-dairy creamers, and ice cream. But giving up these “bad foods” seems so negative. To make the transition away from trans fats, start with some fresh fruits, real milk in your coffee or something else that will be a delight. 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.
We all have heard report after report about how we should stay active, especially as we grow older. It builds endurance in general when we exercise for 30-45 minutes five times a week. It helps prevent body muscle loss if we exercise regularly – the “use it or lose it” notion. It can help stave off bone density loss if we exercise regularly, and we just feel better because exercise releases endorphins which are the “feel good” hormone of the body. While you are thinking about all of that, exercise will help … that is, exercise will help you actually think! Research recently reportedly by scientists from the University of British Columbia demonstrated that those who exercise just three times a week over a six month period scored substantially better on a measure call the Cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS). Notice I said “substantially” better on this scale. We see a lot of studies that make it to the popular press that show differences between people who do X or Y or Z versus those who do not. This study actually took the scientific approach and compared two different segments of a group of 70 people who already early signs of Alzheimer ’s disease. That is, they demonstrated an measureable improvement in the subcortical ischemic vascular cognitive impairment among people who exercised those three times a week versus the other segment who did not. The researchers point out that it would take a 3-point improvement on this scale to be statistically significant, and their measured difference was just less than two points. But the non-exercise group was also receiving an educational program to stimulate them mentally plus normal care and they still fell behind on this scale. Who would turn down a nearly two point improvement…not a slower rate of decline – an actual improvement. The exercise group, however, did show significant improvement in their “6-Minute Walk Test” and their blood pressure. So if you pick up the exercise program you can expect to be more fit, perhaps even lower your blood pressure medication needs. Consider the cognitive improvement to be a bonus. One of the researchers also comments on how exercise has “minimal side effects.” You cannot say that about too many medications. I also see another hidden bonus in that with the added exercise, I can maybe have a portion of dessert. Now that is statistically significant! 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.
While it has been a fairly temperate season where we live and work, not all parts of the world have been spared the heat of summer. As we approach the dog days of summer - August - it may be helpful to offer a reminder on why older loved ones need some seasonal caregiver help in staying hydrated. A good place to start is in reviewing why older adults, as we have experienced in geriatric care management, are actually more at risk for dehydration than younger individuals. An older person’s abilities to retain water and recognize when they are being depleted of water are often diminished.
1. Just as with other sensory capabilities, an older adult’s sense of thirst may have weakened, so they just won't feel the warning signs as a younger person would.
2. On top of that, their sense of taste and hunger are both reduced, so they tend to salt their food more because that enhances taste, yet they will still eat less. This reduces fluid intake, because much of the water we ingest comes from the fruits or vegetables we consume.
3. Because we all tend to eat or drink around meals or at a table with other people, the isolation that many older adults experience takes away opportunities not just to socialize but also to hydrate.
4. As I have pointed out in other postings, older adults tend to have more chronic conditions such as diabetes, alcoholism or elevated blood pressure, and the conditions and/or their medications tend to deplete older adults of their body fluid.
5. If your older loved one has followed the migrations of many, they have left the colder northern climates for places like Florida, Texas or Arizona. However, they take their food and fluid intake habits with them. This exposes them to more dehydrating heat with similar historical water intake from their colder origins.
If you are a caregiver to an older loved one, be aware of how much fluid your loved one takes in on a daily basis. This is not about being the guardian of the water, but it is about asking good questions and offering gently encouraging words about fluid intake. Watch for signs of dehydration like frequent licking of the lips, infrequent toileting trips, lack of appetite or maybe even some amount of disorientation. But don’t overdo it. Older adults also can over-hydrate - although not as commonly - which can be as disturbing to their electrolytic balance as dehydration. And if you cannot be present, it may be helpful to have a hired geriatric care management professional make wellness checks, especially during the height of summer. If nothing else, it can be a time for social interaction which cannot help but spark their food and water intake as well as their intellectual and psychological well-being. Just as a coffee break most often is more than just about the coffee, a water break is more than just about the water. 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.
I promise that I am not going to get up on my soap box about diet and exercise and all the health benefits owing to not sitting around so much. I have a different soap box today. Doctors often refer to this problem as nonadherence, but we also more commonly talk about noncompliance. You often see this on the label of a medication: “Take as directed.” That means two things, and the first is don’t take more or less of it and don’t take it more or less frequently. It also means just plain take it. Only in baseball is it considered really outstanding to have small percentages of success like a batting average that is .250 to .330. (That translates into getting on base 25% to 33% of the times a player is at bat.) But when it comes to taking statins, the numbers are really low. In a study of 5500 patients presented recently at an American College of Cardiology conference recently, researchers followed the adherence of patients who recently had had a heart attack and who had been prescribed a statin to reduce their low (bad) cholesterol. These were “typical” heart attack patients with an average age of 57 years, and 80% of them were male. As the researchers followed these patients they discovered that 25% did not fill the prescription the doctor gave them. And another 25% did not refill their prescription the next time it was due … but it gets worse. Only a bit over 6 percent of the patients took the medication as it was prescribed 80 percent of the time. The small group who took their statins “as directed” had a 48% lower incidence of another heart attack. This matters even more for your older loved one. As a matter of practice, a fair number of doctors take their patients off a statin when they get to their mid-seventies. Doctor must know best, right? But a European study of over 120,000 people over age 75 has shown that stopping statin therapy is a bad idea. As researchers followed these people the group who went off statins had a 46% greater likelihood of a coronary event like a heart attack and a 26% increased chance of a stroke. And this is why I am raising this issue today, because we are Aging Life Care Advisors. I am not setting aside diet and exercise, but I want to underscore that if your older loved one’s doctor prescribes a statin, pester them about taking it. It does make a difference. 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.
In past postings I have talked a good deal about the importance of exercise for seniors who need care and their caregivers. And it is a proven medical fact that exercise is good for us in so many ways - physical and mental. As a geriatric care manager, however, I find that a lot of the older adults with whom we work do not exercise their voices enough - at least not with their doctors. A lot of folks think that they don't know what to ask about their medical conditions or they don't want to appear to be questioning the doctor who has all those degrees and certifications. Well, caregivers and older adults need to exercise their voices as their own advocates:
1. For every appointment with a provider, bring a list of questions about the medications, anything that may be different or just about what to know to be as healthy as possible.
2. Ask even it may feel embarrassing. Doctors and other providers are used to talking about urinary incontinence, sexual dysfunction, prostate problems and everything else.
3. Write down the answers to your questions. There may be a lot of information shared, and you want to make sure you can really process that information later when everyone is back at home.
4. If your loved one is not sure about how to "follow doctor's orders," ask. That way, your older loved one will be able to make changes that improve their health once they are back home.
What kinds of questions can be addressed with your older loved one's provider? Well, just about everything is part of the whole health picture, like:
- Psychological well-being - has your loved one talked about being really sad or blue lately - ask what can be done.
- Stress - have the worries of the day begun to intrude on a good night's sleep, gotten in the way of their usual appetite? - talk about it.
- Falls and balance - has your loved one seemed unsteady or have you noticed bruises? - ask them to bring it up to their provider.
- Medication side effects - or maybe your loved one just does not feel quite right with nausea, light-headedness, dizziness, and such - ask about it.
- Exercise - Your loved one does not have to be in training for a marathon, but exercise for seniors feels better and allows one to do better – so ask the doctor.
- Sleep in general - it may not be stress that is taking away a good night's sleep, but the doctor may have suggestions - ask about it.
And at the end of the day, everything begins to feel better once it is out in the open, so just the mere act of talking about a worrisome health issue may make it a lot easier to deal with everything.

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.
I am not saying that music is not helpful in your digestion or in your love life, but a recent compilation of multiple scientists’ research makes a strong case that music is a wonderful assist for your older loved one’s sleep … or for your sleep or anyone’s sleep. When I say multiple scientists’ research, it is a method called meta-analysis that systematically analyzes findings from a series of studies of a given subject and quantifies the consensus or lack of consensus. All of us at one time or another have “lost sleep” over some worries or events or maybe something we ate. But it’s estimated that as many as 40% to 70% of older adults have fairly routine sleep disturbance, and it takes a toll on these individuals’ cognition, not to mention mood and general temperament. Analyzing their data from five randomized trials, these researchers found that music statistically significantly improved sleep quality. There also was a statistically significant difference with those who listened to more “sedative” music reporting better sleep outcomes than those listening to more “rhythmic” music. And the longer subjects listening to their settling music, the better their sleep patterns. So, what does this translate into for your recommendations to your older loved ones or to put into practice for yourself? Sedative music was more clearly defined as having a slower tempo of about 60 to 80 beats per minute, a smoother melody line, no percussion and a lower volume. In short it’s music that is all the things that a rock concert is not. And that four week difference I cited. When cultivated as a long term habit, music can improve one’s sleep … and therefore, life … in a very tangible and sustainable way. So, next step is to sort out your music library, and then, well sleep on it. 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.