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

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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Not Where You’d Expect Protection from Dementia
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there...
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December 28, 2021
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Get Smart!
Would you look for advice from an investment counselor who simply promised a lower rate of loss on your...
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August 24, 2021
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Breaking News for Alzheimer’s … part 1
The big splash on the medical news this past week gratifyingly was not COVID-19, but instead an approval of...
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June 15, 2021
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To B or Not to B12?
I have written a lot about dementia over the years as well as other issues that can mimic the...
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May 11, 2021
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Diseases that Mimic Dementia…But Are Treatable-part 3
As you can tell from now a third installment about other medical conditions that can mimic dementia, it’s not...
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March 22, 2021
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Diseases that Mimic Dementia…But Are Treatable – part 1
Dementia is the condition that adult Americans fear the most, and tragically there are conditions that can give a...
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March 9, 2021
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In the Caregiver's Words

Recent Client Praise

We all have at least one thing in common in this time of COVID Quarantine – we are making more of our own meals at home. The list probably goes on, but I think of this as an opportunity for hitting our dietary reset buttons. In fact, it is an opportunity each day to have a more thoughtful menu…think of it as New Year’s Resolution meets Ground Hog Day. At the gym where I worked out (they are closed now) there always was a first of the year surge in the volume of people crowding the workout spaces and locker rooms. But inevitably there also was a later drop off around February one where people got back to all the other life distractions, or comfort foots or just bad habits. I came across a number of research pieces this past week that show that good food choices can statistically reduce our risk of cognitive decline. Why not use the present time to shop and prepare the foods that will give us a truly different quality of life now and as we emerge from the quarantine. The “recipe” is really pretty simple; it’s the basic Mediterranean Diet. In two trials that actually were focused on preserving eye function called Age-Related Eye Disease Study (there were two: AREDS and AREDS2), researchers found that diet was related to cognitive decline. They measured the intake of fruits, vegetables, grains, legumes, red meat, fish, fatty acids and alcohol. AREDS tested cognitive function at five years, and AREDS2 tested at 2, 5, and 10 years later. Overall, the higher the adherence to a Mediterranean diet, the lower the risk of cognitive decline. The statistical significance was impressive with this difference being attributed to chance alone being about one in ten thousand. When the researchers looked into the details the strongest predictor of healthy cognition was fish intake. Check them out here. It is important to note that we are talking about the risk of cognitive decline, not the rate of decline. The rates of cognitive decline were fairly similar across all dietary groups. As with all studies, the scientists are looking more closely into the results and also into further tests to see that the results can be replicated. While they are doing that, however, we still have some quarantine time left to change our habits a bit. Bon Apetit. We at CCM want you all to remain safe and follow the rules so that you all will get through this health crisis. And if you follow as many of these guidelines as you can fit into your day, you will be better coming out of this pandemic than you were going into it. Be safe and be healthier. 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 have all heard someone this season say, “It’s just a cold,” or “I have a touch of the flu,” or similar expressions that pretty much write off a lot of what is going around. And nobody gets pneumonia, right? Wrong! It may sound like a small number, but about 6 of every 1000 people in American will have a bout with what is termed “community-acquired” pneumonia this year. Still sounds small, but the rate triples for 65 to 69 year old people…18.2 per 1000. And for 85+ year olds, the number skyrockets to 52.3 cases per 1000 people. So, if you have an older loved one in your orbit, be vigilant to signs and symptoms that can tell you they have graduated to pneumonia. There are six signs that should alert you to something that deserves a visit to the doctor or emergency facility:
1. Productive cough – the kind that almost rattles with the mucous as a person coughs to clear their lungs.
2. Fever or not – Fever with a pneumonia infection is common among younger individuals, but pneumonia actually can suppress body temp in older cases.
3. Chest aches – While we are most often concerned about heart issues with chest pain, breathing with pneumonia can give similar symptoms.
4. Tired – While the immune system fights pneumonia, it takes energy away from the rest of the body resulting in fatigue.
5. Fuzzy head – The lungs are not the only congested organ; the brain gets a bit muddled with pneumonia also.
6. Breathless – With congested lungs, it should be no surprise that a patient with pneumonia may also be short of breath with even modest activities.
The rules of engagement with pneumonia are simple.
1. Doctors’ orders - especially with completing the full course of antibiotics…be sure your loved one takes all the pills prescribed.
2. Sleep – give the body a chance to devote its undivided attention to fighting the bug by resting and getting help around the house.
3. Fluids – think of it as “flushing” out the system, and it also helps get rid of the congestion in the lungs.
And remember that the risk may be lower for younger people, but the operating rules are pretty much the same. Give all the support you can to help your body fight the invaders too! 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.
I have spoken with Matt Margolis, an Elder Law attorney with Heartland Law Firm recently about VA benefits to which people may not know they are entitled. In this posting, he shares some valuable insights that may expand your options for care cost coverage.

            One very common question that comes across my desk on a daily basis is “Are there any benefits, other than Medicaid, to help pay for the care of my ___________ (insert: mom, dad, husband, wife, brother, sister, etc.)?” Typically, this is being asked because Medicaid is only available for someone in a Skilled Nursing Facility. Because of this, we refer to Medicaid as “nursing home financial aid.” My follow up question to this prospective client is usually asking whether the person they are calling about or their spouse was a Veteran.

            The Veterans Administration (VA) Aid and Attendance Benefit program is the benefit I will discuss with them. In the overwhelming majority of situations, the prospective client has never heard of this benefit. This benefit is actually classified as a “pension” by the VA and is a great source of funds for financially constrained wartime Veterans and/or their surviving spouses to use for their long term care costs such as living at home with a caregiver, adult day care, independent living with a caregiver, assisted living, and/or skilled nursing.

            While family income is one of the determining factors of eligibility, it is important to be aware that the VA allows individuals to deduct their unreimbursed medical expenses, which includes their health insurance premiums, home care, assisted living, adult day care, caregiver, and nursing home costs from their income. As a result, many Veterans who may not have previously qualified might now qualify if long term care has become necessary for them or their spouse.
As a general rule, to qualify for the Aid and Attendance benefit, a family's total assets (excluding their primary residence and vehicles) cannot exceed $80,000. Fortunately, many clients I meet with have assets in surplus of this number. The good news is that with the right strategies and planning, we can still position them to qualify.
            A few things worth mentioning:
In the end, the VA Aid and Attendance pension is a heavily untapped, but much deserved, benefit for those Veterans and/or their surviving spouses who served and fought for our country.

Heartland Law Firm is a holistic elder law and estate planning firm. Heartland Law Firm concentrates in assisting seniors and those in transition with understanding the landscape they are in and what protections and benefits are available to them and their loved ones. Visit their web site at: Heartland Law Firm.

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.
I have talked in the past about making home safer for seniors as well as geriatric care management services for those considering a move to residential communities. But the financial and practical fact of the matter is that owning the family home may prove to be less affordable as well as less livable for adults in retirement. Never mind that classic picture of older adults whose kids have graduated college. They have burned the paper of a paid-off mortgage and can now live for free! Well, a lot of seniors were hit by the Great Recession just like other homeowners, and the house is not really free and clear. For virtually everyone, the cost of the house still includes real estate taxes which continue to rise even though housing values have declined in most markets. And the costs to maintain a house tend to come in big chucks like the cost to replace roofing or a new furnace or a hot water heater and more. Some older adults never got to the point where they could buy their own home in the first place. A study issued by the Joint Center for Housing Studies of Harvard University found that older adults make up about 13 percent of the rental market in the U.S. That is precisely the share of the U.S. population that is 65 years of age or older, and the percentage is expected to grow with the baby boomers adding to the number of renters. Finances and age are just a part of the decision to rent or buy; also important are health and lifestyle. Regarding health issues, if you are a caregiver to an older adult you may find that they can maintain their independence longer in a rental property that in a conventional home. Rental properties typically can offer a residence all on a single floor for any older adult with difficulty getting around. More current housing also will offer elevators to make getting from the ground floor to their apartment unit easier. And don't overlook the convenience of having a landlord taking care of the heating and cooling systems, the laundry machines and the roof. They also will maintain the lawns and walks. Regarding lifestyle issues, older parents may wish to have the added security of being able to be away from home for extended trips without the worry about safety of their homes. The added safeguard of two front locking doors and nearby neighbors can make it easier to take a vacation or a trip to visit the kids and grandkids in another part of the country. And don't forget that lifestyle also can include the freedom that may come from not having the added weekend duties of a lawn and grounds. That extra time back in the week can be a real bonus for an older adult who really does have something better to do. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends who provide geriatric care management services to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
Okay, so it has been five days since you received that box of chocolates from your sweetheart on Valentine’s Day. And if you did not consume truly massive quantities of chocolate all at once, how do you feel? The answer is you should feel the calm that comes from lower blood pressure. This, according to a group of physicians headed up by Dr. Dirk Taubert who did a clinical study on generally healthy people who had elevated blood pressure to find out what happens to their blood pressure if they eat dark chocolate over a period of time. Very simply, they found that it statistically significantly lowered the people’s blood pressure. I bring this up because as a geriatric care manager, a lot of the clients I see have blood pressure that is above what it should be. And I can tell them that the doctors say they should have a diet that regularly includes some amount of dark chocolate. People with dietary restrictions, however, need to check with their physicians.

This dietary recommendation does not take the place of the other recommendations we routinely get from medical professionals about fruits and vegetables and maintaining reasonable portions, but it does offer us a chance for a “healthy” dessert. And the science in their clinical study is pretty solid. Most other studies that have cited the beneficial effects of chocolate have done that based on simply observing some people over time, but Dr. Taubert and his colleagues actually set up a clinical trial with a placebo group and all the customary scientific controls.

This study was particularly relevant to me as geriatric care manager because all the study subjects were 56 to 73 years old. Half the group received 30 mg daily of polyphenol-rich dark chocolate, and the other half of the adults got no polyphenol in their chocolate. Polyphenol is the stuff in dark chocolate that is supposed to confer the benefit. Well, 18 weeks later, Dr. Taubert and colleagues found what a lot of people have been claiming all along. Without any changes in their body weights or their lipid or glucose levels, the group who got the good stuff in their chocolate had their incidence of hypertension decline from 86% to 68%.

To add to the credibility of Dr. Taubert’s research, it was published in 2007 in the Journal of the American Medical Association. You can click on Cocoa Intake and Blood Pressure to see the article. But seriously, don’t eat chocolate just to lower your blood pressure. Do like I do: eat chocolate and savor the flavor.

geriatric care Chicago

…and Happy Belated Valentine’s Day.

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.

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So last week, the turkey turned out really great, the pumpkin pie was awesome, the home football team prevailed, and most of the family showed up for the annual feast. Everybody ate, laughed and played together nicely, but you feel like crying. It just was not the same without mom or dad or some other loved one in the picture. You're not alone if you have this feeling of being let down or even depressed as you try to put on a happy face and enjoy the holidays that used to be so wonderful.

Psychologists call these responses to holidays or other special times of the year "anniversary reactions." The holiday itself may bring back memories of a time when there was a lot to enjoy - which makes holidays without a loved one all the more empty now that they are gone. Or the holiday may be the time when your loved one passed, and it is hard to find the good times in what now is a memory of profound loss.

It is not just about dates on a calendar. There are other potential triggers that bring on a sense of grief and loss almost as fresh as the moment of the initial loss itself. Certain places when we come "home for the holidays" can be triggers for melancholy. Certain smells like those of a favorite dish or of the frost in the air or the candle smoke as the Chanukah candles burn down or the Christmas tree that may soon stand in the corner. And there may be the sounds that open the flood gates as we all shift to the holiday music that will be with us until the day after Christmas. But you don't have to simply resign yourself to the blues; here are some ways to reconstruct a more positive version of your holidays.

1.    Crying gets the sadness out. It's okay to be honest about how you feel by simply letting the emotions out. Crying can be a great emotional release and a relief that will let you then get back on with more positive holiday emotions.

2.    Reflect back on the positive activities that you had enjoyed with your deceased loved one. Find someone - children or grandchildren - with whom you can share the activities, and you may find they begin to give you a new satisfaction.

3.    Memory of loss can stand in the way of other positive experiences that preceded the loss. Talk with close friends or relatives, some of whom may have shared those positive events. By reconstructing the positive, you re-experience moments you had cherished with your loved one.

4.    Collect some of the photos of the good times you have enjoyed with your loved one. Or maybe it is a letter written or other memorabilia that you can place in a special box or album so that you can have stimuli that help to re-experience the moments that have been special.

      These suggestions are not intended to take the place of professional counseling if your depression weighs heavily on you, but they are steps that may help restore the "happy" in your holiday.

      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.