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

The Risk Factors AND Ways to Prevent Alzheimer’s
Alzheimer’s Disease affects nearly six million people in the United States according to estimates from the CDC, and that...
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January 22, 2024
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Memory Doesn’t Have to Decline with Age
Memory decline doesn’t have to be part of a person’s aging process. You may know that I have written...
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October 17, 2023
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Update on Dementia – part 2
I had left you last week with what may have seemed to be an optimistic note regarding the latest...
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June 26, 2023
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Update on Dementia – part 1
You may have heard the noise about a new drug for treating Alzheimer’s disease and other dementias. It would...
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June 6, 2023
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Another Side to the Story
It was just a year ago that Bruce Willis’ family disclosed that the actor would be retiring from acting...
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February 27, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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A Defensive Game Plan for Dementia Outbursts
It’s not just about forgetting or being confused. If you have a loved one with dementia, it is also...
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January 31, 2023
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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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In the Caregiver's Words

Recent Client Praise

Caregivers never have just one job. Most caregivers not only help an older adult or loved one in their orbit, but they also are holding down a full-time day job. And by the way, those who are part of the sandwich generation also have children still living at home who depend upon them. Just when that all sounds pretty onerous, the holidays come along and the demands get ratcheted up to the point of breaking. The turkey and fixings that the caregiver prepares for the holiday table may look and taste fantastic, but the caregiver/chef feels like yesterday's leftovers by the end of the day. If you are a caregiver this holiday season, please follow these four basic recipes for survival so that you do not feel as picked over as yesterday's entree:

1.    Have a helping of freshly served self-congratulations. At Thanksgiving in particular, we all give thanks for the bounty, but do not overlook the caregiver in the midst of all the thanking. The older loved one for whom you care may not be able to thank you if they are suffering from a dementia, but all the more reason that you remember to thank you.

2.    Savor the flavor of a much-deserved break from it all. You have all this family gathered at the feast, and those many hands can also make fast work of the chores, such as cleaning up and tidying after the banquet. Appreciate that family may need to be reminded, but they will actually get into making it a great day for the caregiver – just as much as they got into the pumpkin pie.

3.    Give yourself permission to take a pass on the veggies if you like. Not all of the holiday will be easy on a caregiver, particularly if you find mom or dad is slipping since the last time you were together as a family. Being a caregiver is emotionally demanding and you are entitled to the feelings of sadness or fear, even resentment or anger, about when mom or dad will someday be gone.

4.    You don't have to bake everything yourself. Caregivers often feel that they just need to be a little stronger, just take on a little more or just tough out a rough patch. That sort of "going it alone" mentality can lead to burnout or depression or even anger toward a loved one. Don't hesitate to seek out a professional counselor to help you process some of the feelings that come with the territory just as you would buy the dinner rolls at a store when you are running out of time before dinner.

      If you can follow at least some of these recipes for the holidays, you will be taking care of yourself. And if you care of the caregiver, you will be able to better care for a loved one in as positive a way as you can. Remember: You don't have to be a perfect. You just have to be “good enough.”

      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.
We had significant enough response from a recent post ("Singing is a Breath of Fresh Air for Caregivers") that we thought it important to provide readers with more information. CCM caught up with Jonathan Miller, who conducts Encore Illinois, a choral organization specifically for older adults. Additionally, Maestro Miller will be launching the Good Memories Encore Chorale, intended for people with dementia and their care partners, in the fall of 2018. CCM: Tell us a little about Encore Illinois. How do people find you? And what should anyone who’s interested expect? JM: My wife (Sandy) and I founded Encore Illinois in early 2016. Encore Illinois is an independent not-for-profit organization based in the Chicago area. We provide choral-music education and performance opportunities for older adults under the direction of professional artists. We sing challenging, eclectic 4- and 3-part repertoire with piano in a supportive, encouraging environment. Encore is tuition-based. Encore choirs are non-auditioned, and we make it really fun. We are the local affiliate of Encore Creativity, which is based in the Washington, DC area. Encore is the nation’s largest choral-music organization for older adults (55+). Encore in DC alone has 21 choirs and 1200 singers and is now operating choirs in New York City. Encore in DC has been around since 2001 and is a fantastic organization with which to be affiliated. Encore Illinois in Chicago offers 7 choirs in the city and suburbs, and we’re happy to announce that we now have more than 300 singers currently singing in our Spring 2018 session. People can find out more about us on our website, www.encoreillinois.org. Our choirs are in Hyde Park, the Gold Coast, Evanston, Oak Park/River Forest, Arlington Heights, Glen Ellyn, and Hinsdale. Rehearsals are once a week, during the day, for 90 minutes and start with stretching and vocal warmups. CCM: You’re impressive! You founded Chicago a cappella--an ensemble with a fantastic reputation nation-wide and a premier Chicago ensemble--and remain its Artistic Director. No doubt, skill levels vary greatly among your membership for Encore Illinois. How would you encourage folks who really want to sing but are afraid they aren’t good enough? Likewise, how do you challenge those with more choral experience? JM: You are very kind. We’re finding that word of mouth is bringing more and more people to us, and people are encouraging their friends to give Encore a try. Yes, the skills levels among our singers very widely, and that’s part of what makes it fun. We have many people who are brand-new to choral singing, many others who are back after a break (with the break lasting from 2 to 65 years! – my 82-year-old mother hadn’t sung with us since high school), and of course lifelong choral singers. The repertoire is a big challenge – targeting just the right sweet spot so that, as you way, experienced people are still stretched while newcomers are able to hold their own. We also create a setting where the stronger singers help out others who might need someone singing in one or both ears. Some people prefer a higher-end experience and go back to other choirs, but most people seem to keep coming back over and over. We’re in our seventh session now, and many of our singers have been with us since the very beginning. CCM: What’s your range of repertoire? But also, what kind of music does Encore Illinois like to sing most? How often do you put up a show, and how long do you rehearse it before it’s ready? JM: We have three sessions a year—a fall/holidays session with concerts in December, a spring program with concerts in May, and a rock ‘n’ roll choir in the summer (with only 2 locations) that performs in late July or early August. The current spring program is all American folk songs and spirituals. The range of repertoire is pretty wide; I’m Jewish and like to make sure we do some Hebrew at Chanukah, and we do sing in other languages from time to time. Probably the most difficult thing we’ve done so far is a piece I wrote for Christmas called “Clip, Clop,” which has tricky rhythms that illustrated the donkey’s bumpy ride down the road to Bethlehem. CCM: From your vantage point on the podium, what is it about choral singing that makes it particularly supportive for caregivers? JM: We're launching our choir for people with dementia and their care partners to sing together (Good Memories Encore Chorale – see more info here) in fall 2018 on the Gold Coast and will ramp up to other locations as resources permit. That choir is for people with Alzheimer’s and related dementias to sing along with their care partners – and the idea is that we target people who are still living in the community, outside of care facilities, because that is where the most social isolation tends to happen and where the need for meaningful, regular social contact is the greatest. The Good Memories choral experience is based on the model of the Giving Voice Initiative (GVI), based in Minnesota (www.givingvoicechorus.org). Encore Illinois is a member of GVI. In the GVI/Good Memories model, the care partner sings in the choir along with the person who has dementia. The care partner gets to do something fun, exhilarating, all-consuming, and joyful – something that is sometimes in short supply when you’re caring for someone else. Our model also provides volunteer singers who receive special training about ways to communicate well with people who have Alzheimer’s or related dementias. The volunteer singer is available in case the care partner needs a break and doesn’t want to sit with the person who has dementia. Volunteer singers help make sure that the person with dementia is:
- comfortable in the rehearsal environment,
- tracking with what the music director is asking the choir to rehearse
- safe and tended to during bathroom breaks, etc.
- getting as much as possible out of the choral and social experience
Some care partners who sing with their spouses say “it’s like going on a date.” Other family members say, “Our week pretty much revolves around choir rehearsal.” CCM: Since caregiving seems so all-consuming, I imagine a lot of caregivers who would like to join a choir are worried are worried about emergencies, or not being able to commit. Does your organization have any methods for coping with that? JM: We don’t hear a lot about that, though surely it happens. Even in our regular Encore Chorales, we have emergency contact information on file for every singer. What seems to happen is that the choir becomes central to people’s experience of well-being and that they attend whenever they can! CCM: What kind of change do you witness in people who become associated with Encore Illinois? JM: Joy is pouring out of people at rehearsal. Singers are making new friends and making existing frienships stronger. People are astounded at what they are able to accomplish musically. The jubilation at the end of a concert is palpable—you yourself know this as a performer. There are unexpected blessings. One woman, who records for the blind, told me with shining eyes recently that she now can get through very long phrases of reading out loud without having to do re-takes nearly as often as she used to. She said, “I know it’s because of all the breathing exercises we do in here.” Another is that kids and grandkids (and great-grandkids) of our singers come to concerts to cheer them on – that is one of the sweetest things you’ll ever get to witness. CCM: Thank you so much first for offering your significant gifts to the caregiving community and also for chatting with me. This is your chance to plug any projects you’re working on right now as well as to let us know how to keep up with or contact you for more information. JM: You’re welcome! I’m also composing and arranging a bit and always interested in commissions for new works or arrangements, so if there are other conductors out there looking for good new music, please be in touch. The Good Memories choir is taking a lot of my and Sandy’s attention and will be exciting to have up and running. I’m also doing pop choral arrangements for www.musicnotes.com (I’ve transcribed about 20 Pentatonix charts) and staying active with Jewish music. Also, anyone is welcome to attend any of Encore’s free concerts that we offer to the community in May, July/August, and December; visit www.encoreillinois.org to see our current concert schedule. Interested singers can always visit a rehearsal or two to see if it’s a good fit before they register.
Physical exercise, mental gymnastics or medication: which one has the most beneficial impact on improving or delaying the onset of what medical professionals call “mild cognitive impairment?” First, to clarify, mild cognitive impairment (MCI) is a middle ground between the normal decline of our brain function and the dementias that I have talked about in previous posts. You might even refer to it as “pre-dementia,” except that MCI does not always or inevitably lead to dementia. The rate of cognitive decline increases with age with just fewer than seven percent of adults age 60 to 64 showing signs of mild cognitive impairment. By age 80 – 84 the rate of MCI exceeds 25%. And MCI progresses to dementia in about 15% of patients 65 or older. It is true that the FDA has approved a few medications for their ability to slow the progression of cognitive decline, and you have seen some of them advertised on television. And there are “brain games” available for people who want to keep their faculties sharp…even doing crossword puzzles or just reading have been shown to be of some help in slowing the inevitable mental decline associated with birthdays. Yet, neither of these can measurably improve cognitive function. The American Academy of Neurology has released new guidelines that encourage regular, physical exercise as a way to not just improve overall health, but to also improve memory and slow decline of cognitive processing. They see little value in pharmacologic treatments, and they admit that cognitive training can improve a patient’s score on cognitive measures. Engaging in physical exercise like walking or biking or swimming as little as twice a week actually can improve cognitive function. The new guidelines, as endorsed by the Alzheimer’s Association, are based on research over a six month period that demonstrated that physical exercise just twice a week can significantly improve memory. There are no long term studies yet, but researchers are extending their work, to date, to see if they can actually hold on to that improvement longer. It looks as if we can add one more condition to the list of ailments that can be reversed by diet or exercise. (Do a search in the toolbar for “exercise” and see all the good that can come from working up a little sweat.) 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.
We are professionals providing home care and geriatric care services that enrich quality of life.

Our Creativity: We look at you and your family's individual needs to produce the best possible solutions. Those solutions are not always easy to discover, nor are they always straight forward. Our experience in a wide range of care situations allows us to produce options that may not have been otherwise considered.

Our Care: By assessing emotional, physical, and medical necessities, we ensure your loved one is provided a safe, secure environment. Our motivation is seeing your loved one living as independently as possible and families supported with the tools they need to achieve the best living situation.

Our Expert Management: Seeking to lift your load as a caregiver, we help organize appointments and paperwork, oversee and develop thorough care plans, navigate the essentials for all aspects of senior living, and provide the support family caregivers need. We use real experience to help you make informed decisions about health, psychological, legal, economic and social needs.

Whether we’re finding the best way to help mom or dad live with Alzheimer's, or creating the safest in home care environment possible– you can trust us to be a reliable and knowledgeable resource for geriatric care services. We can connect you to the right local care providers/nurses and tailor care plans specifically for you and your family. We also serve as bridges to help a loved one (as well as their family and friends) make life transitions. Click here to learn more about our services.
Creative Case Management is a personal and professional story.

Charlotte Bishop
MS, GCM, CRC, CCM CDMS, LCPC, is president and founder of Creative Care Management. As a certified Geriatric Care Manager (GCM), Charlotte Bishop leads a team of qualified professionals dedicated to providing solutions to difficult care situations. They are seasoned experts in the field of geriatric and senior care, Chicago-based for over two decades, and happy to help you and your family through any care giving needs.

Caregivers...often find themselves stepping into a void. It only becomes clear that an aging parent or dear friend needs help when the dishes pile up in the sink. You find out that they have difficulty getting to the grocery store when they begin to show signs of poor nutrition or the refrigerator is bare. So the caregiver steps up to help where they can, and the list of what needs doing can seem formidable.
— Charlotte Bishop

President and Founder of Creative Care Management
What do tennis, racket ball and soccer have in common? What do jogging, swimming and biking have in common? You may see that you need at least one partner for each of the first three, and the other three are pretty much solo activities. But the other point is that people who participate in the first three tend, on average, to live longer than the people who participate in the latter three. They are all good forms of exercise and all contribute to longevity, but the team activities just do a better job of giving us more birthdays according to a number of research studies. A 2017 study that followed 80,000 British men and women showed that those who played racket sports outlived those who were joggers. They originally had used this research to identify if the duration, strain or amount of jogging showed any differences in longevity, and the answer was yes those who were in the “happy medium” – not too strenuous and not too gentle - did live longer. On closer examination they further uncovered the greater benefit of racket sports over the solo sport of running. The researchers looked to even more data to see if this general pattern would hold in other populations, and they discovered that a Danish study that encompassed a greater number of activities that people had described in questionnaires showed that people who engaged in more social or team sports like tennis, soccer and even badminton lived longer than the more solo athletes. And they tracked these individuals for 25 years. No surprise, those who had reported relatively little or no exercise during their lives did not survive as long as their more active counterparts. Cyclists who bilked four or more hours a week, for instance averaged almost four more years of longevity than those who chose to “sit out” their lives. Running added about 3.2 years when compared with their sedentary counterparts. But tennis added nearly 10 years to players’ lives and badminton added 6.2 years. Soccer contributed 5 more years to players’ lives. Even when the researchers controlled for education, age and socioeconomic standing, this pattern held. It may be about the kind of cardiovascular benefit conferred by one sport over another according to the researchers, but they offered one more possible explanation. The sports that gave the greatest benefit in years also are team…or social…sports. Other research has often cited social isolation as one of the big detractors from both quality and quantity of life. Social engagement, they pointed out reduces stress at the same time one derives physical benefit from a sport. It seems to give new meaning to being “heart-healthy.” It is not just your pump that is healthier, so is your spirit, and both contribute to more birthdays. 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.