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

How (NOT) to Worry, Stress or Be Anxious
It’s not so much whether you’ll have worries, be stressed or feel anxious…it’s how you’ll manage your worries, your...
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March 21, 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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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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When the IRS Calls…
How about a show of hands regarding the Internal Revue Service (IRS)… Have you ever filed a tax return...
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March 8, 2022
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The “Other” Health Concerns for Older Adults
It was just two weeks ago that I underscored the fact that “older adults have a greater fear of...
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February 1, 2022
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Password Protected?
I often offer advice on how to help your older loved one with challenging tasks or how to protect...
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October 26, 2021
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Your Older Loved One’s Greatest Health Risk?
As our loved ones grow older, we probably are more acutely protective of their health and well-being, especially if...
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September 14, 2021
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Your Flight to Nowhere is Boarding
You have probably put off a vacation or most any travel for more than a year with the threat...
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August 10, 2021
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Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
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April 20, 2021
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Scamming as a Superspreader
We have all seen the advertisements for the on-line services that will help you find your ancestry by taking...
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February 2, 2021
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In the Caregiver's Words

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You already know that depression is far more common among older adults than among younger people. But everyone is at risk for what we used to call "cabin fever" or the winter blues, and it is real. If you or someone you know goes through a period of feeling down after winter has over-stayed its welcome - but recover in the spring - it may be seasonal affective disorder (SAD). If you are a caregiver to an older person who seems to be out of sorts this time of year, there is help.

Most experts suggest that SAD is a simply result of too little natural sunlight, but the symptoms may vary. Common signs of SAD include:

1.    sleeping longer, yet still feeling tired during the day

2.    eating or craving more, especially for foods high in carbohydrates

3.    weight gain due to increased food consumption

4.    less enthusiasm for what used to be a significant interest or activity

5.    generally bad temper or crabbiness

The good news is that the symptoms are not just an inevitable part of the season. Those who suffer from the condition are not resigned to simply wait until spring. There is some consensus that the best treatment is to offer what is most lacking in winter - light. Special lights that offer the broadest spectrum can help. Experts suggest that the light be available early in the day either by sitting in front of what they call "bright lights" or by slowly turning up a light in the morning to simulate an earlier rising sun.

Some people who suffer from the condition find that talk therapy similarly used in treating depression can help to limit the effects of SAD. Exercise is a way to release endorphins and also help re-energize one's body. If you are a caregiver to an older adult suffering from SAD, however, be sure that a doctor approves of any new exercise regimen.

Some suggest that anti-depressants can be a help for more serious cases of SAD, but it is important to stick with the medication once started. Some people may begin to feel better, and sensing that their condition is remedied may go off their medication. This only serves to allow the SAD to settle back in.

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.
What is the most widely used drug by seniors? It’s the same one that is most widely used by all adults: caffeine. It’s estimated that about four in five adults world-wide consume at least one caffeine-containing beverage daily. I am going to share with you not one, but three quizzes on this go to “medication.”
1. Considering caffeine and some common medical conditions, which of these is true?
a. Patients with chronic kidney disease who drink caffeine have significantly lower mortality.

b. Caffeine improves motor function in Parkinsonian patients.

c. The risk for rosacea is dramatically increased with caffeine consumption.
Odd as this may sound, it is “a”. People with chronic kidney disease have a lower risk of dying if they consume caffeine. It was a study among 5,000 chronic kidney disease patients, and those who drank caffeine drinks had a 25% lower risk of dying. Drinking more caffeine did not get more benefit from the caffeine.
1. Which one of these is true about caffeine and heart health?
a. Consuming unfiltered coffee significantly increases the bad cholesterol and triglycerides in the blood stream.

b. Moderate caffeine consumption increases the likelihood of elevated blood pressure.

c. Regular caffeine consumption increases the deposits of calcium in the arteries.

Again, it is “a”. It is all about how the coffee is prepared, because unfiltered coffee can have some bad effects on blood cholesterol. The lesson here must be that filters good; no filters bad.
1. Although this may vary by individual, what is the “toxic level” of caffeine in the blood system of a healthy adult?
a. 400 mg per deciliter.

b. 600 mg per deciliter.

c. 800 mg per deciliter.
Okay, you may be on to me if you said “a”. There is variability across individuals, but 400 mgs is the limit, so more of a good thing can be a bad thing. And the very young have even lower threshold which is a bit scary with all the high caffeine canned beverages available to your people these days. By now, you have to be wanting to know how many milligrams in a cup of caffeine. The answer is about 95 milligrams, but of course, that may vary depending on who is making the coffee. Now, how did you do on the test? If you are satisfied with your score, figure out how much caffeine you have had so far today to see if you should reward yourself with a trip to the coffee maker. 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.
Diet and exercise are the two key recommendations from most doctors and even on the package inserts of most medications for blood pressure, type 2 diabetes and a number of other conditions. And this may not be for just your older loved ones for whom you may be a caregiver; most people at least pay lip service to lowering their caloric intake. So, it seems reasonable that a lot of folks may shift to a low calorie or diet soft drink to reduce caloric intake and maybe even lose some weight. Not so fast! In a study published April 20 in the journal Stroke researchers found that people who drank an average of one low calories soft drink daily had a three times greater risk of stroke than those who drank no low cal drinks over a ten year period. So, what do we make of it? The researchers suggest caution in drinking too many soft drinks in general. But the study did not establish cause and effect. It could be, they suggest, simply a matter of people who were at risk for stroke or vascular dementia owing to their weight were encouraged to lay off the sugary drinks. We just cannot be sure. In other research, intake of sugary drinks was associated with dementia risk…Alzheimer’s dementia, not necessarily vascular dementia. Both studies failed to adjust for other variables like age, gender and weight, and neither of them was a controlled experience in which people could be randomized to two different groups – one drinking sugary drinks and one drinking diet drinks. The ethics of that kind of research are a bit thin anyway. While both studies recommend further research, they both also recommend that a return to water as a drink of preference is a good idea. But there are other data as well…from rats. Researchers found that if they divided rats into two groups who received exactly the same diet, but one group was also given artificial sweeteners, that group gained more weight. Evidently, the brain can be fooled by the artificial sweeteners in some way. The data would suggest to a prudent person, that maybe sweetened and unsweetened drinks have enough questions that erring toward the water option would be a good idea. As with any of these questions, you should consult with your physician before making any radical changes in your diet. 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.
Too much caregiving can be harmful to your health! I have talked in the past about how important it is for us all to help care for the caregiver and that caregivers deserve to take care of themselves in midst of all the other tasks of caregiving. And if they do not attend to their own needs, what then? Well, they run the risk of becoming the proverbial “toast.” I have never seen an actual case of caregiver burnout, but I have seen a fair bit of toast in my years as an aging life care consultant or geriatric care manager. For instance, the middle-aged gentleman with whom I spoke a while ago about his care giving duties for his ailing mother. He summed up his situation by saying, “I’ve gone from five hours of uninterrupted sleep each night to five hours of interrupted sleep each night.” And he very much looked it. If you are a caregiver to an older loved one or know someone who is, look for the warning signs of the “caregiver toast” syndrome:
- The Joy is Gone: caregivers often report how rewarding it is to “give back” to a loved one, but as the time goes by and grind threatens to wear them down, they tire of it. Getting tired of caregiving is not a reflection on how “good a person” you are. It is a sign of burning out.
- Everyone’s capacity is different: Don’t compare your caregiving capacity with anyone else’s. It is not about a cup half full versus empty question. It is about how big your cup is, and yours may empty faster than another person’s.
- It may be how much care you are giving you. The caregiver is often the last person in line to get a break or a rest. If you are a caregiver, you cannot take proper care of anyone if you are not attending to your own needs.
The symptoms of “caregiver toast” syndrome are really tangible. Look for signs of the following in yourself if you are the caregiver…or in someone you may know who is a caregiver:
- Muscle aches in the neck, shoulder and back, headaches
- Impatience, distraction, irritability, diminished drive, guilt, melancholy
- Tiredness, sleeplessness, susceptibility to illness, memory loss
- Withdrawal from regular engagement like clubs, religion or social circles
What is a symptom or a diagnosis without a remedy? The toasted caregiver needs to start some healthy activities along with perspectives on themselves. Key will be a healthy diet and sleep cycle; acceptance of any shortcomings and credit for the accomplishments; seek help in regaining perspective, insight and even humor; seek out conversation, companionship and just the touch of others. Find resources with whom to share the load and the journey. Turn down the heat to avoid becoming toast. Charlotte Bishop is an Aging Life Care Professional and 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.
It ended with almost uncontrollable laughing. That’s how one of our team describes his conversation with his mother about making her funeral plans one day not long ago. Yes, you heard that right…they talked about her memorial service and had a great laugh together. My take on that is that once the incredible stress around a topic that no one wants to talk about is addressed, the relief is almost giddy. We laughed too when he relayed the part about Googling funeral hymns and singing along with his mom the ones she particularly liked. Trust me; this is not a unique story, and it is only one of the “difficult conversations” families can have. According to AARP, 70 percent of Americans say they feel that it is important to have an end of life conversation with their family members, but only 30 percent have had that conversation. The younger generation in the family may not hear the conversations that older adults have among themselves about death and dying, and parents may not want to “burden” their adult children with talk of end of life. But that will not change the fact that death is a universal event for all of us. If you are that adult child who would like to help your parent with the conversation, there are some ways to “break the ice” in order to have a productive conversation. First, you don’t have to start with end of life questions; you can start with some of the more mundane issues about health or medical issues. Every professional painter will tell you that there is a whole lot of prep work before they even put the brush to the paint. Start with mentioning perhaps a friend whose parent had a medical episode, and the adult children were not even aware that their parent had a problem with their (fill in the blank…heart, lungs, etc.). So those same children could not even supply their parent’s physician’s name or the medications they were taking or any of the other details that the paramedics or emergency room personnel had asked. Or you may even point out that your significant other has all the details on your medical health “just in case.” Would your parent also wish to have you in the know about their health…just in case? And there may be certain circumstances…
- Mom, if your medical professional makes any kind of new diagnosis, do you want to know every detail, treatment options, prognosis, or just the big picture stuff?
- Dad, if the doctors have treatment options for a condition, do you want to know all the details, or just what your doctor recommends?
And there are some issues that can be clearly laid out in documents for the medical record. Called POLST in Illinois (Practitioner Orders for Life Sustaining Treatment), it is considered a legal document that becomes part of a patient’s permanent record which states what kind of measures they wish to have applied in emergency situations. It is more than a Do Not Resuscitate (DNR) order; it covers the extent to which medical professionals should work to sustain them in an emergency. The Illinois site for this legal document also has suggestions for how to have the conversation. Obviously, the conversation can get into details like the one I started this post with, but it may not be the first conversation. We as Geriatric Care Managers also get the call to help families cover these kinds of issues, and we have made this into a form called the Life Span Care Plan(SM). 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.