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

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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Better than a Resolution
After nearly a year of a pandemic and its quarantine, we are all ready to get back to normal. ...
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January 12, 2021
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Too Good to Be True
With over 300 clinical trials on vaccines for COVID19, it perhaps is not a surprise that at least two...
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December 1, 2020
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Abuse Thrives in Pandemic
Guest post author Gregory Peebles is a team member at CCM whose work focuses on helping aging adults and...
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June 16, 2020
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In the Caregiver's Words

Recent Client Praise

Here in Chicago we just had a day time high temperature of 88 degrees this week, but I am thinking of the holidays. The grass may still be green and the leaves may still be on the trees, but Yom Kippur is less than a month away, Thanksgiving is only two months, and so on. And I have a speaking engagement next week we are co-sponsoring with SASI (Services for Adults Staying in their Homes) called “Holiday Observations” – details are at the end of this posting. I will not be talking about how to “observe a holiday;” rather, I am going to be speaking to those who may be caregivers to older loved ones and what they should be looking for when families get together for any of the end of year holidays. Let me give you the sneak preview… When I speak with caregivers who will be reuniting with older loved ones, I encourage them to be observant for signs that their loved one’s "quality of life” may be compromised and to engage in conversation to get feedback on how their loved one is actually doing. What should you look for?
1. Household Clutter – You older loved one does not have to be a hoarder to be at risk with the accumulated clutter of daily living. Every year one in three adults over age 65 fall, and most of these falls are at home. Look for worn carpeting or scatter rugs that may be trip hazards. Or stacks of newspapers and magazines or wires that may be obstacles to walkways in the home.
2. Pantry Stocked – While you may be able to tell if your older loved one is losing weight, whether they are eating well may be a bit more subtle. You will surely have occasion to have coffee in the kitchen, so use it as a chance to surreptitiously check that your loved one is well-provisioned.
In your conversations with your older loved ones, take it one step further than simply asking the glossy “How are you doing?” What can you ask?
1. How are you sleeping? – We all know that as we get older we simply need less sleep, but insomnia is another matter altogether. They may show the wear of too many sleepless nights, but the poor sleep could be a symptom of poor nutrition or even depression. When we talk to employers we often ask what keeps them awake at nights; not a bad start with your older loved one either. A pattern of poor sleep can lead to other health problems: increased blood pressure, inflamed blood vessels, increased stroke risk and more. If you do not ask, it may be you who loses sleep.
2. Coffee in the Kitchen? – I had mentioned this as a way to get a current take on how well your loved one is eating. But ask about when they have coffee. Coffee during the early half of the day can impart all sorts of healthy benefits: reduced risk of stroke, diabetes and even some types of cancer. Taken too late in the day, however, we get back to sleep issues.
3. Activities? – What does your loved one do on a regular basis that keeps them engaged or keeps them active? They do not have to wear a pedometer to track their activity levels, but it is important that they get out and move. Walking about an hour a day has a marked impact on wellness by way of increasing caloric burn and helping with cardiovascular circulation. It's true that if they do not use it, they will lose it.
4. How are you? – I started by saying we have to move beyond the general questioning, but it is important to ask how your loved one is feeling. Depression often has some very tangible tells. .And cardiac issues can have warning signs that can occur months before an attack. For women the signs are less clear than they are for men, so don’t assume that indigestion is about food or any other subtle cues are just a passing issue. Listen for what they may call “nothing;” it can be something.
If you are a caregiver to an older loved one, enjoy family and the holiday, and take the conversational opportunity to make it a healthy holiday and new year. You also are invited to the SASI/CCM event: 6pm - Tuesday, September 27 Bradley Investment Center 3000 Central Avenue, Evanston Noon – Thursday, September 29 Evanston Chamber of Commerce 1609 Sherman Avenue, Ste. 205, Evanston These workshops will be free, but registration is required. Please call – 847/864-7274 or email – info@SASIathome.org End of year gatherings and visits can provide an opportunity to observe the older adults in your family in a new way. What should you look for? What can you do if you have concerns? Come to find out…and bring your questions. Charlotte Bishop is a certified Aging Life Care Professional (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.
As a geriatric care manager, I have the chance to work with all manner of caregivers and the elders or others with special needs for whom they care. Sometimes a caregiver becomes significantly more than the person who may help a loved one with shopping, cleaning or other personal needs. There are occasions when that individual becomes sufficiently frail or mentally compromised that they need the support and control of a guardian.

I recently spoke with an attorney, Gordon Gault, who specializes in trusts, wills and probate among other legal areas. We talked about what a guardianship means and when it is appropriate as well as how it comes about. Gordon first explained that a guardian is substantially different from just a caregiver in that a guardian must be appointed by a circuit court judge. That appointed guardian is then able to act on behalf of the individual who is either under the age of 18 or is deemed disabled in some other way.

How can a guardian be useful? I have talked about elder abuse and fraud in another blog posting. A guardian can be appointed when it is concluded that the individual is giving away money or other assets to individuals who may be manipulating to their own ends. This appointment is intended to protect the individual and only happens after a court hearing complete with a physicians’ or other professionals’ opinions being weighed.

I have talked about powers of attorney for health care and for finances in an earlier blog posting, but a guardianship clearly takes this up a notch. But it is important to recognize that not only must a judge be convinced that the individual in question is unable to take care of themselves, but that judge also will oversee the guardian’s activities. As you can see, a guardianship pretty much takes control of an individual’s affairs, but this whole process does not all have to be left to attorneys. Gordon highly recommends that anyone who has a family member growing incompetent, get the powers of attorney signed as a first step. Anyone over age 60, he says, should sign these POA papers so that they can be available should a need arise. And later if you have to get a guardian appointed, you may be able to do it on your own if it is just the individual and their care. If it is an estate worth more than a couple thousand dollars, according to Gordon, you will need an attorney for the paperwork.

If you have questions, please feel free to reach out to Gordon Gault using this link. Gordon is a Chicago-based attorney.

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.,geriatric care manager Chicago,geriatric care Chicago

Copyright ©2011
If dementia were a foot race Alzheimer’s would be number one, but the first place finisher of this race might not even be able to see the runner-up on the track to the rear. The Alzheimer’s Association estimates that there are about 5.8 million Americans of all ages currently living with the second place condition. Lewy Body dementia, considered to be number two in prevalence in America, totals only 1.3 million people, to date, but researchers at the Mayo Clinic suggest that this number may be a profound underestimate because of the nature of the disease. The “Lewy Bodies” which are the hallmark of the disease of the same name accumulate in the neurons of the brain and affect both cognition and movement. As a result, it often is misdiagnosed as Parkinson’s disease. And the cognitive part of the decline often confuses it with Alzheimer’s disease or even vascular dementia. To make it more confusing, Parkinson’s disease has its own dementia manifestation. So, what does one look for that can be a clue that a loved one may have the onset of Lewy Body Dementia? First, this is a diagnosis for a neuro-psychologist, not a family member, but be aware of changes like the following so that your loved one who may have the second place dementia can get the best help as early as possible:
1. Hallucinations may be one of the early signs, and note that hallucinations can be more than just visual…like hearing what is not there or even smelling what is not present.
2. Movement issues that can be like Parkinson’s like rigid muscles or tremors, shuffled walking, etc.
3. Autonomic changes that can cause dizziness or falls and curiously digestive changes like constipation with no changes in diet.
4. Confusion and memory loss also come along with the package and account for some of the difficulty in distinguishing this condition from other dementias.
5. Difficulty with sleep such as intense dreams with associated physical movement or just plain drowsiness throughout the day.
6. Mood changes that show a clear downward trajectory like depression or apathy or even more aggressive behavior.
If you’re thinking that all of these symptoms look like other dementias or like Parkinson’s, then you can appreciate why Lewy Body Dementia can be misdiagnosed. So, it may be number two, but it may be a lot closer to the first place in this category than we know. 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.
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders, and it’s not the virus. Those with any of the forms of dementia living in facilities designed to protect them from the deadly virus have died, not from COVID, but from isolation. The number of COVID deaths has broken through the 200,000 mark this week, and we all know that older adults are much more vulnerable to the virus than younger Americans. Senior communities, in particular, have been extraordinarily careful about not allowing family members from the outside to get near their older loved ones in order to protect residents from infection. But doctors have reported a surprising rise in the numbers of falls, pulmonary infections, sepsis and depression among dementia patients during these past six months among patients who had been quite stable and otherwise healthy for years prior to the pandemic. An option to explore with your loved one’s senior community is to seek permission to hire a private duty caregiver through an agency who can attend your loved one. Many communities are overworked and understaffed in the present pandemic/quarantine, and added personal attention will benefit your loved one. The Alzheimer’s Foundation of America (AFA) has some recommendations for families and caregivers of someone who has been diagnosed with Alzheimer’s or other dementia caring at home:
1. Dementia patients have sensitivity to water, so sing a couple verses of “Happy Birthday” as you help them wash as a pleasant distraction;
2. Be careful to be a calm model, because a dementia patient will be very attuned to what you say and your body language;
3. Since washing is critical and they may resist washing, talk in a soothing tone and consider a fragranced soap that they may like;
4. As an alternative for cleaning hands use an alcohol-based hand sanitizer – 60%+ alcohol according to CDC;
5. Encourage consistent hydration to bolster their immune systems, but also be prepared to assist with more trips to the restroom;
6. Have visual and tactile diversions on hand like photo albums, lively musical movies or just sorting the socks from the week’s laundry.
Everything about this pandemic is unprecedented, a word that I personally have used more times in the past six months that all of my years leading up to it. So, this is the latest learning in response to the scientists who are paying attention to the impact of COVID. We will keep you informed as we learn along with everyone else on this “unprecedented” journey. 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.
This is the second in a series of posts on dementia in advance of the release of my new book, How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. It will be released soon through Family Solutions Press of Los Angeles and available from Amazon. We will keep you up to date on details. Who is at risk for dementia? The simple answer is that in only about one in twenty cases is there any leading indicator or marker for Alzheimer’s in the form of a specific gene, and these are the early onset (before middle age) cases. There also is the ApoE4 gene variant. Individuals with one copy of this variant can have as much as four times the risk as others in developing the disease, and two copies of ApoE4 increase the risk to tenfold. Women also are at somewhat greater risk than men. And sadly, not only are women more likely to be diagnosed with the disease, but they also are more likely to be a caregiver to someone with the disease. For all other cases, it is simply a matter of increasing risk as one ages. The risk factors in general across all the dementias tend to revolve around birthdays, poor diet, poor exercise, poor intellectual/ social engagement as well as diabetes, high blood pressure or depression. For the dementias that are specific to either Parkinson’s or Huntington’s, the cognitive compromises simply accompany the physical progressions of these diseases. The processed food consumption that has been linked to our global epidemic of obesity is also tied to the rising rates of Alzheimer's disease world-wide. We don't mean to sound the alarm about sugar, but we came across an article recently that tied together a number of facts and trends that we all may have seen. And we all should be very alarmed! As professional care managers, we often work with older adults who have developed medical conditions that reflect a lifetime of poor health and nutrition habits. We see the elevated blood pressure and the obesity that can arise from sedentary lifestyles and poor diet. One of the more common developments we see is the onset of type-2 diabetes resulting from a lifetime of too many sweets, poor diet in general and lack of exercise that have resulted in what doctors call "insulin resistance," the pancreas' inability to keep producing enough insulin to process all the carbohydrates or sugar. What you may not know is that the brain also produces insulin, and that when faced with a prolonged assault from more sugar than it can process, its ability to produce insulin may falter and then fail. The result has been referred to as "type-3 diabetes." The research has been piling up. For instance, people who suffer from type-2 diabetes (type-1 is the form that people are either born with or develop as an immune response) have deposits of amyloid-beta in their pancreas. Sound familiar? Yes, amyloid beta deposits in the brain are a signature marker for Alzheimer's disease. And this also begins to explain why type-2 diabetics are estimated to be anywhere from 50 percent to 100 percent more likely than others to also develop insulin-resistant Alzheimer's disease. Type-2 diabetes does not cause Alzheimer's disease, but type-3 diabetes is caused by the same poor diet that causes type-2 diabetes. This may begin to also explain why the rates of the two conditions both have tripled in the United States in the past forty years. This, along with a lot of other inflammatory conditions related to the heart and the circulatory system. In related research scientists have found that one of the more common medications used to treat type 2 diabetes, metformin, has a neuroprotective benefit as well as its indicated benefit in addressing blood sugar levels and pancreatic function. The research coming out of a close analysis of Veterans Administration data by a doctoral candidate at Tulane University suggests that metformin can have a long term neuroprotective effect that can stave off the brain deterioration of Alzheimer’s and Parkinson’s. In my book, we cover what we know about dementia, what can be done to stave off the effects of dementia and most importantly what caregivers can do for their loved ones with dementia and for themselves. 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.

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elder abuse

Everything to Lose

Scamming as a Superspreader

Better than a Resolution

Too Good to Be True

Abuse Thrives in Pandemic

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