elder abuse

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

It was a story about a prescription shared over lunch recently. During the course of a lunch with a caregiver, he relayed the “prescription” his spouse had received some ten-plus years ago from a specialist when she was first diagnosed with a chronic condition. …and how that specialist had reinforced that same prescription now more than a decade later, because it was working so well. When originally prescribed, the spouse had just received a diagnosis for one of those chronic and degenerative conditions no one wants to receive. While offering a medication that would help to mitigate some of the physical manifestations of the condition, the doctor paused and added another prescription. He said, “I also prescribe that you stay active, you stay engaged and you stay loved.” Let me explain, and then let me share the outcome of this doctor’s prescription. The doctor knew that retaining the same level of activity as the patient had once enjoyed was not a realistic expectation, but to continue any activity was vitally important to her well-being. Staying active means walking when you can no longer jog, or going for a drive when you can no longer bike in the country or embracing new activities or hobbies, learn a language or take up arts or crafts when you may no longer able to do the heavy lifting of what used to keep you active. Staying engaged means not giving up, for sure. But it means sharing experiences with others. It can be as basic as attending a musical or drama event or being engaged in an organization that is focused on lending a hand to the less fortunate. It means seeking help and accepting help from others within the community or even going on line for support. There is a support group for almost every chronic condition, and sometimes the affirmation of just knowing that someone else actually has experienced what one is now experiencing can be a breath of fresh air. Staying loved is a special kind of engagement. And to stay loved, one also must extend oneself and love another. It also means that one must engage in self-care, the active effort to feel better. It can also be as simple as taking time to relax, binge on a favorite program, read a book or listen to some particularly special music…especially with someone that one loves. There are a couple bonuses in this particular doctor’s three-pronged prescription. One, this particular patient has not had a change in the other prescription dose or strength in that entire decade-plus. Their condition is, as they say, well-managed. Two, it is great advice that the caregiver could follow and derive benefit as well. I always tell caregiver’s that there is an “I” in caregiver. There also is an “I” in care receiver! 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.
November is National Alzheimer’s Awareness Month, and that means it is a good time to talk about how to deal with this frightening condition. There has been ample press and research in recent months about how Alzheimer’s works, the damage it produces, as well as insights into how to arrest or cure the condition. However, the fact remains that an estimated 5.5 million people of all ages are coping with this degenerative condition. And more than 19 of every 20 of these individuals are 65 years of age or older. So, the question for caregivers to those people is how can we support their quality of life as they cope with the condition?

       A lot of research from around the world focuses on how to address Alzheimer’s and other dementias, and some of this has shown that there is a lot to be said for more than just the medical care these patients receive. Part of a growing body of work on “patient-centered” care has shown the benefit of modifying certain environmental factors for people with Alzheimer’s. A study of long term care facilities in Spain showed the positive impact of modifying such environmental factors like temperature, light and noise.

       Among samples of dementia patients from each of these facilities, the researchers took measures of quality of life either from the patients directly or by proxy indirectly from staff. Quality of life measures included patient mood, interaction with others, physical comfort and their relative abilities to manage standard activities of daily living. As researchers measured these factors, they also took measures of temperature, light and noise in areas the patients occupied during any given day – their own rooms, the living room, the dining room.

       They found that higher temperatures were consistently associated with lower quality of life among residents. Low lighting, they found to be associated with depressed moods among residents, and the greater the noise, the lower the social interactions among residents. To get quantitative, noise levels above 50 decibels were consistently associated with more negative quality of life for residents. In a positive vein, when day time hours had brighter light and evenings had lower light, sleep and mood patterns for residents were significantly improved. The researchers also found that higher daytime temperatures resulted in more demands from residents for care or attention from the staff.

       If you want to be an informed advocate on behalf of an institutionalized family member or loved one with dementia, please check out the rest of the findings. They can be found in the Journal of the American Geriatric Society.

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. Visit our For The Caregiver page for more information and resources.
Therapy dogs work, because we all – as the saying goes – get by with a little help from our friends. It may be a cliché and it may be a good basis for a song, but it also works. Moreover, recent research shows that those who happen to have the companionship of furry friends have better medical outcomes. The research among chemotherapy patients demonstrated that patients who had the benefit of a dog with them during their treatments scored statistically higher on measures of “social well-being.” In my experience companion animals in assistive care settings make a difference for all the residents who get the benefit of a pet or a stroke of the furry worker dog. On my son’s campus, they also bring therapy dogs on the rounds during finals week. But do not just take the scientists’ word for it; dogs are mammals, and mammals emote. I know you can talk to some people who claim their pets know what they are thinking or when they are having a “bad day.” We don’t want to project too much intellectual capacity to our four-legged friends, but mammals emote. Reptiles and amphibians don’t. I understand that it has something to do with the physiology of their brains. If you have a pet these holidays – and it is well-behaved around strangers – don’t hesitate to share the warmth…even if the warmth also brings a bit of residual fur along with it. Everyone benefits when you share that love…and I believe even the dog will benefit. Speaking of which…the picture that accompanies today’s post is of a Jack Russel mix. The reason is that we have an orphan within our service community. Her name is Annabelle, and she was orphaned just this week after a number of years of faithful service to her master. She is only seven years old, and if you or someone you know could give her your love, she promises she will return the favor. She is only 15 pounds and she runs on regular fuel, so you will get lots of great miles per ounce. Please reach out to me or click on the link for info@creativecaremanagement.com . What better time of the year than now to share the love? Have a great holiday season and a very happy new year! 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.
For caregivers to older loved ones in northern climates, winter is more than just a warning about dressing for the cold. Especially with the recent round of record cold temperatures across two-thirds of the nation, here are some recommendations for assuring that your older loved one will be safe throughout the rest of this season. It is the Ice. It is not just the cold that can be a threat to your older loved one's safety, it is the slippery surfaces that accompany p[lunging temperatures. With about 1.6 million Americans visiting the ER because of a fall each year, it is important to prepare your loved one for treacherous walkways. Encourage your loved one to think of going outdoors as an athletic event; wear shoes that are appropriate for the conditions and do some stretching before heading out. Skin Protection. Older skin is both thinner and drier which means that an older person will bruise or cut more easily. They also may be more prone to nosebleeds. All of this encourages keeping indoor humidity a bit higher in order to have skin as prepared as possible for the assault of the cold, dry outdoor air. And boost your older loved one's inner humidity by encouraging more aggressive hydration with fluids. Prepare for Outages. Encourage your older loved one to stock up on staples should outdoor conditions get in the way of the weekly run to the store. And should the power go out or the pipes freeze, have them stockpile a few gallons of extra water - just in case. Flashlights with extra batteries along with candles and blankets are also essential back-up, and have a system in place for regular wellness calls by phone as well as from willing neighbors throughout the season. Keep Warm. This may seem obvious, but remember than an older adult's sense of feeling is diminished with age or because of chronic conditions like arthritis, diabetes or just poor circulation. Keeping the thermostat at or above 68 degrees F is a good marker, but still be listening in your wellness calls for any sign of cognitive difficulties like slurred speech which could be signs of hypothermia. Seasonal Affective Disorder (SAD). The long nights and short days of winter can take their toll on anyone, but age has its own way of exacerbating depression. Encourage your older loved one to get out and socialize and be alert to the glum noises of SAD in your regular wellness checks. All of these general warning signs also should be a reason to reach out to neighbors or programs that can call on an older loved one. Meals on Wheels, for instance, is only partly about food; it also is a way to keep isolated people from becoming even more disengaged. And this may not be just about your older loved one if you are a distance caregiver; check around your own community to see where you can be that neighbor who checks on someone whose day will be just a bit warmer for your reaching out. Take heart - Spring is only a bit more than two months away! 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.
Yesterday, we talked about dealing with stress and melancholy during the holidays. Here are even more tips that you can use to cut down on stress and post-holiday blues while caring for a loved one. Remember, it is okay and understandable to feel down during and after the holidays. But the more you are prepared, the better your holidays may be.
1. It’s okay to say no. When it comes to holidays, if you feel the need to cut down on the amount of gatherings you’ll be able to attend this year – there’s no need to worry. Pace yourself – you’ll have a much better time, especially you tend to feel overwhelmed when running around place to place.
2. Keep gatherings small. You may find that scheduling festivities with smaller groups is much easier to manage as well as much more comfortable for you and your loved one.
3. Communicate. If you plan to host a gathering or go to one, be sure to talk to your loved one about it often so he or she is able to anticipate being social. In addition, talk to your guests beforehand about your loved one’s condition if they haven’t visited in a while.
4. Give yourself and your loved one a break. Realize that it is okay to take time out for yourself as a caregiver. You may find that setting aside a bit of time to relax is just what you need to reduce stress levels. Recognize that your loved one may need some quiet time too.
Last but not least, monitor how you’re feeling as you go through the holidays. If you’re feeling melancholic during festivities because you’re remembering how things were in the past, understand that this is okay and you should let yourself feel them. However, it may be a matter of focusing as much as you can on positivity, your loved ones, your happiness, and the present moment. You can find more these tips at Caregiver.com.

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.
If you ask most medical providers what is the number one health issue affecting older adults, you might get a list that looks like this:
Arthritis…

Hypertension...

Asthma...

Blindness...

Cancer...

Chronic Bronchitis. ...

Coronary Heart Disease. ...

Dementia.

I think that misses the point. I think the health issue that affects most older adults is lack of HUGS!

Yes, everyone who gets older also is at risk for becoming more isolated, having less contact with others, having fewer intimate friends and family around and yes, fewer hugs. And hugs are a big deal.

A psychotherapist named Virginia Satir suggests that we need four real hugs a day just to survive, eight hugs a day to maintain our health and twelve or more hugs to grow. We are not talking about a little Hollywood hug with an air kiss; a real hug that delivers health benefits is about 20 seconds in duration. This kind of hug is a trigger that tells your brain to release a hormone called oxytocin, and that is good for you in many ways. And the list of “hug benefits” goes on:
1. Hugs lower your cortisol levels which improves your heart health by lowering your blood pressure and more.
2. Hugs reduce pain and the inflammatory response of some immune disorders and even improves the immune system for people who have cancer.
3. Hugs stimulate the thymus gland which regulates the white blood cells that defend your body against infection.
4. Hugs tell your brain to release dopamine which is another hormone that also positively reinforces good feelings and even motivation.
5. Hugs elevate the serotonin levels which help to counter pain while elevating happiness and decreasing sadness.
We are not talking about a one and done thing here. I am not suggesting we drop by to visit and older loved one for a hug. Think about hugs as part of a nonverbal communication that can become a habit. And with the holidays upon us where families will be getting together, think about how to give your reunions a health benefit. Remember…for every hug you give, you also get one back! 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.

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