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

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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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

October 29th is World Stroke Awareness Day. We may not be hearing as much about strokes as we once did, because in the United States the incidence of strokes is on the decline. Just under 800,000 people will have a stroke this year, and three-quarters of them will be over the age of 65. The reason the incidence in the United States is on the decline is because Americans are doing a better job of managing their blood pressure and because fewer of us smoke. Because so many of the stroke victims are older adults, it is important for caregivers to help their loved ones to further prevent stroke. With the proper preventive measures fully 80% of strokes could be prevented. Here are some suggestions for preventing strokes:
- Know your loved one's blood pressure; this is a routine part of anyone's annual physical, but you also can get a screening at health fairs or even your retail pharmacy using a machine;
- Know the signs of atrial fibrillation, a condition in which the heart rate goes so high that it fails to pump blood effectively which can lead to pooling and clot formation;
- Stop smoking - this is just one more very good reason to kick the habit if your loved one has not already done so as smoking doubles a person's stroke risk;
- Monitor your loved one's cholesterol intake and blood levels - any total cholesterol count above 200 is cause for concern;
- Manage blood glucose levels in your loved one if they are a diabetic - one of the complications of diabetes is poor circulation which can lead to stroke;
- Diet and exercise are part of almost every approach to better health - boost your loved one's intake of fruits and vegetables (five portions a day) and reduce intake of trans-fats and salt;
- Manage alcohol intake - most doctors recommend limiting alcohol consumption to two or fewer drinks a day.
The good news about managing these risk factors is that not only will you as a caregiver be reducing your loved one's risk of stroke, but you will be adding to their quality of life as well. In addition, you may find that these healthy habits also are contagious which can results in a healthier caregiver. Stroke prevention can become a win-win! For more information, I recommend checking out the web site for the National Stroke Association (http://www.stroke.org/site/PageNavigator/HOME). 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.
This month we’ve addressed ways to mitigate holiday blues and that familiar feeling of melancholy for both the caregiver and the loved one throughout the season. However, for an older loved one, that feeling of unhappiness, especially if it lasts well after the holidays may be signs of depression. Depression can be common in older adults and can come in many different forms. There are also many different reasons why depression might be triggered – including being associated with various medical conditions. For instance, depression has been linked to viral infections, malnutrition, stroke, lymphoma, hyperthyroidism, and others. Some medications are also commonly linked with depression.

Moreover, when an older adult or parent starts to lose some of the independence that they once had – whether caused by a deterioration of mental or physical capabilities – they might develop thought processes associated with “learned helplessness.” This happens when the loved one starts to see their failures (whether perceived or not) as a sign of being completely helpless and having no control over their own lives. Also, as mentioned in previous entries, the sense of loss can weigh heavily on a senior parent. This is not just due to loss of another family member, but also the loss of their previous capabilities, roles, or responsibilities.

It is extremely important to not diagnose depression on your own. Have your loved one assessed by a professional. What they may be experiencing might not be a disorder at all. It may be signs of another issue. However if you are certain your loved one has depression, here are three different eldercare solutions you may want to consider:

Antidepressants. This is usually provided as primary treatment for moderate to severe cases of major depressive disorder if preferred by the patient. Be sure to double check with doctors to ensure that these medications don’t interfere with anything else your loved one might be taking.

Psychotherapy. For those who are uncomfortable taking medication for depression, this is a suitable option. Psychotherapy helps identify factors in your loved ones lives that might be contributing to depression as well as teach valuable coping skills.

Depression Care management. This is a great treatment option for those who already are within an in home care system or care management program. Care managers will help identify signs of depression and facilitate treatment options, including ensuring that a healthy regimen is kept while working alongside a psychiatrist or physician.

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.
“Charlotte was incredibly helpful to me yesterday and more so today. I'm delighted to have such a competent, caring partner. Also, Charlotte was instrumental in finding a new primary care physician for Margaret.”
Harriet Brandt, Faith in Action Evanston
This week is National Women’s Health Week. The reason I mention “caregiving” in the title to this posting can probably be summed up in one word: Stress. If we were all together in a room, I would see a lot of heads nodding, because those women who are caregivers know what kind of stress this is…but you may not all be accepting that it is also costing your health to be that stressed caregiver. One woman with whom I spoke some time ago said it best when she remarked that she didn’t think twice about canceling her own physician appointment in order to accommodate a medical appointment for her father for whom she was a caregiver. There are more than 65 million caregivers in America today, and two out of three of them are women. But that is not all. The majority of these caregivers are married and have full-time jobs. And 37% have a child or grandchild under 18 years of age living with them. No surprise that caregivers’ health care costs are significantly higher, because caregivers are sicker. And they don’t practice good wellness habits. Caregivers smoke more, drink more alcohol and get fewer preventive screenings. Ditto that “good wellness habits” thing. There is not a quick fix to this health risk that women caregivers seem to uniquely have. There is no one size fits all, but there are some steps that all women – not just the caregivers – should take:
1. Find what makes you happy and go there…frequently.
2. Schedule a wellness visit with your primary care physician - now.
3. Ask about what preventive screenings or vaccines you should have on your calendar.
4. Get active…walk more and farther, and do it five days a week.
5. Eat healthy…which is not to say you cannot still have your guilty pleasures, but you do need good sources of protein and lots of greenery in your diet.
6. Get enough quality sleep…most experts talk about eight hours a night.
7. If you smoke, quit; if you text and drive, quit; if you drink, monitor your alcohol consumption.
8. Find what makes you happy and go there…frequently. I have repeated this for a reason.
And I probably need to add that you should starting working on this list now, because procrastinating on your health is not an option. 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.
May has been Geriatric Care Manager Month for 31 years. Now, with a change in how we refer to ourselves – starting with our national association – May has become National Aging Life Care Month. And we Geriatric Care Managers still are GCMs, but we are also referring to ourselves as Aging Life Care Professionals. I would be really interested in what you all think of the change in our “name.” Aging Life Care Professionals provide guidance and advocacy for families who are caring for older loved ones or disabled individuals…what we at CCM have always called “caring for elders and others with special needs.” With a specialized focus on issues related to aging, we assist clients with the challenges of aging, such as finding appropriate housing, in-home care, referrals to medical providers or elder law attorneys, as well as the advocacy and support that provides families peace of mind. In other words, Aging Life Care Professionals do what we as Geriatric Care Managers have always done. What do you think? Leadership within our organization did a lot of soul-searching along with a lot of asking people who have worked as clients with our members about what it is we all do. The answers from this journey showed that what we as GCMs do is pretty much valued by the clients whom we serve. We meet people who are going through the gradual changes of life and help make that path easier. We also meet people who have experienced sudden life-changing events within a family such as a fall, a sudden diagnosis or any of the crises that affect how independently an older member of the family is able to live. We are the people who help families to navigate these paths with sometimes a lot of “forks in the road.” As I like to explain to prospective clients, we are the option-makers for the decision-makers. And since we are daily navigating various parts of this path – a path that our clients typically are navigating for the first time – we can offer a lot of insight that comes from training and relevant experience. Let me get back to the forks in the road metaphor. We help with the road sign that shows you to slow your vehicle to 35 miles per hour on the curve coming up, because we have been down that stretch of road before. Most people appreciate that kind of navigational help when they realize what might happen if they maintained their 65 miles per hour going into that curve without some warning. Please let me reiterate that I would like to hear from you about what you think of our name change. Does knowing that we are the professional experts on Aging and Life Care give you any new sense of what we all do? Please send your thoughts to us at info@creativecaremanagement.com . We are still here to help you and your loved ones on their journeys. And with this blog, I will continue to keep you updated on the road conditions ahead. Drive carefully… 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.
Our vice president for geriatric care management services, Steve Steiber, Ph.D., brought some startling information to my attention recently, and it concerns the risk we don't often think of when we hear that an older loved one has been hospitalized. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM.
For older adults, who are admitted to a hospital intensive care unit, it would seem that discharge from the hospital means they are out of the proverbial woods. Not so, according to researchers affiliated with Vanderbilt University Hospital. They studied older adults who were discharged from the hospital after a stay in the ICU. What were they were looking for? Complications from what they termed Potentially Inappropriate Medications (PIMs) and Actually Inappropriate Medications (AIMs). Very simply, AIMS are medications whose side effects or likelihood of adverse events outweighed the potential benefits the medications were supposed to confer. PIMs were seen as medications where the jury might still be out. In short, they were looking to see what negative outcomes were associated with the patients' prescriptions separate from their medical conditions. This is a big deal if you are a caregiver to an older adult, very simply because drug-related admissions for 65 to 84 year olds have increased by 96 percent between 1997 and 2008. And approximately half of all drug-related hospital admissions are among adults 80 years of age and older. As we all know the over 65 age group is growing more rapidly than the population at large, so we can only expect this risk to grow. Getting back to PIMs and AIMs, about half of all older adults are discharged with at least one PIM, and four out of five of these older adults are discharged with an AIM. This is all the more exaggerated among patients who have been in the ICU, since 85% are discharged with at least one PIM and more than half are prescribed at least one AIM. The lessons the researchers learned is that some of the AIMs that patients were discharged with were appropriate and useful in the ICU, but should have been discontinued upon discharge. As a caregiver, be aware of the new medications that your older loved one was started on in the hospital ICU, and ask your attending physician if they should be continued at home. The most common AIMs that patients carried home with them on discharge were:
- anticholinergics (37%) - These drugs are used to treat asthma, COPD, incontinence, stomach cramps, and muscular spasms. They can be used to help patients sleep when they are hospitalized.
- nonbenzodiazapene hypnotics (14%) - These are almost always used as a strong sleep aid, but if a patient takes them home beware of their effect with alcohol.
- opioids (12%) - These are indicated for significant pain, most often associated with trauma or in post-surgical recovery. There is significant addictive potential, and these should not be maintained long term.
So, if your older loved one carries home any of these prescriptions, ask the provider why they are appropriate for use at home. If they are appropriate, also then inquire for how long the patient will be taking them safely or for what kind of side effects you should be looking. Please let Steve know if you have any questions about drugs or their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends who deliver geriatric care management services to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.