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

How Old You Really Are
One of my staff worked with a senior community in upstate New York near Elmira a number of years...
Read more
August 8, 2023
0
0
Ain’t No Sunshine…
…When She’s Gone.” Or how about, “You are My Sunshine, My Only Sunshine?” or “Here Comes the Sun?” or...
Read more
February 21, 2023
0
0
Burn Calories to Reduce Dementia Risk
We most often think about exercise as a way to work off the calories that we may have consumed,...
Read more
August 30, 2022
0
0
Food Fight
When you hear the word cancer a lot can come to mind such as “cancer survivor,” “living with cancer,”...
Read more
August 23, 2022
0
0
Before or After the Fall
I came across an informative piece in the Washington Post about a week ago, and it brought to light...
Read more
July 26, 2022
0
0
Why a Flamingo Stands on One Leg
You’ve all probably heard the old joke about why a flamingo stands on one leg…and we have all seen...
Read more
June 28, 2022
0
0
When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
Read more
May 17, 2022
0
0
HDL Graduates from “Good” to Better
You may have had the conversation with your physician about your cholesterol levels during your annual physical; there are...
Read more
April 26, 2022
0
0
Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
Read more
April 5, 2022
0
0
Consult Your Lifestyle Physician
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral...
Read more
March 29, 2022
0
0

In the Caregiver's Words

Recent Client Praise

We have all heard someone this season say, “It’s just a cold,” or “I have a touch of the flu,” or similar expressions that pretty much write off a lot of what is going around. And nobody gets pneumonia, right? Wrong! It may sound like a small number, but about 6 of every 1000 people in American will have a bout with what is termed “community-acquired” pneumonia this year. Still sounds small, but the rate triples for 65 to 69 year old people…18.2 per 1000. And for 85+ year olds, the number skyrockets to 52.3 cases per 1000 people. So, if you have an older loved one in your orbit, be vigilant to signs and symptoms that can tell you they have graduated to pneumonia. There are six signs that should alert you to something that deserves a visit to the doctor or emergency facility:
1. Productive cough – the kind that almost rattles with the mucous as a person coughs to clear their lungs.
2. Fever or not – Fever with a pneumonia infection is common among younger individuals, but pneumonia actually can suppress body temp in older cases.
3. Chest aches – While we are most often concerned about heart issues with chest pain, breathing with pneumonia can give similar symptoms.
4. Tired – While the immune system fights pneumonia, it takes energy away from the rest of the body resulting in fatigue.
5. Fuzzy head – The lungs are not the only congested organ; the brain gets a bit muddled with pneumonia also.
6. Breathless – With congested lungs, it should be no surprise that a patient with pneumonia may also be short of breath with even modest activities.
The rules of engagement with pneumonia are simple.
1. Doctors’ orders - especially with completing the full course of antibiotics…be sure your loved one takes all the pills prescribed.
2. Sleep – give the body a chance to devote its undivided attention to fighting the bug by resting and getting help around the house.
3. Fluids – think of it as “flushing” out the system, and it also helps get rid of the congestion in the lungs.
And remember that the risk may be lower for younger people, but the operating rules are pretty much the same. Give all the support you can to help your body fight the invaders too! 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.
We all know that Boomers - who began reaching age 65 just two years ago - are the largest segment of the U.S. population. Aging boomers are expected to total about 71.5 million by the year 2030, but what you may not know is that as many as one in ten of the Silver Tsunami will be lesbian, gay, bisexual or transgender (LGBT). This is important, because the generations that preceded them who were LGBT simply accommodated the "closet" when they aged. Never mind the ageism and racism we still find in some quarters, a lot of the institutional providers for seniors may not yet have embraced a welcoming culture for people of alternative gender preferences. As a geriatric care manager, I see this as a perfect storm with three fronts, a storm which has the potential to create one of the largest threats to aging well - social isolationism. If you are a caregiver to an older LGBT partner or loved one, you will need to be alert to the potential challenges. For instance, there are likely to be limited or no programs for alternative lifestyle older individuals in rural or suburban areas. And the gay male experience of aging is exaggerated among men where there is a more pronounced premium on being attractive or desirable. Generally speaking being 40+ among gay men can be seen as equivalent to being 80+ in the straight community in terms of being marginalized. The social isolation that is a consequence of "premature aging" and marginalization also increases the gay population's risk for depression, substance abuse, low self-esteem or even suicide. The rate of suicide among gay men is about six times that of straight men. LBT women may have it even worse. More than one-third, according to recent surveys, say that they have not divulged their sexual preferences to their health care providers. They also are less likely than gay and bisexual men to have purchased long term care or life insurance. About one in five LBT women are caring for an aging partner, but they also feel less prepared financially than gay men for retiring. Put all these factors together, and the LGBT community is less inclined to seek attention for health issues for fear of hostile or judgmental providers. Poor health care translates into even earlier institutionalization in long term care facilities. Also, it is ironic that in national surveys that nearly three in four LGBT individuals anticipate that they will be caregivers to another person, but one in five are unsure they will be cared for themselves when the need arises. Adding to this potential caregiver shortfall, many gay couples simply do not have conventional family to care for them. If you are a caregiver to an LGBT elder, encourage the following: • They have a Last Will and Testament that is really according to their "will" o With clear advanced directives/living will • Their partner/spouse has Durable Power of Attorney (health and finance) • Informal caregiving arrangements are clear and followed • Priority rights for hospital visitation are followed • There is Joint Ownership of Property with Rights of Survivorship And for us all: Recognize that all humans deserve compassionate care which respects their personhood and their definition of family and their wishes. 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.
I came across some recent research that is - to say the least - counterintuitive. People drink diet carbonated drinks because they are being careful about their sugar intake and their health, right? Well, recent research reported in the Journal of the American Geriatrics Society says the opposite is true among older adults. A group of scientists at the University of Texas Health Science Center in San Antonio, Texas, studied the link between diet soda consumption and weight and waist size in 750 patients over age 65. What they found seems to be the opposite of what one would expect from people consuming "diet" beverages. The scientists measured the waist, height and weight of these 65+ year olds along with their diet soda intake over a ten year period. For their analysis they divided the patients into three groups: those who consumed at least one diet soda daily, those who drank less than one soda daily and those who drank no diet soda at all. The first group showed an average increase of 3.16 inches in their waistlines over the decade of the study. Those who consumed less than one diet soda a day increased an average of 1.83 inches during this ten years, but older adults who drank no diet soft drinks increased their waistlines by only about 0.8 inches. Ironically, the increase in waist size was not tied to an increase in overall weight. It was the belly fat associated with diet sodas that resulted in growing waistlines. As I have written in other posts, the weight we put on around our middles is the most unhealthy, and it has a direct and negative impact on cardiovascular health. And while the researchers cannot explain exactly why this increase in waistline was tied to drinking low calorie carbonated beverages, it is pretty clear that diet soda should be off the menu for older adults. I also have mentioned in other postings that carbonated drinks have a negative effect on a person's esophagus resulting in a higher likelihood of gastro-esophageal acid reflux, GERD, owing to the carbonic acid in sodas. Carbonated drink consumption also is associated with calcium depletion in the bones and ultimately osteoporosis. So, if you are a caregiver to an older loved one encourage them to find alternative beverages to their diet sodas. At the very least help them to cut their intake of these caustic libations as even getting most of the way to a zero soda goal will have its benefits. 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.
I don’t know how many of us would like to live full-time in Disney World, but most of us have some very fond memories of maybe the early days with the Mickey Mouse Club or a trip to one of their theme parks. But there is something new from the Imagineers of Disney, and it’s a senior residence designed for those 55 and older. The first of these “Storyliving Communities” is being built in California where they are preparing a community that in their terms “is a little more magical.” This is not a pitch for this megacorporation’s next big way to engage the market with a bit of fantasy. It’s my way of saying that as your older loved ones approach retirement and move into it, encourage them to “reimagine” the next phase of their lives. If you go to your search engine and type in “how to retire,” you will get a ton of advice on how to save, what are the financial vehicles and how much is considered enough to last…and of course, some tips on planning for long term care, etc. But what about how to get to retirement and then find a life that can be fulfilling? Allow me to offer some suggestions for those nearing retirement to anticipate as well as for those already retired to perhaps do some rethinking and tweaking of their plans. Consider:
1. Mind your diet so that you preserve your health and your quality of life.
2. Plan and then refine a daily plan that keeps you busy – at your pace.
3. It’s not a light switch…you can ease into retirement gradually.
4. Exercise your mind as well as your body.
  1. Mind: take on a language, join a book club, embrace puzzles.
  2. Body: your personal record may be behind you, but set goals.
5. Make new friends, join a club, volunteer for a good cause.
6. Get to know your health care provider better…before an emergency.
7. There are two ways to stop working – screaming or smiling.
  1. Don’t obsess…get professional help to let go, if need be.
  2. Keep your work friends…they’re still friends with whom you can share.
8. Don’t make a bucket list…make a pamper yourself list.
9. As we all look at relaxing travel restrictions…relax your own restrictions and get away.
10. Invest in your community – lots of needs can reward your effort with lots of thanks.
It’s really easy to get caught up in what we can’t do as we once did, but don’t fall into that trap. If you need an excuse to do more walking, get a dog who will take you farther and show their appreciation in return. Try some new recipes, plant some new flora, see a new part of the world…and learn just enough of their language to immerse. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
May is Mental Health Awareness month, and that makes it a good time to talk about America’s Drug epidemic…an epidemic that affects older adults every bit as much as it does teens. It also is a good time to start a conversation with that older loved one in your orbit. Mental health is not just an issue of seniors, but you might be surprised to know that prescription drug misuse disproportionately affects Americans 65 and older. And it is part of an growing trend. In 1988 about one in three Americans had been prescribed three or more medications, but that has grown to well over half the 65+ group now having three or more meds in their bathroom cabinet. And that does not include the rising rate of alcohol abuse among seniors in America. Why the increase? When you talk with public health officials they cite an increasingly fragmented health care delivery system where all of a patient’s physicians may not be communicating with one another. So, the number of prescriptions will rise as a function of the aging complaints and the number of physicians a patient sees. Older patients are receiving an escalating number of anti-depressants, anti-anxiety meds and prescriptions for sleeplessness. And older patients just live long enough to have more pain and more medical issues, and that begins to explain the escalating number who receive prescriptions for opioids…it is not just “take two aspirin and call me in the morning” any longer. And aging has a way of exposing an individual to more of life’s losses that simply take an emotional toll: • Retirement is not always freedom – for many it is an emotional loss • Older adults also can outlive spouses and friends – another emotional loss • Some older adults live in fear of outlasting their money – an emotional strain • Surgery or other life changing medical episodes – an emotional strain • And the list goes on… All of the above can result in that conversation with a physician who attempts to relieve some of the physical or emotional pain medicinally. Or an older adult can self-medicate with alcohol. So, if you are a caregiver to an older loved one or have someone special in your circle, take time for a conversation. You may be surprised by what you learn. You may also find that you can be part of a mentally healthy solution to what may be affecting that individual. Starting a conversation is a great way toward becoming part of the cure. 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.
First, I want to thank everyone who helped get the word out on our recently-orphaned therapy dog, Annabelle. I am happy to report that Annabelle has found a new, adoptive home and that dog and master are doing great. Thank you for making our internet community work. Now, shifting gears… Hospitalization seems to figure prominently in most of the new clients we see. It is either a recent trip to the hospital that triggers the call to a care manager, or it also can be a surprise discharge from the hospital that sets everything in motion. You may ask, why should a discharge be the urgent situation? Well, the practical side of health care as we know it these days revolves around a big push to discharge patients “sicker quicker.” It can happen with the nurse or an aide walking into the hospital room and simply announcing to the patient and whomever is at their bed side that it is time to leave…often for a nursing home. Most patients and their families will scramble to comply. Nobody really wants to be hospitalized, but how prepared is the patient or the family for a return home or a quick departure for the nursing home? The fact is you need to know your rights. A family in this circumstance can file what is called a “fast appeal” of a pending discharge with a Medicare Quality Improvement Organization. Make that telephone call on the spot, and the patient can stay in the hospital until an independent physician reviewed the circumstances. Every 65+ year old adult admitted to a hospital as an inpatient has the right to challenge a discharge if he or she feels unprepared to leave. But few people understand the process that’s involved. In fact, all Medicare patients upon admission should receive a written notice of their rights. It will be labeled: “Important Message from Medicare” and in it you will be supplied with the name and a phone number for your Medicare Quality Improvement Organization (QIO). These are the people who handle fast appeals and other quality of care issues. Once you make a call, you or your loved one may be asked to fill out a form that allows the QIO to act on their behalf. Once that fast appeal has been filed, the hospital cannot transfer the patient. But you don’t necessarily have to be surprised. Ask on a daily basis what the expected departure date may be. Now, there is fast and there is really fast. Make sure that if a patient is to be discharged under the 24 hour mark, the stay may not be considered an inpatient hospitalization. It may simply be labeled as “observation” and therefore may not be covered as a hospital stay. Make certain of your rights here so that you are not billed inappropriately. Make sure that your primary care physician and possible also a care manager are in the loop so that you will have an advocate. 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.