Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • elderly careChicago's Geriatric Care Manager Center of Excellence

Medicare’s Surprising Cost Savings
Medicare has been one of those political footballs where both sides of the aisle have had an entrenched position...
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September 5, 2023
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Follow Your Gut…You’ve Got No Choice
It was back in the sixties and seventies that so many folks embraced the mantra: “You are what you...
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April 11, 2023
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Spring Tips for the Holiday Caregiver
We all know that that Spring in the Midwest isn’t on a straight line from Winter toward Summer, but...
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March 28, 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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Ain’t No Sunshine…
…When She’s Gone.” Or how about, “You are My Sunshine, My Only Sunshine?” or “Here Comes the Sun?” or...
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February 21, 2023
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Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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To Sleep, Perchance to Dream
No, this isn’t a refresher course on Shakespeare and the famous Hamlet soliloquy. (Spoiler Alert – Hamlet was ranting...
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January 2, 2023
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A Viral Trifecta?
To get to the question in the email first, the Spanish flu of 1918 did not get its start...
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December 13, 2022
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Planning for the Holidays is More than a Menu
The latest news reports suggest only about 10 percent of American Adults have received their seasonal booster for COVID. ...
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October 24, 2022
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What’s COVID Going as for Halloween?
It’s been a year and a half since the COVID19 vaccines came on line to address the pandemic when...
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October 11, 2022
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In the Caregiver's Words

Recent Client Praise

I have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about the recent news on prescribing for patients with high cholesterol. He has nearly two decades experience in pharmaceutical and medical device consulting prior to joining CCM about 8 years ago. He reports: This week the American Heart Association and the American College of Cardiology issued new guidelines on what patients should be prescribed medication to lower their cholesterol. If followed, these guidelines could double the number of patients receiving prescriptions for the most common medications called statins. You may be familiar with the drugs with names like Crestor, Tricor, Lipitor or Zetia. The reason more people may receive prescriptions is that while the guidelines do not change the target "bad cholesterol" (LDL) level, it looks to other risk factors. The old rules just looked at the level of "bad cholesterol" in a patient's blood. The new guidelines look at other classic risk factors, such as:
- patients with type 2 diabetes between ages 40 and 75 and who have LDL levels at or above 190;
- patients with a cardiovascular risk 7.5 percent or higher between ages 40 and 75 and who have LDL levels at or above 190.
It really comes down to the risk factors first and the cholesterol level second when a prescribing decision is made. It used to be just by the numbers - the LDL numbers - regardless of cardiovascular risk or diabetic condition. So people with elevated LDL, but minimal risk factors may not receive a prescription. The new rules translate into about 33 million adult Americans receiving prescriptions for statins-caregivers and their older loved ones. About 44 percent of adult men would qualify, but only about 22 percent of women would be prescribed a statin. Under the old guidelines, only about half as many adults would have received a prescription. Please let Steve know if you have any questions about drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: Steve Steiber.
Once every 67 seconds. Every 67 seconds someone in the United States develops Alzheimer's Disease, and among the adults over age 65 in the U.S. about one in nine have the condition. That is about five million older adults, one in ten of whom will die from this disease each year. There are about three caregivers for every one of the older adults with Alzheimer's Disease, and they provide about 17.7 billion uncompensated hours of care each year. But there is help for those with Alzheimer's and their caregivers. As a professional geriatric care manager, I am certified and a member in good standing of the National Association of Professional Geriatric Care Managers. Earlier this month they did what they are calling an "InstaPoll" of those of us who are members. The results from the poll of we care managers, it turns out, offers some very practical advice from those of us who work with clients with this condition every day. The feedback from the nearly 300 NAPGCM members who responded to the poll distill down into six recommendations for caregivers:
1. The most common recommendation revolves around the fact that dementia develops in stages, and that is important that a caregiver be attuned to the capabilities that a person with AD will retain versus lose so that communication is appropriate.
2. Test for a response to such communications as reminiscing. If the care receiver responds positively to talking about the past and long term memories, it can be very positive and affirming to break out the scrap books and memory boxes.
3. To guard against social isolation, try to keep up the old routines and engagements as your care receiver enjoyed before. With less social engagement comes the risk for depression and even further isolation.
4. For those of you who may have raised children, the game of "Mommy and daddy always come back" was important at a young age. It will be that way also with some AD patients for whom an absent caregiver is just gone. Reassurance is key.
5. Don't rush with change, especially the disruption of moving to a new residence. While it is important that an AD patient be secure from wandering, it also is important they be given time to adjust to the concept and an upheaval of house and home.
6. Where there is loss, especially that of a spouse, it is important that a care giver monitor the AD patient for signs that the stress is overwhelming. Their capacity for processing grief will be compromised by the Alzheimer's.
If you would like more information on NAPGCM's InstaPoll or on professional care manager advice as well as a care manager locator, just go to our association's web site: http://www.caremanager.org . 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@cr eativecaremanagement.com.
I like Simple. If you do also, then you will like the American Heart Association’s and American Stroke Association’s “Life’s Simple Seven.” In short, what they find is: what works well for cardiovascular health also shows the promise of working really well to stave off dementia caused by strokes, vascular dementia, and even Alzheimer’s disease. If you have an older loved one whom you would like to see have a healthier heart, you will get the added benefit of a healthier brain by encouraging the Simple Seven. And there is a bonus...it also will work for you! The seven steps that have been recommended to improve heath health now also are considered as important to improving your brain’s health. "Life's Simple 7" are considered to help prevent dementia caused by strokes, vascular dementia, and Alzheimer's disease. They have been chosen by AHA and ASA as metrics to help confer brain health. "…the same risk factors that cause atherosclerosis are also major contributors to late-life cognitive impairment and Alzheimer's disease," commented Philip Gorelick, MD, Mercy Health Hauenstein Neurosciences in Grand Rapids, Michigan, chair of the advisory writing group. The seven steps are a combination of individual characteristics and behaviors that help to foster better brain as well as heart health: 1. Don’t smoke 2. Be physically active 3. Maintain or reduce body mass index to less than a 25 on the scale 4. Have a healthy diet – there are guidelines for this 5. With a combination of exercise/reduced weight have a blood pressure of <120/80 mm Hg 6. Without meds (but with diet and exercise), have a total cholesterol <200 mg/dL 7. Maintain an A1C (fasting blood glucose) < 100 mg/dL Before this most recent analysis, researchers tended to look at brain health and heart health as pretty much different conditions caused by different lifestyle or health behaviors. But "over time we have learned that the same risk factors for stroke that are referred to in Life's Simple 7 are also risk factors for Alzheimer's disease and possibly for some of the other neurodegenerative disorders," Dr Gorelick noted. All of this is a step toward better brain health while at the same time promoting better heart health. This is one of those fortunate opportunities where a person can get two for the price of one. Take better care of your heart and you get better brain health as a bonus. Take better care of your brain, and your heart also gets a benefit. Not a bad bargain for anyone who is a bargain shopper…no coupons required. Be healthy. 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.
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine, but you likely have been laid low by the other scourge: the quarantine. I’ve talked about the ill effects – particularly among older adults – of the enforced isolation to tamp down the spread of COVID-19. Yet, there are active steps all of us can embrace to not just survive this pandemic, but to thrive. Here are Six Simple Steps you can take daily to help body, mind and soul get from lethargy to energy:
1. Sunshine – It’s particularly challenging this week to get outside, but sunshine boosts the mood; try a SAD (seasonal affective disorder) lamp, if you can’t get to the real thing.
2. Steps – I know that 10,000 steps a day is the often recommended dose of walking, but even 5 or 6,000 can boost your mood and burn carbohydrates.
3. Speaking – It doesn’t have to be a ZOOM call, but reach out regularly to people in your orbit; a number of Clubs who are not meeting these days are working phone trees, because human connection is important.
4. Social – But not social media and news is what you need; limit the time you take in the news or scroll on your FB page – they have made it addictive, so don’t get hooked.
5. Share – We get through crises, because we know how to give and also to receive. If you have an older neighbor or loved one, recognize they may not ask for help…so don’t wait for the request…offer.
6. Slack – Cut yourself some. We all set goals and we all have high expectations of ourselves, but you need to show grace to yourself just as you would with others.
As you can probably tell, this list could go on and on. Most of these revolve around having a heightened sense of what is good for you and also a sense of what would be beneficial for others, especially older loved ones with cognitive issues like dementia. We are social creatures who benefit from the good will of others and from giving to others. Please pass it on; you’ll be better for having done so. 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.
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: Both together are better for your cardiovascular health than either alone. We see a continuous stream of nutritional information about what colored food is best for us (hint: brightly colored) or that flavonoids are healthy or that high fiber is key to any diet or how many calories should be consumed daily. Yes, the list is seemingly endless. And there can be a lot of accumulated data that are used to support a given position on any of these sources of nutrition, but we don’t always see really large population studies over very long spans of time. Well, in Britain where the government picks up the tab for people’s health care, they invest in broad-based studies to improve health, and what better place to start that with what people eat or drink. Tapping into an existing panel of nearly 366,000 study participants who are part of a panel of the UK Biobank, scientists were able to follow these individuals’ tea and coffee consumption as well as their health statuses for a median of 11.4 years. What they found may be rather surprising, and the statistical significance of the results was even more startling. The researchers found that of these nearly 400,000 people, 2.8% experienced a stroke and 1.4% developed dementia (the vascular, not the Alzheimer’s dementia) over those 11.4 years. These health outcomes were tied to tea or coffee consumption. Those who consumed two to three cups of tea or coffee showed a 30% reduction in strokes and 28% reduction in dementia. Those who drank less than two cups of either beverage had much smaller reductions in either health outcome. The greatest benefit came to those who drank two to three cups of both tea and coffee daily, and the difference from the non-drinkers was slightly better, 32% and 28%, respectively. The odds that these 32% and 28% reductions could have occurred by chance alone were between one and two in a thousand! The researchers continued to follow patients who had strokes and found that the coffee and tea consumption protected them even more from vascular dementia. Again, there was no discernable benefit for Alzheimer’s disease or for that matter hemorrhagic stroke. As a final note, if you were to peruse the 600+ posts to my blog over the years you will find a theme. Paying attention to our diets and exercise are the two best things we can do to live both well and longer. The next time a friend suggests you meet for a cup of coffee or tea, you now have one more reason to say yes…and maybe ask for a refill. 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.
Americans fear Alzheimer’s disease more than any other condition including cancer, heart disease, stroke or any other life-threatening diseases according to opinion polls. I’ve written a lot about this memory-robbing condition that affects more than five million people in America, and it’s the diagnosis no family wants to receive about an older loved one. But if there were a blood test that could predict your loved one’s likelihood of developing Alzheimer’s, would you want to know that this disease is in your future? Researchers at the Washington University School of Medicine have developed a blood test that appears to be 94 percent accurate in predicting Alzheimer’s. The researchers not only looked for the genetic hallmark of Alzheimer’s disease, APOE4, but also for signs of amyloid beta in the blood. They followed up this blood testing with PET scans of study subjects’ brains to confirm the early tells of Alzheimer’s disease. The test has not been approved by the FDA yet, but 94 percent is impressive. So, why would we want our loved one’s to know that they were all but certain to develop this cognitive condition as much as two decades before symptoms appear? Or you may even be asking yourself if you would want to know. There may be no cure for the condition, but other research shows that early preventive steps can do a lot in stalling the onset of the most damaging symptoms of the disease. With a 20 year head start, a lot can be done while we all await more effective treatments. Here are the preventive steps:
1. Get the test when it becomes available.
2. Up diet to a Mediterranean menu or equivalent.
3. Get in good physical shape and stay fit.
4. Practice good sleep hygiene – 7 to 8 hours of sleep nightly.
5. Engage more socially for mental stimulation.
6. Immerse yourself in music – sing or perform.
7. Learn something new, work puzzles, challenge your brain.
8. Moderate alcohol intake.
As I look at the list, it seems like a pretty good New Year’s Resolution for all of us, or if you already made and kept one, it’s never too late to start anew. So, perhaps while we await FDA approval on the test, we all can work toward our better selves? 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.