Chicago's Geriatric Care Manager Center of Excellence – Since 1991 | Chicago's Geriatric Care Manager Center of Excellence

Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
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July 7, 2020
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Dementia: We’re Not Post-COVID Yet
If you have a family member or loved one with dementia, this pandemic and its restrictions have been exponentially...
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May 26, 2020
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Distance Caregiving Through a Wall
I’ve written numerous times about distance caregiving, and one of the observations I have offered is that distance is...
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May 19, 2020
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Caregiving During COVID: Four Tips for Reengagement
You may recall that I have recommended limiting your news consumption, because it really does add to our stressed...
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May 12, 2020
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Listen to an Astronaut about COVID-19
A small percentage of us may be coping with symptoms of COVID-19 or we know someone who is, but...
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March 24, 2020
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Trusted Voices on COVID-19
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a...
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March 17, 2020
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One is Number One Threat to Seniors
We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to...
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March 10, 2020
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Helping Your Older Loved One – AND You – Avoid COVID19
All of us here know how to prepare for a blizzard, people in the South know how to prepare...
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March 3, 2020
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Part 2: Five Important Tips for Caregiving and Self-Care
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000...
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February 18, 2020
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Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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In the Caregiver's Words

Recent Client Praise

It is the "crime of the century" and you have heard of it, but you may be having a rough time remembering it right now. That is, in part, because it has gone largely under-reported, and the bad guys may not have been prosecuted. If you are thinking this is the story about the financial institutions who were responsible for the crisis that fueled the "Great Recession," you are wrong, but it is a financial crisis. Those who are 65 years of age or older in this country represent only 13% of the population, but they get a disproportionately large share of the attention from scammers. And it is not just the affluent and older population; it is the relatively poor as well as the rich among those who are of an age. The National Council on Aging warns of some of the more common scams that occur. 1. Medicare/Insurance Fraud: A federal grand jury just this month indicted a Florida physician for up-charging Medicare for over $2.1 million; since Medicare is funded by you and me, all of us pay for that one. 2. Fake Drugs: Even with the provisions of the Affordable Care Act, medications can cost a lot. The internet and phone callers have been targeting older adults by selling "cheaper medicine," but the drugs are counterfeit. 3. Funeral Crashers: A scammer can follow the obit column and show up at the funeral to present the grieving family with a false debt allegedly owed by the deceased. 4. Looking Marvelous: In search of the eternal youth elixir, consumers at any age who want to look younger than their years can find a whole host of scammers with fake goods that make big promises and cost big dollars. 5. Phone Fakes: It is not bad enough that an older person can be duped by a fake telemarketer, but it often happens that an accomplice of the first scammer will call later to secure even more dollars offering to help reclaim the first loss. 6. Going Phishing: Older web surfers may not recognize the difference between a legitimate request for updated personal information and one that is stealing their identity and their dollars. 7. Too Good: Yes, if the investment is too good to be true, please appreciate that it is just that. Does the name Bernie Madoff ring a bell? And he built his pyramid scheme with money from friends. 8. Candy Grams: Beware of any callers who request that the money - ostensibly for a family member in trouble or a worthy charitable cause - be sent via Western Union or MoneyGram. These don't require ID at the receiving end. If this does not scare you on behalf of your older loved one, what should scare you is that all these scammers are incredibly creative. Today's scam always has the potential to transform into a new version that will surprise someone tomorrow. Beware of the Nigerian prince who offers to share his inheritance... 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.
If you were diagnosed with dementia, would you want to be told? If you said “yes,” you are in agreement with nine of ten Americans in nearly two dozen national surveys on the subject. Even among patients actually diagnosed with some form of dementia, 85% said that they wanted to know their diagnosis. Yet, according to the Alzheimer’s Association fewer than 50% of Alzheimer’s patients or their caregivers actually have been told by their healthcare providers. Why the disconnect? I have written in the past about people’s greatest fears as they age, and it is not that they may (will) die; it is losing their cognitive abilities. A fair number of healthcare providers reportedly withhold the dementia diagnosis from their patients and the patients’ families because they are concerned about the stigma that knowing may represent. Others are concerned about the impact a misdiagnosis might have or they just do not know how to communicate with these patients or help the family learn to cope with the diagnosis. Some providers also write this off as just another part of “normal aging” or ironically they “forget” to mention these cognitive symptoms. Despite all the logic or the excuses, there remains an ethical obligation to disclose a dementia diagnosis and to help the patient and family confront the issues head on. There is a general appreciation that dementia is presently incurable, but knowledge of the diagnosis early can help families to decide on treatments as well as a future plan of care. There are currently five FDA-approved treatments for Alzheimer’s Disease … the acetylcholinesterase inhibitors like Aricept and memantine, Namenda. None of these can prevent or reverse the disease, and none of these is indicated for other dementias beyond Alzheimer’s. But they can slow or eliminate the build-up of beta-amyloid or tau proteins. In a recent posting I also talked about dementia being type 3 diabetes, so medications that can limit the inflammation in the brain or insulin resistance also can have some benefit for patients. And there are therapies in development that show some promise as well. While all states have some level of mandatory reporting of abuse on the part of healthcare providers, only a handful require dementia disclosure. More require reporting epilepsy as a traffic safety issue than require dementia. But it is more than a traffic safety matter; disclosure is one more step toward helping the caregivers to dementia sufferers get training and help in their day to day activities. As recently as 2012, it has been reported that more than 15 million Americans provided in excess of 17 billion hours or unpaid care to loved ones with dementia. If you are a caregiver to someone showing signs of cognitive decline, speak with your loved one first and then accompany them to their next physician’s visit. Speak with the physician about your concerns. Most likely you will need a referral to a neurologist who will put in an order for a brain scan. If you insist on a candid conversation, not only will you know what the actual diagnosis is, but you will be directed to a host of community resources to help everyone manage your care receiver’s condition. You and your care receiver will be better served. 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.
We are less than a week away from Mother's Day, and preparations are in motion, cards are purchased, reservations are made and flowers will be sent. That is what Mother's Day has come to represent for most of us, but there will be some for whom Mother's Day is more an occasion for dread or sadness. That is because Mom is no longer here to celebrate the date. Especially in my work as a certified geriatric care manager, I've talked with caregivers who have lost a mother. I find that there can be a lot of denial or depression as May comes around. It seems easier to ignore the day, or maybe the sad, slippery slope of depression seems unavoidable. That is where I come back to one of my mantras for all caregivers, and that is that the caregiver needs to care for herself or himself. What does caring for the caregiver look like when one is facing an important, but seemingly hollow, holiday? You can begin by letting the mom who lives in your memory remind you of the good times or the kind words or the special places. Mother's Words. If you have a sibling, perhaps start the conversation about what "mom used to say." If she used words of encouragement like, "It is not about what the other kids do; it is about just doing your best." Or maybe mom liked to talk about finding the "silver lining." Mother's Things. Those of us who have lost a mother also probably saved an item or maybe several of the things that delighted mom or that we particularly associate with her. Maybe your mom kept a collection of your pictures or clippings from the school paper? My mom kept a small spiral notebook of jokes so that she could remember and share them with others. Most of them were admittedly a bit corny, but they make me smile even now when I go through the pages of memories on days like Mother's Day or her birthday. Mother's Actions. It can also be special to do some of the things that your mother used to do as a way of "taking a walk with mom." Maybe mom had a favorite park or garden where she liked to go on "her day." May is such a wonderful month for all the new blossoms of spring, and taking that walk can bring back wonderful memories complete with beautiful buds and their wonderful scents. Or some find it really great to go to mom's favorite restaurant and have their own favorite dish or order the chocolate pie that always was mom's guilty pleasure. It really all comes down to making the day special for yourself just as you used to make it special for your mom by caring for the caregiver. Doing that special something for yourself just as you used to do it for your mom can actually make you both feel better about her day. And if you are a mom with kids of your own, it can also be a wonderful way to let them know how to someday manage their own transition of Mother's Day. Charlotte Bishop is a certified 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.
Why a kidney alert for caregivers to older loved ones? Because nearly half of adults over the age of 70 in America may have chronic kidney disease and many of them may not even know it. That means that for those of you reading this who have an older loved one, about half of you should be paying attention to your older loved one's risk factors for chronic kidney disease. As a geriatric care manager for caregivers and their older loved ones we often get the call only after a crisis has occurred, but chronic kidney disease is one of those silent crises affecting as many as half of our client caregivers' loved ones. Here are the risk factors you should be looking for if you are a caregiver who wants to avoid the crisis in the kidneys:
1. Does your older loved one have high blood pressure? We tend to think of hypertension as a condition that affects the heart and the circulatory system, and it does. But it also affects the kidneys' ability to filter the fluids in your loved one's body. If kidneys are impaired, all the other major organs of the body are compromised.
2. Does your older loved one have diabetes? If the diabetes or even prediabetes is not well-managed by diet or insulin, the kidneys pay the price. Those extra glucose molecules that stick to the red cells begin to gum up the kidneys, and that again puts everything else at risk.
3. Does your older loved one smoke? We all have heard about how smoking is bad for a person's heart and lungs, but a lifetime of smoking also compromises the kidneys. It does this, because the smoking raises blood pressure, and as I said, high blood pressure will compromise the kidneys' ability to filter fluids.
4. Does your older loved one have a weight issue. It's very simple. Extra pounds translate into elevated blood pressure, and you can see where that takes your loved one.
5. How old is your older loved one? Birthdays are not exactly the problem that can result in kidney compromise, but a lifetime of exposure to any of the risk factors I have highlighted will harm the kidneys' function. As a caregiver, you should help your older loved one also appreciate that kidneys do more than just filter the fluids we consume each day. They clean the blood and help to regulate blood pressure. The kidneys also help in regulating the calcium that is available to your older loved one's bones which can be why some people develop kidney stones (which are calcium oxalate). So, all of this is to help show that geriatric care managers also help families use nutrition to improve the health of their older loved ones which translates into not only increased quantity of life, but also enhanced quality of life.
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.
As a geriatric care manager, I often find clients who are on the right medications, but they are overwhelmed by the numbers and schedules of their meds. Older adults consume an average of four or five prescription medications a day along with two more over the counter (OTC) drugs.

While adults over the age of 65 represent only about 13% of the U.S. population, they consume about 30% of the prescriptions written in America today. I wrote about this last November, and talked about the potential for drug-drug interactions and the unique challenges to the health of an older person’s slower metabolism and lower hydration. I also discussed how one of the important tasks for a caregiver is to ask for a pharmacist or geriatric care manager to do a “medication audit” to be assured that the older patient is not at risk for adverse drug events or interactions.

What I did not devote much space to in that earlier blog is how multiple medications very simply present a real challenge to an older patient to keep all those prescription dosing regimens straight. This often results in noncompliance – or failure to take prescribed medicines – of one sort or another. Health professionals tell me that the reasons for noncompliance usually come down to:
- Forgetting – Elderly patients can lose track of all their prescriptions and schedules; it may be cognitive dysfunction or just being overwhelmed.
- Labeling – Labels may be clear to doctors, but older patients on numerous meds may not track dosing times a day or with or without food and more.
- Cost – Rather than admit that they choose between food and medications, some older patients may consciously avoid some doses or split pills.
For patients who forget doses, there are pill organizers that can be set up for a week – or even a month – at a time. The caregiver can step in to organize the medications along with clear instructions on when they are to be taken. There is a whole host of pill organizers, some with alarms. Google “pill organizer” and see.

There is a lot of variance in labeling of pills. In a recent survey of 464 adults aged 55 to 74 years old published in the Archives of Internal Medicine, the patients averaged dosing six times a day for the average of 7 drugs they were taking. While most drugs could be dosed four times a day at most, patients did not understand their labels sufficiently to consolidate their doses. There is regulatory movement on rules to standardize and simply prescriptions with universal medication schedules. You can help an elder by organizing their meds; the fewer times a patient takes medicine (not necessarily the fewer pills), the better their compliance.

Cost is an issue many elders may not bring up out of embarrassment. Caregivers, however, can work on behalf of their elder to ask for generic equivalents to branded medications. Where only branded medications are indicated, question the physicians’ office about manufacturers’ patient assistance programs, especially for patients without prescription drug coverage. Check the manufacturer’s web site for programs to help defray the full retail cost. You may also find much better prices on-line or through mail order houses when the prescription is filled for 90-day doses instead of 30 days.

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.

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