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

A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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Drugs and Birthdays May be Bad Chemistry
Most of us have grown up with the faith that when we have a medical issue, there is likely...
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October 10, 2013
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4 Geriatric Care Manager Tips for Preventing Falls in Older Adults
We as certified geriatric care managers all hear about older adults falling. Caregivers often do not expect their own...
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October 9, 2013
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Four Caregiver Health Safety Tips
I have written a number of blog postings on safety in the home, and most of them have focused...
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September 10, 2013
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Caregiver (Sibling) Rivalry
Raise your hand if you ever had a disagreement with a brother or sister as you were growing up. ...
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September 5, 2013
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Nine Geriatric Care Management Guidelines for the Caregiver
About one in ten American adults, or approximately 44 million people who provide unpaid care to another adult, are...
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September 3, 2013
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Five Geriatric Care Manager Tips for Helping Your Elder Remember
When we as geriatric care managers talk about memory loss and aging, it seems inevitable that the discussion turns...
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August 29, 2013
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Caregivers Need to Prepare for Medicare Too
I recently spoke with one of the financial advisors we list on our Geriatric Care Management Support Tools page,...
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August 28, 2013
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It Is Never “Just” Diabetes
I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights,...
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August 21, 2013
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Caregivers Cannot Ask Doctors This Question
I have talked in a lot of my postings about advanced directives and how we all need to prepare...
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August 15, 2013
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In the Caregiver's Words

Recent Client Praise

In a recent post, I shared what Allyn Rawling said about what to consider when mom or dad are moving out of the family home. Ms. Rawling addressed some of these factors, especially the benefits that assisted living can provide – eliminating possible isolation, ensuring safety, among others. Here are some other aspects to look for when you next visit your loved one.

First, you may notice and overall unraveling of your loved one’s quality of life. For instance, the home itself isn’t well kept and there are safety hazards that have gone unnoticed. You may find that your loved one isn’t taking care of themselves as well as they should, especially when it comes to grooming, bathing, and feeding themselves. Bills might be going unpaid. It is important to note however, that some of these factors may be fixable with some caregiving consultation and changes around the house. However, moving out of the home may be an option that your parents might have to consider.

Second, the family home may simply no longer be safe for your loved one. If the stairs are too steep or if help is not readily available when there is a need, a safer residence may be in order. If mom or dad show bruises, but do not admit that they have fallen - perhaps more than once - it may be time to talk to your parents about independent living. Remember to underscore the "independent" in the living option, because they may have images of the last generation's "old folk's home" or some other outdated stereotype.

Third, it is a tough topic to bring to your parents as they’ll want to keep their independence as long as possible, again a reason to emphasize the "independent" in independent living. Be patient. Start the conversation well before an immediate decision is required. Also, help to make it their decision, their process and their terms. If your older parent does not own the decision, guess who will own it, and that will be a costly bit of ownership for you as a caregiver.

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.
May is National Geriatric Care Manager Month, but I am thinking that most of you probably did not get the memo. You may have been following my blog – especially those with an older parent or loved one – and you know what it means to be a caregiver, but not as many may know what a geriatric care manager (GCM) is. Geriatric care managers are the people who work with caregivers to older parents who want time for their own families and confidence that their mom or dad will be well cared for. We also work with older adults who do not want to be a burden to their families as they navigate health care issues and make decisions about where and how they can live as independently as possible.

And a person does not have to really be a caregiver to seek the services of a geriatric care manager. We also work with professionals who want to get help for their aging clients when they have had a life-changing incident and wish to remain as independent as possible. These are professionals who want to help their clients maintain quality of life when life changes and coordinate the medical and other resources that make that happen.

I sum up what it is to be a geriatric care manager by describing the four activities where I am most involved in helping elders or others with special needs:
1. Resource: GCMs make the home of a loved one who is aging in place more secure. We help show families what services can be brought to an elder’s home and at some point identify what are the best alternatives to home. And quite often with sandwich generation adult children of older adults, we can be there at a doctor’s appointment when they cannot be there.
2. Counselor: GCMs help families to reach consensus about how to best care for mom or dad when there are so many options or in cases where it may seem that there are no good choices. We help caregivers to older adults or even spouses to sort out whether it is just tiredness or if it is depression or old age.
3. Advocate: GCMs help to coordinate the care from multiple medical specialists who may be attending to an older adult and make sure they are all communicating with one another and with the caregiver. We also work to document a clear care plan the helps to preserve the life an older adult really wants, and we are the eyes and ears to look out for what is best for an elder if they are living in a senior community, assisted living or nursing home. We are particularly alert to any signs of abuse or exploitation.
4. Friend: GCMs are also good listeners, because it can be really important that a caregiver have someone with whom they care share how hard it really is to reverse roles with the parent who had raised them from childhood. It helps for me to have been a caregiver, so I can personally and professionally empathize with what it is like.
For more information on geriatric care management visit Care Manager.

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 Charlotte Bishop.
We all know that an object at rest tends to stay at rest, and that is as true of older adults as it is younger ones if you look at the frightening statistics on the obesity epidemic in America. Habits developed over the long run tend to be harder to break, but the fact is that appropriate exercise for older adults can get easier and easier just by the simple fact of dong it. Because the corollary to my first scientific law is that objects in motion tend to stay in motion. And exercise gets easier. Doubtful?

Here are nine reasons:
1. Starting a new exercise routine may feel clumsy at first, but so did dancing, riding a bike and a lot of other physical work we have all gotten better at with time. Muscle memory will help, because your body will make new nerve pathways to make your exercise easier with time.
2. Blood flow improves when you exercise at any age. The smallest vessels actually can increase in number fueling all parts of your body as your heart rate routinely increases with practice.
3. We all have seen body builders grow muscles into sculpted works of art. Well, we do not see the heart, but it gets stronger also with workouts that are even modestly strenuous. This is true of older adults as well as college athletes.
4. With the muscle memory and greater cardiac capacity comes increased confidence among elders who exercise. Physical confidence, in turn, creates greater overall confidence and a sense of “can do.” Older adults with a regular workout routine also will sleep better.
5. We have heard from too many fanatics about “no pain-no gain.” The opposite is, in fact, true. As an older adult works out over time, the body raises its threshold for working. With time, an older adult can do more and more without that shortness of breath or even the soreness afterwards.
6. Take that last one to a higher level, and if the older body begins a regular regimen of moderate exercise, the body’s hormone system will reward it with cocktails called endorphins. Endorphins are basically a homemade version of morphine to help the body feel better and better.
7. The power plants in your cells also will begin to grow in number with exercise over time. You cannot see them, but the mitochondria, as these power plants are called, become more numerous so that your body can burn more carbohydrates and fat to create more energy.
8. Exercise will encourage better eating habits. It is true, because a lot of those bad habit foods – comfort foods – are linked to stress, anxiety or even depression. Since exercise works against these negative emotions, some of the craving for the junk food will ebb as well.
9. Exercise actually makes a person happier. Tied to some of what I mentioned in #8, exercise really lifts the spirits, and it does it in part through releasing chemicals called serotonin, dopamine and norepinephrine. These chemicals can be as effective as some of the drugs often prescribed for depression.
Before you exercise or encourage an elder to exercise, see a doctor to sign off on your fitness to exercise.

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.,geriatric care manager Chicago, geriatric care Chicago

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What do tennis, racket ball and soccer have in common? What do jogging, swimming and biking have in common? You may see that you need at least one partner for each of the first three, and the other three are pretty much solo activities. But the other point is that people who participate in the first three tend, on average, to live longer than the people who participate in the latter three. They are all good forms of exercise and all contribute to longevity, but the team activities just do a better job of giving us more birthdays according to a number of research studies. A 2017 study that followed 80,000 British men and women showed that those who played racket sports outlived those who were joggers. They originally had used this research to identify if the duration, strain or amount of jogging showed any differences in longevity, and the answer was yes those who were in the “happy medium” – not too strenuous and not too gentle - did live longer. On closer examination they further uncovered the greater benefit of racket sports over the solo sport of running. The researchers looked to even more data to see if this general pattern would hold in other populations, and they discovered that a Danish study that encompassed a greater number of activities that people had described in questionnaires showed that people who engaged in more social or team sports like tennis, soccer and even badminton lived longer than the more solo athletes. And they tracked these individuals for 25 years. No surprise, those who had reported relatively little or no exercise during their lives did not survive as long as their more active counterparts. Cyclists who bilked four or more hours a week, for instance averaged almost four more years of longevity than those who chose to “sit out” their lives. Running added about 3.2 years when compared with their sedentary counterparts. But tennis added nearly 10 years to players’ lives and badminton added 6.2 years. Soccer contributed 5 more years to players’ lives. Even when the researchers controlled for education, age and socioeconomic standing, this pattern held. It may be about the kind of cardiovascular benefit conferred by one sport over another according to the researchers, but they offered one more possible explanation. The sports that gave the greatest benefit in years also are team…or social…sports. Other research has often cited social isolation as one of the big detractors from both quality and quantity of life. Social engagement, they pointed out reduces stress at the same time one derives physical benefit from a sport. It seems to give new meaning to being “heart-healthy.” It is not just your pump that is healthier, so is your spirit, and both contribute to more birthdays. 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.
What if I told you there is a threat to your mental health that is three times more common than Alzheimer’s disease? Yes, about five hundred thousand people each year will be diagnosed with Alzheimer’s, but 1.5 million adults will be diagnosed with type 2 diabetes. Scientists have reported that type 2 diabetes has a measurably negative impact on cognitive function as adults with the condition age. While these stats are not positive by any means, the critical difference is that type 2 diabetes can be controlled or avoided! Type 2 diabetes is different from type 1 diabetes in that those with type 1 are insulin-dependent. That is, they need to take injections every day to keep their blood sugar levels in check. There are medications for type 2 diabetes also, and you have seen many of them advertised on television, and these generally are oral medications. But unlike type 1 diabetes, type 2 can be managed by diet and exercise. Researchers in Australia reported on a study that tracked 705 older adults for more than four years. They found that those who were type 2 diabetics had a decline in their verbal fluency during this four year time frame, but those without diabetes actually showed a small cognitive improvement. They also measured the brains of these subjects using imaging and found that both groups showed a similar modest decrease in brain size which is a normal part of aging. It was the diabetics that showed measureable cognitive decline, most notably a decreased ability in “word-finding.” The researchers add the usual caveat that their findings do not demonstrate cause and effect, but the fact remains that those with type 2 diabetes just had lower scores on their word-finding ability. The real deal here is that unlike Alzheimer’s or other neurological conditions, type 2 diabetes can be avoided or at least minimized by some simple steps. The Centers for Disease Control and Prevention suggest that if you or a loved one are moving through and beyond “middle adult years,” follow these basic recommendations to best prevent type 2 diabetes and preserve your brain power:
- Lose some of that extra weight as obesity is linked to type 2 diabetes.
- Cut back on the intake of “bad cholesterol.”
- Cut way back on carbohydrates like sugar, cereals, alcohol.
- Keep blood pressure under control.
- Get up and exercise daily.
Since type 2 diabetes can happen at almost any age, this may be one of those medical recommendations that everyone can do together. And this also is one of those medical conditions that can be managed by the individuals with the condition. 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.
When I get a call about our geriatric care management services, most people are not asking for a geriatric care manager, per se. They are asking a question about something they have noticed or been told about their older parent or loved one. The question most often is about a change in the older parent that sets off the caregiver alarm that something is just not quite right. In this posting I am going to go through some of the questions I hear and then explore some of them in more detail in later blogs. Please also let me know any questions you may have or any telltale signs you may have seen in an older loved one that give you concern.

Change in eating habits: Have you noticed that your loved one's clothes are fitting more loosely, that they miss meals or that they just don't have the appetite they used to? Losing interest in food or eating significantly less are not normal or inevitable parts of aging. But older stomachs do empty more slowly than a younger adult's, and food may be less appealing because the sense of smell and taste are diminished. Yet, the fact remains that malnutrition is a serious health threat to an older adult. “There’s a fair amount of evidence that suggests if you lose appetite as an older person, in the next six months, you’ll have a higher chance of dying.” This is according to Dr. John Morley, professor at the medical school and Director of Geriatrics at Saint Louis University Hospital.

The cause may not be directly tied to food losing its appeal, per se. It may be that your older loved one simply has poor fitting dentures that just take the joy out of eating; it is actually painful. Loss of appetite is also potentially a sign of depression among older adults.

Older adults also have had a lifetime of losses, such as retirement, debilitating chronic disease, death of a close family member or simply not being as socially engaged as they once were. And these losses can become a huge emotional burden that detracts from appetite.

Any of these causes that lead to a diminished appetite can also ultimately lead to malnutrition which is a slippery slope. Malnourishment can lead to a reduced immune system and the ability of the body to resist diseases or other assaults. Small cuts or bruises will be slower to heal or even be more prone to infection in a malnourished older adult. As the malnourished body looks for nutrition it will feed upon itself, particular muscle. Once an older adult's muscle mass is diminished they will, in turn, be more susceptible to falls or even degradation of bone mass and fractures. And it is hard to put the healthy weight back on.

So, when next you visit the older adult in your life or have a meal with them, take note of the food they consume and what gets left on the plate or not served. Also, check their refrigerator if they are living independently. Look for how well-stocked it is, signs of food well beyond expiration dates or spoiling. It is not just about eating a full meal as much as fueling a healthy, older body.
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.