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

COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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It’s Not a Sprint
I think it occurred to me Sunday afternoon last week, and I was anticipating Monday. But Monday was Labor...
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September 15, 2020
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That’s Not A Senior Moment
We all hear the phrase used as an excuse for a bit of memory lapse … that it’s just...
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September 1, 2020
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Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
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August 18, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 2020
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Pre- Instead of Post-?
When was the last time you studied after a test? Or prepared your dinner after you had dined? Or...
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July 21, 2020
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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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In the Caregiver's Words

Recent Client Praise

Every 39 seconds someone in the United States will suffer a stroke, and about three of every four of these people will be 65 years of age or older. Since May is Stroke Awareness Month, it is a reminder of how important it is that you can quickly recognize the signs of possible stroke. Time is a critical factor because the onset of stroke is always sudden and the window of opportunity to address the severity and permanence of the stroke's effects is very small. Yet, stroke is the fourth leading cause of death for adults in the United States and one of the leading causes of disability. The best thing you can do if you are a caregiver for an older adult is get them to emergency care as soon as possible after the first signs of a stroke. And, of course, the best way to be able to do that is to be able to recognize the warning signs of the onset of a stroke. There are five signs of stroke all caregivers should know, but research has shown that only about one in three adults recognizes even one of the signs. All of the signs share one thing in common; they are sudden. If you see the sudden onset of any of these, you need to call 911:
1. a dramatic headache that seems to come out of nowhere, especially in someone not prone to headaches;
2. dizziness or a loss of balance or coordination;
3. difficulty in word formation or an incoherence or confusion in speech patterns;
4. a numbness on one side or the other; this may be in the face or limbs or it can be an entire hemisphere of the body;
5. difficulty in focusing one or both of the eyes.
The reason that it is important to get immediate attention is important to get immediate medical attention is because medical providers must be able to assess the cause of the stroke in order to offer effective treatment. In embolic strokes, the stroke itself is caused by a blood clot. There are different forms of blood clots, but treatment will be built around dissolving the close. In hemorrhagic strokes, a blood vessel commonly has burst resulting in a leak causing the resultant stroke. Perhaps even more important than understanding the warning signs of a stroke after it occurs is preventing one in the first place. If you are a caregiver, help you loved one to eliminate risk factors like smoking, excessive alcohol consumption, high blood pressure or high cholesterol. They should also manage their weight or diabetes or heart disease if they have these conditions. SO, you can be not just a caregiver; you can be a life saver! 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.
Remember the ads that started with a plea: “Help, I’ve fallen and I can’t get up?” That is so twentieth century. Today, it is Alexa, please turn off the lights in the living room. Alexa, please play Guns and Roses…you get the point. Now, Alexa is making house calls for your older loved one. This past week, Amazon rolled out new software tools that are Alexa-compatible to help people at home communicate with their providers. Think about mom or dad now able to let their doctor know that they are able to get up and about at home following their surgery. Or they can report that they are having very little post-op recovery pain or that the infection seems to be under control today. That is all well and fine, others would say, but that patient feedback is strictly confidential. The good news is that Alexa communicates with your loved one’s health care provider … just like a healthcare provider. That is, the communications from home to hospital are HIPAA-compliant. The software developers have built in protections so that what is communicated by way of Alexa or Siri or Amazon or Google stays confidential. Amazon specifically is keeping tight control on who can use the platform with only six companies so far having received access. It used to be that “telemedicine” was via phone connectedness…and then via computers, but now it is just a voice away with an in-home set of ears sharing everything with a health care provider. Soon enough, those who cannot ambulate as easily or drive can order their prescription refills through Alexa. Developers are also at work to develop software that can understand medical records as well as ask the right questions of patients at home to help keep medical status current for the humans at the clinic who wish to check up on patients in their homes. There is more:
- Cigna has a system available to its large national clients so that they can better manage their health and wellness goals;
- Express Scripts allows for prescription renewal as well as tracking progress as the pills get delivered home.
- Another health system enables a home device to enable residents to identify the nearest provider with appointment availability when needs arises.
- Another digital health company interacts with people in their homes to manage chronic conditions like diabetes.
I cannot help but imagine Alexa helping that diabetic patient at home by monitoring their cookie and ice cream purchases…maybe tech gone too far? 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.
Everybody forgets something! There is a heightened awareness - even fear - of Alzheimer's or other forms of dementia especially as we all advance in years, but simple forgetfulness does not inevitably lead to a dementia. And if you are a caregiver, the older adult in your orbit may be very self-conscious or worried at having misplaced the car keys. Or maybe it is blanking on a favorite author or the name of a friend that they happen upon on the store. No one of these events means that dementia of any sort is encroaching on their faculties, but sometimes it is not enough to reassure an older adult that it is not what they fear. It can be helpful, however, to take specific actions that are known to help keep one's brain healthy and sharp.

            Let me share five helpful tips from a well-regarded neurologist named Dr. Majid Fotuhi. You may have seen him on Dr. Oz, if you follow the program. Some say Dr. Fotuhi's advice can even prevent Alzheimer's; you be the judge. At the very least, these steps can help to strengthen the brain of virtually anyone who puts in the effort.

1.    Cross-Train: Anyone who exercises routinely knows that it is important to trade off the activities of your work out; they call it cross-training. Try changing which hand you use to comb your hair or take a different route to the store or use a soup spoon with your non-dominant hand. It is not easy, but it challenges your brain to learn something new, and as the brain adjusts to this shift it rises to the challenge by using areas of the brain that may have been under-utilized before.

2.    Relax: Stress is not just bad for your cardiovascular system; it is harmful to the brain because it releases a stress hormone called cortisol. So, several times each day, go to a quiet, darkened room and practice deep, slow breathing. Change out of clothing that may be restrictive and remove your shoes to signal your brain you are serious about relaxing. Do this for seven minutes.

3.    Mnemonicize Something: Okay, so the real word is simply "mnemonic. Challenge your brain to remember five spices from a recipe by making a word out them: Salt, Pepper, Oregano, Tarragon, Sage. See how long you can make the word or use the first letters to make a silly sentence.

4.    Increase Blood Flow: If your doctor says you are sufficiently healthy, walk up and down the stairs a few times, do ten push-ups, or do twenty sit-ups. All of these will raise your heart rate and increase blood flow to the brain, and that will grow new brain cells.

5.      Infuse DHA: There is a nutritional supplement called docosahexaenoic acid which is an omega-3 fatty acid which just happens to make up a large part of your brain matter. You can get it from fish that come from colder sea water, and it also can be purchased in your drug store or health food store. It has been shown to promote a healthier, even younger brain.

If you want to learn more about any of this, Please check out Dr. Oz's web site.

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.
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.
Dr. Oliver Sacks explains neuroplasticity in his editorial, “This Year, Change Your Mind,” in the New Year’s Day editorial page of the New York Times. As a geriatric care manager, I have encountered clients whose injuries have induced deficits of some sort from which recovery plans are designed and executed. Physical injuries such as lost limbs, vision, hearing or others have fairly clear rehabilitation trajectories, and the injured individual can learn and work through them to recover as much of a productive life as possible.

Neurological injuries like those Dr. Sacks offers as examples require remolding an organ that we do not see from injuries that also may be invisible. As Dr. Sacks explains, neuroplasticity offers the means by which the brain can remold itself to overcome a deficit. For a geriatric care manager, the deficits do not have to be as dramatic as a spinal cord injury, the onset of blindness or even a stroke. We see every day the consequences of older adults’ inactivity and the cumulative deficits that can grow out of the under stimulated life. The brain does lose some of its pathways through natural attrition, and it is critical for a vibrant life for the aging individual to keep working in order to maintain the pathways they already have as well as to create new ones as some of those may become unavailable. A colleague likens it to commuting in the brain. There may be detours and rerouting, but an active individual will always find a route home.

There is a case of a 70+ year old client whose spouse is suffering from Alzheimer’s inexorable progression. While there is little to do to forestall that condition, he takes it upon himself to exercise at his facility’s gym three times a day, he is a voracious reader and he is an active participant in his wife’s care team so that he can be both physically and mentally able to care for his wife to whom he is entirely devoted. Or the 90+ year old woman who will keep up with her grandchildren when they come to visit – as exhausting as it may be. She is a brilliant conversationalist, she rarely repeats herself and she completes the New York Times crossword puzzle. What do they have in common? They both push the boundaries of the envelope.

They both are pushing the plasticity of their brains.

Dr. Sacks exhorts us to “change our mind” this year as part of our 2011 resolution. I would expand that to include all of those on whom an elder or person with special needs depends, and encourage those caregivers to help push the envelope for those in their care in order to effect a change of mind and a robust life in 2011 for all.

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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