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

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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Stranger Things: Step up Your Diet with New Options
If I were to ask you what you or an older loved one had for dinner yesterday, the chances...
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October 4, 2022
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Treatments for Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the third of four posts we’ll offer on the subject. I...
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September 20, 2022
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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,...
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August 30, 2022
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The Will To Do the Right Thing
This whole idea to write up a legal document to give surviving loved ones clarity about how to take...
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August 9, 2022
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Before or After the Fall
I came across an informative piece in the Washington Post about a week ago, and it brought to light...
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July 26, 2022
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Why AND Is the Most Important Word
Do you recall the 1991 movie called City Slickers? It was another great role for Billy Crystal, but it...
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July 19, 2022
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What You Can and Cannot Change About Dementia
Let me start with the short answer to a question we raised in the email announcement of today’s post. ...
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June 21, 2022
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A Good Habit Missing for Most Older Adults
Even among those older adults who dodged COVID, “gymnesia” may be a lingering effect. Please let me explain… What...
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May 24, 2022
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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...
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April 26, 2022
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In the Caregiver's Words

Recent Client Praise

We are fortunate to have a new contribution from a good friend and colleague, Julie Northcutt of Caregiverlist.com. Julie offers a caution in this contribution about the scams that seek to prey on older adults, so please give her warning a read...

“Holidays are a magical time, but unfortunately they are also a time when law enforcement sees a spike in online and telemarketing fraud, especially directed against the elderly. According to the Federal Trade Commission, nearly 25 million Americans are victims of consumer fraud each year. Senior citizens continue to be a rapidly increasing segment of the population. Why are seniors especially vulnerable? Seniors are seen as easy marks with “nest eggs” that make them attractive to con artists. According to the F.B.I., “people who grew up in the 1930s, 1940s, and 1950s were generally raised to be polite and trusting. Con artists exploit these traits, knowing that it is difficult or impossible for these individuals to say "no" or just hang up the telephone.” In addition, because the elderly are sometimes socially isolated, the elder will stay on the line just to converse with another human being.

“Silver Surfers” are the fastest growing group of Americans using computers, recent studies have shown, using email as an essential way to keep in touch with loved ones. This makes them especially vulnerable to illegitimate “charity” organizations looking for donations, lottery scams and bogus product offers. Elderly victims are less likely to report the fraud because they don’t know who to report to or they are embarrassed to admit they have been scammed. One of the more popular schemes this season is the “grandparent scam.” In this scenario, someone calls a senior and poses as their grandchild or a friend of the grandchild. The caller claims that the grandchild has been in an accident or is in trouble and needs the grandparent to wire them money. The grandparent is also urged not to tell anyone. Once the money is sent, it is unlikely it can ever be recovered.

What is a senior to do if they suspect fraud? Seniors are urged not to reply to any emails offering “free” medical equipment, miracle cures, or lottery prizes that require up-front payment for processing. Never give out sensitive information over email or phone, including social security numbers and bank information. Verify charity information before donating. In the case of the “grandparent scam,” seniors are urged to call their grandchildren to see if they are really in trouble. Everyone is vulnerable to deceptions during the holiday season. None more so, it seems, then our senior population. If you or a loved one has been the victim of a scam or fraud, report it to your local Department on Aging. You may help prevent others from becoming victims as well.”

Julie Northcutt is founder and president of Caregiverlist.com. We encourage you to visit her website.

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.
If you are a caregiver to an older loved one, you may find it a bit overwhelming to keep up with all the medications they take each day, and the times of day they take them. But have you thought about the potential side effects as well? The average older adult living independently is taking more than five prescription medications daily, and those in nursing homes may be taking at least seven prescription medications. We call this “polypharmacy.” We all have at least some sense of the side effects that many of these medications may carry, but what you may not know is that some of these medications have some unhealthy interactions with the other medications.
Recent research in the United States among older adults living independently found interactions between drugs in about 15% of the cases. In another study in Europe that tracked older patients being discharged from hospitals, as many as 70% were on medications with some interactions, and 24% were at risk for serious interactions among the drugs they were taking when they were discharged. What should you look for? Review the medications your older loved one takes looking specifically for these medications: • Statins – the drugs used to lower cholesterol • Proton Pump Inhibitors - the drugs that work against GERD or acid reflux • Antibiotics - the real offenders tend to be sulfa drugs or fluoroquinolones • NSAIDs - these are the pain relievers like Naprosyn, Motrin, etc. • SSRIs - these include the anti-depressants like Prozac, Celexa, Paxil • Calcium-Channel Blockers - like Norvasc • Warfarin – the blood thinner also known as Coumadin. This seems like a short list...no problem. The fact is that statins are the most commonly prescribed drug for older adults. More than half of those over age 55 are prescribed statins to lower their LDL. About one in five older adults in America take PPIs. And you can see with the number of medications your older loved one may take the likelihood of an interaction escalates. And some of these drugs also do not play nice with certain food groups or vitamins. If you see signs of muscle weakness, cramping or difficulty standing or walking, as well as fatigue or confusion, check in with your loved one’s doctor. But if you really want to be proactive take the list of the medications your loved one consumes regularly to your local pharmacist…and don’t forget to add the over the counter medications which can include PPIs or NSAIDs as well as an accurate assessment of alcohol intake. And next time you accompany your loved one to a physician’s office visit and the doctor recommends a new prescription, ask what can be taken from the list! 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.
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.
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It may be just the first week of summer, but if you are a caregiver to an older adult it is not too early to be alert to the toll that summer's heat can take on your loved one. Working in geriatric care management, one of the factors that always figure into my assessment of a client's overall condition is the weather and how well-equipped they may be to cope with what nature sends our way. To avoid the dangers that heat can represent for an elder adult, follow these six tips: • Replace the water lost. Perspiring is the body's way to lower its temperature, but it will happen at a higher rate during the hot months of summer. It is imperative that an older person consume more fluids during summer to replace what is lost to perspiration, and that this is not caffeinated or alcoholic liquids which by themselves dehydrate a body. • Ask their physician. How one copes with the heat can be dependent on the medications they take. I have talked in past postings about the large number of medications older adults typically are prescribed, and many of them can place a person at higher risk for heat-related issues. Especially if they are on a diuretic for high blood pressure, they are losing fluids, a condition that will be exacerbated by the heat and perspiring. • Dress for success. Success in this case means clothing that will allow more ventilation. Encourage your older adult to wear loose fitting clothes, and choose lightweight fabric like cotton or synthetics. A hat will not only protect the skin from dangerous sun rays, but it also is portable shade to cool your older loved one. • Don't overdo it outdoors. Even a walk in the park may prove to be too strenuous in summer's heat, so help your older loved one monitor how severe the heat is and modify outside activity accordingly. If they will be active encourage them to do so early or late in the day to avoid the highest temperatures, and take more frequent water breaks. If they will be poolside, encourage them to actually get into the water to cool down. • Cool down. It is possible that your older loved one does not have air conditioning, so find other retreats for the really hot days of summer. Public libraries, shopping malls, public activities centers or other venues can provide a break from the heat and offer social engagement as well. Opening windows on most nights also will give a relief from summer heat along with regular cool baths or showers. • When all else fails. Even with all these preventive efforts, you may still find your loved one succumbs to the heat, so watch for signs of over-heating. If you see one or more of the following - muscle spasms, headaches, over-tiredness, nausea - get your loved one to a cool area immediately. Begin to rehydrate them as well as use cool, water-soaked cloths on their neck, head or wrists. Running cool water over a person's wrists also will have a more general cooling effect on the whole body as the cooler blood circulates. If symptoms become worse or are accompanied by disorientation, rapid pulse or seizures get them to medical help right away. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends providing elder care management needs to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
Autoimmune diseases have gotten a lot of press in the past decade or so, because scientists have developed biologic agents that have been able to slow or halt the progression of many of these diseases. The list includes the usual suspects you have seen on television commercials like rheumatoid arthritis, plaque psoriasis or Crohn’s disease. But the category also includes conditions like type 1 diabetes, lupus, multiple sclerosis and nearly twenty other medical conditions. Well, these conditions may be poised to get some more attention. Researchers in the United Kingdom have found a link between patients who early in their lives have been diagnosed with an autoimmune condition and those same patients later developing dementia. This includes both Alzheimer’s disease and vascular dementia. It all comes down to big numbers. The researchers accumulated data on roughly 1.8 million patients who had been diagnosed and treated for autoimmune conditions between 1998 and 2012. They also had a control group of about 7 million patients – those who had not been diagnosed with an autoimmune condition. Of the 25 autoimmune conditions, 18 of them proved to be statistical predictors of later development of dementia. The disease with the most dementia diagnoses later was hypothyroidism. Over all the autoimmune conditions, the risk of developing dementia later was about twenty percent higher than for the control cohort. That said, we are talking very small risks for either group. Of the dementias, Alzheimer’s disease was a slightly lower risk outcome than vascular dementia. The researchers speculate that as patients with a disease like RA likely will be taking NSAIDS like naproxen or ibuprofen which may also have a neuroprotective effect against Alzheimer’s disease. Overall, the risk for developing any dementia was slightly higher for men over women, but there was substantial variability across specific autoimmune diseases. The research seems in general to be encouraging further study of anti-inflammatory drugs as preventive care against dementia…perhaps to see if the same anti-inflammatory drugs that address autoimmune conditions can have an effect on neuroinflammation. The Alzheimer’s Association is taking this seriously. Last year they announced a $7million investment in clinical trials looking at drugs addressing brain inflammation. The researchers suggest that the data are preliminary, but admit that the inflammatory route is worth more analysis. 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.