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

Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best lives. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte Since one of the primary uses of the Internet is to find things, it was inevitable that we would turn to it when looking for love. The “market” responded, and these days it seems thereare as many web sites and apps as there are people looking to date. Older adults, not wanting to be left out of any opportunities, now have match-making services that cater exclusively their cohort’s desire to connect, or to reconnect after loss. What advice can we give to aging adults and those who support them in living their fullest lives?
1. Be ready. Trying to start a relationship at any stage in life is complicated. It’s especially tough to get “back in the swing” after profound loss. Even caregivers and family should leave space for lots of complex feelings, staying ready for extra conversation. If you or your loved one is experiencing more difficulty than is comfortable, talk therapy can be of great assistance working through grief or even into “learned loneliness.”
2. Get creative. A good profile shows personality and flair, while also being honest and accessible. Anyone looking to create an online persona should ask friends to take new, current pictures, brainstorming with confidantes about what makes the relationship-seeker unique. We know only the subjective portion of ourselves. Outside perspective can really help us understand what others experience when they encounter us.
3. Avoid clichés. Lots of people like “long walks on the beach,” but if someone has a special knowledge of tides, or shells, that’s a point of connection or interest. Potential dates know then that the walk won’t be just aerobic awkward silence.
4. Stay safe. Online dating isn’t dangerous, but successful users of the service know that precautions are necessary. They start by having conversations on a mobile device, as landlines can be traced to an address. When it’s time to meet, they make sure to do so in a very public space - best for coffee or lunch - transitioning to more privacy or less daylight only once trust has been established.
5. Stay safe, the sequel. If the relationship becomes physical, intimacy should be safe. (Please note that if you are the adult child to an older loved one that intimacy can span everything from holding hands, so be sensitive, and don’t assume.) That said, the numbers regarding disease transmission among older adults continue to rise at alarming rates. Yet, intimacy is natural, and everyone has a right to enjoy it. You thought “that talk” was awkward when you were an adolescent child to your parent! Appreciate that everyone also has a right to stay healthy through conversation and proper precaution.
6. Remain positive. It would be great to meet Mr/Ms Right immediately, but the old saying about kissing frogs remains true at any stage of life. It’s also true that a positive connection of any kind—even if not potentially romantic—is preferable to self-isolation. Meeting folks with open-ended mindset is a healthy way to begin any relationship any
Charlotte Bishop is a best-selling author , 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.
Do you have pain in your back, particularly your lower back - that area around your belt line or slightly lower? If not, please consider yourself lucky, but also just wait. According to some experts, about four in five Americans will at some point in their lives experience low back pain...chronic low back pain. What may be surprising is that most of these cases have no specific cause that can be diagnosed. As a geriatric care management professional, I hear about this a lot. And if you are a caregiver to an older adult, you may hear this from your loved one as well, or you may be experiencing the pain yourself. So, as a consequence, doctors are seeing more and more of these patients, and without having a specific cause to address they may be tempted to treat the pain. While surgery may be an option for serious spinal conditions, most of this low back pain does not reach such a level of acuity to justify surgery. A lot of doctors have started giving injections into the site with anti-inflammatories, opioids, or in some cases vitamin B-12. Injections would be great if they worked, but there is not much evidence to suggest that the injections are any more than a short term fix for the pain. A research commentary, reported earlier this summer in the Journal of the American Medical Association, says that there is almost no evidence in the larger literature that injections have any positive effect over the long term. Other reports suggest that they likewise do not substantially reduce the likelihood of surgery later. There was one research study published in February that actually showed the opposite; patients with pinched nerves in their lower back receiving injections showed less pain relief than a control group who received no injections. The JAMA authors are now recommending against injections. What are the alternatives? Here are :
1. For those with above average weight, especially belly fat, weight loss can be very beneficial.
2. Strengthen the back muscles with more exercise. It could be as easy as taking longer walks, swimming or riding a bicycle.
3. In a journal called The Clinical Journal of Pain, doctors recommend yoga or Pilates as a somewhat more aggressive approach that has showed good results.
It does not have to be confusing. According to some physicians, we seem to have made a symptom into a diagnosis. That is to say that pain is the result of something being wrong, and we ought to treat the source of a problem. Yet, most doctors do not like to prescribe long walks or losing weight, because patients ask for a "quick fix" to their problems. We have come to view pills as a solution to our problems instead of changing our lifestyles. I have talked in other postings about helping older adults to have more active lifestyles, because it will be helpful for their sense of well-being. Being more active, it seems, also will be good for addressing low back pain. Do it in small measures at first, but be persistent and grow the number of minutes, laps, blocks or other measure of investment in an active life. If you as a caregiver are walking with your older loved one, you also may find that the social activity of conversation is a health boost. Make sure their shoes give them solid support. The pain may not totally go away, but chances are that there will be relief at least during the exercise. And the relief can continue to grow. Charlotte Bishop is a Geriatric Care Management professional 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.
In our book, How Do I Know You?: A Caregiver’s Lifesaver for Dealing with Dementia, we say: Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed. Stop the presses. New research suggests that there may be ways to slow the onset of the disease, if not prevent it. Let me repeat that. Some early results from a cognitive training regimen show that it may be possible to delay or slow the onset of Alzheimer’s disease. It may even be preventive, but that will take a very long term waiting game to see if the delays that are evident in the clinical studies can be sustainable. The results from this research show that a computerized cognitive training program in which patients were enrolled was able to reduce the risk for onset of dementia by 29% at ten years! In scientific jargon, that’s not nothing! Here is the other great part: those subjects who engaged in the most training got the most benefit. Does that sound like what we see in professional athletes …or professional anything? Those who put the most work into the program get the most out of it. Please let me tell you the rest of the story…Existing research has demonstrated that mental training that focused on retaining memory or processing did not reduce any risk for dementia. This present research was a study in Toronto among nearly 2,800 older adults whose average age was 73.6 years and who were living at home. They were assigned to three groups with three types of cognitive training: • memory, • reasoning and • processing speed. It was the processing speed groups which showed the results. Compared with a control group, those who went through this training had a 29% lower risk of developing Alzheimer’s. The memory training and reasoning groups were not different from their respective control groups after 10 years. All of this held true even after the investigators adjusted for any differences in other conditions or characteristics like gender, diabetes, depression or cardio-vascular health. Researchers are not sure why processing speed works this way, but it may be that working on processing speed builds up mental reserve. Maybe it’s like interval training for athletes. Mastering speed…bursts of work…grows their overall capacity. When the dementia erodes some of their cognitive capacity, they simply have more capacity on which they can draw. Clearly, a couple next steps will include following these people longer…but also trying to tap into what really is happening in the brains. That said, it stands to reason that if you can work on your “processing speed,” you will retain more ability over the long run. Get processing! 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.
As a geriatric care manager, I have to admit that we are very skilled at not only providing senior care options for those among our clients with medical conditions, but translating medical speak into a language that clients, caregivers and families can process. A lot of these are chronic conditions that progressively impact the caregivers' loved ones, and some have some rather scary names. But one of the medical "conditions" that does not have a name associated with it is every bit as important as those medical jargon labels like chronic obstructive pulmonary disease or congestive heart failure and more. It is called "functional status." If you are a caregiver, you may have seen your loved one's chart at some point, and it has a lot of information on it. A fair bit of it covers the ongoing record of a patient's vital signs, measures like heart rate, blood pressure, temperature and more. But you will not see a measure called functional status, what some in our field these days are calling the "sixth vital sign." The key reason to know your loved one's functional status is because that is a really good predictor of how easily or rapidly they will recover from, for instance, a hospitalization. If your loved one is going through chemotherapy, it will also dictate how aggressively the doctors can treat the cancer. They call it performance status. But for every discharged patient, functional status is also a very important predictor of whether they will be re-hospitalized within the next 30 days. How well one is able to take care of oneself is really critical to a healthy recovery. And functional status is all about self-care like bathing oneself, taking one's medications when they are supposed to be taken, preparing a nutritious meal and more. Functional status is what gets a discharged patient back on their feet, and being up and about is one of the best ways to avoid having other problems like pneumonia or bed sores. Getting back to re-hospitalization, Medicare is starting to take functional status very seriously, at least indirectly. Starting in October they will be monitoring hospitals' readmission rates, and those who are above the national average will begin to pay penalties. So, doctors should start paying attention and recording their patients' functional statuses. Because it will not be the patients' medical condition alone that will put them back in the hospital; it will be that interplay between how they take care of themselves - their functional status - and their medical condition. It is interesting that we, as providers of senior care solutions, have been focused on those two dimensions all along. We call the combination of good functional status and a medical condition to be "quality of life." If you are a caregiver, you can really help your loved one by helping them to be as active and self-sufficient as possible. If they cannot be totally independent, then assistance in any of the activities that challenge them can still improve their net quality of life by leveraging their functional status. It will be better for your caregiver quality of life as well. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends providing senior care options to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
It used to be that people feared public speaking more than dying, but with the increasing prevalence of a number dementia, it seems that people more fear losing their faculties than fear losing their lives. But while prevalent, dementia is not inevitable, and there are steps we all can take - at any age - to stave off cognitive decline. Here are five. 1. Go fishing - You probably have heard or read that fish oil is healthy for your brain, and a number of studies have supported that notion. The antioxidative omega-3 fatty acids in fish oil seem to be an aid to later life brain health. Researchers have quantified this beneficial effect in clinical studies comparing people who consume omega-3 with those who do not, so eat fish. 2. Sound sleep - The estimates of sleep apnea's prevalence range from 25 to 40+ million adults in the United States alone. The most common and obvious product of this nightly disturbance of sleep is the excessive daytime sleepiness that results, a sleepiness that over time not only reduces quality of life, but if unchecked, it also impairs memory as well as general motor coordination, ability to concentrate and a number of other facets of cognitive function. So if you know someone who has sleep apnea, get help. 3. Sleep aids - A good night's sleep is precious, but using a prescription sleep aid may be a mixed blessing. There is evidence that some of the prescription solutions for sleeplessness cause selective amnesia or even hallucinations or sleep activity. People on some of these agents have reportedly engaged in sleep driving, making telephone calls or even preparing and eating food with no recall of the events. The cure for sleeplessness can be worse than the condition. 4. Night caps - It is true that alcohol can make one drowsy, but it does not enhance the quality of sleep. Researchers have shown that alcohol disrupts the formation of memories in the brain. It may not be dementia, strictly speaking, but recurring memory lapses can make day to day functioning a bit shaky. 5. Single Tasking - Multi-tasking may be the hallmark of the 21st century, but far from making us more productive, it actually hinders cognitive productivity. One researcher refers to this as the :dementia of distraction," the kind where you walk into a room while checking your phone for a text, but then forget why you entered the room. This dementia knows no age requirements, because teenagers can be as prone to the distraction of multi-tasking as older adults. As you may imagine, the list could actually go on and on, but the dos and don'ts of this short review highlight what to embrace and what to avoid to enhance cognitive function at almost any age, but particularly as one ages. Can one avoid dementia entirely? Probably not, as there is some research pointing to a genetic component to conditions like Alzheimer's Disease, but following these basic guidelines can preserve brain function to the fullest extent possible. So sleep well, eat healthy and stay focused. 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.
When you were young, you may have dreamed of being like Superman or Wonder Woman. They both had remarkable powers that made them more than just better than the average person or even the best among the average humans. They had powers that came from something very special about their makeup, in the former case, well, “super powers.” Scientists at Northwestern University’s School of Medicine are using similar language now to refer to a rather small subset of people who live to be not just over 90 years of age, but some to be old enough to celebrate their 120^thbirthday. They are “Super-Agers.” Are you a super-ager? Well that depends. The physicians involved in the research are looking at a lot of factors that may help make a superager like psychosocial factors, education, family history, genes, physical health and the brain. And they are looking at people over 80years of age who have the memories of those 30 years younger as well as a control group of “average” people. For instance, they have found that super-agers have a thicker cerebral cortex, the important outer layer of the brain responsible for memory, attention, language and thinking. It was thicker than the normal agers, about the same size as members of the younger, middle-aged control group. There were other exceptional facets of the super-agers’ brains such as that part of the brain that controls social behavior. The scientists also have taken blood samples to further assess the DNA of the superager. So, if it is all based on the genes we receive, or as some say the parents we have chosen and that these people may be less numerous than only one of every hundred within the overall population, what’s the point? Well, one of the researchers points out that you don’t have to be the one who has the right genes to live longer. If they find that the superager’s’ genes turn off a certain protein or turn on a certain metabolic process that contributes to longevity, then you don’t have to have better genes to live longer. You just have to have some help to adjust the proteins, the metabolic processes or whatever it is that works the magic. So, there may be good news for us all. If you have an older loved one in your orbit who shows signs of being a superager, encourage them to reach out to NU’s medical school…today. 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.