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

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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Five Things You Need to Know about Coronavirus
Okay, there may be more than five things you want to know about the coronavirus, but these five basics...
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January 28, 2020
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Alzheimer’s: A Cure at Hand?
I have posted before that the currently approved therapies for treating patients with Alzheimer’s disease are not really very...
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January 21, 2020
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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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In the Caregiver's Words

Recent Client Praise

You don’t have to be a meteorologist to know that winter can be particularly challenging for older adults in the upper Midwest. So, I am not going to talk about slipping on ice or hypothermia; I think most of us and our older loved ones get those. I am going to talk about four of the more subtle and insidious hazards of a protracted cold spell.
1. Winter Depression: Isolation is bad for the soul…or more medically speaking, the mind. Being trapped inside their house or apartment, older individuals may be protecting themselves form frostbite, but they also may be setting themselves up for depression. If you have an older loved one who lives alone…or even if it is a couple…make a wellness check to bring a bit of cheer to them. Social engagement is one of the best remedies for winter blues.
2. Power Outages: When the power goes out in the summer, it may mean we have to eat the ice cream before it melts. But in the winter a power outage can mean frostbite can be happening under their own roofs, not just outside. Make sure your older loved one has flashlights and back-up batteries, warm blankets and a battery-powered radio. The CDC has a longer checklist.
3. Dietary Variety: Help your older loved one not just have enough food, but have enough variety to get ample quantities of vitamin D. That includes milk and cheeses, seafood, leafy vegetables and fresh fruits. You do not have to be a culinary wizard; it is the variety and freshness that count.
4. Carbon Monoxide: For homes with gas fireplaces or furnaces that vent from the side of the house. Be aware of leaks in the apparatus inside the house as well as blocked exhaust ports that may become blocked by snow. Check on the carbon monoxide detectors in the hour to see that they are working and have back-up batteries for those as well.
And between trips to visit your older loved ones, please give them a call as well. All of this will help take the chill as well as some of the bleak off their winter. 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.
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.
When I say there is no ‘D’ in dementia, it is not that I am Deficient in spelling. Medical research has been accumulating that people with low levels of vitamin D in their bloodstreams are more likely to experience cognitive decline and even develop Alzheimer’s Disease. When I say cognitive issues, it is not all aspects of brain function. The declines associated with vitamin D deficiency are focused on episodic memory loss and deterioration of executive function. Researchers from University of California, Davis and Rutgers University studied 382 adults whose average age was 75.5 years old. These adults received cognitive assessments which categorized them as having dementia (17.5%), having mild cognitive impairment (32.7%) or as cognitively normal (49.5%). Vitamin D levels were lowest for those diagnosed with dementia, but there was only very nominal difference in vitamin D levels for those who were mildly impaired and those who were classified as cognitively normal. All of these adults were studied for nearly five years and then assessed again. During that time the magnitudes of decline in episodic memory and executive function were greater in adults who had been diagnosed as vitamin D deficient or vitamin D-insufficient. The investigators found that regardless of their baseline cognitive assessment, their ethnicity or a range of other risk factors, those who had been vitamin D deficient at the beginning of the five year period were at greater risk of developing Alzheimer’s Disease. Scientists continue to study the association between vitamin D levels and dementia. While there are no studies that suggest taking vitamin D supplements can prevent Alzheimer’s, doctors in practice are not waiting. They are prescribing D for their older patients, especially those who are already at low blood levels of the vitamin. We who live in northern regions should be particularly on top of getting enough sun to activate our natural vitamin D, consuming more dairy products and green leafy vegetables and augmenting our diets with vitamin supplements. Charlotte Bishop is an Aging Life Care Professional and 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 are a caregiver, you probably know that the number of hours this job demands is onerous. According to a recent AARP survey, caregivers report an average of more than 20 hours a week taking care of an older loved one. This is on top of the "day job" they already have as well as any other family duties they may have for a spouse or children at home. So who is taking care of the caregiver? One person who probably is not caring for the caregiver is the caregiver him/herself. If you are a caregiver for an older adult or someone else with special needs, try out these suggestions so that you can survive and even thrive your caregiving responsibilities.
1.    Remember to laugh. It is no surprise that caregiving is stressful, and one of the casualties often is one's sense of humor. Laughter is a great stress-reliever that we have to give in to regularly, because it will make everything else a lot easier.

2.    Remember to be "normal." Caregiving can be demanding and often unpredictable in ways that tend to take over one's life. Perhaps you used to have a favorite television program or you enjoyed going for brisk morning walks or some other habit that gave you pleasure. Indulge yourself with one of these returns to normalcy and you will be more refreshed to return to your caregiving after.

3.    Remember your friends or colleagues. Caregiving can squeeze one's social life tremendously, and isolation can only make the weight all the heavier. Take time for a lunch or coffee with people you like, and some of the stress will go down a notch or two.

4.    Remember to get help for the emotional demands. This can be in the form of a support group or perhaps a counselor or your cleric. Talk with someone who will help give you some coping tools and understand why you need them.

5.    Remember to check up on your health. You probably attend all the doctor's visits for your loved one, but when was the last time you had a check-up yourself? It is not just emotional health that can suffer under the stress of caregiving, so keep healthy.

6.    Remember to forget some things. You may have a whole list of "must dos" on a weekly basis, and it is really acceptable to drop some items from your list. Hire someone to do your housekeeping or shoveling the walk or mowing your lawn.
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
November is National Alzheimer’s Disease Awareness Month, so I am going to give a lot of attention throughout this month to what we know as well as what we don’t know about dementia generally and Alzheimer’s disease specifically. More Americans fear an Alzheimer’s disease diagnosis than fear dying, and that should be no surprise, given that a new Alzheimer’s diagnosis is given every 67 seconds in the United States. But we should all be cautious in accepting any Alzheimer’s diagnosis for a loved one at face value. Research has shown that 24 percent of diagnoses actually are misdiagnoses. Given that there are about 100 different manifestations of dementia, perhaps we should be surprised that the rate of misdiagnosis is so low? And it is important also to bear in mind that the health care provider making the diagnosis may or may not be well-qualified to make the call either for lack of experience or for lack of proper tools with which to diagnose. Our team became involved with the mother of one of our people, because she was showing signs of cognitive decline. He recalls that on one of his visits her common introductions to friends of hers had become “You don’t have a name…this is my son.” He and his sister started making calls to her primary care physician’s office to get a sense of what was going on. In his mother’s file the diagnosis was “organic dementia.” The doctor had further prescribed an FDA-approved medication called Namenda for his mother for that “organic dementia.” First, Namenda is indicated for Alzheimer’s disease (not “organic dementia”) and is to be used in combination with another drug for Alzheimer’s called Aricept. Now with his mother’s doctor on the line, our staff member questioned why the prescription for a condition for which his mother had not be diagnosed and that was to be used only with a medication she had not yet been prescribed? And at $350 out of pocket per month? The doctor mumbled something about whether the son wanted his mother to have an autopsy to diagnose the condition…or was it the money. Stunned at how behind the times the doctor was, the son simply said it was the cost and the doctor withdrew the prescription. Let me get back to the autopsy. A decade and a half ago scientists could not definitively diagnose Alzheimer’s until after the individual had died and an autopsy of the brain could be performed. Now, we have neurologists who can confidently diagnose the condition with MRIs, PET scans and blood tests along with cognitive tests in real time and an historical look at a patient’s records. In these neuro-psych exams, the specialist is able to not only identify the condition, but more importantly what can be done. As it turns out with our team member’s mom, she had vascular dementia, the end result of numerous “mini-strokes” over time that deprived more and more parts of her brain of blood flow. As his mother’s condition deteriorated she was required to move from independent living to assisted care and finally to a memory unit. I have noted before in other posts that there are no cures for Alzheimer’s; well, there was no cure for vascular dementia that had progressed as far as it had for our team member’s mom either. But she lived to be more than ninety years of age and had a quality life. In the end, her quality of life was greatly assisted by those around her who knew the source of her dementia and how best to care for her. And that is as happy an ending as one can hope. For the rest of this month I am going to be talking a bit more about how dementia often gets confused with delirium or depression, as well as Alzheimer’s disease and also address your questions. Please just email me your questions or concerns at info@creativecaremanagement.com . 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.
I have been hearing that the web resources I have been offering in my postings have been informative and helpful. I am regularly reminded that one of my principal roles as a geriatric care manager is to be a resource directing people to others. And that those “others” are not just health care providers.

In keeping with that notion, I have compiled some web resources here that may prove useful for elders and others with special needs who may also be on limited budgets.

These are just a few of the sites that you may find .useful, but may not always pop up in a web search engine when you are looking for answers to your elder law questions:

AARP has a program called Legal Counsel for the Elderly (LCE). You may wish to join AARP – if you have not already – to get full access to this program, but it has much to offer individuals who wish to understand their rights as well as how to get legal paperwork for an elderly family member or loved one in order: Legal Council for the Elderly.

For the latest legal perspectives on legislation affecting elders, legal-financial challenges facing elders and more, you can also go to the web site for the association that represents elderlaw attorneys, the National Academy of Elderlaw Attorneys (NAELA). Simply go to: NAELA Legal Affairs.

The National Senior Citizens Law Center is a non-profit organization whose principal mission is to protect the rights of low-income older adults. Through advocacy, litigation, and the education and counseling of local advocates, we seek to ensure the health and economic security of those with limited income and resources, and access to the courts for all. Go to:http: National Senior Citizens Law Center.

At all of these sites you will also find directions to professionals in your geographic area as well as other web resources that you will find useful.

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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