Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Geriatric Care ServicesChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 10

Six Geriatric Care Management Tips to Beat Summer Heat
It may be just the first week of summer, but if you are a caregiver to an older adult...
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July 1, 2013
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Four Geriatric Care Management Considerations about Fall Prevention
About one in five adults over the age of 65 will fall in their homes during the course of...
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June 17, 2013
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Five Geriatric Care Management Secrets to Living Forever
There is a lot of news about the “older market” or other stories featuring someone who has reached the...
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June 13, 2013
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Geriatric Care Managers Do What?
It’s June, and school is out for a lot of kids and everyone is thinking of taking time off....
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June 3, 2013
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Nine Geriatric Care Management Tips on Caregiver Talk for Dementia
If you are a caregiver to someone with dementia you may have found that communication can be frustrating, but...
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May 20, 2013
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A Caregiver’s Warning Signs of Stroke
May is National Stroke Awareness month. As a certified geriatric care manager, I maintain that it is a good...
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May 13, 2013
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A Caregiver’s Guide to Stroke Survival and Recovery
The best estimates suggest that more than 7 million American have experienced and survived a stroke of some sort. ...
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May 13, 2013
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A Hearing Test for Caregivers
We often refer to Geriatric Care Managers as the eyes and ears for the family when they cannot be...
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May 9, 2013
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Mother’s Day without Mom?
We are less than a week away from Mother’s Day, and preparations are in motion, cards are purchased, reservations...
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May 6, 2013
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In the Caregiver's Words

Recent Client Praise

I bet if I asked for a show of hands for any of you who have flown on a commercial airline within the past year, there would be only a precious few who did not raise their hands. Now, if I were to ask if you had made a plan about what you would do if one of the engines failed and the plane was forced to make an unexpected landing scarcely a hand would raise. And that’s okay, because all the airline professionals have logged hundreds of hours training so that they know exactly how to get everyone safely on the ground and off the plane under almost every circumstance. Now, if I were to ask how many of you have an older loved one who depends on you in some fashion, how many of you would raise your hand? It may be your aging parent, a spouse or partner with some medical challenges or the neighbor that does not seem to have family whom everyone on the block has adopted. Now, do you have a plan for next steps…the call that comes when you least expect it? Every 67 seconds, someone in America is diagnosed with Alzheimer’s, and that is only one of the multitude of cognitive issues that can affect aging people. Every 105 seconds a 65+ year old in the United States is hospitalized with a fractured hip. Eighteen percent of auto fatalities are among drivers 65+ years old, a rate 50% higher than the rest of the population. And then there are the other chronic health or simply accidental issues that can arise among our older loved ones, and the vast majority of those who will be caregivers to them are not prepared with a plan. Hope is not a plan! Let’s start with how you can make a plan. How about the talk no one wants to have with their older loved one…is it safe for them to drive? I was at a talk recently where the doctor who hosted the session talked about what I would call the “pre-talk” when it came to safe driving and aging. And the pre-talk also has a pre-plan. Consider this to be the small step toward a dialogue with your older loved one that will help prepare everyone for their healthier aging…and your older loved one gets the chance to buy-in. You can choose which path feels comfortable for you. One is called the Driver Planning Agreement and it simply is your asking your older loved one to read a sheet that they will sign if they agree that they will consent to talk about their safe driving with a person whom they will designate on the agreement. The other is about letting them begin to assess how they, in fact, are driving… It is a self-rating test that will give them an objective opportunity to rate themselves in a way that can open the door to a conversation they may not otherwise have had with you or other loved one. And they still get to control their lives and their plan. This is just one way to addressing the changes of aging, and it is just a start. But it also is the beginning of a plan! And you will find it is not so difficult after all. All conversations have to begin somewhere, and this just could be your “road map” to a better place for talking about driving as well as talking about everything else on the life path. 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 Mental Health Awareness month, and that makes it a good time to talk about America’s Drug epidemic…an epidemic that affects older adults every bit as much as it does teens. It also is a good time to start a conversation with that older loved one in your orbit. Mental health is not just an issue of seniors, but you might be surprised to know that prescription drug misuse disproportionately affects Americans 65 and older. And it is part of an growing trend. In 1988 about one in three Americans had been prescribed three or more medications, but that has grown to well over half the 65+ group now having three or more meds in their bathroom cabinet. And that does not include the rising rate of alcohol abuse among seniors in America. Why the increase? When you talk with public health officials they cite an increasingly fragmented health care delivery system where all of a patient’s physicians may not be communicating with one another. So, the number of prescriptions will rise as a function of the aging complaints and the number of physicians a patient sees. Older patients are receiving an escalating number of anti-depressants, anti-anxiety meds and prescriptions for sleeplessness. And older patients just live long enough to have more pain and more medical issues, and that begins to explain the escalating number who receive prescriptions for opioids…it is not just “take two aspirin and call me in the morning” any longer. And aging has a way of exposing an individual to more of life’s losses that simply take an emotional toll: • Retirement is not always freedom – for many it is an emotional loss • Older adults also can outlive spouses and friends – another emotional loss • Some older adults live in fear of outlasting their money – an emotional strain • Surgery or other life changing medical episodes – an emotional strain • And the list goes on… All of the above can result in that conversation with a physician who attempts to relieve some of the physical or emotional pain medicinally. Or an older adult can self-medicate with alcohol. So, if you are a caregiver to an older loved one or have someone special in your circle, take time for a conversation. You may be surprised by what you learn. You may also find that you can be part of a mentally healthy solution to what may be affecting that individual. Starting a conversation is a great way toward becoming part of the cure. 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.
Last week I talked about Ice Cream, Lunch and Light Bulbs as part of a retirement plan. Those three and more help us to make it tangible what we want to support us logistically, socially and physically as we retire and ultimately face some diminishing of what we have been able to do. And it’s a plan that can evolve over time; Living Well does not happen without really thinking about it all the way until…until we can’t. But there also is some paperwork and concept work you should be prepared to do as you look to living well in your next stage of life. I’m a list person when it comes to travel; I make the list, I check everything off and we head to the airport. Here’s your Big Picture list:
- Legalese: You may have prepared a Power of Attorney for both healthcare and finance, but reread what you have to be sure this includes people you trust. This is particularly true if the documents are time stamped with a date you don’t remember. A lawyer whom I respect puts it this way: “Make sure these are people who love you more than they love your money.” Also, add a Trust document, and make sure your life insurance is titled properly.
- Medical: Keep a current list of your providers, your medicines and dosages and emergency contacts. Add a Physician’s Order for Life Sustaining Treatment (POLST is more comprehensive than a Do Not Resuscitate order). And First responders suggest that copies of all of these be kept in a plastic bag in your freezer…labeled…or some other easily found location.
- Finance: Most of us will at some age have access to Social Security benefits, but that’s still a bit tight as one’s sole income in retirement. Set aside money in an IRA (or ROTH IRA), or 401K or consider yourself fortunate if you have a pension. Get professional advice early and each year meet with your financial advisor to review. Think of it as Save – Spend – Review…rinse, repeat.
- Dream: What would you like to do? Where would you like to go? I am often a facilitator of this part, but it’s never my dream…it’s yours. All of this makes for your next year’s plans, and it also makes it a bit easier to get through the doldrums of winter as you anticipate your next adventure…I refuse to call these bucket lists. Call it a Live Well Blueprint…and when you follow your (not anyone else’s) blueprint, you will live well.
Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
According to national statistics, about six million older adults are abused each year. That amounts to almost one of every ten adults over the age of 60 who have been physically, sexually, emotionally or financially exploited. If you are a caregiver to an older adult, be alert to someone in their home, in their community or on staff in their nursing home who may be an abuser. The statistics suggest that nearly two thirds of the reported cases of elder abuse are instances of an adult child or spouse of the older person who is the abuser. How do you know if your older loved one is being abused?

The challenge in spotting abuse is that abuse can take any number of forms. At the most general level, look for changes in your older adult's personality or behavior, especially their tendency to argue, their tension or irritability. Regarding the specific signs of specific types of abuse:
- Emotional abuse - Behavior that can be mistaken for dementia like mumbling, thumb-sucking or rocking actually are self-soothing behaviors of an abused elder. Look closely to the dynamic between the elder and any caregiver who seems belittling or minimizing to the elder.
- Physical abuse - Look for bruises, abrasions or welts, especially if they are on both sides of the body which suggest some kind of external restraint. Be wary of explanations of bruises or broken bones being the result of the elder's falls or clumsiness. Be on the lookout for the caregiver who seems never to be out of ear shot, suggesting a fear of being discovered. You may also see torn clothing, broken glasses or other signs of physical excesses.
- Sexual abuse - Be wary if your loved one's front door being unlocked or other signs that they are not secure in their house or apartment. More important are the signs of bruising around their genitals or breasts or vaginal or anal bleeding. As with more general physical abuse, be suspicious of torn or bloody clothing, especially undergarments.
- Financial abuse - First, appreciate that if an older adult has been defrauded by one of the many internet or telephone exploiters, they may be ashamed to admit it. Look for large withdrawals or checks or charges and the purchase of unnecessary services or goods. Be suspicious of changes in wills or titles for property and cars. Be aware of any cash, jewelry, artwork or other valuables that suddenly go missing.
- Neglect - Neglect can be self-inflicted or imposed by a third party. Be sensitive to signs they are not eating or drinking sufficiently or if they are poorly or insufficiently clothed. Let your nose lead the way; are they not bathed regularly, or are soiled adult diapers or garbage accumulating?
We have only scratched the surface, but it comes down to being aware of any changes for the worse. If you are a distance caregiver and cannot be present, engage someone local who can be your eyes and ears (and nose). 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 my last posting I spoke to ways to improve the safety and accessibility of the bath for seniors who choose to age in place at home. Some of the same preventive measures can apply to the kitchen, but the kitchen also poses some of its own unique hazards.

As with the bath, beware of scatter rugs in front of sinks or food preparation areas. Areas that may be targets for water or grease spills should have non-slip mats or nothing at all. Check all thresholds leading to and from the kitchen to be sure there is nothing that may be trip hazard to individuals whose stride may be devolving to a shuffle. For individuals who may be unsteady on their feet, consider grip bars in key spots as well as check the walkways in and around dining areas to make sure there is enough clearance for easy mobility. Also look for electric cords or clutter on the floor.

As with all areas of the house, check to see how much wattage can be accommodated by fixtures, and maximize the light while also minimizing the shadows cast by the lighting. In addition to task and ambient lighting while the elders are using the kitchen, place night lights in strategic parts of the kitchen to aid with walking late at night. As with the bath, you may also consider the night lights that automatically turn on when the ambient light falls beneath a critical threshold. As a person ages more and more items on upper shelves may be out of reach. Facilitate easier access to upper shelves with step stool that also has a grip bar on top. Reinforce in your conversations with your loved one that stepping onto chairs to reach a shelf is always a fall hazard. If practical, move frequently used items to lower shelves or to the counter top. You may also consider the assistive grab devices that can be as easily used to retrieve items from floor level as to grab items from higher shelves. Check out Sammons Preston; beware of heavier items that may fall on the reacher.

Gripping may also be a challenge to individuals as they age, especially cast iron skillets – great for cooking, but hard to manage. With less manual strength, opening jars or bottles can be difficult. The gripping devices that fit over the lid can make turning or twisting a great deal easier. Check out kitchen and other supply stores like the Container Store. Similarly, there are accommodating devices that can help with cutting, can opening and other day to day tasks that require nimble hands or stronger grips. There also are nonslip bowls, cups, knives and more.

I had mentioned the potential for forgetfulness. If your loved one leaves the lights on or the ice cream out on the counter, they will not pose a hazard to their safety. If the gas stove is left on or an oven is left baking, these can be real fire risks. Consider getting portable timers that your elder can carry with them after starting the cooking. It is better that they have the time with them so that they will be sure to hear the alarm when it goes off that left behind in the kitchen where they may not hear it. And one more caution regarding the stove. If your loved one retains a gas stove, talk to them about avoiding loose-fitting clothes that could catch fire. And if there has been a real accident already, either disconnect the stove (with the help of a professional), or replace it with an electric cook top.

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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You have heard me make some pretty big claims, and you may think this one is over the top, but 80 year olds who run every day have the body of a 40 year old who does not exercise. I have seven suggestions that will help anybody to stave off the ill effects of aging and maybe even turn the clock back. 1. Re-engineer your Genes: We are programmed to age by losing about 5 pounds of muscle per decade and gain about 10 pounds of fat. Exercise experts tells us that we can retrain our muscles to act younger. In fact with just 6 months of strength training a body can learn to preserve muscle mass, in effect, rolling back the biological clock. 2. Re-learn to Lift Properly: Lower back injuries are among the most common maladies of older adults, because we do not lift correctly. Men should squat to lift with their toes pointing forward. Women should modify this with a slightly wider stance and with the toes pointing out more. 3. Confuse your Muscles. Mix up the exercise regimen so that your muscles do not stop using certain groups and overuse others. You have heard that doing brain puzzles makes the brain more nimble. The same can work for the muscles of the body by what trainers call "muscle confusion." The result is stronger and more agile. 4. Confuse your Brain too: Well not confuse so much as make both halves of your brain work with each other. If your exercise includes crossing your limbs over to their opposite side as one does in dance exercise or lunges or yoga, it further strengthens how your brain's hemispheres can work and respond to change. 5. The Important Muscle: When you work out aggressively, your heart works aggressively. Trouble is that most of us do not exercise the heart enough. Current guidelines suggest 150 minutes of cardiovascular exercise a week, but some new research suggest that optimal heart conditioning comes from closer to 240 minutes a week. More is better! 6. Impact is Good: Just as muscle density can diminish with years, so also bone density wanes over the years. This accounts for why astronauts lose bone density in zero gravity - no impact. Dancing, walking and jogging are essential for maintaining bone heath. 7. 10,000 May Not Be Essential: We have long heard that we are to take 10,000 steps a day. I know someone who tracks it with his phone, and there are people who wear pedometers to keep up the pace. Canadian researchers actually have moderated this to 7,500 steps a day - a bit over four and a half miles. Doing more is fine, but don't beat yourself up. This is where I have to add that you speak with your health care provider about any new exercise regimen just to be sure it is safe for you. But when your doctor says yes, look forward to winding back your clock. 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.