Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Geriatric Care ServicesChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 4

Everything to Lose
Not a day goes by that the sun does not linger a bit longer, that the landscape gets a...
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April 20, 2021
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Not Just Spring…
We’ve heard of Spring Training for those who follow baseball teams like the CUBS or the SOX, and we...
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April 13, 2021
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Three Steps to the Now Normal
Yes, it has been a long year, maybe in part because it has been more than a year of...
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April 6, 2021
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As If COVID Were Not Enough
We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the...
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March 30, 2021
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Diseases that Mimic Dementia…But Are Treatable-part 3
As you can tell from now a third installment about other medical conditions that can mimic dementia, it’s not...
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March 22, 2021
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Diseases that Mimic Dementia…But Are Treatable – part 1
Dementia is the condition that adult Americans fear the most, and tragically there are conditions that can give a...
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March 9, 2021
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Can I Have A Hug?
I doubt there is anyone who does not have something that they have not been able to do during...
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March 4, 2021
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A Game Where Everyone Wins
Pick your metaphor. If you want your knife to slice easier, you sharpen it. If you want to improve...
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March 2, 2021
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What Tony Bennett Can Teach Us
Tony Bennet has arguably been one of those “one in a million” kind of musical talents, but sadly he...
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February 9, 2021
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Scamming as a Superspreader
We have all seen the advertisements for the on-line services that will help you find your ancestry by taking...
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February 2, 2021
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In the Caregiver's Words

Recent Client Praise

I've talked about being on the lookout for signs of early onset dementia as we all begin our holiday gatherings. Dementia may be difficult to detect for a number of reasons. First, early onset can be evidenced in very subtle or small changes in behavior or recall, so it may be the accumulation of a number of tells that begin to tell us there is some slippage. Second, most of us are so fearful of losing our faculties that we tend to deny it or try to hide it from others, and after all who doesn't forget someone's name at some point? Third, loving couples tend to compensate or cover for one another. One partner may see the lapses in the other, but work to help their partner feel as empowered as they were before this decline. For all of these reasons, it underscores how we all should work to be empathetic and sensitive to the special needs of a loved one who may experience some form of dementia, because they can still function very well with some accommodation.

            So, once you do notice something or perhaps any number of things that are just not quite right in your older loved one, be sensitive about how you broach the issue...if you bring it up at all. As dementia sets in, it may cause a great deal of anxiety in the person with the symptoms. The anxiety understandably comes from a feeling of helplessness, and it is important to not provoke the anxiety into full blown defensiveness or angry outbursts. Here are three suggestions for friends, families, and caregivers on how to soothe an older adult with some form of dementia while maintaining a meaningful line of communication.

1.    As you plan the holiday gathering, think about the way these events have always been hosted in the past. Keep the surroundings and the routine familiar, and avoid noisy restaurants, especially places where the older person may be unfamiliar. If there has always been a certain way you prepared the pie, do it that way again, and you may be amazed how the tastes and the smells bring a wonderful memory back even to someone with memory loss.

2.    It may be appropriate to downsize the gathering a bit. In the past you may have invited a whole host of friends and family, but a smaller gathering of familiar faces will prove much easier for a person with dementia to navigate. While not every face will have a name for a person with dementia, familiar faces will put them more at ease.

3.    Appreciate that it is short term memory that is the most common casualty in dementia, but you can still talk about the early memories which everyone can replay and enjoy together. And it does not hurt to hear a wonderful memory repeated more than once at a family gathering.

            Finally, it is really all about family and sharing a positive moment, so be sensitive. If a story is repeated more than once you can indulge that. The most important thing to remember is to just enjoy the family moment. Follow your instincts about what has always been special in the past, and it likely will be pleasant for everyone again this year.

            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.
As a geriatric care manager, I am always alert to changes in people's eating habits and proper diet. As people age they naturally experience a decline in their appetite in part because their taste buds are not as responsive as they were when they were younger. Loss of appetite is also a potential sign of depression, and depression is one of the most common conditions older adults experience owing to the losses associated with their stage in life and aging. But if the diminished appetite leads to anemia owing to low iron intake, then there may also be a risk for dementia according to scientists. These scientists started with a group of over 2,500 mentally healthy women and men whose average age was 76. They then followed these people for 11 years testing them regularly for their blood counts and other mental function tests. At the outset of this study 392 people were clinically testing as anemic. By the eleventh year of this study 455 people had developed clinical dementia. These researchers also measured all study participants' age, gender, education, blood sugar levels (and diabetes diagnoses) and more than a dozen other biologic metrics. In statistical analysis they controlled for all these other variables and found that anemia still was a strong predictor of dementia beyond these other possible causes. In fact, of the people who started the study with anemia, they had a 49 percent greater risk of developing dementia during the 11 years of the study. What makes this study very compelling is that it is a prospective design. It is not one of the many studies we often see where scientists can ask questions about a person's background in an effort to explain a current condition. It also is a large panel of people for a study, so the chances a statistical error are reduced. What the study cannot tell us is what kind of treatment for anemia could "prevent" dementia. If you are a caregiver to an older loved one, what is the lesson to be learned from this research. At the very least it seems that caregivers should be watchful of their older loved ones' diet as a relatively easy way to rule out at least one potential cause of dementia. I have written about other steps that can be taken in other postings. Exercise and keeping mentally active are among those other steps that people of all ages can engage in to stave off mental deficits like dementia. 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.
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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a common topic of our discussion. I have asked Gregory Peebles to talk about this topic from the vantage point of his experience. 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 life. An Associate Care Manager, Gregory has been a part of our team for over a decade. – Charlotte Home. Not only is there no place like it, conveniently located wherever you hang your hat, that fits--like an old, comfortable shoe, but it’s also a place that once we leave, to which we can never return. While most find this very stressful, some are secretly happy for a new chapter. Indeed, lots of people confirm they like adventure, but small is the number who enthusiastically embrace major residential change. So what’s the difference? Well, for one, the direction of action: people elect to go on adventures, but change just seems to happen to us. This is a major life change, and those inclined deserve the opportunity fully to grieve their loss of home sweet home. However, once the initial grief has been addressed, we’ve got work to do! Change isn’t the end, and there’s plenty of life and happiness yet to be found no matter the location. Where that happens is up to you. The diversity of the experience of aging can be exciting, and, with the number of Americans joining the group of aging adults, the kinds of communities that now exist will only become more varied. Right now the kinds of accommodations available generally fall into a few groups.
- Active Adult Communities – Often neighborhoods with individual bungalows, these communities are based on the model of so-called “snow birds” who opt to transition to such a residential community rather than maintain a larger space. Living in one of these communities requires a high level of independence (and income). Individuals or couples with highly social personalities thrive in this setting.
- Independent/Congregant Living – Facilities of this type, while slightly less luxurious than an Active Adult Community, feature many of the same accommodations with a denser population. In an urban setting, they are often high-rise apartments indistinguishable from nearby housing, with dining, health care, and leisure activities on the premises. If considering this type of facility, be sure to keep nearby entertainment and accessibility in mind.
- Assisted Living – A senior for whom it has become difficult to care for themselves either because of physical limitations or decreasing independence will often find an exciting new life in such a facility, either through public assistance or private pay, where skilled staff are present to provide diverse care. If the care receiver is also living with cognitive decline, such a facility with a “Memory Unity” may be advisable.
- Skilled Nursing – On average, aging adults who become residents within skilled nursing facilities – SNFs - are those who have health problems, who require 24-hour care, and whose ability to manage the Activities of Daily Living is severely impaired. Nursing home care, too, is expensive, but public assistance programs such as Medicare or Medicaid relieve the cost.
Change is difficult, but not unmanageable. New identities await us and are only limited by our willingness to embrace them and the imagination we bring to our experiences. Change is scary, and rightly so, but when we weather even the most difficult transitions together, and our lives are no longer recognizable from before, we may--if we choose to--learn that home is something that we take with us wherever we go, and that it is recognizable not by its address, but by the love shared and the people with whom we share it, common to both our memories and our futures. One final thought: This is when people often reach out to Aging Life Care Professionals to help smooth the transition to a new residence and to ensure ongoing care. CCM has helped countless families like yours succeed in this new chapter. Contact us today and let us assist you. 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.
You know what makes a real difference between grade school children and adults over the age of forty? We could go down an entire list of physiological and intellectual and stature differences, but there is one you may not have considered, because it’s in your head. Ask most kids in primary school how old they are and you’ll get a fair bit of “I’m going to be ## in whatever month their next birthdays are. Ask someone over forty a similar question as a group of Danish researchers did of 1,470 study subjects and it flips pretty dramatically the other direction. On average, these researchers got answers that were 20 percent younger that the subjects’ actual ages. Across all of these study subjects the age deflation was a fairly consistent 20 percent difference which led the researchers, and probably you as well, to ask, “Why a consistent twenty percent?” What age do you think yourself to be in your head? I attended a seminar a number of years ago, and one of the lectures was from a recently-retired university professor who introduced his session with a simple rule: “You have to get older, but you don’t have to act your age.” He promptly plopped a beanie on his head and proceeded to elaborate. I spoke with him on our break and asked him what motivated him to retire from his tenured position and his university and take his subject matter to other venues. I did not then know to ask him how old he thought himself to be, but his story suggests that he wanted to put a brake on aging. His best friend on the faculty had died in the past year which gave him pause to take stock and reroute his life. Or, did he refuse to get to be “that age” but changing lanes to a track that felt more vital, younger? This is not an uncommon story line for “aging adults,” although the details of each person’s story will be different from the others. Some of this phenomenon may also be that our society tends to discount what an older adult can bring to the table. Ask anyone who still wishes to stay on their career path into their sixties or seventies…until they report to that new 35 year old manager. Our society and most western societies tend to attach less value to older workers’ wisdoms. Yet, Asian cultures celebrate age for its place within a hierarchy where chronological age is correlated with prestige. Their brain age to chronological age gap is also smaller and smaller yet is the gap between how old an individual is and how old they feel in their minds in Africa. These latter also tend to be a bit more culturally homogeneous and socioeconomically more homogenous as well. All of this does underscore that age divide, but it should not stop you from enjoying the gathering for your next school reunion or the music they play that “takes you back” to your youth. At the end of the day we are all an accumulation of countless experiences across our years, and you should feel to travel back to whenever you want. To answer the title’s question, what’s in your head may be worth revisiting whenever you choose. Enjoy your trip! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, LLC, 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.
If I were to ask for a show of hands, I don’t think anyone would say they actually wish to be diagnosed with Alzheimer’s Disease or any related dementias. And yet there are a number of lifestyle and health choices that each of us makes any given day that make us look a lot like “dementia volunteers.” Let me share with you some of what the Centers for Disease Control and Prevention (CDC) has found when they dug into the preventable risk factors for dementias that Americans report. In 2019 the CDC surveyed 162,000 adults 45 years of age and older about a range of lifestyle and healthstyle habits that can impact a person’s likelihood of developing Alzheimer’s disease or related dementias (ADRD). The most common factors that can precipitate ADRD are high blood pressure and failure to engage in regular aerobic physical activity. Almost half of those surveyed fell into this risk category, and another one-third reported being obese, almost one in five had diabetes, and nearly as many were chronically depressed. But that’s not all. One in ten of these adults were binge drinkers, 11% had hearing issues and 15% smoked cigarettes. What effect do these “lifestyle choices” have on the risk of developing ADRD? For starters, one in every nine of those in the study reported subjective cognitive decline, a strong indicator of later ADRD. For those with no risk factors from the list above, their risk of developing subjective cognitive decline was only 4%, but that risk rose to 25% for panelists who had four or more risk factors. Looking at just those with subjective cognitive decline, more than one third had four or more risk factors. It extended to the other risk factors as well. Compared with the base, three in ten of those with depression, one in four with hearing loss and one in nine reporting binge drinking also reported subjective cognitive decline. So, it’s a veritable checklist to reduce the risk of these serious cognitive issues. Think of such measures as the equivalent of using seat belts in cars. Their use is up to the driver, but using them makes a huge difference in the event of a crash. Seat belt use in the most recent year available from U.S. government sources reduces death by 45% and serious injury by 50%. Buckle up! Other research in UK found that modifying 12 risk factors – yes, there are more – over one’s lifetime prevents or delays 40% of dementia cases. So, review this list with an older loved one - or any loved one for that matter – and manage your way and their way to better cognitive health. What you do will make a measurable difference for everyone. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.