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

Why a Flamingo Stands on One Leg
You’ve all probably heard the old joke about why a flamingo stands on one leg…and we have all seen...
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June 28, 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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Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out...
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June 7, 2022
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0
Act Now to Prevent Dementia
If I were to ask for a show of hands, I don’t think anyone would say they actually wish...
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May 30, 2022
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0
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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0
Is It Medicare (Dis)Advantage?
That’s not covered. The estimate is that about 28 million older Americans have opted out of traditional Medicare and...
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May 3, 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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Heavy Drinking Helps?
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: ...
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April 19, 2022
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When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
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April 12, 2022
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Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
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April 5, 2022
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In the Caregiver's Words

Recent Client Praise

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.
How about a free genetic test to learn more about your ancestors? Free… And finding out about the people who no longer are alive to tell their stories? And your older mom or dad figure why not... Well, identity theft is why not. How many of you have taken the test to find out more about your ancestors? You know, the one where you offer a sample of your saliva in a tube, mail it off and they return a “report” to you that details what they know about where other people with similar genetic profiles call “home.” Most people find they have ancestral roots that go back to a lot of places, not just the family homeland they heard about as children. So, of course, scammers would be finding a way to use this test which is supposed to put us all on the map in order to defraud unsuspecting elders. The U.S. Department of Health and Human Services Office of Inspector General has sent out an alert. Scammers are offering people qualified for Medicare to get the same test that you or I may have paid for on-line. You may have thought your older parents were pretty insulated from this kind of scam, but here is how it works. We’ve all been to the public health or “aging well” events where a roomful of professionals are giving away books on senior residential options, refrigerator magnets, sticky note pads and a cool bag for carrying home the haul of freebies. There are other ways like telemarketing and door to door calls, but scammers are offering the unsuspecting older individuals a free cheek swab by simply providing their Medicare identity, and the target who does not recall that they no longer need to provide their social security number don’t hesitate to offer that in exchange for an ancestral map. Well, it becomes an access point to a different kind of map, your loved one’s financial map. And with the address and social information, scammers can begin the kind of work they do all too well. So, prepare your older loved one to be vigilant about:
- If a testing kit arrives at your loved one’s home, tell them to not do a thing if their physician did not request a test. Better yet, take note of the address of return and report it to the authorities.
- If a stranger offers a genetic test and…by the way…asks for a Social Security or Medicare number, stop. In fact, anyone other than a physician’s office or lab should not be given any of these pieces of identification.
- If anyone asks for Medicare information, and they are not a medical provider to your loved one, beware. So, this is more than saliva in a test tube. If you suspect Medicare fraud, depart the Office of the Inspector General of the Department of Health and Human Services.
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.
We all know that Boomers - who began reaching age 65 just two years ago - are the largest segment of the U.S. population. Aging boomers are expected to total about 71.5 million by the year 2030, but what you may not know is that as many as one in ten of the Silver Tsunami will be lesbian, gay, bisexual or transgender (LGBT). This is important, because the generations that preceded them who were LGBT simply accommodated the "closet" when they aged. Never mind the ageism and racism we still find in some quarters, a lot of the institutional providers for seniors may not yet have embraced a welcoming culture for people of alternative gender preferences. As a geriatric care manager, I see this as a perfect storm with three fronts, a storm which has the potential to create one of the largest threats to aging well - social isolationism. If you are a caregiver to an older LGBT partner or loved one, you will need to be alert to the potential challenges. For instance, there are likely to be limited or no programs for alternative lifestyle older individuals in rural or suburban areas. And the gay male experience of aging is exaggerated among men where there is a more pronounced premium on being attractive or desirable. Generally speaking being 40+ among gay men can be seen as equivalent to being 80+ in the straight community in terms of being marginalized. The social isolation that is a consequence of "premature aging" and marginalization also increases the gay population's risk for depression, substance abuse, low self-esteem or even suicide. The rate of suicide among gay men is about six times that of straight men. LBT women may have it even worse. More than one-third, according to recent surveys, say that they have not divulged their sexual preferences to their health care providers. They also are less likely than gay and bisexual men to have purchased long term care or life insurance. About one in five LBT women are caring for an aging partner, but they also feel less prepared financially than gay men for retiring. Put all these factors together, and the LGBT community is less inclined to seek attention for health issues for fear of hostile or judgmental providers. Poor health care translates into even earlier institutionalization in long term care facilities. Also, it is ironic that in national surveys that nearly three in four LGBT individuals anticipate that they will be caregivers to another person, but one in five are unsure they will be cared for themselves when the need arises. Adding to this potential caregiver shortfall, many gay couples simply do not have conventional family to care for them. If you are a caregiver to an LGBT elder, encourage the following: • They have a Last Will and Testament that is really according to their "will" o With clear advanced directives/living will • Their partner/spouse has Durable Power of Attorney (health and finance) • Informal caregiving arrangements are clear and followed • Priority rights for hospital visitation are followed • There is Joint Ownership of Property with Rights of Survivorship And for us all: Recognize that all humans deserve compassionate care which respects their personhood and their definition of family and their wishes. 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.
Chicago Retirement Community Experts
With over two decades of experience in elder care services, we have assessed and developed close relationships with the best retirement communities in Chicago and its surrounding areas so we can connect you with the best of the best.
Life in a Retirement Community
If you are considering transitioning your elder loved one to a retirement community in Chicago area area, you know that choices are plenty and oftentimes it’s not clear what is the right choice. That is where we come in. Our Chicago elder care specialists work to ensure the best living arrangements possible for your loved one.
What is a retirement community?
A retirement community refers to a housing complex or building of older adults living independently surrounded by their peers, without any extensive outside assistance. Life in a retirement community is about convenience and the independent freedom to connect socially with other retirees in a safe and relaxing environment. Residents are free to explore their surrounding communities, and many of them maintain and operate their own vehicles.
Is retirement community right for you?
If your elder adult is interested in the freedom of independent living with the benefit of being surrounded by their peers, a retirement community may be what they are looking for. However, to make sure this is the ideal arrangement for your loved one, we always begin by conducting a thorough evaluation of their lifestyle preferences, their physical and mental state, and even an associated budget. Then, based on the information we uncover during evaluation, we develop a personal geriatric care plan for your loved one and present top choices for retirement communities in the area. We even take care of the application paperwork for you. We know that trying to maintain a balanced lifestyle, while taking care of an elder loved one is difficult, but if you have the right people helping you, it is doable. So, contact our geriatric care managers today for a free initial consultation and let us help you make your life and the life or your elder loved one balanced and stress-free.
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Recent Client Praise

We see the numbers on a daily basis. How many have died from COVID, to date, we all probably know is more than 372,000 in the United States alone. The number who have had the disease and survived is a bit more murky, because not all cases are detected or reported. We know how many have been vaccinated: about 40% of eligible Americans have had at least one dose so far and about one in four Americans have received both doses. We all have been making the push to that finish line to be rewarded with a 94% immunity from COVID. The number that has not been broadcast as much, if at all, is the number of people who have lost a loved one to COVID…not just known of someone as almost all of us do. The number of people who have lost a dear family member or friend is estimated to be about nine individuals for every person who has succumbed to COVID. Do the math for our own domestic turf, and that is well over 3 million Americans who have been … and likely continue to be … grieving for a loved one who has died. Some people may say that these losses … well … just happen, and people eventually get over it or through it. Hold that thought, because scientists have studied the biological effects of grief and found that grieving is actually life-threatening. Sure, we probably all realize that grief can lead to depression which is not to be taken at all lightly. But it also leads to changes in the immune system and it triggers inflammation in the entire body. Chronic inflammation in the body also can lead to cardiovascular disease, diabetes (type 2) and even some forms of cancer. We don’t see this from the outside, but it is analogous to instantly becoming morbidly obese; grieving is the same kind of ticking time bomb. So, what can we do if we have had this kind of loss or know someone who has lost a loved one? A grieving person will not move beyond that sense of loss, but they will – often with professional help – move forward able to retain a loving memory that walks alongside the loss. So, people don’t get over grief nearly so much as learn to move forward with it. Lora McInerny is the host of a really helpful web site whose name speaks volumes. It is titled, “Terrible. Thanks for Asking.” She had been through a deep personal loss, and had just a few too many people ask the wrong question, “How are you doing?” Some even chimed in with the cliché, “These things happen for a reason.” A better question can be “What did you do today…or yesterday?” or “What have you been doing?” You get the picture. If you have not experienced a loss, there is a good chance that you know someone who has. I recommend you visit the web site. Make someone’s day better. 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.

Why a Flamingo Stands on One Leg
You’ve all probably heard the old joke about why a flamingo stands on one leg…and we have all seen these lanky birds if we’ve ever been to a zoo. The answer is simply, “If they lifted the other leg...
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June 28, 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. ADRD is a term in common medical use that captures a number of conditions whose hallmark is cognitive decline: Alzheimer’s...
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June 21, 2022
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Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out of the woods yet.” In fact, our scientists/pathfinders cannot tell us how far we may have to go to truly...
Read more
June 7, 2022
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0
Act Now to Prevent 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...
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May 30, 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 business has more facilities than McDonald’s, Dunkin’ Donuts and Taco Bell combined, and saw almost universal closings during the pandemic? ...
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May 24, 2022
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When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor you want more roles in more productions, because more visibility means better contracts. If you’re a working professional, you want...
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May 17, 2022
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Is It Medicare (Dis)Advantage?
That’s not covered. The estimate is that about 28 million older Americans have opted out of traditional Medicare and for what are called Medicare Advantage plans. They are not just Medigap which came about soon after Medicare was enacted...
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May 3, 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 three of these they follow. Your LDL, the one that can gum up arteries, is the more worrisome, but it...
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April 26, 2022
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A recent report from the Congressional Budget Office created a bit of a stir among geriatric care managers, because it predicted that the dollars spent on nursing homes and longer term care will amount to 3.3 percent of gross domestic product (GDP) by the year 2050. It is true that in the most recent year for which there is data, Americans spent $192 billion on these living environments, or about 1.3 percent of GDP. This past May, the National Association of Professional Geriatric Care Managers asked its members if we had an opinion on older adults moving into nursing homes in such numbers. However, there are alternatives:

The best thing older adults can do is make a plan. We all make vacation plans and maybe even retirement plans; we need to make plans around aging in place while still preserving quality of life.

Next in line is taking stock of home. It is easy to not see that the home in which parents raised a family just doesn't work as well for older adults who may have some mobility issues - hint: an elder care manager can help.

With an objective picture of the home layout, set about making home a safer and easier place to live than it is now. Grip bars in a bath room, extra lighting in the halls and ramps instead of stairs can be a start.

And it is important to remember who actually is going to live in the home. Well-intentioned children of older parents may want to come in and do a "home-makeover," but it is really important to help mom or dad lead the team.

And just as it takes a village to raise a child, there are resources and people in your older parents' community who can provide support. If you don't know what services or agencies can be brought in, again ask a professional. (We also have some listed on our "Support Tools" page of this web site.)

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 ccbishop@creativecasemanagement.com.
Pick your metaphor. If you want your knife to slice easier, you sharpen it. If you want to improve your time in a race, your train harder. If you want to improve your golf drive, you practice. What all three of these have in common is that if you invest a bit of time in a thing, you will have a better outcome. If you go to the Chicago Children’s Museum website they offer a clear mantra, not just for kids, but for all of us: “When we play, we learn. We create. We strengthen and grow. Chicago Children’s Museum’s mission is to improve children’s lives by creating a community where play and learning connect.” The museum may not be open during this pandemic, but the mission still applies. Research published in the New England Journal of Medicine has demonstrated a clear link between physical and mental activities and reducing the risk of dementias. And other scientists have replicated these findings that playing – both physically and mentally – is a great way to stay mentally sharp. I recommend any or all of the four V’s as ways to defend against dementia:

Visualization – the classics here are chess and checkers, but there are countless card games that can qualify as well. Linking what you see in your hand or on the board with planning for your next move keeps your brain sharp.

Verbalization - yes, it is about conversation, but up your game by being creative. When my kids were very young, we would ask at dinner about what they had learned at school or the best thing that happened…story telling.

Virtualization – board games have come a long way since checkers and chess. They often offer challenges to find or accumulate or decipher something. They even have a new one in the current age called Pandemic: check it out.

Visitation – even with the rollout of vaccines, we may be slow to get back to “normal,” but computers and cell phones give us visual and audio contact with the world. Check into what others are doing, and share your stories too.

And you can tie some of these together. We have played some games with our adult children on Zoom, and yes, they are still amazed that we can beat them on occasion. I have an associate who is committed to putting stories to the photos in his album, and he has some really great stories to share. The brain also benefits from a good workout. We may not be able to go to gyms without putting ourselves at risk, but walking, running, even workouts with zoom masters can be not just a tension reliever, but also a brain enhancer. 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.

Dr. Oliver Sacks explains neuroplasticity in his editorial, “This Year, Change Your Mind,” in the New Year’s Day editorial page of the New York Times. As a geriatric care manager, I have encountered clients whose injuries have induced deficits of some sort from which recovery plans are designed and executed. Physical injuries such as lost limbs, vision, hearing or others have fairly clear rehabilitation trajectories, and the injured individual can learn and work through them to recover as much of a productive life as possible.

Neurological injuries like those Dr. Sacks offers as examples require remolding an organ that we do not see from injuries that also may be invisible. As Dr. Sacks explains, neuroplasticity offers the means by which the brain can remold itself to overcome a deficit. For a geriatric care manager, the deficits do not have to be as dramatic as a spinal cord injury, the onset of blindness or even a stroke. We see every day the consequences of older adults’ inactivity and the cumulative deficits that can grow out of the under stimulated life. The brain does lose some of its pathways through natural attrition, and it is critical for a vibrant life for the aging individual to keep working in order to maintain the pathways they already have as well as to create new ones as some of those may become unavailable. A colleague likens it to commuting in the brain. There may be detours and rerouting, but an active individual will always find a route home.

There is a case of a 70+ year old client whose spouse is suffering from Alzheimer’s inexorable progression. While there is little to do to forestall that condition, he takes it upon himself to exercise at his facility’s gym three times a day, he is a voracious reader and he is an active participant in his wife’s care team so that he can be both physically and mentally able to care for his wife to whom he is entirely devoted. Or the 90+ year old woman who will keep up with her grandchildren when they come to visit – as exhausting as it may be. She is a brilliant conversationalist, she rarely repeats herself and she completes the New York Times crossword puzzle. What do they have in common? They both push the boundaries of the envelope.

They both are pushing the plasticity of their brains.

Dr. Sacks exhorts us to “change our mind” this year as part of our 2011 resolution. I would expand that to include all of those on whom an elder or person with special needs depends, and encourage those caregivers to help push the envelope for those in their care in order to effect a change of mind and a robust life in 2011 for all.

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.

Copyright ©2011

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I have a small pillow in my living room that speaks to me. In stitched letters it says, "What? Chocolate is not a food group?" My family knows that one of my favorite "food groups" is chocolate, and I don't mean because I am on a health kick looking for the benefits of dark chocolate; I just like good, old-fashioned milk chocolate. But let me tell you that when I have a chocolate craving, my body may really asking me for something more than my brown, sweet treat.

There is a growing body of literature that explains many of our cravings as our body's signals for what it really wants; we just don't speak the language. We fail to translate the cravings in quite the way our bodies are trying to communicate. This has real implications if you have an older loved one for who you are a caregiver. As one ages the taste buds become less sensitive, and appetite wanes. And if you are taking your older loved one's interest in foods or cravings too literally as you listen, you may think you are satisfying their body's nutritional needs when, in fact you are not. Let me start with my own craving.
1. Chocolate. If your elder expresses a craving for chocolate, they may really be translating their body's need for magnesium, a very important electrolyte in the human body. While chocolate can offer some magnesium there are better sources. Chocolate is okay - thank goodness - but your body will benefit from a variety of magnesium sources such as certain vegetables, nuts and seeds. So if your elder has a regular craving for chocolate, try offering legumes, nuts and seeds to avoid the sugar and fats that accompany the magnesium in commercially-available chocolate.
2. Potato Chips. I see this in our household where a certain family member would prefer a bag of potato chips rather than a handful or two. So much for portion control. Potato chip craving may actually be an expression of an iron deficiency. This kind of deficiency triggers a craving for crunchy foods, and potato chips -while crunchy - come up short. Iron-rich alternatives include dark meats, fish, poultry and darker green vegetables. And this overlooks the huge intake of sodium that potato chips offer and nobody needs.
3. All of the Above. This is where the psychology gets interesting. Let's say your older loved one can still smell the peanuts that you just had, but they had been disciplined and translated their craving into having a portion of raw carrots. But a half hour later, they still can all but smell the peanuts and they cave in and subsequently gorge on the peanuts. They should actually feed some of their craving when it expresses itself, but in moderation. That still leaves room for the healthy foods they will eat later and moderates the caloric intake that has become such a national epidemic.
At the end of the day, it is about balance and understanding what our bodies are telling themselves. If you are that caregiver to an older loved one, don't become the food police, but perhaps there can be a role for a food translator to help them understand their own bodies' language when cravings make their voices heard.
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@cr eativecaremanagement.com.
We’ve all heard someone explain…typically referring to that paunch around our middle…that their “metabolism has slowed” from what it was when they were younger. There are changes that accompany everyone’s journey from teens to middle years and beyond, but our metabolic rates aren’t a big part of the change. In fact, the resting metabolic rate (RMR) of humans doesn’t change much from our early years in the mid-20s to as old as our 40s and 50s. Metabolic change really begins to trend slower about age 60 when the cellular metabolic rate begins to trend down about .07 percent a year…it will take about 14 years for the metabolic rate to decline by one percent. But what changes? Well, the human body is constantly at work breaking down muscle as well as building it up, but an older body requires a higher threshold of protein consumption to kick the muscle-building apparatus into gear. This happens at the same time that older adults’ appetites may be waning. The “younger you” could build muscle from a breakfast that included a couple eggs…about 12 grams of protein, but if you are 60 or older your body needs a bigger signal to turn on the muscle-building machinery. In fact, it takes about 25 grams of protein to get things in motion. And breakfast is the best time of day to kick the machinery into motion…for the whole day. The consequence if one doesn’t give the body’s machinery the right protein cues is a consistent decline in muscle mass, as much as 3 to 8 percent decline per decade. The cycle continues also to create more fat instead of muscle if we don’t hit the protein manufacturing threshold. And other ill effects can kick in. Because muscle cells burn more energy than fat cells, a shortage of muscle cells leaves more sugar in the stream which both build more fat and overloads the pancreas as it tries to process the sugar. And you know the rest of that cycle – it’s called type 2 diabetes if carried too far. Talk to your older loved ones about getting more acquainted with where their protein is coming from and in what quantities. A useful bar to set would be about 25 to 30 grams of protein consumed at every meal every day, but especially breakfast. Compliment the protein with colorful fruits and vegetables which will add inflammation-fighting to their diets. Top all this off with fiber, not dessert. The best sources of fiber are in the legume and related families of food. The rest is strength training. I recall a human-interest news story from some time ago in which a WWII vet was talking about his secret – 20 push-ups a day and 10,000 steps. He continued to be in great shape, and a great role model for all who wish to live well in order to age well. 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.