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

The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
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January 25, 2022
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After COVID, What Next…Parkinson’s?
We are all too familiar with the alarming death rates of those who contract COVID, and the hyper-transmissibility of...
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January 18, 2022
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It’s Not a Resolution – It’s Self-Care
A caregiver to an older loved one or other person with special needs takes care of everything, right? A...
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January 13, 2022
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Not Where You’d Expect Protection from Dementia
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there...
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December 28, 2021
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If It’s Not Happy or Merry?
I explained in an earlier post about why we refer to Holidays in the plural, and how we are...
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December 14, 2021
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Making Your Holidays Happy Again
Yes, “holidays” is a plural word here. Please allow me to digress on this plurality and simply point out...
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November 16, 2021
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A Head-Healthy Diet
When we speak of dementia, it almost invariably is about Alzheimer’s Disease, but there are multiple types of cognitive...
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November 9, 2021
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Cognitive Improvement without Losing Sleep
It seems you can’t talk with anyone about aging these days without the subject of cognitive health or dementia...
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November 2, 2021
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Password Protected?
I often offer advice on how to help your older loved one with challenging tasks or how to protect...
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October 26, 2021
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Confused to Be Fit
Confusion usually means we’re not getting something right, but in physical training and even physical therapy, muscle confusion can...
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October 12, 2021
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In the Caregiver's Words

Recent Client Praise

In my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved ones to find meaningful quality of life. In part, that may translate into helping a loved one to find social and age peers within their communities as their lives and perhaps even the meaning of quality of life may have changed. It also can extend to their desires for maximal independence, developing or preserving meaningful friendships, or even finding personal connections or intimacy. Intimacy? Yes, and you may have thought that your first talk with your parents about sex when you were an adolescent was awkward. Hold on.

As a geriatric care manager, part of the job description is about helping older clients with the challenges of aging, and part of it is about helping caregivers to appreciate their loved one's changing predicament and embrace those changes as well. "Mature intimacy" is one of those dimensions that call for equal portions of each.

If you have an older loved one who is single and wants to have a meaningful relationship, you likely need some guidelines:
1. The first thing you need to do is set aside the old "tapes" that may be in your head, your old beliefs about what intimacy is for you or was for your older loved one. Things are different now.
2. Now, turn that around and appreciate that your older loved one's early experiences will not guide their quest for a meaningful relationship now. The world has changed and age also has intervened. As a caregiver, you can gently help them to feel more comfortable with life's changes.
3. Appreciate that you may be asked about life and intimacy, and if you are not comfortable talking about it with your older loved one, encourage a conversation with the family doctor or a counselor or even sex workshops in some communities.
4. If you do break the silence remember that intimacy is more than intercourse. Just touch - as in holding hands - is something that older adults may long for. Try to set aside arbitrary expectations about what sex is that are based on what sex was. Encourage your older loved one to relax and enjoy the company.
5. Recognize your limits as a caregiver. A lot of parents had their children read books about intimacy before having "the talk." There are books available for mature sexual encounters as well (e.g. "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only).
6. Safe sex is critical in a time when STIs are potentially everywhere. There is a web site called SaferSex4Seniors. They also are on YouTube.
7. There are professionals who can help your older loved one. Check out the web site for the American Association of Sexuality Educators, Counselors and Therapists.
Now, that was not so bad was it?

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.
I like Simple. If you do also, then you will like the American Heart Association’s and American Stroke Association’s “Life’s Simple Seven.” In short, what they find is: what works well for cardiovascular health also shows the promise of working really well to stave off dementia caused by strokes, vascular dementia, and even Alzheimer’s disease. If you have an older loved one whom you would like to see have a healthier heart, you will get the added benefit of a healthier brain by encouraging the Simple Seven. And there is a bonus...it also will work for you! The seven steps that have been recommended to improve heath health now also are considered as important to improving your brain’s health. "Life's Simple 7" are considered to help prevent dementia caused by strokes, vascular dementia, and Alzheimer's disease. They have been chosen by AHA and ASA as metrics to help confer brain health. "…the same risk factors that cause atherosclerosis are also major contributors to late-life cognitive impairment and Alzheimer's disease," commented Philip Gorelick, MD, Mercy Health Hauenstein Neurosciences in Grand Rapids, Michigan, chair of the advisory writing group. The seven steps are a combination of individual characteristics and behaviors that help to foster better brain as well as heart health: 1. Don’t smoke 2. Be physically active 3. Maintain or reduce body mass index to less than a 25 on the scale 4. Have a healthy diet – there are guidelines for this 5. With a combination of exercise/reduced weight have a blood pressure of <120/80 mm Hg 6. Without meds (but with diet and exercise), have a total cholesterol <200 mg/dL 7. Maintain an A1C (fasting blood glucose) < 100 mg/dL Before this most recent analysis, researchers tended to look at brain health and heart health as pretty much different conditions caused by different lifestyle or health behaviors. But "over time we have learned that the same risk factors for stroke that are referred to in Life's Simple 7 are also risk factors for Alzheimer's disease and possibly for some of the other neurodegenerative disorders," Dr Gorelick noted. All of this is a step toward better brain health while at the same time promoting better heart health. This is one of those fortunate opportunities where a person can get two for the price of one. Take better care of your heart and you get better brain health as a bonus. Take better care of your brain, and your heart also gets a benefit. Not a bad bargain for anyone who is a bargain shopper…no coupons required. Be healthy. 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.
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For so many medical conditions, the package inserts - that thin white paper with the fine print - for doctor-prescribed medications say that "diet and exercise" are first line. This applies to medications used to treat high blood pressure, weight loss or even type 2 diabetes. Would it surprise you to hear that diet and attitude are first line defenses against dementia or other cognitive decline? More and more research is pointing to the importance of the foods we eat as well as our outlooks on life as preventive measures to forestall the onset of dementia. Start with cynicism. Researchers in one study started with a group of more than 600 people whose average age was 71.3 years at the beginning of the study. Initially, the researchers collected data on the patients overall health, their levels of cynicism (yes, you can measure cynicism) and their cognitive statuses using validated scales. Over the course of 8.4 years, the researchers continued to assess all patients' levels on all these metrics. At the end of this time frame, 46 of the original number of patients had, in fact, developed dementia. The scientists adjusted for age, gender and depression, but still found that individuals who started out this study interval with higher measureable cynicism were statistically more likely to develop dementia. Moreover, about two years later more than half of the study participants had died, and those who had been classified as statistically more cynical were more likely to be among the number who died. Switch gears now, and another study based out of Rush Presbyterian Medical Center in Chicago found a positive link between people with quantifiable "purpose" in their lives and their ability to live dementia-free. This study followed about 1,000 people age 80 for about seven years. It measured physical, psychological and cognitive aspects of these patients over the duration of the study. These subjects also agreed to donate their brains for further analysis upon their deaths. At the end of the seven years, the researchers found that those with the highest scores on "purpose" were 2.4 times more likely to remain free of any signs and symptoms of Alzheimer's Disease. These subjects also were less likely to develop mild cognitive impairment, one of the early signs of impending Alzheimer's. Those with high purpose also had had a lower mortality rate than the others and had fewer disabilities as they aged. When the patients did die, the doctors performed autopsies of their brains. Even among those who had manifested no signs of Alzheimer's on cognitive tests and had maintained measurably higher levels of "purpose" some still had the plaque of AD on their brains. The conclusion was that the patients with purpose could more readily work through the deficits and maintain higher functioning cognition. The moral? We often hear people talking about the importance of attitude. And a good attitude certainly enhances the quality of life of those around the people with good attitudes. Evidently, it is also very good for the health, mental functioning and longevity of those with the positive attitudes too. 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.
This marks the 100^th posting on our blog since its inception October, 2010, and it gave me pause to stop and reflect on what one learns at 100. So, whom better to ask than people who have had 100 birthdays, made it to that milestone and have been paying attention along the way. I have gathered together here a short compilation of wisdom from some centenarians whom I felt had something to offer the rest of us. You tell me what you think.

    Ruth offers advice on life and style. Appreciate that Ruth lifts weights everyday and practices Pilates weekly, an activity she just picked up when she was 92. Perhaps her most memorable piece of advice is about time and age; she says, “Don't look at the calendar just keep celebrating every day.” This, from a lady who does not wear blue jeans and makes herself get up and out every day for at least a short walk. (And she is a real believer in the values of skin moisturizer.)

    Ephraim is a doctor still in practice at age 100 His advice to all of us starts with choices. The two important choices that top his list include “choosing the right parents” and then “choosing the right spouse.” The doctor still has a sense of humor, and you will appreciate that if you go to his site to see the rest of his advice which include “keep breathing.”

    Jessie is the other side of 100 at 105. She commends that peace is the root of happiness. She does not count her time in years, but rather in minutes and the promise that each minute holds for her. She also stays active and only just recently gave up her favorite activity, swimming, at the age of 101.

    Patsy is a quiet man at age 100. His secret is to simply enjoy life. Part of that includes his weekly treat from the local pizzeria, one slice of thin crust sausage pizza. And when he is asked what he means by enjoy, he responds: “I like to be sociable with everybody.”

    Fauja finished the Toronto marathon last year. This stands as a Guinness record, and Mr. Singh was very excited to make the distance on behalf of local charities. Perhaps the secret to being able to run that far at age 100 is to not start, as Mr. Singh did, until you are 80 years old and also to surround yourself with friends as Fauja did for his run.

So, the common thread? Maybe the lesson we can take from centenarians is that it is not about a destination as much as it is about a journey. It is not about having lived to 100; it is about having lived each day along the way.

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 .
April showers are supposed to bring May flowers, but what does May bring? It brings Mental Health Awareness Month…among other things. If you are a caregiver to an older loved one, this is particularly important. Mental illness – particularly depression – is a high risk for individuals as they age. One out of every four older adults has some form of diagnosable mental illness in any given year. About six percent of older adults manifest some form of clinical depression, but older adults can also respond to talk therapy and medication for their mental health issues at rates comparable to younger adults. Yet, older adults more often go undiagnosed and therefore untreated. Some people have a lifelong battle with a mental illness like depression, but for many more it may be precipitated by a condition like stroke, Parkinson’s disease, diabetes, cancer or arthritis. But older adults also have a life that has accumulated losses, most specifically they have lost friends, family, loved ones. We all probably know that the average life expectancy in the U.S. is just under 79 years…that means that the typical 79 year old has lost half of their friends and family by that time. The rate of suicide for 75+ year olds in the U.S. also is higher than any other younger cohort, in part because those over 65 have a “success rate” in their suicide attempts that is five times more lethal than those who are younger. This is not to depress you; it is a wake-up call. It will be up to those of you who are caregivers to older loved ones to look for the signs, because only half of depressed patients are diagnosed by their primary care physicians and only half of patients who discuss any depressive symptoms with their physicians will get any treatment. So, what should you look for?
- Any signs of a sad or “blue” phase that lasts more than a couple weeks
- Difficulty remembering things or confusion in even familiar settings
- Self-medicating with pain medications or alcohol
- Perpetual worries around money or health or loved ones
- Sustained challenges sleeping or concentrating
- Intense caregiving for a loved one that is not allowing them to “get a break”
If you see any of these signs, bring them to your loved one’s physician’s attention…and be persistent if the signs and symptoms persist. Sadness or depression are not “just part of getting older.” Eighty percent of older adults who are diagnosed and get treatment recover from their depression. Your “mental health awareness” can be their mental health cure! 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.