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

Driving with Dementia
I was at an event this past week and had a conversation with an attendee about her parent and...
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November 26, 2019
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Alzheimer’s Disease State of the Nation
It is sadly ironic that it was former president Ronald Reagan who designated November as National Alzheimer’s Awareness Month...
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November 20, 2019
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Dementia Quiz
Which of the following regarding what we know of dementia are true? Adolescent personality traits predict later onset dementia....
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November 12, 2019
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All Cause Dementia in Three Seconds
November is National Alzheimer’s Awareness Month. We also shift from Daylight Saving Time to Standard Time…I hope you appreciated...
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November 5, 2019
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Who’s On First
You’re seated with your frail mother in a jet at about 28,000 feet, row 15. You had volunteered to...
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October 29, 2019
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Alzheimer’s Breakthrough
In health care some basic rules apply, no matter what the medical condition. Number one is that prevention is...
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October 22, 2019
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Ten Tips to Healthy Aging – continued
I left off last week with the first five (of ten) tips to healthy aging. Before I continue with...
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October 15, 2019
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Ten Tips to Healthy Aging
If I were to ask for a show of hands, I suspect nearly all would want their older loved...
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October 8, 2019
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What to Remember…
Do you remember when you had your last dental exam? Your last annual physical exam? Eye exam? How about...
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September 30, 2019
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Lights On?
The rest of the oft-quoted phrase is a pejorative about how “Nobody’s Home.” And we know it’s supposed to...
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September 25, 2019
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In the Caregiver's Words

Recent Client Praise

I have had the good fortune to connect with Julian Hills, a content writer and blogger for a great website and resource, Drugwatch.com. When I asked about the latest on diabetes and treatment, she offered these things to consider when it comes to elder care at home.

Diabetes is the seventh leading cause of death in the United States. Controlling the disease can save lives, but it’s also important for caregivers to know that controlling it can also come with its own set of consequences. Diabetes occurs in people who have high blood sugar because their body cannot move sugar into fat, liver and muscle to be stored for energy. The pancreas either does not make enough insulin or cells do not respond to insulin.

There are two common forms of the disease. The first, called type 1 diabetes, can be diagnosed in people of any age. The cause is unknown. These people need daily injections of insulin. The second, type 2 diabetes, is becoming more prevalent in the United States due to high obesity rates. Teens and young adults are now among many of the people developing type 2 diabetes. The Centers for Disease Control estimates that more than 8 percent of Americans have diabetes. Controlling diabetes is important because if untreated the disease can cause heart disease, stroke, hypertension, blindness and kidney disease. With nearly 26 million estimated cases in this country alone, an entire drug industry has blossomed, and caregivers need to be aware of the complications that have arisen from this group of drugs. While many of the medications on the market have helped patients control their condition, there are also a number of complications being reported.

As more and more people depend on these drugs, more and more lawsuits associated with their usage are arising. Here are some examples of conditions associated with these drugs:
- • Actos helps patients with type 2 diabetes by making their cells more sensitive to Insulin. But studies show extended use of the drug has been linked to an increased risk of bladder cancer. Patients taking Actos need to watch for painful or bloody urination, and unusually severe back pain.
- • Byetta is an injectable drug for type 2 patients. The drug controls blood sugar, but has been linked to damage of the pancreas, kidneys and thyroid. These complications can be fatal.
- • Januvia works in tandem with other type 2 diabetes medications to increase their effectiveness. It’s not for type 1 patients. Pancreatic cancer and pancreatitis are closely associated with the drug. In 2011, the Food and Drug Administration received nearly 200 reports of acute and chronic pancreatitis linked to the drug.
- • Victoza is another drug aimed at fighting type 2 diabetes. It has been linked to thyroid tumors, as well as pancreatitis and kidney failure.
Not all patients will suffer from these complications, but drugs may not be the only option. Adopting a healthier lifestyle may help people depend less on medication and avoid the potentially dangerous effects of these medications. Caregivers need to remember that helping people with the condition develop better diet and exercise habits is a great way to control the effects of type 2 diabetes.

SOURCES: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/
http://www.cdc.gov/diabetes/pubs/factsheet11.htm
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

Julian Hills is a content writer and blogger for Drugwatch. His journalism career has taken him from newspapers to local television news stations and even a 24-hour cable network in the Southeast. Julian is a graduate of Florida State University.

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 who need help with elder care at home in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
Perhaps you have now had the chance to once again be together with family and older loved ones for the holidays or maybe the visit is still on your calendar? If so, you may have noticed or soon will notice that some things are not quite the same, and the changes may be subtle. You may notice that your older loved one's reaction time behind the wheel is more than a bit slow or tentative. You may see evidence that your loved one is more than just "behind on housekeeping;" there may be signs that taking care of home is just more than they are up to. Or you may notice that they have some difficulty standing after sitting for a time or that there is a shuffle to their walk. What can you do? Driving. Talking about giving up the car keys may be premature, but the per mile rates of auto accidents escalates rapidly after about age 70. So, you have to ask yourself if you would prefer to have this hard talk before or after a collision. Then, you need to ask how you would want to be approached if you were the questionable driver. Ask them about how safe they feel on the road with "drivers these days." And do not hesitate to reach out to your loved one's primary care provider as someone who may be able to speak with more authority. Housekeeping 101. This one is more than keeping tidy in the kitchen. If you have done a surreptitious check on the quality and quantity of food your older loved one has in the pantry or refrigerator, you may have found limited quantities as well as staples beyond their expiration dates or making their way to a science experiment. This may be as simple as getting a shopper for your mom or dad, and you can offer to help them find someone to help with the "heavy lifting." Another "heavy" may be in the housecleaning category. No one really relishes pulling out the refrigerator to vacuum or to get under the bed to chase out the dust bunnies. Getting your loved one to agree to help with the heavy lifting on this front may be a nice step toward getting more help as needs change. Fall Risks. Housekeeping may help in beginning to eliminate some of the fall risks your older loved one may face at home. Every year about one in three adults over age 65 have a fall, fortunately not all of them serious. But look for worn carpeting whose frayed edges are a trip risk, particularly on stairs. Scatter rugs also are a big risk as are cords for electrical devices that may be blocking walkways. These may be easy suggestions to make, but you may also wish to bring in a professional like a geriatric care manager who can walk through a veritable checklist on what to look for along with many of the easy fixes. With all of these facets of "home improvement," it is important to remember that you do not have to go it alone in the conversations with mom or dad. You may enlist the support of your siblings so that the whole family is trying to lend a hand, particularly if you collectively have a history of working together around the house. Barring that, you also can raise these subjects in a less threatening way, such as in the kitchen while helping with serving or preparing the next family meal...just one on one. Or if it is the older father, a walk around the yard or block may be an easier venue for a conversation. People tend to talk easier if the talking accompanies a task. There is always that family friend of your older loved one who has been like the extra aunt or uncle who can help facilitate a conversation. And here again, talk with a geriatric care manager about your concerns and how best to bring them up to an older loved one. It does take a village. 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 mentioned in the previous post that November is National Alzheimer's Disease Awareness Month, so I have invited the Alzheimer’s Association to provide a guest blog. You will see a quote in this posting from Melanie Chavin, Vice President of Program Services in our own Greater Illinois Chapter. You also will find a link to the Chapter on the "Support Tools" page of our site.

            In 1983, President Ronald Reagan, who was later diagnosed with Alzheimer’s disease, designated November as National Alzheimer’s Disease Awareness Month. President Bill Clinton named the week of Thanksgiving as a time to honor caregivers in 1997, and that has expanded to National Family Caregivers Month. As an organization founded by caregivers, the Alzheimer’s Association® applauds caregivers and hopes to make their efforts a little easier year round with an innovative resources that have been designed specifically with families in mind.

            This year, the Alzheimer’s Association launched two free resources for families impacted by Alzheimer’s disease. Alzheimer’s Association Alzheimer’s Navigator™ is an online tool to help caregivers and people with dementia evaluate their needs, identify action steps and connect with local programs and services. Developed with the feedback of people living with Alzheimer’s and caregivers, Alzheimer’s Navigator also allows users to reassess needs and adjust care plans as the disease progresses. ALZConnected™, powered by the Alzheimer’s Association, is the first social networking community designed for people living with Alzheimer’s and their caregivers.

            "These online tools can be a great help for families,” said Melanie Chavin, vice president of program services for the Alzheimer’s Association, Greater Illinois Chapter. “There are so many resources available to assist families and individuals living with Alzheimer's, and Alzheimer’s Navigator can put them in touch with resources they never knew existed. AlzConnect's online community can help people living with dementia to feel less alone by providing support and encouragement from others in the same situation."

            Following a brief welcome survey, Alzheimer's Navigator users complete a set of focused questions. Their responses result in customized action steps ranging from activities of daily life to legal and financial planning to safety precautions. Each user’s action plan is specific to current needs and is designed to change as the disease progresses. When local resources are needed, Alzheimer's Navigator works in conjunction with Community Resource Finder, an online search engine, to link the user to community programs, services and resources such as adult day care or long-term care facilities.

            Alzheimer’s Navigator users can also create and manage care teams so that multiple people can access and participate in the customized action plan, enabling long-distance caregivers to be involved and primary caregivers to share the responsibility. Alzheimer’s Navigator may be accessed at www.alzheimersnavigator.org.

            ALZConnected is a specialized social network that allows members to connect and communicate with people who understand their unique challenges 24 hours a day, 365 days a year. They can also pose questions and offer solutions to dementia-related issues, create public and private groups organized around a dedicated topic and contribute to message boards.

            ALZConnected combines the features of many social networking sites and the popular Alzheimer’s Association’s message boards. Members create “connections” by extending and receiving invitations. ALZConnected may be accessed at www.alzconnected.org.

            There are 210,000 people living with Alzheimer’s and 581,773 unpaid caregivers in Illinois, according to the Alzheimer’s Association2012 Alzheimer’s Disease Facts & Figures. The Alzheimer’s Association will continue to assist families in a variety of ways to best meet their needs. This year has marked significant progress in the fight against Alzheimer’s with the development of the country’s first national plan to address the epidemic, but we have a long way to go to meet the goal to prevent and effectively treat Alzheimer’s disease by 2025. It is critical that we help the millions of Americans families currently battling this progressive and fatal disease.

For more information on Alzheimer’s disease or available resources, visit alz.org or call

1-800-272-3900.

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. Visit our For The Caregiver page for more information and resources
If you are a caregiver, the most important item your older loved one can bring to a doctor's visit is ... YOU! It is really helpful for your older loved one to have an extra set of ears to hear what the doctor asks or says about your loved one’s condition, but it also allows a caregiver to ask questions that may not have occurred to your loved one. And frankly, there are a number of people “of an age” who just don’t feel comfortable questioning their physician – Doctor Knows Best, etc. Well, now physicians are also bringing along a companion to the office appointment. Some hospital systems are adapting their own technologies to uses that are compatible with the Smartphone platform. There are still others that are available for doctors to use with their patients, and many of these are in the App Store. The next time you accompany a loved one to their medical appointment, as your physician about: • Treatment Plan – an App that allows health care professionals to customize a treatment plan to your loved one’s condition. It allows the provider to formulate a specific treatment plan that can be sent to another Smartphone in order to track details once the patient returns home. • Treatment Progress Indicator – Especially for conditions like anxiety, depression or other behavioral issues, it is important that the patient carries home the plan of action as well as a regular update using a diagnostic tool like a short form questionnaire to see that symptoms are resolving or that the patient is adherent with the medication. • Physical Therapy To Go – Anyone who has been to medical visit with physical therapy as part of the at home recovery has seen the paper stick figure drawings of how the therapy is to work. Some of that can easily get lost in translation, and worse yet, are the recommendations that are verbal. They now have an App for video instruction on how the actual therapy is to work. • Prescription Adherence – We have come a long way from the day of the week pill boxes. There are now reminders that can be uploaded to the patient’s phone (of the caregiver’s phone) to persistently remind the patient when it is time to take that pill. In some applications, it also will block taking a pill when it is not the right time. There is a growing host of other Apps that physicians have at their fingertips that can help diagnose skin lesions or other dermatological issues. They also have Apps that can transmit photos of wounds from bed side in a nursing home in order to get informed recommendations from wound specialists to the bid side providers. And there will doubtless be even more as early as … well, tomorrow. Stay tuned. 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.
Caregivers never have just one job. Most caregivers not only help an older adult or loved one in their orbit, but they also are holding down a full-time day job. And by the way, those who are part of the sandwich generation also have children still living at home who depend upon them. Just when that all sounds pretty onerous, the holidays come along and the demands get ratcheted up to the point of breaking. The turkey and fixings that the caregiver prepares for the holiday table may look and taste fantastic, but the caregiver/chef feels like yesterday's leftovers by the end of the day. If you are a caregiver this holiday season, please follow these four basic recipes for survival so that you do not feel as picked over as yesterday's entree:

1.    Have a helping of freshly served self-congratulations. At Thanksgiving in particular, we all give thanks for the bounty, but do not overlook the caregiver in the midst of all the thanking. The older loved one for whom you care may not be able to thank you if they are suffering from a dementia, but all the more reason that you remember to thank you.

2.    Savor the flavor of a much-deserved break from it all. You have all this family gathered at the feast, and those many hands can also make fast work of the chores, such as cleaning up and tidying after the banquet. Appreciate that family may need to be reminded, but they will actually get into making it a great day for the caregiver – just as much as they got into the pumpkin pie.

3.    Give yourself permission to take a pass on the veggies if you like. Not all of the holiday will be easy on a caregiver, particularly if you find mom or dad is slipping since the last time you were together as a family. Being a caregiver is emotionally demanding and you are entitled to the feelings of sadness or fear, even resentment or anger, about when mom or dad will someday be gone.

4.    You don't have to bake everything yourself. Caregivers often feel that they just need to be a little stronger, just take on a little more or just tough out a rough patch. That sort of "going it alone" mentality can lead to burnout or depression or even anger toward a loved one. Don't hesitate to seek out a professional counselor to help you process some of the feelings that come with the territory just as you would buy the dinner rolls at a store when you are running out of time before dinner.

      If you can follow at least some of these recipes for the holidays, you will be taking care of yourself. And if you care of the caregiver, you will be able to better care for a loved one in as positive a way as you can. Remember: You don't have to be a perfect. You just have to be “good enough.”

      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.
I have not taken a real opinion poll, but from feedback I get as a geriatric care manager from my clients what scares them most is not the prospect of dying. It is the prospect of losing their mental abilities. Alzheimer’s disease is high on the list of “feared medical conditions" even though it is down at number seven on the list of overall causes of death among Americans. With “National Memory Screening Day” coming up on November 16, I thought it would be a good time to share a few perspectives on Alzheimer’s and related cognitive conditions.

Alzheimer’s is just one of the three major types of dementia that health care experts talk about. Dementia is any disease that can cause progressive loss of memory or function. Alzheimer’s has a lot of “name recognition,” but there also is vascular dementia. Vascular dementia is a result of the arteries that bring blood to the brain hardening. Just like the kind of hardening of arteries that starves the heart over time, vascular dementia starves the brain. Finally, there is a third category that covers a number of conditions like Lewy Body, frontotemporal dementia and even Mad Cow disease, but these are quite uncommon.

There also are “dementias” that are reversible. Depression can be confused with other dementias, and it is very common among older adults. Other medical conditions like hypothyroidism, Lupus, vasculitis, some venereal disease or B12 deficiency can cause reversible dementia. Substance abuse – common among older adults – is a source of reversible dementia. And other prescription medications can impair recall and cognitive function.

Some of the classic signs of the onset of Alzheimer’s disease you can look for include when the individual:
- Tells the same stories
- Asks the same questions
- Has difficulty with numbers
- No longer does the things they commonly have done (cooking, sewing)
- Gets lost in unfamiliar places (restaurants)
- Neglects their own self-care
- Defers to a caregiver (“Ask my spouse”).
A person can do a small self-check as well. I suggest to my clients that each evening they write down a short list of notable events from that day. The next morning they should review what they wrote the night before to determine if they can remember them. It gives them peace of mind, because we tend to forget that everyone forgets some things along the way.

There is a lot more ground to cover on this, and I will get to more in later postings. For more answers or resources, go to the web site of the Alzheimer’s Foundation of America. I also would like to address your concerns or questions in future postings, so please e-mail me at Charlotte Bishop.

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.