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

How to Say No to Cancer
Who would say “yes” to cancer, you may be thinking, but saying “no” means you’re committed to the lifestyle...
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July 23, 2024
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LIFE: What Are You Going to do About It?
I had the good fortune this past weekend to attend a Billy Joel concert, and he had a great...
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June 24, 2024
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What’s Your Complaint?
If you grew up in a family as I did we were taught not to, or shown role models...
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June 11, 2024
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Can’t Find Your Keys?
When I speak to some clients our conversation moves from their work lives and forward to their retirements now....
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April 16, 2024
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If You Want to be More Fit, Don’t Exercise…
Just coming off Super Bowl Sunday, it’s easy to talk about who could run faster, who could pass more...
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February 12, 2024
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Why D is More than a Passing Grade
There is much talk recently about “grade inflation” which rather diminishes the formerly exclusive appeal of a report card...
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January 29, 2024
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How to Get All the New Years You Can
It’s not a magic pill or a quick transformation, but it’s not difficult either. The “it” is greater longevity,...
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January 17, 2024
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It Only Works If It’s YOUR Resolution
How many New Year’s Resolutions have you broken in your life? Be honest. Now ask yourself how many of...
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January 9, 2024
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A Happy – And Well – Holiday for All
It’s the season of holidays. We started with Thanksgiving and then Channukah, and we have yet to tackle Christmas...
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December 19, 2023
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Questions and Answers to Live Well
Many of you have heard me talk about having a Live Well Blueprint as an anchor component to being...
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December 5, 2023
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In the Caregiver's Words

Recent Client Praise

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1 New contact form submission received from CreativeCareManagement.com - Caregiver Advice on Bad Medicine [fullname] <[emailc]> info@creativecasemanagement.com, lynda@llvirtual.com From: [fullname] <[emailc]> Phone: [phones] Message Body: [question] -- This email was sent via the contact form on the Creative Care Management website, http://www.CreativeCareManagement.com. Your message was sent successfully. Thanks. Failed to send your message. Please try later or contact the administrator by another method. Validation errors occurred. Please confirm the fields and submit it again. Failed to send your message. Please try later or contact the administrator by another method. Please accept the terms to proceed. Please fill the required field. The field is too long. The field is too short. Date format seems invalid. This date is too early. This date is too late. Failed to upload file. This file type is not allowed. This file is too large. Failed to upload file. Error occurred. Number format seems invalid. This number is too small. This number is too large. Your answer is not correct. Your entered code is incorrect. Email address seems invalid. URL seems invalid. Telephone number seems invalid.
Barbara Bush, wife and mother to presidents, has taught us another lesson this past week, and it is about how she chose to die. She taught us that palliative care and hospice care are different concepts, but she also taught us about the importance of an end of life plan. Let me start with the first. Let me clarify that hospice care is reserved for patients who will face an end to treatment and wish to be comfortable. Palliative care is simply the “comfort care” we saw requested for Ms. Bush, but it can be for any patient about to embark on a difficult or painful treatment regimen. We deal with a lot of families of older loved ones who are faced with difficult diagnoses. If the diagnosis has a treatment option that may prove difficult or painful, doctors may suggest palliative care. And that is when some family members may freak out just a bit… not an exaggeration. Yes, they may freak out because there is an association between palliative care and end of life, or hospice care. So what we saw for the former first lady was a care plan that included anything she needed to simply die comfortably, hospice care, but they did refer to it as comfort care. Ms. Bush was able to make her own decision at the point when a choice needed to be made, but so many people will not get that chance. This is also why it is important for families to have a discussion about the “what if scenarios” that families may face. What if there is no hope for recovery? What if the patient will not regain consciousness to make a decision about how to cope with a potentially painful end of life? As an Aging Life Care professional, we talk about the importance of a care plan. A key element of a comprehensive care plan will be what to do if. ….If mom cannot make the choice for ending treatment…If dad’s dementia precludes dad’s own decision for comfort care. We were told in Ms. Bush’s eulogies that she ended life pretty much on her terms. I would encourage us all in this country to make plans with family members that will assure the same level of comfort…that we should all end life on our own terms. If you have not already, it may be time to speak with your older loved one about what “their terms” are. You and they will be very gratified that you were sufficiently bold to start the conversation. 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.
No surprise to anyone with a medical condition that drug prices continue to soar even during this past decade of near zero inflation. If you have a loved one 65 years of age and older, you need to know about coverage of these increasingly pricey drugs. The four things you should know:
- According to a recent Senate minority report, the twenty most commonly-prescribed brand name drugs for Medicare recipients have gone up in price ten times more than inflation over the recent five years.
- The brand names are: Diskus, Crestor, Januvia, Lantus/Lantus Solostar, Lyrica, Nexium, Nitrostat, Novolog, Premarin, Proair HFA, Restasis, Spiriva Handihaler, Symbicort, Synthroid, Tamiflu, Ventolin HFA, Voltaren Gel, Xarelto, Zetia and Zostavax.
- Half of these medications have a generic equivalent that can be substituted at substantially-reduced prices: Crestor, Januvia, Lantus, Nexium, Nitrostat, Premarin, Symbicort, Tamiflu, Voltaren Gel, and Zetia. (Synthroid has generic competition, but as a Narrow Therapeutic Index (NTI) agent, switches across manufacturers are a bit challenging; Restasis and Lyrica will have a generic competitor yet this year.)
- A Pharmaceutical Research and Manufacturers of America industry group spokesperson said the report was misleading, because companies “negotiate robustly” with Medicare Part D. Really?
If you are a caregiver to a Medicare-qualified loved one, it may be time to review their medications with their primary care physician. Physicians have the option of specifying that a generic alternative may be substituted. Aside from Synthroid, ask them if they would check the box to allow substitution. Diabetes treatments, for instance, may be bit more nuanced. Ask them to explain their reasons. And do your homework ahead of time so that you know the price differentials of brand versus generic. 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.

As a geriatric care manager, the most common comments I get when I speak to groups seem to start with “I wish I had known you when…” The “when” is usually followed by a family story of mom’s fall and broken hip, dad’s dementia diagnosis, a dear friend who has THAT diagnosis. We may call it care management, but Dr. Phil calls it “crisis management,” and in his recent book titled Real Life, he says: “For most of us, our formal education and other life experiences don’t give us any information about crisis management, problem solving, or even problem recognition.” So, in an age when you can Google anything, most people do just that when the crisis hits. But when you Google anything, that is just about what you find…anything. Not only that, but it rarely is just one crisis that caregivers to older adults have to address. In interviews with three dozen Care Managers in 2016 and 2017 we asked them to talk to us about their clients. Their experiences with families going through crises of caregiving fall into the following categories:

TYPE OF CASE	%
Alzheimer’s Disease, Dementia	66.2
Home Safety	66.2
Medication Questions, Complications	58.2
Acute Medical Crises	50.3
Inadequate Self-Care	48.0
Chronic Medical Condition	46.8
Family Support	45.5
Residential Transition	39.9
Patient Discharge, Home Care	38.6
Financial Challenges	33.7
Other	34.5

What is the important takeaway from this table? It’s the numbers. We asked the Care Managers whom we interviewed to tell us what percentages of their clients fall into each of the categories you see. It may be no surprise that clients may have more than one issue going on at a time, but the sum total of what you see here is well over 500%...527% to be precise! It gets complicated when more than one thing is going on at the same time. The older parent of this family is diagnosed with Alzheimer’s disease, but in all likelihood this person also is at risk for what professionals term elopement, or wandering. They may just wander off, and not recognize where they end up. Hopefully they will be fortunate and be found by a well-intentioned neighbor or police officer who can help them return to the safety of home. So, right off the bat we have dementia and home safety issues, but they also may not be compliant with their medications for a chronic cardiac or respiratory condition because they do not remember. They may have been victimized by a telemarketer to whom they have given their credit card information which is how the family identified that dad has memory issues in the first place. And now the family reaches out for help to find a secure residential option. So, it rarely is just one issue that creates a crisis for the new caregiver; it’s a five alarm fire. Okay, I share this brief example not to scare you to death, but rather to get your attention and let you know what the caregiver reality is all about. What caregivers need to do is first, realize they do not have to go it alone. Second, it can be really helpful to find someone who knows the good options from the bad options, because Google offers options, but does not know the difference. 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.

LifeWorks Erie is the provider of relevant, contemporary programs, services and lifelong learning opportunities that engage the 50+ individuals who are interested in staying active mentally and physically and want to lead healthy, vibrant lives.
Who We Serve

We serve as a trusted filter and adviser to older adults and their families regarding choices which enable living well, maintaining independence and access to complimentary services throughout the changing needs of aging. Through our programs and services, LifeWorks Erie encourages optimal aging by offering opportunities for wellness in all of its dimensions: intellectual, emotional, mental, physical, psychological, and spiritual. Learn More At: www.lifeworkserie.org
Program and Service Areas

Lifelong Learning
Regardless of age, but particularly during the aging process, stimulates curiosity, exploration, and new experiences that in turn decreases the incidence of various diseases and promotes health and well-being.

Non-Medical Services & Programs
Including the New Horizon Music Project, Return to Work Counseling, Oral History Collection, Creative Aging, Café Service, Computer Usage, and many other services as describe on our website.

Prevention & Health Management
Members of our staff are certified in Chronic Disease Self Management, Reiki, Therapeutic Yoga, Powerful Tools for Caregivers, and Arthritis Fitness. Our staff includes a Recreational Therapist, Nurses, and a Certified Fitness Instructor. LifeWorks Erie offers health screenings, counseling and education, and flu and other vaccinations to the community.
Creative Care Management proudly supports Lifework Erie's work, especially as it relates to elder care services.
Please consider what I am sharing with you here to be the raw material side of recommending some recipes for your upcoming Thanksgiving feast. By raw materials, I mean that these recommendations are not recipes, strictly speaking, but I am recommending your feast this week have ample quantities of vitamins D and E. In fact, you might carry these doses over into your regular diet after this week. If you are like most folks who have been following advice on healthy eating, you already appreciate that vitamin D is very important for bone health and vitamin E is central to heart health. But what you may not have seen is that both of these also are important to brain health. Separate studies have shown that vitamin E can help to keep Alzheimer's at bay and vitamin D can lower the risk of cognitive decline. Starting with the case for vitamin E, researchers at New York State University have studied the effect of regular quantities of walnuts (rich in vitamin E) on what they termed "Alzheimer's-susceptible mice." Granted, these are animal studies, but the nutrition needs of mammals can be generalized to some extent. And their results published just this month were quite striking. The group of mice in their experiment who consumed regular doses of walnuts showed statistically significant improvement in learning, memory, motor skills and even anxiety levels over the mice who received no walnuts. (How do they measure anxiety in mice?) No surprise that walnuts contain Omega-3 fatty acids as well as other antioxidants which have been proven in other studies to ward off cognitive decline. And then there is vitamin D. This was a study among older Italian adults rather than mice. The researchers tracked vitamin D levels of nearly 2,000 adults whose average age was 73.9 years for over four years. They found that those individuals with vitamin D deficiency or insufficiency (measured by their serum 25OHD) were more likely to have declining cognitive skills as measured by a standard test called the "Mini-Mental State Examination." This was compared to their baseline test at the outset of the study which showed all participants to begin at comparable and robust levels of mental ability. It is important to note that this second study simply noted the differences among individuals based on their blood serum levels and did not control what they ate. More testing will be needed to see if vitamin supplements can make a positive difference versus in mental capacity. And, of course, the first study was on mice, so it would be helpful to move this up to humans. And by the way, the amount humans would consume to give the equivalent dose for what the mice ate would be only about 1-1.5 ounces of walnuts daily. So, if you are a caregiver to an older loved one this holiday, these two studies may not include any recipes, per se, but they do suggest what you may wish to add to your Thanksgiving spread as well as the dinners that will follow. And you don't have to choose between these two vitamins; cover your bets by adding a bit of D and a bit of E. 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.