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

Negative Thinking Causes What?
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health...
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July 7, 2020
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While Quarantining, Prevent Alzheimer’s
We’ve heard Doctor Fauci say it many times…that we have to deal with this pandemic on the virus’ terms,...
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June 30, 2020
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A Second Epidemic for Seniors
What is the one thing that almost all of us have had more of than before the COVID-19 pandemic…time! ...
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June 23, 2020
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What COVID Has Changed in Nursing Homes
We are still in the throes of the COVID-19 pandemic, and the consensus among public health experts is that...
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June 9, 2020
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Race-Related Stress Too
I’ve posted a lot over the years on the factors that affect aging…and aging well so that when you...
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June 2, 2020
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Dementia: We’re Not Post-COVID Yet
If you have a family member or loved one with dementia, this pandemic and its restrictions have been exponentially...
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May 26, 2020
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Distance Caregiving Through a Wall
I’ve written numerous times about distance caregiving, and one of the observations I have offered is that distance is...
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May 19, 2020
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Caregiving During COVID: Four Tips for Reengagement
You may recall that I have recommended limiting your news consumption, because it really does add to our stressed...
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May 12, 2020
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COVID 19 and Stress
I heard a reporter talk about cases of post-traumatic stress disorder growing during this pandemic and quarantine. I admit...
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May 5, 2020
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COVID on Your Calendar?
COVID 19 was not in my calendar for 2020, and I strongly suspect it was not in yours either. ...
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April 29, 2020
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In the Caregiver's Words

Recent Client Praise

This month we’ve addressed ways to mitigate holiday blues and that familiar feeling of melancholy for both the caregiver and the loved one throughout the season. However, for an older loved one, that feeling of unhappiness, especially if it lasts well after the holidays may be signs of depression. Depression can be common in older adults and can come in many different forms. There are also many different reasons why depression might be triggered – including being associated with various medical conditions. For instance, depression has been linked to viral infections, malnutrition, stroke, lymphoma, hyperthyroidism, and others. Some medications are also commonly linked with depression.

Moreover, when an older adult or parent starts to lose some of the independence that they once had – whether caused by a deterioration of mental or physical capabilities – they might develop thought processes associated with “learned helplessness.” This happens when the loved one starts to see their failures (whether perceived or not) as a sign of being completely helpless and having no control over their own lives. Also, as mentioned in previous entries, the sense of loss can weigh heavily on a senior parent. This is not just due to loss of another family member, but also the loss of their previous capabilities, roles, or responsibilities.

It is extremely important to not diagnose depression on your own. Have your loved one assessed by a professional. What they may be experiencing might not be a disorder at all. It may be signs of another issue. However if you are certain your loved one has depression, here are three different eldercare solutions you may want to consider:

Antidepressants. This is usually provided as primary treatment for moderate to severe cases of major depressive disorder if preferred by the patient. Be sure to double check with doctors to ensure that these medications don’t interfere with anything else your loved one might be taking.

Psychotherapy. For those who are uncomfortable taking medication for depression, this is a suitable option. Psychotherapy helps identify factors in your loved ones lives that might be contributing to depression as well as teach valuable coping skills.

Depression Care management. This is a great treatment option for those who already are within an in home care system or care management program. Care managers will help identify signs of depression and facilitate treatment options, including ensuring that a healthy regimen is kept while working alongside a psychiatrist or physician.

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.
In my last posting, I talked about how a caregiver can facilitate an older adult’s decision around when it is time to surrender driving their own car. As I said in that blog, it is important as a caregiver to help facilitate the older adult’s decision about something like driving a car versus retiring a car rather than make the decision for them. It is no less true of decisions on living at home versus moving to a senior residential community.

Let me help you with some of what I have learned in talking with hundreds of older adults who have wrestled with this decision.

Let me start by saying that yes, it is in part a decision based on financial means. Even selling one’s home and the financial windfall that sale can represent may not provide enough funds for a couple or individual to move into a senior residential community – especially some of those that feature resort-like amenities in the Sun Belt or elsewhere.

Research among individuals who are “age-qualified” to reside in a senior residential facility offers some amazingly consistent findings. First, only about one in twenty to one in ten individuals with enough income and assets actually want to live in a community of seniors. What attracts these few to senior communities is fairly consistent.

Older adults most often are looking to give up the heavier duties of living in their own homes. They value having someone else mow the lawn, shovel the walk and otherwise maintain the grounds. They also like the idea of handing over the responsibilities for heavy cleaning and even regular upkeep. And the security of having a place in which they feel protected from strangers while still enjoying the freedom of coming and going is also key.

Where the community is located is not quite as important as knowing that they will have easy access to shopping and entertainment. One of the draws of some of these communities is the religious sponsorship that means the individual will be among others of similar spiritual orientation. And they want to know that they will continue to be as active as they wish.

So during the holidays if the conversation with elders in your midst begins to turn to some of the responsibilities of home ownership that weigh upon them, they may be ready to discuss alternatives. It starts with what they may not want to do….not what they cannot do any longer.

In an upcoming blog, I will be talking with Eric Parker on a more medically-driven decision - how to select a nursing facility.

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.

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Twenty two minutes. Every twenty-two minutes someone over age 65 dies as a result of a fall, and this is almost double what that figure was just ten years ago. These are called severe falls, and it is not that the individual dies at the time of fall as much as they will succumb to other complications subsequent to the fall. Because just as the incidence of falls has increased, the incidence of heart disease, stroke, arthritis, diabetes and other chronic conditions has increased among older adults. With the increasing numbers of medications that older adults take for their medical conditions, there also is an increased risk for confusion, delirium or imbalance as side effects of the prescriptions. We also are seeing an epidemic of severe - but not fatal - falls, nearly 2.5 million of which result in trips to the emergency room in America each year. This is fifty percent more than just ten years ago, and the incidence is double for women what it is for men, because women are living longer. So what can caregivers do to help their older loved ones living safely and independently? Take your cue from some innovative senior residential facilities around the country. In past postings I have talked about making lights within reach of bedside for older loved ones who may be getting out of bed during the night or in the early morning hours of darkness. There are now new ways to install floor lighting around the bed or along the usual paths from bed that are motion-activated. As your older loved one sits up in bed and their feet reach toward the floor, lighting strips like those on jet airline aisles are activated and light the way to a safe trip to the bath. In the bath, motion sensors turn on enough lighting to make navigating what can be the most dangerous room in the house much clearer and safer. One other innovation being introduced into senior residences is color contrast seats for the commode. Instead of the interior design rule of matching colors, some residences are making the toilet rings black against a white commode to provide an easier contrast for those whose eyesight may not be as sharp as it once was. And grab bars in the bath as well as along any halls and stairways to give a ready assist to older loved ones who may be sufficiently willful to ignore the doctor's orders to use a cane or walker. And who said floors can only be made of wood or tile? Interior decorators are coming out with attractive new floor coverings that absorb shock as a last line of defense against fatal falls. Consider also tasteful color contrasts to help older eyes distinguish step treads on the stairways as well as paths along halls. For anyone who recalls my "mitten test" for household door handles, switches, etc., you will like this suggestion. Get a pair of cheap sunglasses and rub Vaseline over the outside of the lenses. As you walk through the house you will have a much greater appreciation for what older vision - particularly vision impaired by cataracts - can literally look like. Add six pair of socks to your feet and you will be able to take a walk in their eyes, instead of a walk in their shoes. 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.
It was an editorial in Time Magazine back in 2010 that brought up the concept of the "coping conundrum." They said: "There is guilt and mystery and anger and fear embedded in a process driven by love". They were talking about the notion we as a society seem to have it that as our parents grow older and more dependent that it is almost a reverse child-rearing syndrome that the sandwich generation experiences. We "raise our parents?" Not so, they warned. So, let's look at ourselves just a bit. With teens, we can (try to) tell them what they can and cannot wear, what they can and cannot do. We can dictate their hours, and when they do not get the keys to the car until they get the hours of driving logged. So how does that work when you talk to the parent who gave you the keys...maybe grudgingly... and you are proposing to take the keys away from their 60-70 years of driving experience. It is not access to a car; it is a habit, it is independence; it defines life in the suburbs; it is part of the "American dream." And there was Maria Shriver's report that came out in 2010 that essentially said that 10 million women would either care for an Alzheimer's parent or have the condition themselves. Caregiving is a big deal, because it is as much about our parents as it is about ourselves. This is the part where we all go look up conundrum in the dictionary. The number of Alzheimer's patients is going to triple over the next four decades. How would we want to be treated? So, it gets interesting. We all are living longer which means that those of us who are predisposed to conditions like Alzheimer's are more likely to manifest the symptoms. Back to the analogy of "raising" kids. We do not raise our parents, and we ourselves do not want to be viewed as children of our own children. Yet, the end game is about diminishing capacities of our older family members. Are we "lowering" our parents...hopefully very gently? ...versus raising children? So, now comes the coping advice. Rule number one for all of you who are caregivers is that you need to take care of the caregiver. Here is the subordinate rule. Find help in caring for the caregiver. And please know that what geriatric care managers (GCMs) do is support rule number two as well as rule number one. Yes, we assess, plan and execute to help the older loved one or other person with special needs. But every bit as important, GCMs help to care for caregivers. Remember that with every conundrum, there also is either an answer or perhaps even a cure. 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.
If you are a caregiver to someone with dementia you may have found that communication can be frustrating, but you need to remember how frustrating communication is for the patient as well. As a geriatric care management professional, I'm going to offer a couple of postings on how to get the most out of communication with someone suffering from Alzheimer's or other types of dementia. The figures reported suggest that as many as one in every ten people over age 65 will develop some form of dementia. It is important right off the top to appreciate that the dementia patient is going to be frustrated as they try to address not just your questions, but perhaps even who you are. This confusion can manifest itself as anxiety (imagine being always lost), irritability, poor self-esteem or depression (by only if they are aware of their condition). Appreciate also that most forms of dementia are progressive medical conditions that will worsen over time requiring you to adapt your communication to meet the changing needs. Follow these tips for more effective communication for you both:
1. When you first approach the patient, do it from the front so as not to startle them; use their formal name - Mr. Jones - as you address them and maintain eye contact.
2. Be calm and reassuring by speaking slowly and in a gentle tone, using simple words; repeat yourself if necessary or rephrase only after trying the same wording a couple times.
3. Take your time speaking so that the patient can take their time to process your question and formulate a response; and remember just one question at a time.
4. How you speak and how you look will be as important as what you are saying, so smile and speak in a gentle voice.
5. Humor can be relaxing to both you and the patient, but always be careful to not make the patient feel they are the object of the humor.
6. If the patient is a loved one, hugs and touches are every bit as important now as they may have been when the patient was more lucid.
7. Try to keep to a regular schedule of daily activities with a dementia patient to help them feel the comfort of a routine; change is difficult and can create unnecessary anxiety.
8. Appreciate that early learning may stay for a long time after the patient no longer tracks a given conversation; in religious services I have found that a patient may not track a scriptural reading, but they can recite the Lord's Prayer.
9. While a dementia patient may take longer to dress themselves, it is important to allow them to do so. If you begin doing tasks for them, they may lose the ability to take care of themselves entirely.
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.