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

Would You Want to Know?
Americans fear Alzheimer’s disease more than any other condition including cancer, heart disease, stroke or any other life-threatening diseases...
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February 23, 2021
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No Vaccine for the Other Plague
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine,...
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February 16, 2021
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What Tony Bennett Can Teach Us
Tony Bennet has arguably been one of those “one in a million” kind of musical talents, but sadly he...
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February 9, 2021
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Scamming as a Superspreader
We have all seen the advertisements for the on-line services that will help you find your ancestry by taking...
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February 2, 2021
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Until the Vaccine?
We have all been following the news on vaccine rollouts, and frankly you may have been as disappointed as...
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January 26, 2021
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Good Lies are Good Therapy?
There are those who have not seen any changes in their lives in the midst of this pandemic and...
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January 19, 2021
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Better than a Resolution
After nearly a year of a pandemic and its quarantine, we are all ready to get back to normal. ...
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January 12, 2021
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Good News from 2020?
Raise your hand if you haven’t heard enough bad news in 2020. I thought so. We know we are...
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January 5, 2021
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You and Byrd and Thoreau
I think it is safe to say that most of us are really ready for this pandemic and quarantine...
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December 30, 2020
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How the COVID Vaccines Work
If you’re like me, you have been following too much news on the pandemic, but hopefully you also have...
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December 15, 2020
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In the Caregiver's Words

Recent Client Praise

For how many years have women been told they need to take some sort of calcium supplement even before they advance in years to avoid osteoporosis? Okay, it’s a big number, but that’s not the point if you have an older loved one in your life. It’s more than calcium that is needed in a person’s diet to get the benefit of bone density that the calcium is credited with preserving. Calcium intake throughout a person’s life is needed to grow or maintain bone mass. It was the early sailors that understood that a person also needed fruits containing citric acid in order for the body to actually put the calcium to use maintaining serum calcium levels. They didn’t worry about osteoporosis’ they worried about scurvy. So this is another part of the more complicated calcium story and what the body really needs. First of all, food is the preferred way to access calcium, because foods containing calcium also contain other nutrients. Getting your calcium through food also avoids the mega doses of the mineral that can be associated with cardiac risks. In addition to calcium, vitamin D is needed to help the body absorb calcium. Vitamin D has the added benefit of improving muscle performance and balance. It keeps your bones strong and your muscles nimble. And vitamin D is activated by sunshine, so it is not just eating food with sufficient vitamin D and calcium, it is getting out in the sunshine…although there are nutrients that can help the body utilize the vitamin D in the absence of sunshine. Researchers also have shown some benefit of phytoestrogens, some of which are found in soy products, with women. Omega-3 fatty acids that you have heard about in conjunction with Alzheimer’s prevention also confer benefit to the skeleton especially in conjunction with calcium because they contain phytoestrogens. Antioxidants like flavonoids found in some vegetables, wines and fruits offer beneficial bone effects as well. Vitamin B12 and magnesium also are being actively investigated for their bone health benefit. On the flip side, researchers advise against fish products like cod liver oil as they can work against bone health. What is the big takeaway? First, calcium is important, but it works best in conjunction with some of these other vitamins and minerals. And all of this works better in association with diet in general, not as pills or supplements. The best dietary supplements are a range of fruits and vegetables, many of them found in your salads or even dinner wine. And what is the best thing about a balanced meal? The good company that can come with dinner can also improve life for your older loved one who may be more at risk for social isolation than malnutrition. It is rarely just one thing! So invite mom or dad to dinner. 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.
For a what, you may ask? I have either talked about or invited elder law attorneys to talk about advanced directives like Do Not Resuscitate (DNR) orders, living wills, powers of attorney and other documents that will help to assure that an older adult's end of life wishes are honored. And that is where POLST comes in. It is a standardized (by state) document that walks through a patient's wishes for end of life care that falls short of a DNR. POLST is Physician Orders for Life-Sustaining Treatment. The majority of states have enacted such legislation following the lead of Oregon in 1991. It is standardized for the state and is typically a brightly colored single sheet so that it will stand out in a patient's file. (Illinois' form is two pages.) Not only doctors, but first responders and other clinicians will understand the instructions of the POLST. It is not for everyone, but if your older loved one is frail or suffers from a life-limiting illness, you should consider having a talk with your loved one's physician along with your loved one. If your older loved one's physician can honestly say they would not be surprised if that person died in the following year you would be well-advised to start the conversation in order to have the POLST on file. What would that look like in a standardized form? In Illinois, the form asks for all the usual patient-identifying details, contact information for your older loved one's preferred contact, physician contact information and the physician's signature. The rest is pretty much a check list. Check yes or no if your loved one agrees to having CPR in the event their heart stops. If your loved is still breathing and there is a pulse, check yes or no for comfort measures only, for limited added interventions or for intubation for ventilation. To these the physician can add other measures. Finally, check yes or no for what kind of nutritional supplements are desired if your loved one cannot be fed by mouth. The rest is referred to as documentation that this discussion occurred between competent adults. To see the Illinois form, please go to this link (http://www.idph.state.il.us/public/books/dnrform.pdf) As you can imagine, life or end of life decisions are not so cut and dried. There are some potential ethical issues to be addressed here. Clear and sensitive discussion needs to occur among you as the caregiver, your older loved one and the rest of the family. And then there is the real question of whether your older loved one can really understand all the medical speak. It may prove helpful to bring in a professional counselor to talk this through with the family unit so that all voices are heard and all questions or objections are raised. Most important, however, is that your older loved one feels that it is they who are in charge. This ultimately is not about the doctors or the family; it is about the care receiver.
If you’re like me, you have been following too much news on the pandemic, but hopefully you also have been following the good news of the new vaccines being released. Yet, national polls show that more than 40% of Americans claim they will not take a vaccine when it becomes available, evidently a carryover of years of false science from anti-vaxxers and maybe a present mistrust of government. So, how effective can a vaccine be if only about 60% of Americans will accept the cure? Well, scientists say that until we can vaccinate 70% to 90% of the population (and this can be combined with those who have had COVID-19 and recovered), we won’t have herd immunity. Let me start with my title of this week’s post and remind everyone that the vaccine only works if you take it. Second, let me give you the breakdown on how these rather unique vaccines will work. But first, please allow me to take an historical detour to the first scientifically-proven vaccine and Dr. Edward Jenner, considered by many to be the father of modern immunology. This is also where the drawing here originates. Edward Jenner lived in the late 18^th century when smallpox was a viral killer. There had long been rumors in Jenner’s time that milk maids contracted something called cowpox from their occupation, but that they were subsequently immune to the feared smallpox. Long story short, Dr. Jenner proved that to be the case, and cowpox vaccination as a prophylaxis against smallpox ultimately became the standard of care. Flash forward to here and now, and we have some new vaccines that make use of the messenger RNA which facilitates the replication of COVID-19, but is not the virus itself. Scientists can wrap each piece of mRNA into a nano particle of lipid (natural fat) and inject it into a patient. The lipid melts away, and the patient’s immune system sniffs out some alien messengers (the mRNA) which triggers the body’s alarm system to its immune system. Immune system rallies and attacks all cells with that mRNA code and sends more of its responding troops to their ready position throughout the body. If anything tied to COVID-19 sets foot in the human territory the responding cells are ready and in force. Boom. Immunity. This should be one of those films we used to get in school about why we are supposed to wash our hands during flu season. Or some of you can recall polio vaccines and how polio has been nearly eradicated through the ongoing work of Rotary International and the Bill and Melinda Gates Foundation’s efforts. Rotary has this disease down to only Afghanistan and Pakistan, and sadly efforts have been sidetracked by the current viral plague called COVID-19. Yet, the volunteers with Rotary and allied organizations have been so relentless that we have very nearly eradicated polio in the world. You have to believe in something during this unprecedented time; choose to believe in the science. 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.
It's official. May is National Geriatric Care Manager Month. And that means now is a good time to share some perspective on just what a certified geriatric care manager is. You would think that there is a boilerplate definition or description of what a care manager is, but my experience has taught me that a care manager is different for every family with whom we get involved. Different, because every family's needs are different, but there are a couple points that may shed some light. A geriatric care manager is someone who works both inside and outside the "medical model." That is to say, you would not go to a care manager for your annual physical, a blood draw or one of the other typical things we go to a physician or other provider for. But a geriatric care manager can take all that as information along with a lot of other inputs to assess a client's health along with something many consider to be at least as important, and that is their "quality of life." A geriatric care manager then works with an older adult and their family or caregivers to recommend a plan to optimize quality of life and well-being. I often refer to our job as one in which we are "the option-makers for the decision-makers." This assessment and plan creation can be an ongoing process as a person's needs change with time. What I also find is that we are the people who can go along for the physician visit when caregivers may be working their day job, taking care of their children or simply be too far away to attend to those duties. We are the eyes and ears for the family and caregivers when they cannot be present. In fact, we often have referred to ourselves as "your sister in Chicago" or Evanston, or Naperville or Lake Forest... You get the picture. So, why sister? According to both AARP and the MetLife Mature Market Institute, it usually is the woman who attends to family caregiving needs. For women, the total lost wages owing to time off from work or taking leave for caregiving averages $142,693. What family with caregiving duties would not benefit from having an extra sister on board? And it is important to know that Geriatric Care Managers are certified by the National Association of Professional Geriatric Care Managers (NAPGCM), an association formed in 1985 to advance dignified care for older adults and their families. Certified Geriatric Care Managers are professionals who have extensive training and experience working with older people, people with disabilities and families who need assistance with caregiving issues. They assist older adults who wish to remain in their homes, or can help families in the search for a suitable nursing home placement or extended care if the need occurs. The practice of geriatric care management and the role of care providers have captured a national spotlight, as generations of Baby Boomers age in the United States and abroad. For more information or to access a nationwide directory of professional geriatric care managers, please visit www .caremanager .org 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.
It's June, and school is out for a lot of kids and everyone is thinking of taking time off. In fact, by a certain time of the year most people who are going to take a summer vacation will have made their plans. We all know how to make plans and make reservations to get to where we want to go. If we look beyond what month it is and think about seasons of our lives, we may also be thinking about retirement. By a certain time of life most people will have made retirement plans. We all know where to turn to get advice on how to make plans and maybe even a picture of where we would like to be once we become financially independent. As a geriatric care manager, let me suggest also that by a certain time of life most people will not have made plans for getting older. In fact, the plans that need to be made for getting older typically will not be made by an older adult, but rather by their caregivers. And the typical caregiver will not always know where to turn to make those plans for their older loved one. So, please allow me to share with you what is usually 60% of my first conversations with someone who e-mails us or makes a call as a way of explaining what a geriatric care manager does. Looking at that first example of summer vacations, it would be really great if there were a geriatric care equivalent to Travelocity. Or talking of retirement, it would be really easy if having a plan for getting older would be like following that arrow line in the television commercial. But there is hope. Making plans for getting older can be easier than a lot of caregivers think. The majority of the first conversations I have with clients are a lot about what they are looking for like: • home medical care for an older parent, or • a senior community where mom or dad can move or • where to go for what they see as the onset of dementia in a loved one. As the conversation unfolds, it usually becomes clear that what is needed first is an overall assessment and then a plan for the options available to support a loved one in maintaining their maximum quality of life. One of my associates calls us the "wedding planners" for getting older. To just get home care may be a bit like that wedding planner who just tells you where they have a great stock of wedding dresses when you were really looking to plan that "special day." To just get a list of senior communities in the area may ignore the other options for aging in place that could come from a full assessment leading to a plan. And it may be dementia or it may be interactions among any of the multiple medications that your loved one has been prescribed by multiple providers. What may be more helpful is someone to look at the big picture and help make a plan. If you are a caregiver, think about your concerns for your older loved one, but also consider looking into geriatric care managers. They are essential in providing an overall informed assessment and even more important for discovering all your options. The person who can best do that likely is the person who sees the big picture and knows all the resources available. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
Making decisions on behalf of a loved one is not always easy. Yet the challenge can be eased with information. The most common questions I get as a geriatric care manager revolve around:

1. What should a caregiver do to address their loved one’s need?

2. How does a caregiver make choices among alternatives to help their loved one?

To help with both of these decisions there are a good many free resources available to everyone. Your older family member or someone else with special needs may be in Chicago and you may live in Nashville, but you can get good information from all your own nearby healthcare providers, legal advisers, financial consultants, or other experts. These individuals should be able to direct you to their own national member organizations or associates they personally know in another city. Local hospital discharge planners can be very helpful, because it is their job to get at least medical help for individuals who are preparing to return to their homes after a hospital stay. Just remember that their job ends at the hospital door for discharged patients, so they do have limitations.

You can also do in-home research at the click of your mouse. I have found a web site called senior citizen’s guide to be really helpful. It has city by city listings of health, housing, services, and activities by most major metropolitan areas. Even if your loved one is in a smaller community miles away, one of these metropolitan centers can be very helpful starting places in directing you to allied services within your target geography. Just contact them. Or contact a local public library, and ask for the reference librarian.

Here are some WEB resources to start:

AARP

Senior Options

Eldercare Web

National Association of Professional Geriatric Care Managers

You will find some others on our CCM Resources page

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