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

Would You Want to Know?
National Geographic has a new documentary series, Limitless with Chris Hemsworth, starring, of course, Chris Hemsworth of Disney’s Marvel...
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November 29, 2022
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Planning for the Holidays is More than a Menu
The latest news reports suggest only about 10 percent of American Adults have received their seasonal booster for COVID. ...
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October 24, 2022
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What’s Scarier than Halloween?
The short answer to this question is cybersecurity breeches. First, how do you know if that spam in your...
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October 18, 2022
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Become a Dementia Detective by “Talking the Talk”
Today we have a guest Post from Christina Padilla, a speech-language pathologist and Certified Dementia Practitioner living and working...
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September 27, 2022
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Diagnosing Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the second of four posts we’ll offer on the subject. A...
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September 13, 2022
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Dementia, Distraction, Delirium and Depression
September is Alzheimer’s Awareness Month, so we’re going to be sharing four posts that will help everyone with what...
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September 7, 2022
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Before or After the Fall
I came across an informative piece in the Washington Post about a week ago, and it brought to light...
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July 26, 2022
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Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out...
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June 7, 2022
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When the IRS Calls…
How about a show of hands regarding the Internal Revue Service (IRS)… Have you ever filed a tax return...
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March 8, 2022
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The “Other” Health Concerns for Older Adults
It was just two weeks ago that I underscored the fact that “older adults have a greater fear of...
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February 1, 2022
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In the Caregiver's Words

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We've all used the expression, "Don't lose any sleep over it." Turns out that losing sleep is one thing that can happen a lot more frequently as we age and it often is associated with other serious medical conditions.   The common causes of older adult insomnia are dementia, heart disease, kidney disease, heartburn or reflux, asthma, diabetes, thyroid disease or even prostate issues. So if you are a caregiver to an older adult who has been having trouble sleeping, it is worth paying attention.

And at the same time, insomnia is not always just one kind of condition. Some older adults have trouble falling asleep initially and some have trouble staying asleep. Some insomniacs may wake up several times a night, perhaps because they need to make trips to the bathroom, and some just cannot seem to feel rested in the mornings because they do not get a quality night's sleep.

As we grow older we need less sleep than we did as children or teenagers. Although we as a nation seem to deprive ourselves of sleep by getting up early, staying up late or both, the average adult needs about seven to eight hours of sleep a night to function well. People who say they need less may just have grown accustomed to getting by with less sleep, but they may also have a difficult time focusing during the day or may be cranky or irritable.

Sometimes it may simply be consuming caffeine, nicotine or alcohol, or it can be nutritional supplements or even vigorous exercise too close to bedtime that get in the way of good night's sleep. If you know someone who has trouble getting enough quality sleep, here are some tips that may help without resorting to the pharmaceutical sleep aids we have seen advertised a lot:

1.    It may be the afternoon nap that has to be taken out of the day's schedule in order to feel sufficiently tired to sleep at night...or the dozing off in front of the television after supper.

2.    Make sure the bedroom is dark enough and quiet enough, and move the clock out of sight so that there is not the temptation to keep checking what time it is.

3.    Don't use the bed as place where you eat, watch television or read so much that it is no longer that restful haven at the end of a day.

4.    Try to go to bed at the same time every night, and have some real physical activity each day so that the body will have something from which to be tired.

5.    Encourage your older adult to make a written list of the things they will do the next day so that the mind does not get caught up in the mental list-making that keeps the body awake.

6.    Above all, relax before bed time; it can be helpful to have a calming time that helps to really separate the day's activities from the night's surrender to sleep.
            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.
Too much caregiving can be harmful to your health! I have talked in the past about how important it is for us all to help care for the caregiver and that caregivers deserve to take care of themselves in midst of all the other tasks of caregiving. And if they do not attend to their own needs, what then? Well, they run the risk of becoming the proverbial “toast.” I have never seen an actual case of caregiver burnout, but I have seen a fair bit of toast in my years as an aging life care consultant or geriatric care manager. For instance, the middle-aged gentleman with whom I spoke a while ago about his care giving duties for his ailing mother. He summed up his situation by saying, “I’ve gone from five hours of uninterrupted sleep each night to five hours of interrupted sleep each night.” And he very much looked it. If you are a caregiver to an older loved one or know someone who is, look for the warning signs of the “caregiver toast” syndrome:
- The Joy is Gone: caregivers often report how rewarding it is to “give back” to a loved one, but as the time goes by and grind threatens to wear them down, they tire of it. Getting tired of caregiving is not a reflection on how “good a person” you are. It is a sign of burning out.
- Everyone’s capacity is different: Don’t compare your caregiving capacity with anyone else’s. It is not about a cup half full versus empty question. It is about how big your cup is, and yours may empty faster than another person’s.
- It may be how much care you are giving you. The caregiver is often the last person in line to get a break or a rest. If you are a caregiver, you cannot take proper care of anyone if you are not attending to your own needs.
The symptoms of “caregiver toast” syndrome are really tangible. Look for signs of the following in yourself if you are the caregiver…or in someone you may know who is a caregiver:
- Muscle aches in the neck, shoulder and back, headaches
- Impatience, distraction, irritability, diminished drive, guilt, melancholy
- Tiredness, sleeplessness, susceptibility to illness, memory loss
- Withdrawal from regular engagement like clubs, religion or social circles
What is a symptom or a diagnosis without a remedy? The toasted caregiver needs to start some healthy activities along with perspectives on themselves. Key will be a healthy diet and sleep cycle; acceptance of any shortcomings and credit for the accomplishments; seek help in regaining perspective, insight and even humor; seek out conversation, companionship and just the touch of others. Find resources with whom to share the load and the journey. Turn down the heat to avoid becoming toast. Charlotte Bishop is an Aging Life Care Professional and 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.
As you can tell from now a third installment about other medical conditions that can mimic dementia, it's not a quick diagnosis once one sees cognitive difficulties in an older loved one. And the isolation of this past year’s pandemic and quarantine certainly have created the perfect storm for health and environmental issues to conspire to make folks seem “not quite in touch.” When I asked for you to guess one of the remaining medical conditions that can mimic dementia, nobody got the right answers, despite the fact that nearly one in five of you who read the last email clicked through to the post. Well, no more suspense, here are three more “look alikes”. Did you know that…
1. Hearing or Vision Loss can create dementia-like symptoms. It stands to reason that those among our loved ones who have trouble hearing, will have difficulty also in processing what is said to them. And those who cannot see clearly will face challenges in orienting themselves in the world. As we all come out of hibernation, encourage your older loved one to have an eye exam as part of their annual preventive health measures. And if you are asked to repeat yourself in conversation, or if it seems your loved one is not registering what you’re saying, ask their doctor for a referral to an audiologist.
2. Urinary Tract Infections are relatively common in older adults and they can precipitate dementia-like symptoms. The key here is that there is relatively rapid onset of the symptoms, which are your sign if you are a caregiver to get your older loved one to the doctor. With the appropriate antibiotic, the condition and the delirium can be cleared up in a week or so.
3. Some Medications can induce dementia-like symptoms as an unwanted side effect. Anticholinergics, like diphenhydramine, are a classic case of a medication that has side effects that can be as powerful as the originally designed main effect. Also know as Benadryl, this medication is marketed perhaps even more often as a sleep aid, not an allergy aid. But these drugs also can block brain chemicals important in cognitive processes as well as some motor functions.
As we wrap up this triathlon of posts on dementia mimics, the common learning for those of you who are caregivers to older loved ones is very basic. Be observant for changes in cognition in your older loved one and ask questions. Your best ally in this likely will be your loved one’s health care provider who also will have a history with your loved one. They also will be able to discern even small changes in mental processing and will be quick to make the appropriate referrals, if indicated. But you will be the primary advocate, the one who will get your loved one to the provider in the first place. It is becoming very safe for the vaccinated people to get to medical providers, and the providers themselves are taking all the right precautions as they “open up.” And did I mention that now that we all are getting our vaccines, we can slowly begin to relearn hugs. Give one and get one…a vaccine and a hug, that is. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
If you are a caregiver, you probably know that the number of hours this job demands is onerous. According to a recent AARP survey, caregivers report an average of more than 20 hours a week taking care of an older loved one. This is on top of the "day job" they already have as well as any other family duties they may have for a spouse or children at home. So who is taking care of the caregiver? One person who probably is not caring for the caregiver is the caregiver him/herself. If you are a caregiver for an older adult or someone else with special needs, try out these suggestions so that you can survive and even thrive your caregiving responsibilities.
1.    Remember to laugh. It is no surprise that caregiving is stressful, and one of the casualties often is one's sense of humor. Laughter is a great stress-reliever that we have to give in to regularly, because it will make everything else a lot easier.

2.    Remember to be "normal." Caregiving can be demanding and often unpredictable in ways that tend to take over one's life. Perhaps you used to have a favorite television program or you enjoyed going for brisk morning walks or some other habit that gave you pleasure. Indulge yourself with one of these returns to normalcy and you will be more refreshed to return to your caregiving after.

3.    Remember your friends or colleagues. Caregiving can squeeze one's social life tremendously, and isolation can only make the weight all the heavier. Take time for a lunch or coffee with people you like, and some of the stress will go down a notch or two.

4.    Remember to get help for the emotional demands. This can be in the form of a support group or perhaps a counselor or your cleric. Talk with someone who will help give you some coping tools and understand why you need them.

5.    Remember to check up on your health. You probably attend all the doctor's visits for your loved one, but when was the last time you had a check-up yourself? It is not just emotional health that can suffer under the stress of caregiving, so keep healthy.

6.    Remember to forget some things. You may have a whole list of "must dos" on a weekly basis, and it is really acceptable to drop some items from your list. Hire someone to do your housekeeping or shoveling the walk or mowing your lawn.
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
We all know that Boomers - who began reaching age 65 just two years ago - are the largest segment of the U.S. population. Aging boomers are expected to total about 71.5 million by the year 2030, but what you may not know is that as many as one in ten of the Silver Tsunami will be lesbian, gay, bisexual or transgender (LGBT). This is important, because the generations that preceded them who were LGBT simply accommodated the "closet" when they aged. Never mind the ageism and racism we still find in some quarters, a lot of the institutional providers for seniors may not yet have embraced a welcoming culture for people of alternative gender preferences. As a geriatric care manager, I see this as a perfect storm with three fronts, a storm which has the potential to create one of the largest threats to aging well - social isolationism. If you are a caregiver to an older LGBT partner or loved one, you will need to be alert to the potential challenges. For instance, there are likely to be limited or no programs for alternative lifestyle older individuals in rural or suburban areas. And the gay male experience of aging is exaggerated among men where there is a more pronounced premium on being attractive or desirable. Generally speaking being 40+ among gay men can be seen as equivalent to being 80+ in the straight community in terms of being marginalized. The social isolation that is a consequence of "premature aging" and marginalization also increases the gay population's risk for depression, substance abuse, low self-esteem or even suicide. The rate of suicide among gay men is about six times that of straight men. LBT women may have it even worse. More than one-third, according to recent surveys, say that they have not divulged their sexual preferences to their health care providers. They also are less likely than gay and bisexual men to have purchased long term care or life insurance. About one in five LBT women are caring for an aging partner, but they also feel less prepared financially than gay men for retiring. Put all these factors together, and the LGBT community is less inclined to seek attention for health issues for fear of hostile or judgmental providers. Poor health care translates into even earlier institutionalization in long term care facilities. Also, it is ironic that in national surveys that nearly three in four LGBT individuals anticipate that they will be caregivers to another person, but one in five are unsure they will be cared for themselves when the need arises. Adding to this potential caregiver shortfall, many gay couples simply do not have conventional family to care for them. If you are a caregiver to an LGBT elder, encourage the following: • They have a Last Will and Testament that is really according to their "will" o With clear advanced directives/living will • Their partner/spouse has Durable Power of Attorney (health and finance) • Informal caregiving arrangements are clear and followed • Priority rights for hospital visitation are followed • There is Joint Ownership of Property with Rights of Survivorship And for us all: Recognize that all humans deserve compassionate care which respects their personhood and their definition of family and their wishes. 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.