Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Geriatric Care ManagerChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 4

Scammer v. 23.1
Call it Ocean’s 65+…instead of Ocean’s 8 or Ocean’s 11…but it doesn’t have a caste of Hollywood stars, and...
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March 7, 2023
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Another Side to the Story
It was just a year ago that Bruce Willis’ family disclosed that the actor would be retiring from acting...
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February 27, 2023
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Ain’t No Sunshine…
…When She’s Gone.” Or how about, “You are My Sunshine, My Only Sunshine?” or “Here Comes the Sun?” or...
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February 21, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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Passing on Personal Possessions is Perplexing for People: 6 Pointers
As you gathered with loved ones over the holidays, you may have realized it’s time to start discussing how...
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January 10, 2023
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A Viral Trifecta?
To get to the question in the email first, the Spanish flu of 1918 did not get its start...
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December 13, 2022
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One More BIG Addiction?
If you’re old enough to remember 1969, then you are old enough to remember this bold addition to the...
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December 6, 2022
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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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Saying “No” May be the Right Answer
Saying “yes” when someone asks you to do something can be like eating candy. It feels right or good...
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November 15, 2022
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In the Caregiver's Words

Recent Client Praise

Most of you probably know that Alzheimer's disease is the most common form of dementia among younger and older Americans. One in three Americans dies with either Alzheimer's or some other form of dementia. Scientists make a distinction between what they call late-onset and early-onset Alzheimer's Disease. Very simply, early-onset is a disease that manifests itself among patients younger than 65 years old, and late-onset is among those who are 65 plus. As a geriatric care management professional, you can imagine that I commonly am involved with families who are addressing this frightening condition in a loved one. If you are a caregiver to an older adult or other loved one who has developed Alzheimer's, you are very familiar with short term memory loss as well as confusion, language difficulty or other cognitive issues. But there have been some recent possible breakthroughs in Alzheimer's research, particularly late-onset Alzheimer's. What makes this potentially more exciting is that the specific Alzheimer's manifestation where this research has relevance. It is for the common non-familial kind of Alzheimer's Disease, the one that has seemed so unpredictable. In research published in the journal Nature, scientists at Columbia University seem to have narrowed down the late onset Alzheimer's to two genetic pathways. They then compared the genetic pathways among study subjects who had not manifested Alzheimer's and they did not have these pathways. They found in other subjects that these two pathways were associated with the development of what is called amyloid plaque. And that those without these particular genes did not have the amyloid tissue. While this research is all very preliminary, the good news is that when scientists find these "pathways" are tied to the onset of a disease, they can then begin to research what they can do to therapeutically modify the pathways – in effect, turning off the gene expression. It is going to take a lot more research and testing, but it offers a much awaited bit of good news for the more than 5 million Americans and their caregivers who are living with this disease. For more information on the disease, we have links to the Alzheimer's Association on our geriatric care management Support Tools Tab. 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 ccbishop@creativecasemanagement.com.
You can imagine that I follow a lot of clinical news feeds, and I keep files. I have files for dementia, files for residential living options and yes, I have a file for research that gives us insights into how people who live longer got there. There is no one secret to living longer, but there are some things that people who live longer do that can help us all: • An 80 year-long study that tracked people and their mental habits found that people who are more thoughtful and “plan-ful” live longer. • Multiple studies have consistently shown that people who have more friends or are more socially-active live longer. (They probably also have more fun…) • But choose your friends carefully, because their habits rub off…do your friends work out or do they smoke, do they make good food choices or eat junk? • In the “friends” vein, people who are married or have been married (divorced or widowed) live longer than those who have stayed single. • Napping is good for you; those who nap regularly have a 37% reduced risk of cardiovascular disease. • That extends to your overnight sleep also; people who get less than 5 hours of sleep a night are simply less healthy…if you snooze, you WIN. • Eat more fiber and fruits and vegetables; the end result is a much reduced risk for obesity … especially the belly fat that is the greatest risk. • Regular exercise to the tune of at least two and a half hours a week helps fend off heart disease, depression and some kinds of cancer. • If you drink alcohol – one drink a day for women and one to two for men; moderation reduces the risk of heart disease more than even than those who don’t drink at all. • Be chill – people who don’t carry a grudge or who are not always crabby or who are less stressed have lower rates of heart disease as well as other health issues. • Have a purpose in your life – you will live longer and reduce your risk of Alzheimer’s disease. These are the big issues to use as your guide to a longer life. As you read them, you may find that many of them make for a happier life as well. That probably is not a coincidence! Live well. 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.
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
Everyone's abilities and needs change as they age, but home may still be the same physical space it was twenty or more years ago. It's important not to wait until there is an accident to make changes that can help accommodate an older person's changing needs. It is easy to get ahead of where you need to be by presuming that the decision is about whether the best place for a loved one is home or an assisted living facility, a skilled nursing facility or some other new residence. I wrote in my last blog about the basic categories of "activities of daily living" (ADLs) that help us evaluate how a person is caring for themselves. The ADLs are hygiene, continence, toileting, dressing, eating and transferring. As a GCM, I often do what you might call an audit of the older adult's home while they are there. In that audit I look for signs of what they can and cannot do for themselves and what may pose hazards given their abilities.

Take for example, hygiene. Even a cursory observation can tell you if the older person has bathed or shaved recently, if their clothes are clean, etc. It can be as easy as securing the services a home care aid who can be present in the mornings or evenings or even just a few times a week to help with personal grooming or showering. Dressing is linked to this, and it may be that more frequent visits may prove necessary, because the older individual's range of motion may be limited making it difficult to get easily in or out of clothes.

With continence, it may be the family who may notice that there has been "an accident." Remember, however, that this is highly embarrassing to the older adult. They may even be embarrassed to purchase adult diapers at a store. The fix may be as simple as making the purchases discreetly for them. Toileting itself may become difficult owing to diminished dexterity. Grip bars in the bathroom as well as an elevated seat for the commode may be in order. You can also assess how well the older adult is able to feed themselves by either seeing them at the dining table or just look at the front of their clothes for evidence of spills. Or are they not eating or losing weight? They may need someone to prepare nutritious meals, because it is a real pain to cook only for one.

Finally, if just getting around the house has become a challenge to the older adult, watch their gait. Do they shuffle or are they unsteady? Get rid of scatter rugs in the house; they are a fall waiting to happen. Consider grip rails along hallways or a walker for getting around. I have an 84 year old client who had broken a hip, made it through rehab, but did not want to be seen using a walker. What won her over was finding a sleek machine in hot red that looked like it belonged in the Tour de France. She is not using a walker now; she is showing off.

We have resources listed on our site, but think about calling on a local home care agency for personal care, Meals on Wheels for food preparation or look for a durable medical equipment distributor for a walker. Hire a handyman to refit the bathroom or halls with grip bars, put bigger handles on kitchen cabinets, build a ramp for the stairs and more. You don't hire a Geriatric Care Manager to do this, but we can spot solutions to needs you may not see and know the resources that you may not know.

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.
If I were to ask you to make a New Year’s Resolution for your own happiness, what would your resolution be? Perhaps go on a long-anticipated vacation to France? Drop some of that weight that would help you get about on your own more easily? Or, just win the lottery and become an overnight millionaire?

According to a group of Harvard scientists who have been following a panel of 724 individuals and their families for 85 years, a happy life is not about things, places or money. It’s about nurturing strong relationships over the long haul. Relationships, they point out, are like sports training. Training to be physically fit is not a one shot affair. It’s about working and stretching and building your muscles and endurance. It even takes a team to make that kind of fitness happen.

People who have a durable network of friends, and perhaps even a “best friend” over the long haul, have quantifiably happier lives. It’s a kind of mental health and physical health insurance policy that helps people weather personal loss, ward off depression or memory loss and even live longer. Think of the alternative. We all know folks who are socially isolated…no surprise that the rates of depression among isolated individuals is high. During the protracted quarantines of the initial wave of the COVID pandemic, it was the folks who did not have people to whom they could reach out or from whom they could expect outreach who suffered mentally and had the poorest health outcomes from sickness.

So, how does a person strengthen relationships?
- It’s not just more friends; it’s also the quality of those relationships…the people in whom you can confide and who, in return, will share innermost thoughts, desires and fears with you. It’s not just a numbers game.
- It’s not just for extroverts; it’s also the small book club or the community garden team or a hiking friend with whom you can talk as well as walk. It may be just a few one-on-one relationships you have that will support you far more than a community club or such.
- It’s not too late to make those strong friends; it’s about what you do today to reach out and make yourself as available to “new friends” as it is about retaining your lifelong friends.
Making and keeping friends is an ongoing process, and the outcomes may surprise you. In welcoming new folks to your community club or church or condo association you may find the next strong relationship that nourishes both you and the new friend. People with whom you have lost contact may be as delighted as you when you reach out to renew acquaintances. The person you know with a different political leaning may be just what you need in a friend if you both can look beyond the politics and find the commonalities. Or when you go to the next gathering of whatever group and make a simple commitment to talk to three new people before you allow yourself to seek a safe corner to settle or call it a day. And, like physical training, strength comes from repeated effort and mixing up the routine in new ways that make our muscles work harder. Think strong!

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
I have written in past postings about some of the interactions between medicines that older adults may see if they are placed on multiple medications for their multiple ailments. But it is not just interactions that should get our attention. As a geriatric care manager I am increasingly focused on my clients’ medication even if they are on only one prescription. The reason for my renewed focus is in that flimsy sheet of paper with the really small type that you will find included with every prescription a pharmacist dispenses; it is called the package insert. And beyond reminding you how and when to take the medicine, it gives the patient and their caregiver some important warnings about the potential for side effects that particular medicine has.

Dr. Jon Duke of Indiana University and some colleagues reported recently in the Archives of Internal Medicine on the startling rise in the number of side effects that medications are listing in the package insert. We have all seen the television advertisements with those incredibly long lists of side effects they include at the commercial’s end. Dr. Duke and his associates found an average of 94 side effects for new drugs released following the Food and Drug Agency’s guidelines for package inserts. And these labels make for some interesting reading with side effects like “compulsive gambling.” But they also list some side effects that are both troubling and widespread. Who wants to feel worse after taking a medicine, but nausea is found in 75 percent of the drug labels according to Dr. Duke.

One of the reasons the lists are becoming so long is that companies are listing everything that showed up during the clinical trials required for the drugs’ approvals as well as anything reported to them after the drug began to be prescribed by providers following approval. Drug companies defend this relatively new and exhaustive approach to listing side effects as a fair warning to patients and their physicians, but Dr. Christine Cheng wrote a letter that appeared in the same journal issue as Dr. Duke’s article. In her letter she talked about the “information overload” that this labeling represents. These exhaustive listings of everything and the kitchen sink may include side effects that are not at all related to the drug itself, and only confuse prescribers and patients alike. You can find in the same drug’s label a listing of both drowsiness and insomnia, for instance, or diarrhea and constipation.

My recommendation to caregivers and the elders and others for whom you care is to talk with the prescriber or go on-line to read what other patients on the same medication are experiencing. Find out what is likely to have a real effect on the elder in your care. There probably is no medicine without side effects, but instead of being over-informed, you need to be well-informed by the providers who care for your elder or other person with special needs.

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.