Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Geriatric Care ManagerChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 5

Doing Your Homework on Medicare Coverage
If you or an older loved one are at that age in the magical transition – otherwise known as...
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November 8, 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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What’s COVID Going as for Halloween?
It’s been a year and a half since the COVID19 vaccines came on line to address the pandemic when...
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October 11, 2022
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Stranger Things: Step up Your Diet with New Options
If I were to ask you what you or an older loved one had for dinner yesterday, the chances...
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October 4, 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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Treatments for Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the third of four posts we’ll offer on the subject. I...
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September 20, 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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Burn Calories to Reduce Dementia Risk
We most often think about exercise as a way to work off the calories that we may have consumed,...
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August 30, 2022
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In the Caregiver's Words

Recent Client Praise

About 50% to 70% of Americans will die without a will. So, you can imagine that the percentage without a “living will” or other type of “advance directive” is even larger. I attended a program last month in which a local lawyer specializing in elder law, Eric Parker, shared a lot of useful information about the types of advance directives and answered some common questions people have about them.

With the holidays coming and everyone getting together, I get a lot of questions as a geriatric care manager about how to help an older adult or someone else with special needs. The holidays may be a good time to have some discussions about what an older loved one really wants. In very plain terms, this conversation – while potentially awkward – will help assure that others do not make the critical health care decisions for an older adult. And, of course, these are discussions we do not have to be “old” to begin to have.

I start out by saying that I am a geriatric care manager, not a lawyer, and this is not legal advice. But let me give you a brief overview of the legal documents you should consider having in place so that health decisions are in accordance with what your loved ones actually want. If you want more information, I also will give you some Web resources to answer your questions.

First, a “living will” allows the writer to tell their doctor whether they want death delaying procedures used if they have a terminal illness or if they are unable to act. This only works with incurable or irreversible illnesses, so it is limited.

Second is the Gold Standard of advance directive, the “durable power of attorney for health care.” It allows the individual to name a person who will make health care decisions on their behalf. This can include refusing “life-saving treatment,” but it really is meant to take the place of the patient’s own decisions, so it covers a lot more than a living will.

Third, is the “do not resuscitate order” or DNR. It is limited to dictating that the patient does not want CPR if the heart or lungs stop.

Finally, the last one is not truly an advance directive, but it allows a family member to make certain health care decisions on behalf of the patient if there is no other advance directive. It is called a “health care surrogate act.”

Now comes the hard part – determining what is best for your loved one. And that is where good legal counsel is essential, but do your homework first. Check out some of the following elder resources:

Eric Parker has a ElderLaw Blog with lots of helpful information

AARP about advance planning

Caring Connections has state-specific advance directive requirements

Rainbow Hospice and Palliative Care talks about advance directives

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.
Do you remember when you had your last dental exam? Your last annual physical exam? Eye exam? How about flu shot? Or shingles or pneumonia vaccine? Gets to be a rather long list, doesn’t it? Your medical providers’ names and contact information? Now, if you have an older loved one, you now have another list of to dos and information to track. Yet you should have all of this and more at your fingertips, because knowing the stats could very well save your loved one's life ...because they may not have all of that information readily available either. The good news is that most health care systems these days keep all of that in a large data base that is accessible by patients, so you simply have to know your loved one’s user name and password. But you should get organized nonetheless. The categories of information you will want organized (consider an accordion file folder if you are more comfortable with paper or a file folder on your personal computer if you can digitize all information):
- Basic contact information, in case of emergency( ICE) and medical releases (If you need a form for this, please write to our info@creativecaremanagement.com -we will share one we use, powers of attorney (for medical), advanced directives, etc.
- Personal medical history of your loved one as well as relevant family medical history given that many medical conditions are genetically linked - "in the family."
- Current primary care provider information and predecessor providers if there has been any switch of providers.
- Other medical specialists whom your loved one has seen or continues to see, such as OB/GYN, cardiologist, endocrinologist, etc.
- Dentist contact information and a history of dental visits and any conditions of ongoing concern
- Alternative providers which may range widely from chiropractors to podiatrists, from acupuncturists to massage therapists and more.
- A record of all recent lab or other diagnostic tests and screenings.
- A history of all immunizations including the seasonal flu vaccines as well as less frequent TB tests, tetanus immunizations and beyond.
- A list of all medications (dose amount and frequency), over the counter medications (e.g., analgesics, sleep aids, etc.) and nutritional supplements.
- Insurance contact information as well as any forms or recent billing advice forms in order to track who has been reimbursed and who has not or even who has billed inappropriately.
- Allergies to foods or medications or other environmental risks (e.g., bee stings) of note.
- And, of course the "miscellaneous" category for everything else that may be relevant (e.g., pets and their food preferences, passwords, etc.).
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.
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In my past two postings, I know it may have sounded a bit bleak that we don’t have any FDA-approved therapies that can really address the underlying cause of the cognitive decline that is associated with dementia. That said, with so many health care professionals studying this condition, of which Alzheimer’s is a part, it is refreshing to see that we do find promising approaches with some regularity…or maybe I should say with some irregularity, but with reasonable frequency. I did mention a number of healthful steps that should be taken to reduce the risk of developing Alzheimer’s specifically and dementia generally. Let me add one more healthful step that has recently come to my attention - pomegranate juice. Pomegranate juice is an antioxidant that now has been tested against placebo for its efficacy with dementia, and it shows a positive effect in delaying the decline of what researchers term visual memory decline associated with aging. It was a randomized trial in which 261 participants were assigned to receive either pomegranate or a placebo. After 12 months, both groups were administered a standardized test of “visuo-spatial memory.” Memory decline is generally associated with aging and poor health style. This most recent research is part of a larger body of research that has been going on since at least 2013. In addition to this most recent study, scientists have studied pomegranate juice with animals as well as young to middle-aged subjects. In some of the research pomegranate juice did more than prevent further decline; it actually improved memory. Improvement was not seen in this most recent study, but with only eight ounces of pomegranate every day those who had the juice were statistically better off than those who had not received pomegranate juice. Do you see a pattern here? A whole lot of healthy lifestyle interventions seem to work for a whole lot of healthful outcomes…at the very least dodging some pretty difficult bad outcomes…like Alzheimer’s. Back to pomegranate. The researchers are studying the juice more closely, and have found that the juice is not only an antioxidant, it also is an anti-inflammatory and there is reason to believe that it also has specific anti-amyloid effects. This last one is what brings us back to its potential for Alzheimer’s disease. I will keep you posted on this as well as other ongoing research. 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, it is not a typo. There are some new changes to insurance coverage under the Affordable Care Act that will have a big impact on one of America's often overlooked health care needs: hearing. Did you know that one in five adult Americans have some form of hearing loss according to the National Institute on Deafness and Other Communication Disorders. Yet, only about one in five of the one in five with a hearing loss actually have used a hearing aid in the past. That translates into about 40 million adult Americans go without a device that could re-engage them with the world, and it mostly is because hearing aids are expensive - about $1,000 to $5,000 - and last only about three to five years before a replacement is needed. The implications for the older population are staggering. Among adults between 65 and 75 years of age, the percent with some hearing lost, but this jumps to fifty percent of those 75 and older who have a hearing deficit. In past blog postings, I have talked about two of the major challenges of aging: loss and isolation. Picture those two amplified by the inability to hear the words of comfort from another person or to engage in social activities simply because one cannot hear well. But there are changes afoot. The Affordable Care Act stipulated a requirement for coverage for the ten "essential health benefits" (EHBs). Advocates for hearing health see number 7 of these ten as applying to hearing: "rehabilitative and habilitative services and devices." While this is not a done deal, there are increasing numbers of states and/or insurers who are getting on board with hearing health just as they had in the past with vision or dental health. UnitedHealth Group has introduced a hearing health option in 2011 that can be either a benefit or at least a discount. Closer to home, Blue Cross/Blue Shield of Illinois is now offering a discount benefit to their members through TruHearing. With these giant insurers in the lead, you have to believe that others will follow now that the playing field for health insurance has become more competitive. You should also check your AAA insurance or AARP membership for discounts. And Veterans Benefits and the Federal Employee Benefit Health Program have always included a hearing health benefit for their members. If you are a caregiver to an older loved one who is having hearing difficulties, give one of these entities a call. You may be very pleased at what you - and your loved one - hear. 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.
One of my clients recommended a web resource recently, and I am so impressed by it that I am passing it on to you. So often in the process of caring for an elder or other person with special needs we come up against medical language that can be difficult for someone who is not a trained professional to grasp. We can always look up a word in the dictionary, for sure, but the specific way words are used when speaking of geriatric and related issues can be rather esoteric. So, when I can across the glossary of terms offered at the Silverado web site, I just had to pass it along. Please check out: Silverado Glossary. You will get a quick grasp of the differences between amyloid and aneurysm or between dementia and delirium. It also offers really helpful suggestions on the early warning signs of Parkinson’s or Alzheimer’s and more.

The same site also is a wonderful compilation of other web resources that can be very helpful for the caregiver trying to navigate a new medical condition or other complication for which a little support or explanation would be greatly appreciated. They have another window on their site that offers at least a couple dozen resources that may be just what you need. Please check out: Silverado Web Resources. It has everything from links to Alzheimer’s support groups to veteran’s health benefits and more.

If you find resources like these, please do not hesitate to pass them on to me, and I will share them on the blog site. Also, do not hesitate to send me your questions, and I will do my best to answer them.

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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