Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • home care servicesChicago's Geriatric Care Manager Center of Excellence

Not Just Spring…
We’ve heard of Spring Training for those who follow baseball teams like the CUBS or the SOX, and we...
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April 13, 2021
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Can I Have A Hug?
I doubt there is anyone who does not have something that they have not been able to do during...
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March 4, 2021
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A Game Where Everyone Wins
Pick your metaphor. If you want your knife to slice easier, you sharpen it. If you want to improve...
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March 2, 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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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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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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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 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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In the Caregiver's Words

Recent Client Praise

I get asked a lot of times what we do as geriatric care managers, and you can go to our national association's web site (caremanger.org) for their answer. But since we most often get called in to address a life crisis or other life-changing event in the life of an older loved one, I thought it would be helpful to offer what it looks like in action to be a geriatric care manager (a GCM) when the call comes in. As a GCM, what we do best is assess a situation, make a plan and then assist in executing the plan. Most of the caregiver calls we get, however, leave very little time to assess and plan, because it is a family emergency when our phone rings. Mom or dad has fallen with a resulting hip fracture or mom or dad has had a stroke or a heart attack or some other medical emergency. A geriatric care manager is not the first responder, but we are the second responders who help the older loved one's support system find their options and recover some sense of normalcy. Sometimes it becomes a new normal, because life has changed for everyone. Caregivers may not realize how "normal" has changed so instantly at first, because the hospital providers have done a remarkable job of stabilizing the patient and averting a life-ending disaster. And even the course of the hospital trajectory seems normalizing. A discharge planner comes to the older loved one's room and explains how home health will be prescribed or how physical therapy will be ordered and the road to recovery seems pretty clear. At this point, please do not mistake what I am saying for a criticism of hospital discharge planning, but look closely at what they call the process. They do not call it normalizing planning, they do not call it the new normal planning, they do not call it life planning; they call it discharge planning. Their major focus is on getting the patient safely out of the hospital and into the next level of care - it may be a rehab center in the case of a broken hip or a nursing home in other cases or home with a provider coming to them for their care. But who is looking to help create a plan for regaining and optimizing quality of life? Who is there to help make home a safe place for an older loved one with some new physical or health deficits that were not there before? I have just given the job description for a geriatric care manager. GCMs are the people who help make home safer...or if not home, then help to offer the options for a safe place for your older loved one. We are the people who help to find and coordinate the services or physical assists for a person whose life-changing event will not allow life to go back to what it once was. As I tell our clients, we are the option-makers for the decision-makers, and "quality of life" is our goal not just for the older loved one, but for all the caregivers as well. We also are the voice of the caregiver and the older loved one. We are the advocates who will speak up when a referral is not to the appropriate medical specialist or when something in the medical record does not make sense. One of my clients once observed that we "translate medical speak" for the family. And we even go one beyond that by asking questions not every lay person would think to ask. We also recognize what a tough path an older loved one's care trajectory can be for the caregiver. We are there to help care for the caregiver as much as for the older loved for whom they called us in the first place. 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.
As a geriatric care manager, I often find clients who are on the right medications, but they are overwhelmed by the numbers and schedules of their meds. Older adults consume an average of four or five prescription medications a day along with two more over the counter (OTC) drugs.

While adults over the age of 65 represent only about 13% of the U.S. population, they consume about 30% of the prescriptions written in America today. I wrote about this last November, and talked about the potential for drug-drug interactions and the unique challenges to the health of an older person’s slower metabolism and lower hydration. I also discussed how one of the important tasks for a caregiver is to ask for a pharmacist or geriatric care manager to do a “medication audit” to be assured that the older patient is not at risk for adverse drug events or interactions.

What I did not devote much space to in that earlier blog is how multiple medications very simply present a real challenge to an older patient to keep all those prescription dosing regimens straight. This often results in noncompliance – or failure to take prescribed medicines – of one sort or another. Health professionals tell me that the reasons for noncompliance usually come down to:
- Forgetting – Elderly patients can lose track of all their prescriptions and schedules; it may be cognitive dysfunction or just being overwhelmed.
- Labeling – Labels may be clear to doctors, but older patients on numerous meds may not track dosing times a day or with or without food and more.
- Cost – Rather than admit that they choose between food and medications, some older patients may consciously avoid some doses or split pills.
For patients who forget doses, there are pill organizers that can be set up for a week – or even a month – at a time. The caregiver can step in to organize the medications along with clear instructions on when they are to be taken. There is a whole host of pill organizers, some with alarms. Google “pill organizer” and see.

There is a lot of variance in labeling of pills. In a recent survey of 464 adults aged 55 to 74 years old published in the Archives of Internal Medicine, the patients averaged dosing six times a day for the average of 7 drugs they were taking. While most drugs could be dosed four times a day at most, patients did not understand their labels sufficiently to consolidate their doses. There is regulatory movement on rules to standardize and simply prescriptions with universal medication schedules. You can help an elder by organizing their meds; the fewer times a patient takes medicine (not necessarily the fewer pills), the better their compliance.

Cost is an issue many elders may not bring up out of embarrassment. Caregivers, however, can work on behalf of their elder to ask for generic equivalents to branded medications. Where only branded medications are indicated, question the physicians’ office about manufacturers’ patient assistance programs, especially for patients without prescription drug coverage. Check the manufacturer’s web site for programs to help defray the full retail cost. You may also find much better prices on-line or through mail order houses when the prescription is filled for 90-day doses instead of 30 days.

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.

Copyright ©2011
If you think being a caregiver to an older loved one is hard--with all the trips to help them do laundry, the meals prepared, the trips to the grocery store, the calls received all hours of the day or night--try doing all of that across town or across the country One of every seven of the more than 44 million caregivers in America is a “distance caregiver.” That’s about six to seven million caregivers. And one in four lives 20 minutes or more away from the loved one in need. “Distance” does not have to be miles and miles away, because the local family member who has a job or has a spouse or has kids…or maybe would like to have a life can be just as challenged as the son or daughter time zones away. Distance caregiving carries its own set of unique stressors tied to the challenges of absence and logistics. But there are ways to make it work and to make it less stressful. There are interpersonal tools that can make the caregiving more effective and easier for the distance caregiver:
- Cultivate legal, financial and health resources close to your loved one
- Plan and coordinate visits from other friends or family members to your loved one
- Empower your care receiver to “own the choices” surrounding their support
- Communicate, communicate, communicate.
Leverage the technology of the 21^st century:
- Schedule a daily, regular time for talking with your care receiver
- Use an app for face-to-face communication
- Install smart devices that allow you to monitor home temperature and locks
- Give your care receiver a wearable monitor for vitals and emergency calls
- Place home cameras for security and to track medication adherence.
Not all tech is easy at first, so give yourself and your loved one a learning curve to become more proficient. Inform local members of their care team about any monitoring that will inform their tasks. In my next installment I’ll offer some tips on how to take a proactive role on the health care team while also keeping your care receiver empowered. If you are one of the 44 million or know someone who is, please stay tuned… 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.
Over the past couple years on more than one occasion I have talked about what a geriatric care manager (GCM) is. Even though the national association that accredits professional geriatric care managers (NAPGCM )is about 30 years old, the question of what we are still comes up. But there is more you should know about a care manager if you are one of the caregivers or family members looking to engage a geriatric care manager to help with your loved one. Here are eight questions I recommend you ask anyone you are considering for your circle of care.
1. What are your credentials? A GCM should also have other training or credentials like a rehabilitation degree, nursing diploma or social worker license in addition to being certified as a GCM. Ask about that.
2. Are you certified or licensed? Are they a certified geriatric care manager or simply providing services to older adults? Just as you would not want a lawyer who did not pass the bar or an accountant who did not have a CPA, you would not want just anyone who claims they “care for older people.” You can visit the Association web site to see the standards; check the link above and also look for the logo on their web site.
3. How long have you been providing elder care? There is no magical number of years, but you should decide how much experience gives you confidence and comfort that mom or dad will be in good hands
4. What about emergencies? You are not looking for a paramedic when you engage a care manager, but you need the peace of mind that your local resource can help in case of an emergency.
5. Does your company have any “relations” with other service providers? You definitely want someone who knows area resources like home care or senior residential communities. But be careful of anyone who may receive pay for referrals or who may simply steer you to their own services.
6. How will you communicate with me? This really is about what you want. Do you want a regular call, calls after medical appointments, routine e-mails or some other communication that will answer your questions and give you peace of mind?
7. What are your fees? First, you should receive a written document or contract with the fees and billing policies laid out. An article in the Wall Street Journal a few years back said that the national range of $80-$200 provided a “good buy” considering everything a GCM can do for a family.
8. Can you provide references? This will help you to get it in the “customers’ own words” from someone who has been in your shoes. You can also look for certification by the Better Business Bureau.
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 Charlotte Bishop.

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If you are a caregiver, you probably have talked with your older loved one in person or on the phone. You also may have swapped letters in the mail, but chances are that you have not been emailing...let alone texting mom or dad. Yet, all of that is changing. Now that we are starting off into 2014, we are seeing a clear majority of adults 65 years of age on the internet...and that bar may have been cleared as early as 2012. That certainly changes how some of we caregivers are communicating with mom or dad at distance. Here is the rest of the story. Nearly two of five 65+ year old internet users also are on Facebook. Half of these access their Facebook page on any given day. And nearly 90% of internet users age 65 and older are sending and receiving e-mail messages half of the time. As recently as 2010, only about 57% of adults 65 years of age and older had a cell phone, but that has increased to almost three in four adults of retirement age with mobile phones. Among those 76 and older the rate of cell phone use is approaching two out of every three of this cohort. The major problem older adults today face is the employment into retirement chasm - a technology divide. Those who are in the labor market tend to take for granted that what they learn at work to a large extent is what they also embrace in some form or another at home. So, now move beyond the retirement launch and one no longer has access to the latest technology that an employer used to provide. It is not age that takes individuals out of the electronic communication loop. The simple transition to retirement exacerbates a digital divide. So, encourage your parents to be both videoconference experts and gamers. Help them to Skype or find the latest in webcam technology so that they and their grandchildren can stay in touch and in view. And as the grandkids grow, encourage the grandparents to purchase gaming technology like Wii. They, of course, can use the latest gaming platform to engage the grandchildren, but they also will find gaming opportunities that will help them to maintain physical agility. This latter option is what a trainer I know calls "muscle confusion." Using different games on a rotating basis - or at the fitness center different machines and moves - will help the muscles maintain important agility and strength. Both of these will help to preserve the "spring in the step" as well as strength and endurance. Getting back to staying in touch with the grandchildren, the more that your older loved one stays in touch with what is current the more they will feel relevant and engaged. All f this helps t maintain physical vigor as well as ward off the most common concomitant of getting older...depression. So, technology for younger individuals may be about being cool and in touch, but for your older loved ones it also is about being connected and healthy. Keep connected...be the bridge. 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.

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home care services

Not Just Spring…

Can I Have A Hug?

A Game Where Everyone Wins

No Vaccine for the Other Plague

Until the Vaccine?

How the COVID Vaccines Work

COVID’s Other Deadly Toll

Hold Your Friends Close and Stangers Closer

Dementia: We’re Not Post-COVID Yet

Distance Caregiving Through a Wall

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