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

Mittens Before the Frost
I was asked today about the “mitten test.” It was one of our colleagues who had remembered something I...
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September 18, 2018
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GOOD NEWS FOR CHRONIC CARE
Associate Care Manager Gregory is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and Medicare Counselor, whose work...
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August 6, 2018
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Long-Term Doesn’t Mean Put It Off Until Later
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and trained Medicare Counselor, whose work focuses...
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June 24, 2018
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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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A House is Not a Home (Part 2)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 12, 2017
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A House is not a Home (Unless You’re There)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 5, 2017
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Respite Care – The Holiday Gift to Yourself
Be honest if you’re a caregiver and you can answer YES to more than one of these questions. Sit...
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November 23, 2015
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Caregivers and their Medicare?
Yes, you read it right. I am posting this one about what caregivers should know about their Medicare. But...
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September 12, 2013
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In the Caregiver's Words

Recent Client Praise

In my last posting I shared geriatric care management services for caregivers communicating with a loved one who may be suffering from dementia. If you have a loved one who has Alzheimer's or one of the other types of dementia, you know all too well that they are not the same person they once were. But have you actually spent some time trying to understand who they are? Have you tried to understand what it is like inside dementia? Try this hypothetical situation. As you awaken tomorrow morning, you make note of the time, and you know that the dogs need to be walked because they have been in their crates all night. You have just enough time to walk them and then have breakfast and get to work. As you go downstairs to the kitchen, the crates are not there, the dogs are not there. In a minor panic, you turn to your wife who is there and ask where on earth the dogs and their crates are? If your wife of many years tells you the dogs have been dead for six years and that you have dementia which is making you confused, how do you feel? ...probably confused, anxious, frightened, and then sad - very sad. That used to be what professionals recommended to caregivers of individuals with dementia - a bit of reality-grounding, but today, the more accepted approach is one of empathy or what therapists call redirection and validation. So, this kinder approach to the situation might be to apologize for not letting your loved one know that the dogs are being groomed and that if they wish you can prepare a breakfast for them. A patient with dementia may suffer from delusions or hallucinations, and these can be intense and stressful events. So, affirming their feelings and then helping them to shift to something more soothing can be very helpful. This older adult who just happens to suffer from dementia still is the person with feelings who is just behaving in what they perceive to be a rationale manner. By validating their feelings and then redirecting their behavior, you are helping them to cope with the world as they see it. Some therapists even suggest that this helps to restore a sense of self-worth that will be helpful in avoiding some future episodes or anxiety:
1. First, ask questions that will help you understand what has triggered the response. I had a client who saw little people around the perimeter of the room painting the baseboards. Once we understood that these people did not speak or harm him, we could incorporate them into his world while still interacting with him.
2. Don't think that it all has to be logical. It is more about how your loved one feels than it is about if it makes sense. Just go with it.
3. Especially if your loved one is upset, try to gently find out what makes for the upset. Then, validate by agreeing that you would be troubled also if its happened to you. You will find that the anxiety for both of you will subside.
4. The bottom line for all of this is to gently give your loved one an out and a chance to save their self-esteem.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends who provide geriatric care management services to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
Recently, I had the good fortune to speak with the chief executive of a national specialty, Monarch Specialty Pharmacy, who has advice for caregivers who may be trying to help manage the prescription drug costs of an older parent or other loved one who has Alzheimer's Disease. Stephen Cichy's advice distills down to four tips, one of which is to take advantage of a new discount prescription offering from his company. He talks about Alzheimer's Disease specifically, but you can see that this can apply to a lot of the chronic medical conditions older adults face. Please give it a read.

"I was recently browsing the internet and came across a published report regarding the problem of medication compliance with persons living with AD. Turns out that when persons living with AD get their prescriptions filled, they take their pills as prescribed only about half the time*. (*Curr Med Res Opin. 2010 Aug;26(8):1957-65).

In addition to the challenge of dealing with multiple daily pills and the persistent problem of memory loss, an important factor contributing to the problem of medication use for persons with AD is the high cost of drugs themselves.   Let’s face it, the price of prescriptions continues to soar. In fact, drug prices are the fastest growing chunk of consumers' healthcare expenses, according to the non-profit Families USA.

If you have health insurance, your plan may or may not pay for prescription medicine. It depends on what kind of insurance you have. For example, if you have private health insurance through your employer, some or all of the cost of your medicine may be covered. If you have the traditional Medicare plan (sometimes called fee-for-service), you'll need Medicare Part D to make sure your medicine is covered. If you have Medicaid, the Medicaid plan in your state may cover the cost of prescription medicines with certain restrictions.

As someone who cares for a loved one living with AD, you may know first-hand the complexities of dealing with the high cost of medication. What might not be so evident is the risk of not taking medication as prescribed. When a person’s AD goes untreated, they run the risk of their medical symptoms becoming exacerbated and may end up in the hospital emergency room, or worse, get admitted for conditions that could have been avoided had medications been more readily available earlier.

This problem is vexing, although I’ve learned several tactics that are helping persons living with AD pay for their medications, and that may be useful for you:

1.             Look Beyond Brand Names

Generic drugs can cost as much as 70% less than brand name prescription. Always ask your doctor or pharmacist if there is a generic equivalent for your prescribed medication!

2.            Leverage State and Community Programs

Some state governments offer affordable medicine programs for seniors, people who are disabled and people who have low incomes. Community health centers, Area Agencies on Aging, free health clinics and other community programs may also offer help. Some social agencies, such as the Salvation Army and some private hospitals, offer financial help for people who cannot afford prescription medicines. To use these services, you may need to show that you don't qualify for private health insurance or that you don't make enough money to pay for your own medicine.

3.             Maximize Prescription Assistance Programs

Patient-assistance programs (also called PAPs) are sponsored by companies that make prescription medicine. Each company has its own rules about who qualifies for its PAP. In many cases, you will need to show that you don't qualify for private or public health insurance (such as Medicare or Medicaid). You may also need to prove that your income is below a certain level.

Each PAP has its own application process. In many cases, your doctor, nurse or social worker will need to apply for you. For some programs, your doctor or nurse can submit an application online. For others, the application must be mailed in. It's important to keep in mind that applying for a PAP does not guarantee that you will get your medicine for free or at a lower price.

4.             Tap the GoRx Prescription Savings Program

Prescription savings programs are an innovative new approach to access to free savings on prescription drugs for persons without prescription coverage or for persons with prescription coverage who may require significant out-of-pocket expenses for their medications.

One such program is GoRx™ (www.GetGoRx.com). The GoRx prescription savings program is free and available to every person and family living with AD, with no age, income or health restriction. All commonly prescribed prescription medications are eligible for a discount. The discounts are available to consumers who do not have prescription drug insurance or the particular drug they need is not covered by their insurance. The average savings is 32 percent off the regular retail price the consumer would otherwise pay at the pharmacy. A majority of participating retail pharmacies will honor the GoRx Prescription Discount Card.

Simply put, GoRx™ is a simple and easy way to reduce your cost of prescription medication. The program covers practically any drug, including vitamins and supplements, so you don’t have to worry about checking if their prescription medication is part of the program. "

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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a common topic of our discussion. I have asked Gregory Peebles to talk about this topic from the vantage point of his experience. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life. An Associate Care Manager, Gregory has been a part of our team for over a decade. – Charlotte Home. Not only is there no place like it, conveniently located wherever you hang your hat, that fits--like an old, comfortable shoe, but it’s also a place that once we leave, to which we can never return. While most find this very stressful, some are secretly happy for a new chapter. Indeed, lots of people confirm they like adventure, but small is the number who enthusiastically embrace major residential change. So what’s the difference? Well, for one, the direction of action: people elect to go on adventures, but change just seems to happen to us. This is a major life change, and those inclined deserve the opportunity fully to grieve their loss of home sweet home. However, once the initial grief has been addressed, we’ve got work to do! Change isn’t the end, and there’s plenty of life and happiness yet to be found no matter the location. Where that happens is up to you. The diversity of the experience of aging can be exciting, and, with the number of Americans joining the group of aging adults, the kinds of communities that now exist will only become more varied. Right now the kinds of accommodations available generally fall into a few groups.
- Active Adult Communities – Often neighborhoods with individual bungalows, these communities are based on the model of so-called “snow birds” who opt to transition to such a residential community rather than maintain a larger space. Living in one of these communities requires a high level of independence (and income). Individuals or couples with highly social personalities thrive in this setting.
- Independent/Congregant Living – Facilities of this type, while slightly less luxurious than an Active Adult Community, feature many of the same accommodations with a denser population. In an urban setting, they are often high-rise apartments indistinguishable from nearby housing, with dining, health care, and leisure activities on the premises. If considering this type of facility, be sure to keep nearby entertainment and accessibility in mind.
- Assisted Living – A senior for whom it has become difficult to care for themselves either because of physical limitations or decreasing independence will often find an exciting new life in such a facility, either through public assistance or private pay, where skilled staff are present to provide diverse care. If the care receiver is also living with cognitive decline, such a facility with a “Memory Unity” may be advisable.
- Skilled Nursing – On average, aging adults who become residents within skilled nursing facilities – SNFs - are those who have health problems, who require 24-hour care, and whose ability to manage the Activities of Daily Living is severely impaired. Nursing home care, too, is expensive, but public assistance programs such as Medicare or Medicaid relieve the cost.
Change is difficult, but not unmanageable. New identities await us and are only limited by our willingness to embrace them and the imagination we bring to our experiences. Change is scary, and rightly so, but when we weather even the most difficult transitions together, and our lives are no longer recognizable from before, we may--if we choose to--learn that home is something that we take with us wherever we go, and that it is recognizable not by its address, but by the love shared and the people with whom we share it, common to both our memories and our futures. One final thought: This is when people often reach out to Aging Life Care Professionals to help smooth the transition to a new residence and to ensure ongoing care. CCM has helped countless families like yours succeed in this new chapter. Contact us today and let us assist you. 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.
Creative Care Management invites you to browse our FREE downloadable white paper resources – offering both personal and professional geriatric solutions for those who care for the elderly or people with special needs.

Caregiver Advice on Bad MedicineMany are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed and how to spot warning signs.Get This White Paper

Caregiver Counsel on First Aid for the CaregiverIt is no secret that caregiving can be an everyday challenge, especially when managing a full time job and other family responsibilities. Discover tips about how caregivers can limit stress, boost energy, and stay positive in our latest white paper.Get This White Paper

Caregiver Counsel on Caregiving & the New NormalStatistically, more and more people will become caregivers to an older adult in their lifetime. Becoming a caregiver can be sudden and overwhelming as it is. We offer senior care options for preparing and reacting to different obstacles you may encounter.Get This White Paper

Caregiver Counsel on Taking the Old Out of AgingNo one argues that loss, isolation, or medical ailments may represent genuine setbacks as a person ages, but depression is a significant step beyond just feeling down or blue. Learn how to recognize symptoms of depression and how to be happy even at 100 years old.Get This White Paper

Caregiver Counsel on Senior Living OptionsFinding the best living options for your loved one can be tough. Whether it is picking the right senior living community or making your current family home safer, we help you to prepare for a productive conversation with your loved one about these transitions.Get This White Paper

A Caregiver's Guide Toward a Healthier Senior HeartHeart complications and disease are common issues that older loved ones face. Discover easy and practical ways to give you or the senior in your orbit a healthier heart.Get This White Paper

A Caregiver's Guide for Changes & AgingCoping with change can be difficult. It often involves tough decisions and conversations with the person you care for. Discover strategies to help you and your loved one feel more comfortable with transition.Get This White Paper

A Caregiver's Guide for the HolidaysHoliday stress is tough for everyone but especially for caregivers. Find out how to care for both yourself and your loved ones while managing these hectic seasonal times with friends and family.Get This White Paper

Roadmap to Alzheimer's Learn what to expect when you're caring for someone with Alzheimer's. Inside find tips for detecting dementia, how to best communicate with a loved one with Alzheimer's, and more.Get This White Paper

Making Home Safer Make sure your loved one can navigate daily activities as safely and independently as possible. Read about how to secure the most hazardous areas of the home and what action steps you can take to ensure your loved one is living comfortably too.Get This White Paper

Caring For the Caregiver Learn how to be as good for yourself as you are for your loved one. Are you becoming impatient with your loved one? Are you missing work or finding yourself easily irritated? If so, this white paper can help.Get This White Paper
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Caregiver Advice on Bad Medicine Many are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed and how to spot warning signs. Download
In this posting, I have invited Julie Northcutt, President of Caregiverlist.com, a company that uses new technology to deliver objective and comprehensive information and helps families select the right senior care. I have asked her to talk to us about how those “summer family visits” can be productive times for families to lay the foundations for life decisions when there is an elder or other special needs individual in the family. Please give her a read:

“Do your parents live in another city, state or country? Do you only enjoy a lengthy visit with them during summer holidays? If this is the case, remember to take a complete assessment of their current care needs while you are visiting. This will allow you to prevent emergency senior care planning later and eliminate the added stress last minute planning can cause. It is also a good time to assess the home for issues which may be a safety concern due to changing mobility and vision loss. The Centers for Disease Control and Prevention reports falls are the leading cause of injury and death for Americans age 65 years and older. Every year, about 35% to 40% of adults age 65 and older fall at least once. Keep an eye out on your visit home for any areas which might be made safer by making a small adjustment to furniture placement or by adding a safety device. Check on the following areas for any necessary updates so you will have good information to assist you in managing senior care from a distance.
- Medical Conditions: Do you know all of their diagnosed medical conditions? Ask about the more common medical issues which can escalate as we age, such as high blood pressure, high cholesterol, hearing loss, weight gain, arthritis, forgetfulness. Remember that the earlier any medical condition is diagnosed, the better the chances of slowing the progression.
- Medical Providers: Do you know the names of all their medical practitioners, along with their contact information? If they are not seeing a geriatric medical doctor, find out if their doctor has discussed age-related diseases with them and conducted a mini-mental exam in the past year.
- Medications: Are the medications organized and are they taking them consistently? Taking medications at the proper time and as directed (with or without food) does impact the effectiveness of the medication. Find out if they have kept up on refills of all prescribed medications.
- Home Safety: If mobility or hearing or vision losses are becoming issues, find out what products you can purchase to make their daily activities easier. Is it time for a telephone with larger numbers and a louder ring tone? Is it time for an emergency-response bracelet or necklace? Do they have proper grab bars for their bath and toilet? Assess what areas of the home are becoming a challenge and find solutions.
- Driving: How is their driving ability? Ask the neighbors and take a ride with them yourself to find out. You can learn about the senior driving laws in each state at Caregiverlist.com and also learn about ways to address any driving safety concerns with your parents.
- Retirement Care Plan: Where do your parents want to receive care in the event they suffer a stroke, heart attack or fall? Usually Medicare will pay for short-term rehabilitation in a nursing home after a major hospitalization but find out if your senior parent would prefer to recover at home or in a facility.
- Guardians: Who has been assigned the Power of Attorney and the Power of Attorney for Health Care? Make sure everyone knows who will be in charge and where the family keeps these documents.
- Resources: Learn what care providers are available in the area, from nursing homes to senior home care agencies to assisted living communities. This way you will be familiar with the choices.
- Finances: What is the budget for senior care? Has a long-term care insurance policy been purchased? If not, what are the financial capabilities to pay for care privately? CaregiverList provides information on costs of care and ways to pay for care.
Being a caregiver can be daunting, but you can make it better by planning ahead.

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.