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Making Your Holidays Happy Again
Yes, “holidays” is a plural word here. Please allow me to digress on this plurality and simply point out...
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November 16, 2021
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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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In the Caregiver's Words

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In the first of this two-part series, I talked about conversations involving changes in life where you as the child of an older parent may be required to step up to help your parent or see that proper help is available. This second part is devoted to conversations about preparations for end of life, life's final transitions. As with Part 1, these conversations also are a lot about making sure that one's wishes are fulfilled, in this case those of your older parent. As with the other conversations of Part 1, you may find that it is even easier to talk with your older parent about end of life issues if you have attended to your own documents as well.

Last Will and Testament. In the past I have interviewed an elder law attorney about the legal issues surrounding wills and advanced health directives. I am going to break these out a bit. It may surprise you to know that the majority of Americans do not have a written will, and you may be one of them. It may very well be that your older parent is entirely justified in believing that his or her needs will be attended following their demise, and that everything will be divided up equitably among the survivors. But the court system will still intervene in the form of probate to settle these issues legally, and that can only serve to diminish what is there for the heirs. Plus, if one wishes to share mementos or memorabilia with special meaning with an heir, this will carry even more import if the benefactor has written a note about the history of that object. As with some of these other difficult discussions, they may be easier if you make it personal by drafting with your attorney your own will.

Advance Healthcare Directives. And then there is the other will - a living will, which is part of anyone's advanced healthcare directives. The last thing an older parent would probably want in the event of a health crisis is to have a disagreement among family members about what mom or dad "would have wanted." Here again, it can be very helpful to have a family attorney guide you through what documents are needed to preserve end of life choices as an older adults wishes. Once the paperwork is done, it is important also that these documents are part of a parent's medical record and their personal physicians are aware of the document(s) and have a copy in the chart. Also, if a parent is living in a facility, a copy should be on file there. Finally, a copy should be on file at the hospital your parent would use if needed. One last time, by taking care of your own personal documentation you have a great way to introduce the subject to a parent in a very nonthreatening way. Remind them also that you will be quite distressed in such an event and that their decisions and choices in a calmer moment ahead of time would provide better choices.

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.
The Covid-19 pandemic and quarantine are receding in our collective rearview mirrors, but there are some lasting and devastating effects that remain…and they aren’t health-related. We have talked about how isolating the pandemic was, especially for older adults who may have been single during this quarantine. Beyond the unfortunate older adults whose communities may have been ravaged by the virus, the number of older adults who have been and may continue to be exploited financially has seen a sharp upturn. In a recent survey reported by The American Journal of Geriatric Psychiatry, the incidence of financial abuse among older adults has doubled during the pandemic. More than 21 percent of older adults reported some form of financial abuse or scamming during the quarantine which is double the one in ten rate of reported financial abuse in the period before the COVID-19 outbreak. What is all the more troubling is the fact that these are just the individuals who reported being scammed. Given that many financial abuse cases go unreported or unrecognized, we may now be in a continued pandemic of a financial sort among older Americans. Many older adults are relatively easy prey to those who will exploit their social isolation and the prospect that no one is looking out for their well-being while we were all maintaining distance to avoid spreading the virus. It could be a long lost school classmate of mom or dad, or maybe another individual whose work brought them in contact with a lonely senior. If you have an older loved one with whom you are now reestablishing contact, it is important that you help with a financial security check up. If you are not a legal power of attorney, you will have to be delicate about questions, but you can still look for signs of abuse:
- Have their been any changes to estate planning documents?
- Any purchases that seem unusual by their dollar amount or nature?
- Has your loved one been making more trips to the ATM for withdrawals?
- Have any bills gone unpaid?
- Any new credit cards arriving in their mail?
- Has your loved one talked about time spent with a “new friend?”
- Are their any pieces or art or family heirlooms missing?
With all of these, it may not be a stranger who is perpetrating the fraud on your older loved one; it may be a niece, nephew, child or grandchild or neighbor. Be prepared for your loved one to be perhaps indignant if you suggest anything, and be prepared to reach out to a community department of Senior Services. You also can find an accredited Elder Law Attorney by way of their National Association. Elder abuse is an epidemic for which there is no vaccine. Local law enforcement departments also have community outreach offices to help. 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.
I have not taken a real opinion poll, but from feedback I get as a geriatric care manager from my clients what scares them most is not the prospect of dying. It is the prospect of losing their mental abilities. Alzheimer’s disease is high on the list of “feared medical conditions" even though it is down at number seven on the list of overall causes of death among Americans. With “National Memory Screening Day” coming up on November 16, I thought it would be a good time to share a few perspectives on Alzheimer’s and related cognitive conditions.

Alzheimer’s is just one of the three major types of dementia that health care experts talk about. Dementia is any disease that can cause progressive loss of memory or function. Alzheimer’s has a lot of “name recognition,” but there also is vascular dementia. Vascular dementia is a result of the arteries that bring blood to the brain hardening. Just like the kind of hardening of arteries that starves the heart over time, vascular dementia starves the brain. Finally, there is a third category that covers a number of conditions like Lewy Body, frontotemporal dementia and even Mad Cow disease, but these are quite uncommon.

There also are “dementias” that are reversible. Depression can be confused with other dementias, and it is very common among older adults. Other medical conditions like hypothyroidism, Lupus, vasculitis, some venereal disease or B12 deficiency can cause reversible dementia. Substance abuse – common among older adults – is a source of reversible dementia. And other prescription medications can impair recall and cognitive function.

Some of the classic signs of the onset of Alzheimer’s disease you can look for include when the individual:
- Tells the same stories
- Asks the same questions
- Has difficulty with numbers
- No longer does the things they commonly have done (cooking, sewing)
- Gets lost in unfamiliar places (restaurants)
- Neglects their own self-care
- Defers to a caregiver (“Ask my spouse”).
A person can do a small self-check as well. I suggest to my clients that each evening they write down a short list of notable events from that day. The next morning they should review what they wrote the night before to determine if they can remember them. It gives them peace of mind, because we tend to forget that everyone forgets some things along the way.

There is a lot more ground to cover on this, and I will get to more in later postings. For more answers or resources, go to the web site of the Alzheimer’s Foundation of America. I also would like to address your concerns or questions in future postings, so please e-mail me at Charlotte Bishop.

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.,geriatric care manager Chicago,geriatric care Chicago.
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Back in May I posted about how May used to be called National Geriatric Care Manager Month, but with a change in our association’s name it has become National Aging Life Care Professional Month. People have asked me what has changed, and I am reminded of a columnist here in Chicago who used to write for the Sun-Times, but switched over to the Chicago Tribune when the Sun-Times changed ownership. When people asked him what he changed with that move, Mike Royko replied, “My socks!” Aside from the fact that “socks” are not my idea of a fashion statement, I would have to echo what Royko said those many years ago. Aging Life Care Professionals – you can still call us Geriatric Care Managers – still deal with the aging person and their families and the challenges of aging. I say families here, because almost invariably the person who gives us a call is the adult child of an older mother or father…or uncle or aunt…for whom they are a caregiver. And what weighs upon that caregiver most heavily is not just a medical diagnosis, but a quality of life issue. So we most often are focused on reducing the worry, stress and time the caregivers must take from their day jobs…or their family lives…or their personal lives. So what does an Aging Life Care Professional actually do? The short answer is: Whatever it takes. But let me elaborate; it is the same as we formerly did under the label Geriatric Care Manager: • Assess and Monitor-does the older loved one’s current home and their current capabilities work together, or are we seeing the kind of rehabilitation from a fall or illness that we should rightfully expect? • Plan and Problem-Solve-if home is no longer a good fit for the older loved one’s capabilities, what can be done to make it so or what are the alternatives to the current environment, or if an older loved one’s medical condition is not responding to current treatment, what are the options? • Educate and Advocate-when an older loved one does not feel they can ask their physician the important questions or when the living facility is not delivering appropriate care or service, who should be informed and who will stand up for that person? • Coach Families-this is most families’ first time down the path of aging, and a professional with training and experience can help everyone find optimal solutions and facilitate the best outcomes. • Option Making-and as I always tell our clients and our staff, we are not the decision-makers; we are the option-makers for the decision-makers. 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.