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

I had the good fortune recently to meet Jennifer Muskat, the Director of Client Services for San Diego Home Care Assistance. She shared some helpful perspectives on the importance of geriatric care management services for older adults who need emotional support. "The physical obstacles that your aging parent or loved one encounters in old age are often the most noticeable. While you can easily observe their struggles with walking or daily chores, it is much more difficult to recognize, understand and empathize with the emotions they experience on a day to day basis. Your elderly loved one will be forced to deal with a handful of life-changing events as they age. Retirement, forfeiting the right to drive, and the loss of a spouse, sibling or close friend are just a few examples of inevitable changes that accompany aging. Without emotional support from family members during life’s new and unfamiliar events, seniors become vulnerable to depression and often suffer from a decreased quality of life. As an adult, your sense of worth comes from your ability to provide for your family, perform your job well and most importantly, function as an independent individual. Whether from frailty or age-related illness, seniors lose these abilities, resulting in an increased dependency on their adult children. When this role reversal occurs, many seniors experience feelings of worthlessness and a lack of self esteem. Becoming dependent on their children, who once relied on them for everything, is difficult to cope with emotionally. When neglected, these negative feelings can result in depression in seniors. They feel alone and helpless and that no one understands their situation. To ensure the health and wellbeing of your loved one, it is crucial that you are aware of how your loved one may feel. If they seem withdrawn, upset or have just suffered the loss of a close friend or family member, take the time to talk with them. Listen with patience and compassion and try not to criticize their feelings. By letting your elderly loved one know you are by their side and are available to offer emotional support, you can help combat depression and enhance their overall happiness and quality of life. Also recognize that seniors become socially isolated in their later years and encourage your loved one to pursue new hobbies and stay in touch with old friends. Participation in these activities offers another channel for emotional support. We often do not look beyond the physical ailments of our aging parents and fail to provide the emotional support and encouragement they once provided us as children. However, it is never too late to help. Reach out to your elderly loved one and let them know you are there for them as they enter this new stage of life." Jennifer Muskat is the Director of Client Services for San Diego Home Care Assistance. She offers geriatric care management services as an advocate for senior health and wellness. By constantly developing new programs, she ensures Home Care Assistance caregivers can provide optimal quality of life for senior clients. 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. We provide elder care services to those in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
You may not have been following the news in China this past week, but China has enacted what may be the first law governing caregiving to older adults. In a law called the "Protection of the Rights and Interests of Elderly People" enacted this month caregivers are called to task. The law states "Family members living apart from the elderly should visit or send greetings to the elderly persons." This is not what I would consider a very enforceable statute, but it is a sober statement about what caregivers and their older loved ones around the world are increasingly seeing with regards to geriatric care management. AARP and a group called the National Alliance for Caregiving (NAC) have been surveying caregivers since 1997 and an analysis across the years show some interesting trends:
1. the average age of caregivers has been steadily increasing from 46 years old in 1997 to now 50 years;
2. the percentage of caregivers who are women still outnumber men, but the numbers have declined from 73% women in 1997 to the most recent figure of 67% women (this has been generally consistent across caregivers of all ages)
3. the average percentage of older recipients of care is growing - 24% of recipients 85 years of age and older to now 30% being that old or older;
4. the proportion of caregivers who also hold a day job has been quite consistent during the years of these surveys (from roughly three in four to four in five caregivers employed);
5. across all ages of caregivers there is an increasing incidence of leaves of absence from their jobs reported by caregivers
6. "burden of care" measured in hours of caregiving as well as actual activities was measured only in the most recent survey, but it was the older caregivers reporting the greatest burdens;
7. as a counterpoint to this "burden," the older caregivers also were those most likely to use outside services to help in the caring (older caregivers also were less likely to report help from friends);
Getting back to our China example, the law does say "should." But it just may be that the authorities were seeing some of the same trends as we see here in the United States. And this survey’s report pretty much squares with what I see as a geriatric care manager; older caregivers taking care of older friends or spouses shoulder a larger burden, and it ultimately takes its toll on the caregiver. If you know an older caregiver, help them to find resources to take some of the load off; remember also that a large portion of that "load" may be guilt about not going it alone...so be supportive. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified geriatric care management 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.
We may not be hearing QUITE as much about health care reform of late, now that the political debate has quieted. But as “reform” is being implemented one of its principal cornerstones is the same as that of geriatric care management – “care coordination”. I thought this might be an opportunity then to address a question I still hear a lot: What does a geriatric care manager do?

I often describe what we do as geriatric care managers to be working as “option-makers” to facilitate the “decision-makers.” The decision-makers are the elder or other person with special needs along with the families and caregivers. That has a lot in common with what health care professionals and policy makers under the “new” health care are referring to as the medical home or accountable care models.

Last March the second Annual Care Coordination Summit was held in Las Vegas under the sponsorship of consulting firm, Dorland Health. Some of what they discussed is a page right out of the geriatric care manager’s playbook. I said that we as care managers are really “option-makers,” and that is critical in a world where there are so many advances and so much specialization that a patient or even the patient’s primary care physician will be stretched to keep track of everything. And physicians are not paid to coordinate the care of their patients or follow-up with them after all their doctor visits, hospitalizations or other encounters with health care professionals. That is where care managers come in, and that is where leaders at the recent summit talked about how care coordination/management will improve the health care individuals receive.

The professionals who attended the recent summit talked a lot about changing health care from being “provider-centered” to being “patient-centered.” Any of you who are caregivers certainly can appreciate that the elder or other person with special needs is your focus as you support them. Mainstream health care is beginning to catch on. In the process of focusing on the patient, the professionals at the summit saw reductions in costs associated with health care and improved health. For instance, once hospitals begin to think about get appropriate care to patients, they no longer just think about what to do for a patient while they are within their four walls.

So, it seems that as health care providers are more and more thinking about making options available to patients, they are improving the quality of care patients will receive. Most hospitals have “discharge planners” who work with patients and family to prepare to leave a hospital. Accountable care organizations just as with geriatric care managers, however, will be focused on the patient wherever they are, not just the place they have left. Like I said, it seems to be catching on.

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 Charlotte Bishop
Ask any caregiver to an older loved one, and they most likely will admit that it is a stressful – but rewarding – job. But did you know that caregivers over age 65 are 63% more likely to die than people of the same age who are not caregivers? And for reasons that researchers do not fully understand caregiving is an even bigger mortality threat for women than it is for men. This rather alarming introduction is to underscore how serious it is to care for the caregiver. And there are some steps and some options that can take a lot of the crunch out of caregiving and allow all parties to focus on mutual care. If you are a caregiver to an older loved one with a chronic condition, here are some tips on how to take care of yourself along this journey: 1. Recognize your Depression – The estimate ranges from 40% to 70% of caregivers show signs of depression. It is not just “having a bad day.” Watch for your signs of irritability, heavy drinking and difficulty sleeping. Then, get professional counsel or talk with friends who “get it.” 2. Go Easy on Yourself – There are many aspects of your loved one’s condition that you simply cannot make better. But you can help to make your loved one more comfortable, and you can be there to listen. Just showing up is huge; give yourself credit for all of those efforts you make. 3. Take a Timeout – You must keep places on your calendar for “your time.” For some caregivers, that means a workout, for others just a long walk or a hot bath. To do these, you also need to enlist the help of other friends or family who can substitute for you or you can engage respite services from a local agency. 4. Make Your Health a Priority – Do not skip a doctor’s appointment, do not delay an annual physical or routine diagnostic procedure, and stay current with your medications. Be alert to other physical manifestations of your stress like pains, acid reflux or poor sleep. Get help for you so that you can help your care receiver. 5. Make a Plan – Engage the services of professionals who can help you explore your options. When home is no longer an adequate setting for caring for your loved one, get help to investigate the options that can be brought into home or where the new home is going to be. Remember, hope is not a plan and that there are professionals like care managers who know things you need to know. It is entirely possible to give until it hurts. But that does not really help your care receiver or you as the caregiver. Put yourself in your loved one’s place, and consider what you would expect of a caregiver. And at the end of each day, recognize that you have done all that you can, and that is more than enough. 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.
Do you know how kinesiologists refer to walking…at least some of them with whom I have spoken? (These are the folks who specialize in the mechanics of body movement.) They call it “controlled falling,” and we can really appreciate this if we look at toddlers just beginning their first adventures with “walking” upright…it is mostly a series of failed attempts at walking that initially end mostly in falls. Fortunately for toddlers they are built pretty close to the ground, so the falls rarely inflict any real damage. Not so with older adults. June is National Safety Month, which makes it a perfect time to highlight one of the bigger health risks among those 65 years of age and older: falls. And this is a good time to underscore the scope of the risk. Like, one in four older adults has a fall each year, but only about one in two of these are ever reported to their physicians. Yet, over three million of these episodes each year are seriously enough for the individual to end up in the emergency room owing to a resulting head or hip injury. By the way, more than one in four of these ER visits result in a hospital stay owing to a fracture or contusion or worse. If you have an older loved one, don’t wait for the phone call; here are some simple steps you can take to assess your care receiver’s risk as well as help bolster their safety:
- Assess your loved one’s risk for falling using the CDC’s questionnaire;
- Make certain your loved one gets an annual eye exam, and keep their glasses (if needed) are current with their vision;
- If you accompany them to their doctor visit, ask about their feet, posture, leg strength and agility;
- Help assess and address any clutter or other safety issues in your loved one’s “space,” and remember that a lot of this revolves around lighting and ease of access.
This last one has a lot to it. If you would like, we have a home safety checklist that you can use to identify potential trouble spots in your loved one’s house. Just email me at info@creativecaremanagement.com, and I will send you a copy. You may have noticed that I have nearly 600 postings in this blog. Please just type in “home safety” or “fitness” in the search box on the Blog…or any other keywords that are top of mind for you about your loved one’s safety. So, let’s all end this month with a spring into summer, not a fall. 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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