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

Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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A Defensive Game Plan for Dementia Outbursts
It’s not just about forgetting or being confused. If you have a loved one with dementia, it is also...
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January 31, 2023
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To Sleep, Perchance to Dream
No, this isn’t a refresher course on Shakespeare and the famous Hamlet soliloquy. (Spoiler Alert – Hamlet was ranting...
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January 2, 2023
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Why Mister Rogers Was Right
Mr. Rogers Told You…but were you listening? And it wasn’t just once that he shared the message; it was...
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August 2, 2022
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Why AND Is the Most Important Word
Do you recall the 1991 movie called City Slickers? It was another great role for Billy Crystal, but it...
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July 19, 2022
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Looking Out for Your Older Parent 24/7
There will come a time for everyone with an aging parent that the question will arise, “Is it still...
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July 11, 2022
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When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
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May 17, 2022
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Heavy Drinking Helps?
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: ...
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April 19, 2022
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Gaining More than Birthdays
We’ve all heard someone explain…typically referring to that paunch around our middle…that their “metabolism has slowed” from what it...
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March 22, 2022
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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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In the Caregiver's Words

Recent Client Praise

You may have heard about music therapy, and you certainly have heard the often misquoted: “Music doth have charms to soothe the savage breast.” But does it work? Music therapy, that is. There actually has been a fair amount of research into how music can address some of the issues that trouble people, and some scientists in the Netherlands have scoured the scientific literature to see if music can be of help with patients who have Alzheimer’s. Specifically, they looked to see if a case could be made that music can help relieve the agitation, aggression or depression of dementia patients. In what is termed a “meta-analysis,” they examined a large body of literature to see what others have reported. While they could not control for variables like the size of groups being tested or the therapeutic elements of the settings, they did offer some tentative conclusions:
1. Music does not seem to have a measureable impact on a patient’s agitation. But the researchers suggest that there may be an effect, but since the therapy sessions may have been too long in duration, the effect may have been clouded by patients’ in ability to be stationary for the duration of the tests. The “calm” that was expected also could have been clouded by social interactions among patients in a group setting.
2. The findings were pretty much the same with aggressive behavior. There is no evidence. They could not sort out all the other background noise – not the music – to say with certainty that music reduced aggressive behavior.
3. What did seem more clear is that patients who had been predisposed to depression seemed to have a lifting of their moods with music. While this was a more consistent pattern, it might also have been confounded by the fact that the music therapy took place in a social setting. And isolation is one of the big causes behind depression.
When it comes down to it, we really cannot conclude that one kind of music will always have the same effect on all people. The fact that there were some positive changes across most studies, however, suggests that it is more than a bunch of notes. Music can make a positive difference for people who have cognitive issues…it simply may not be enough. But at the end of the day, we may come back to the traditional rule about not doing harm. If music is not a problem for people, then let the band play on. 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.
Caregiving in this century is not just handholding; it combines the latest technologies with caring to allow virtually anyone to be virtually anywhere they are needed. As a geriatric care manager I often am in the role of the “person who knows resources” that caregivers and their loved ones can rely upon.

A new study produced by a partnership between the National Alliance for Caregiving and United Healthcare offers results of a nation-wide online survey of caregivers who are leveraging their caregiving with web-based and mobile technologies. The survey was based on the responses of 1000 Caregivers at least 18 years of age, who provided at least five hours of unpaid care to an adult relative or friend and had already used some form of technology to assist them in their caregiving. To see the full report, please go to The e-Connected Family Caregiver: Bringing Caregiving into the 12st Century. Here are just a few of what I think are their insights for modern caregiving.

The survey asked these people to rate how helpful they found each of twelve different technologies to be. You may get some ideas for your own needs from their answers. The three “most helpful technologies" included:
- Health record tracking that would help the caregiver to follow their loved one’s history, current status and other metrics even if they cannot be at all appointments;
- Shared electronic calendars to allow everyone to track a loved one’s doctor appointments and other needs;
- Electronic reminder systems to help the loved one stay on schedule with medications as well as actually dispense the pills.
Although the most common challenge to using these and other technologies was their real or perceived cost, the greatest benefits caregivers see for themselves and their loved ones are, in order:
- Saving time,
- Managing logistics more easily,
- Enhancing safety for their loved ones,
- Increasing the effectiveness of the caregiver, and
- Reducing the stress that a lot of caregivers feel.
So, what beyond cost stands in the way of caregivers embracing these new technologies and others? Most caregivers want to be told about technologies from a trusted source like their physician before they will buy it. Or they want to actually have someone walk them through how the technology works.

One of the clear themes to emerge beyond the value of technology is the basic fact that almost all caregivers already use technology in the form of Internet access. So, check out the National Alliance for Caregiving website as well as two other medical sites that survey respondents endorsed as trustworthy:

WebMD and The Mayo Clinic. Participants in the survey also gave high marks to the Medicare web site and the Administration on Aging web site.

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 are a caregiver to an older adult, don't be surprised if your loved one is asked if there is a gun in their home during the next doctors' office visit. In the past. such questioning was usually out of concern for young children in a home who may find a loaded weapon in the house. And we have all seen the reports in newspapers across the country when a youngster discovers a sidearm in a parent's room. Now, as geriatric care managers, our profession also involves talking about gun safety among our clients. Why? In an article published just this past week in the Annals of Internal Medicine, doctors are now being encouraged to ask their older patients about firearms in their homes. Doctors are rightly pointing out that the higher rates of dementia, depression or memory issues place older adults at a high risk for suicidal behavior. According to the latest data available, firearms account for more than seven of ten suicides among adults 65 years of age and older. This is compared with just 51 percent among the population as a whole. For those 65 and older, the suicide rate is 14.6 per 100,000 versus only 11.4 per 100,000 of the population overall. And suicides with handguns outnumber homicides with handguns. There is no denying the second amendment rights of all citizens, but the suicide risk is a matter to address. Physicians are now being encouraged to ask about guns in the home among their older patients, which places this at the level of a national health issue. I recently heard a local official talking to an audience of older, middle-aged and younger business professionals about what we may call geriatric suicide. He asked for a show of hands for all those who at some point in their lives have owned motorcycles. I was a bit surprised by the relatively large number of hands that went up. He asked those that no longer had motorcycles to lower their hands, and it was mostly the older contingent who took their hands down. He asked one of the older folks why they no longer owned a two-wheeler, and then another and another. The answer? It wasn't safe for them anymore. A lot of heads nodded. Some may feel that the same reasoning should be applied to those who own firearms. I am not pro-gun or anti-gun, but I am a professional advocate on behalf of older adults. Give the medical guidelines a read to see if this may be a discussion you wish to have with your older loved one. Also, please comment on this posting if you have an opinion you would like to share. Like so many issues that are important for us to address, there are no easy answers. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers and certified professionals who are advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
Most of us have grown up with the faith that when we have a medical issue, there is likely to be a drug to take to alleviate the problem. Yet, we as geriatric care managers have found that more than 700,000 hospitalizations each year result from adverse events or side effects of drugs or because patients are over-medicated. Most of these patients are older adults, despite the fact that those over age 65 years of age represent only about 13.5 percent of the population. If you are a caregiver to an older adult or other person with special needs, you should pay particular attention to the following to keep your loved one out of the hospital:
- It is not just prescription drugs that should concern you. Most of the medicines that we all purchase over the counter (OTC) were once prescription medicines. They can represent potentially harmful side effects like Tylenol with its potential for liver toxicity. And don't forget that even aspirin is an acid; but it was on the drug store shelf before there was an FDA to protect us from its stomach slide effects.
- Keep track of all the medicines your elder may be taking (and include the OTC meds). Most doctors' offices are getting very good about asking what medicines are being taken with each visit, but be prepared with your loved one's lists at each visit. And ask if any can be dropped; you may be surprised at how many prescriptions handle the side effect of another medication.
- Be careful about how a medication is to be taken. Make sure your older loved one and you both understand the time of day a drug is to be taken, with or without food or how it might interact with another medication or even certain foods.
- Read the fine print. Every prescription has something pharmacists call the package insert or PI. Read the indications and usage section of this long page and call your provider with any questions. Also read the adverse events to make note of anything that has a greater than 5% incidence - and what steps to take should that event happen.
- Make sure you watch for anything out of the ordinary and ask your loved one how they feel. It may be just a dry mouth, or it may be hard stools or other side effects they may not volunteer. Everything is important to monitor. And if your loved one suddenly has any difficulty breathing or feels anxious, call your provider.
Underlying all of these caveats, appreciate that your older loved one has less fluid per pound than a younger adult. Their metabolisms also function more slowly. And most drug trials are conducted only with younger and healthier adults, so side effects may be minimal and less consequential. Birthdays and drugs may have bigger side effects than the pharmaceutical companies may have found in their trials. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
I have talked in a lot of my postings about advanced directives and how we all need to prepare for the end of life crisis that will face us ... and our family members. If you are a caregiver, you should have had the talk with your senior loved ones about what care they want under a variety of life's end game scenarios. And hopefully your older loved one has placed in their physician's file or medical chart at the hospital what they would want to happen were they were attached to a respirator or worse. These are those quality of life decisions. That said, you may still face all the questions we all will when we are addressing the mortality of a mother or father. What would mom or dad want? And that is the right question. We all should know with some certainty before the time comes what mom or dad have expressed as their desires should help to avoid the tough decision of life support or end of life. And the one person we really cannot ask is the physician. As a geriatric care manager, I am involved in decisions like this with some frequency, but I always make it clear that my counsel is not based on what I would do in someone else's place as much as it is about honoring the wishes of an older loved one. So, the children of the older loved one can always ask about health care options. What are the likely outcomes of whatever course of treatment and what alternatives does the family have are important conversations to have with your loved one's provider. I recently read of a doctor who was asked by the children of an older patient consigned to the ventilator what he would do if in their situation. Realistically we cannot ask the provider what he or she would do when facing and end of life decision for his or her parent. That is their decision, and it should have been based upon conversations the doctor will have had along the way with the doctor's parents. It is not a medical decision; it is a personal decision. So, the simple point is that if you are a caregiver to an older loved one, you should already have a good idea what the answer is to that kind of ultimate question is. And if you do not have a clear answer, then it is time to restart the conversation. Yes, it will seem awkward at first, but you may be surprised to find that your older loved one already has given this a lot of thought and likely has an answer to help prepare you and them. 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.
In my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved ones to find meaningful quality of life. In part, that may translate into helping a loved one to find social and age peers within their communities as their lives and perhaps even the meaning of quality of life may have changed. It also can extend to their desires for maximal independence, developing or preserving meaningful friendships, or even finding personal connections or intimacy. Intimacy? Yes, and you may have thought that your first talk with your parents about sex when you were an adolescent was awkward. Hold on.

As a geriatric care manager, part of the job description is about helping older clients with the challenges of aging, and part of it is about helping caregivers to appreciate their loved one's changing predicament and embrace those changes as well. "Mature intimacy" is one of those dimensions that call for equal portions of each.

If you have an older loved one who is single and wants to have a meaningful relationship, you likely need some guidelines:
1. The first thing you need to do is set aside the old "tapes" that may be in your head, your old beliefs about what intimacy is for you or was for your older loved one. Things are different now.
2. Now, turn that around and appreciate that your older loved one's early experiences will not guide their quest for a meaningful relationship now. The world has changed and age also has intervened. As a caregiver, you can gently help them to feel more comfortable with life's changes.
3. Appreciate that you may be asked about life and intimacy, and if you are not comfortable talking about it with your older loved one, encourage a conversation with the family doctor or a counselor or even sex workshops in some communities.
4. If you do break the silence remember that intimacy is more than intercourse. Just touch - as in holding hands - is something that older adults may long for. Try to set aside arbitrary expectations about what sex is that are based on what sex was. Encourage your older loved one to relax and enjoy the company.
5. Recognize your limits as a caregiver. A lot of parents had their children read books about intimacy before having "the talk." There are books available for mature sexual encounters as well (e.g. "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only).
6. Safe sex is critical in a time when STIs are potentially everywhere. There is a web site called SaferSex4Seniors. They also are on YouTube.
7. There are professionals who can help your older loved one. Check out the web site for the American Association of Sexuality Educators, Counselors and Therapists.
Now, that was not so bad was it?

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.