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

What’s Your Complaint?
If you grew up in a family as I did we were taught not to, or shown role models...
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June 11, 2024
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A Happy – And Well – Holiday for All
It’s the season of holidays. We started with Thanksgiving and then Channukah, and we have yet to tackle Christmas...
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December 19, 2023
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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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In the Caregiver's Words

Recent Client Praise

We are less than a week away from Mother's Day, and preparations are in motion, cards are purchased, reservations are made and flowers will be sent. That is what Mother's Day has come to represent for most of us, but there will be some for whom Mother's Day is more an occasion for dread or sadness. That is because Mom is no longer here to celebrate the date. Especially in my work as a certified geriatric care manager, I've talked with caregivers who have lost a mother. I find that there can be a lot of denial or depression as May comes around. It seems easier to ignore the day, or maybe the sad, slippery slope of depression seems unavoidable. That is where I come back to one of my mantras for all caregivers, and that is that the caregiver needs to care for herself or himself. What does caring for the caregiver look like when one is facing an important, but seemingly hollow, holiday? You can begin by letting the mom who lives in your memory remind you of the good times or the kind words or the special places. Mother's Words. If you have a sibling, perhaps start the conversation about what "mom used to say." If she used words of encouragement like, "It is not about what the other kids do; it is about just doing your best." Or maybe mom liked to talk about finding the "silver lining." Mother's Things. Those of us who have lost a mother also probably saved an item or maybe several of the things that delighted mom or that we particularly associate with her. Maybe your mom kept a collection of your pictures or clippings from the school paper? My mom kept a small spiral notebook of jokes so that she could remember and share them with others. Most of them were admittedly a bit corny, but they make me smile even now when I go through the pages of memories on days like Mother's Day or her birthday. Mother's Actions. It can also be special to do some of the things that your mother used to do as a way of "taking a walk with mom." Maybe mom had a favorite park or garden where she liked to go on "her day." May is such a wonderful month for all the new blossoms of spring, and taking that walk can bring back wonderful memories complete with beautiful buds and their wonderful scents. Or some find it really great to go to mom's favorite restaurant and have their own favorite dish or order the chocolate pie that always was mom's guilty pleasure. It really all comes down to making the day special for yourself just as you used to make it special for your mom by caring for the caregiver. Doing that special something for yourself just as you used to do it for your mom can actually make you both feel better about her day. And if you are a mom with kids of your own, it can also be a wonderful way to let them know how to someday manage their own transition of Mother's Day. Charlotte Bishop is a certified 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.
October 29th is World Stroke Awareness Day. We may not be hearing as much about strokes as we once did, because in the United States the incidence of strokes is on the decline. Just under 800,000 people will have a stroke this year, and three-quarters of them will be over the age of 65. The reason the incidence in the United States is on the decline is because Americans are doing a better job of managing their blood pressure and because fewer of us smoke. Because so many of the stroke victims are older adults, it is important for caregivers to help their loved ones to further prevent stroke. With the proper preventive measures fully 80% of strokes could be prevented. Here are some suggestions for preventing strokes:
- Know your loved one's blood pressure; this is a routine part of anyone's annual physical, but you also can get a screening at health fairs or even your retail pharmacy using a machine;
- Know the signs of atrial fibrillation, a condition in which the heart rate goes so high that it fails to pump blood effectively which can lead to pooling and clot formation;
- Stop smoking - this is just one more very good reason to kick the habit if your loved one has not already done so as smoking doubles a person's stroke risk;
- Monitor your loved one's cholesterol intake and blood levels - any total cholesterol count above 200 is cause for concern;
- Manage blood glucose levels in your loved one if they are a diabetic - one of the complications of diabetes is poor circulation which can lead to stroke;
- Diet and exercise are part of almost every approach to better health - boost your loved one's intake of fruits and vegetables (five portions a day) and reduce intake of trans-fats and salt;
- Manage alcohol intake - most doctors recommend limiting alcohol consumption to two or fewer drinks a day.
The good news about managing these risk factors is that not only will you as a caregiver be reducing your loved one's risk of stroke, but you will be adding to their quality of life as well. In addition, you may find that these healthy habits also are contagious which can results in a healthier caregiver. Stroke prevention can become a win-win! For more information, I recommend checking out the web site for the National Stroke Association (http://www.stroke.org/site/PageNavigator/HOME). 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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Physical exercise, mental gymnastics or medication: which one has the most beneficial impact on improving or delaying the onset of what medical professionals call “mild cognitive impairment?” First, to clarify, mild cognitive impairment (MCI) is a middle ground between the normal decline of our brain function and the dementias that I have talked about in previous posts. You might even refer to it as “pre-dementia,” except that MCI does not always or inevitably lead to dementia. The rate of cognitive decline increases with age with just fewer than seven percent of adults age 60 to 64 showing signs of mild cognitive impairment. By age 80 – 84 the rate of MCI exceeds 25%. And MCI progresses to dementia in about 15% of patients 65 or older. It is true that the FDA has approved a few medications for their ability to slow the progression of cognitive decline, and you have seen some of them advertised on television. And there are “brain games” available for people who want to keep their faculties sharp…even doing crossword puzzles or just reading have been shown to be of some help in slowing the inevitable mental decline associated with birthdays. Yet, neither of these can measurably improve cognitive function. The American Academy of Neurology has released new guidelines that encourage regular, physical exercise as a way to not just improve overall health, but to also improve memory and slow decline of cognitive processing. They see little value in pharmacologic treatments, and they admit that cognitive training can improve a patient’s score on cognitive measures. Engaging in physical exercise like walking or biking or swimming as little as twice a week actually can improve cognitive function. The new guidelines, as endorsed by the Alzheimer’s Association, are based on research over a six month period that demonstrated that physical exercise just twice a week can significantly improve memory. There are no long term studies yet, but researchers are extending their work, to date, to see if they can actually hold on to that improvement longer. It looks as if we can add one more condition to the list of ailments that can be reversed by diet or exercise. (Do a search in the toolbar for “exercise” and see all the good that can come from working up a little sweat.) 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.
If you or an older loved one are at that age in the magical transition – otherwise known as 65 years old – you’re likely seeing a veritable flood of information directed at you. There is a lot to process if you or your loved one qualify for Medicare, and it would take a great deal more than one posting to convey all that you “need to know” as well as the trove of “nice to know” information. So, I’ll give you some general categories of Medicare-relevant steps and links to the details that can help you and/or your loved one make decisions.
1. New to Medicare – If you or your loved one are soon going to be turning 65, there are a lot of decisions ahead of you. It starts with what seems simple, because Medicare calls them Part A, Part B, Part C and Part D. Part A is about hospital coverage. Part B is about doctor and outpatient services, and it requires that you do some homework like identifying if all your providers “accept Medicare.” Part C is labeled Medicare Advantage and it begins to get a bit more complicated, because this is the place where private insurers play, and you may find it critical to rely on a dependable agent or insurance broker to sort out the real value. Part D is also the domain of private insurers, but the coverage is for prescription drugs, and you’ll want to do a detailed analysis of the amount of coverage for the prescriptions you currently have or what your provider can help with identifying on the horizon…especially insulin or cardiac or cancer or chronic disease medications. Click here.
2. Already Signed Up – It seems like it should be a breeze once you’ve already signed up for Medicare, but there are a lot more steps to getting what you deserve from your coverage. It starts with your visit to your Primary Care Provider, but also includes getting your account fully online, getting a trustworthy family member or friend designated as a contact, incorporate your health plans into your life, your travel and more. And make note of what has worked for you since you’ve been with Medicare and what you’d like to add in the future during open enrollments and more. Click here.
3. Open Enrollment – The easy part of Open Enrollment is putting the dates on your calendar. This year’s open enrollment window is between October 15 and December 7, 2022. And then it requires more homework, especially if you are losing coverage from an employer. The easier parts are Part A and Part B which don’t need to be changed. Part D may see changes in drug prices which may encourage a closer look at alternatives that may offer your prescriptions at better prices. Part C – The Medicare Advantage piece – also involves private insurers who may have changed the doctors or hospitals their plans since you first enrolled. And if you’ve had your drug coverage through Part D, you’ll want to give another look at what prescription drugs are covered and how well. Click here.
As with all homework assignments, it is important to start early, because there may be more than you think to be processed. Please check out the links I’ve shared here and find a reliable insurance agent whom you can trust to help you spend the money frugally and wisely. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
It’s not just about forgetting how to get to where they are going. Older adults – even in the early stages of dementia – are simply at a much higher risk of accidents while driving. While adults over the age of 85 make up only about 9 percent of the population, they are involved in 13 percent of the fatal crashes and 17 percent of the pedestrian accidents resulting in death. Overall, the fatality rate of 85+ year old drivers is 17 times that of drivers 25 to 65 years of age according to the National Highway Traffic and Safety Administration. Is dementia a part of that? Yes, but only a part. Aging is a process that not so subtly erodes an adult’s visual capacity for judging distance, recovering from glare and distinguishing objects in dark or semi-dark conditions. Add to that the physical limitations that osteoarthritis can impose along with slower muscle reaction time and yes, memory deficits, and 85 plus year olds have the highest per-mile accident rates of any cohort beyond the teens. If you are a caregiver to someone within this older cohort - 85+ - this is not a mandate to talk about the car keys just yet, but it is important to be alert to what may be unfolding. Medical surveys of outpatients suggest that as many as 30% of older adults who have dementia may still be behind the wheel. What to look for? Dementia does not simply mean that an older driver gets confused in the parking lot at the mall or gets lost on the way home. Dementia in the driver’s seat translates into unexplained dents or scratches on the car. If you have occasion to drive with the older adult watch for difficulty in lane changes or lane wandering, challenges on turning or difficulty judging distances. Accidents typically are the result of a growing series of mistakes and near misses on the road. Early stage dementia patients may actually be safe drivers, but you should talk to your older loved one’s primary care physician. They will not be able to speak to you about your loved one’s medical condition without sign-off from the patient, so that is a starting point. And appreciate that not all physicians are well-schooled in diagnosing dementia, let alone treating it. If you are concerned about dementia as it may be affecting your loved one’s driving, start by asking the physician about your loved one’s ability to pass a mini-mental exam or other cognitive tests such as the Clock Drawing Test that help assess executive function. If the physician is not able to help, ask about possible referrals. You may find that there are hospital providers who have actual testing programs or driving schools to help assess your loved one’s safety behind the wheel. If the decision is made that your loved one is not safe driving, begin immediately to explore your transportation options. Some older adults will be relieved that the stress of uncertain navigation is no longer a challenge, but others may view it as a significant loss of independence. Be prepared to be an empathetic listener. Steer clear of sentences that start with “at least” such as “at least you did not have an accident…” Picture what you might feel in a similar circumstance and go from there. Don’t try to gloss over the genuine loss your loved one will feel. What are the public transportation options? That may depend on how advanced the dementia is, because navigating train or bus routes can be as challenging as driving. Paratransit and chauffeur services may be an option if they are affordable, but be careful on vetting the services. Check with your local ombudsperson on aging for a secure option. 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.