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

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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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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In the Caregiver's Words

Recent Client Praise

If you are a caregiver, you probably know that the number of hours this job demands is onerous. According to a recent AARP survey, caregivers report an average of more than 20 hours a week taking care of an older loved one. This is on top of the "day job" they already have as well as any other family duties they may have for a spouse or children at home. So who is taking care of the caregiver? One person who probably is not caring for the caregiver is the caregiver him/herself. If you are a caregiver for an older adult or someone else with special needs, try out these suggestions so that you can survive and even thrive your caregiving responsibilities.
1.    Remember to laugh. It is no surprise that caregiving is stressful, and one of the casualties often is one's sense of humor. Laughter is a great stress-reliever that we have to give in to regularly, because it will make everything else a lot easier.

2.    Remember to be "normal." Caregiving can be demanding and often unpredictable in ways that tend to take over one's life. Perhaps you used to have a favorite television program or you enjoyed going for brisk morning walks or some other habit that gave you pleasure. Indulge yourself with one of these returns to normalcy and you will be more refreshed to return to your caregiving after.

3.    Remember your friends or colleagues. Caregiving can squeeze one's social life tremendously, and isolation can only make the weight all the heavier. Take time for a lunch or coffee with people you like, and some of the stress will go down a notch or two.

4.    Remember to get help for the emotional demands. This can be in the form of a support group or perhaps a counselor or your cleric. Talk with someone who will help give you some coping tools and understand why you need them.

5.    Remember to check up on your health. You probably attend all the doctor's visits for your loved one, but when was the last time you had a check-up yourself? It is not just emotional health that can suffer under the stress of caregiving, so keep healthy.

6.    Remember to forget some things. You may have a whole list of "must dos" on a weekly basis, and it is really acceptable to drop some items from your list. Hire someone to do your housekeeping or shoveling the walk or mowing your lawn.
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
I have written in past blogs about some of the inevitable decline of physical capabilities associated with aging, and a lot of them are not really a surprise. We all walk more slowly, we see and hear less clearly, and strength and endurance just are not what they may have been at age thirty by the time we hit seventy. But we do not always think about the sense of smell becoming less acute with age, and there are really important medical and safety risks when a person’s sense of smell begins to fail.

Research reported some time ago in the Journal of the American Medical Association documented that people’s olfactory acuity slips as they age, so much so that it may surprise you to know that 62.5% of persons over age 80 had “impaired olfaction.” Only about 15% of men and women over age 80 were even aware of their shortfall. So what, you may say?
1. Elders who age in place also are typically living in older housing, living quarters in which the heating system also is growing older. If that older resident is unable to smell the telltale odors emanating from their malfunctioning furnace they may be at risk for a furnace explosion or even carbon monoxide poisoning. (One cannot smell carbon monoxide, but there commonly are other odors accompanying a poorly functioning furnace.)
2. If an older adult’s sense of smell is off, they may not be finding the same pleasure they once did with the food at mealtime. (Smelling food is a significant part of tasting food.) Over the long run, this can lead to loss of appetite, weight loss or even malnutrition.
3. When an elder begins to lose their sense of smell, they may be less able to tell when their own body odor has become acute. This, in turn, is an indicator not just of poor olfaction, but perhaps that an elder is less able to shower or bathe or even dress themselves independently. It can be a sign of eroding activities of daily living and the mobility issues this represents or a urinary tract infection. “Bad breath” can signal tooth decay, acute diabetes (breath smells like acetone) or other conditions.
4. In separate reporting, medical researchers have found that diminished sense of smell also can be tied to early onset Parkinson’s Disease or Alzheimer’s Disease.
Now, this is the part where being a caregiver becomes hard if you notice telltale odors this autumn when visiting mom’s or dad’s home. As this the season up north for turning on the furnace, then you should say something. If you see signs of weight loss or decaying food in the fridge, say something. And even if you simply notice that the hug from mom or dad imparts a less than pleasant bouquet, say something. All of these are a “sniff test” that can save your elder from bigger problems.

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.
Today we have a guest Post from Christina Padilla, a speech-language pathologist and Certified Dementia Practitioner living and working in Evanston, IL. Let’s face it: nothing about dementia is easy. It’s as hard on the individuals with dementia as it is on the people who love and care for them. But you can still maintain a rewarding relationship with your loved one by learning some communication strategies to improve your daily interactions throughout the progression of this disease:
1. Focus on the relationship. It is better to be in relationship than it is to be right. Your loved one is going to say things that hurt or upset you, possibly even accusing you of things that are not true. It’s important to understand that this is part of their disease and does not reflect reality. Arguing or correcting them with a “reality check” will only lead to anger and agitation but attempting to enter their reality and understand the true origin of their feelings will deepen your relationship.
2. Identify the underlying need. Given the communication difficulties people with dementia are experiencing, the words they say often don’t reflect the real message they are trying to convey. They may not be able to adequately verbalize when they need to go to the bathroom or feel hunger, pain, cold, loneliness, or sadness. They may feel they are living in a different time of their lives, as many people with dementia regress to an earlier time over the course of their disease. With a few well-placed questions and a little detective work, we can identify the need within their message and help meet it.
Having these two as a general grounding, use these tactics as you communicate:
1. Apologize sincerely. This is not admitting to wrongdoing, but rather offering an apology for the distress they are experiencing. It is important that you be sincere if you use this strategy.
2. This does not mean pretending something is true when it is not, but rather entering your loved one’s experience instead of denying it. If they are having an hallucination, you can ask them about what they see without pretending you see it too. If they accuse you or someone else, you can acknowledge it by saying, “You’re thinking I…” and then try a transition phrase such as, “Let’s figure this out.”
3. Ask simple questions. Yes/no questions are too narrow and will often end the conversation but offering either/or choices (Are you hot or cold? Are you hungry or is it something else?) or asking simple open-ended questions (Can you tell me more about what you see?) is a good way to get more information. Often acknowledging your loved one’s feelings/experience is all they need, and you can gently redirect them by suggesting an alternative activity or segueing into a new conversation. If they feel heard and seen, they will usually follow your lead.
Here are a couple of examples of situations and ways to respond that can help give you more information about what might really be going on:
1. Situation 1: “Someone stole my purse!”
Response: “You’re thinking your purse has been stolen! Let’s figure this out. Where do you usually keep it? Do you need something inside it or did you want to go somewhere?” In this situation, you are not only acknowledging your loved one’s feelings, but also gently helping them to find the lost item while at the same time investigating why they need it. Maybe they are looking for a tissue, want to go for a walk, or are living in a past where it’s their job to do the weekly shopping. Once you figure it out, you can follow their lead or redirect (e.g., why don’t we take a walk to the corner store).
1. Situation 2: “Help, I’m covered in ants! They’re crawling all over me!”
Response: “I’m so sorry, that must be very itchy! Why don’t we move to another chair and put on some of this lotion?” In this situation, your loved one is hallucinating based on a physical stimulus, possibly feeling itchy or even pain. By acknowledging their discomfort and then offering a possible solution, you validate their experience while at the same time calming and redirecting them, and the outcome is much more pleasant than if you had tried to convince them there were no ants. These are just a couple examples of how patience and your “detective skills” can improve your communication and deepen your relationship with your loved one living in dementia … remember that you are living with it and can walk away. They can’t. You won’t always get it right, and every day will present a new challenge, but the more you practice, the more easily you can flow along with your loved one’s experience, and your new understanding may just take you to some wonderful places! Christina Padilla is a speech-language pathologist and Certified Dementia Practitioner living and working in Evanston, IL. She has spent the past 11 years working with adults with neurogenic disorders and disease and their families to improve communication, swallowing, and cognition for a better quality of life. If you wish to ask her a question or wish some help within your own orbit, please email by way of: info@creativecaremanagement.com . 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.
What do hearing aids, exercise, support groups and travel have in common? They all are ways that individuals suffering from Alzheimer’s Disease, specifically, or dementia, generally, can fight these diseases’ progression. Even more important, they help to fight the personal isolation that accompanies these frightening conditions.

We often associate dementias with older adults and the stereotypic confusion that can characterize the individuals with the diagnoses. But it is not just a condition of older adults as the recent public disclosure of The University of Tennessee women’s basketball coach, Pat Summit, highlights. Ms. Summit is just 59 as she goes public with her diagnosis, and it helps others to understand that it can happen as early as 30 and 40 years of age. Younger onset Alzheimer’s Disease technically speaking is the manifestation affecting those under age 65, and there are 250,000 new cases in America every year. Yet, there are ways to fight the downward spiral of dementia.
1. Hearing aids may seem an unlikely fix for dementia. Yet, it is simplybecause hearing aids enhance the clarity of communication and therefore the connection between dementia patients and others that they help alleviate the isolation and bolster memory. When dementia patients can hear more clearly, that connection also helps calm the anxiety that they may otherwise feel when living in a world that is confusing. Hearing aids cannot “cure” dementia, but they can help a patient navigate more confidently.
2. Exercise can be a helpful boost as well as it improves the blood flow and releases calming endorphin into the bloodstream. For a variety of medical conditions, health care providers often talk about the role that “performance status” plays in a patient’s ability to cope. Being more fit helps dementia patients cope just as being fit also helps cancer patients while they fight a tumor or surgical patients as they recover from a procedure.
3. I had mentioned the importance of being connected for a person with dementia of whatever sort. Support groups become the new circle of friends who can truly understand what it is like. This is common across a whole host of medical predicaments from grieving widows and family to returning wounded warriors or recovering cardiac or orthopaedic surgery patients. Somebody else who has been there understands what co-workers, friends or even family cannot quite fathom.
4. Travel is a bit of all these. It is a way to have fresh new experiences that challenge a patient cognitively. When a person experiences what should be familiar settings like home as frighteningly unfamiliar, it can be reassuring to share travel experiences to strange and different places that – well – everyone will find strange and different as well.
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.
How often have you heard comments like: “Oh, mom is just a bit blue;” or “Her husband died six months ago…she should just snap out of it;” or “He just likes his time to himself.” They are all ways to discount what is something of an epidemic among older adults in America today: depression.
If you are a caregiver to an older loved one, the symptoms may be slow to show themselves, but depression is a real medical condition to be addressed every bit as much as dementia or heart disease. Adults 65 years of age and older may only be just 13% of the population, but they account for 20% of suicide deaths. Older adults with depression have healthcare costs 50% higher than non-depressed adults. And depression is common – more than two million older adults manifest some degree of clinical depression. Where should you look for depression? I mentioned widowhood at the beginning. Well, one-third of widows and widowers meet the clinical criteria for depression within the first month after losing a spouse. And half of these are still depressed a year later. Depression also is a classic comorbidity of a number of medical conditions like Parkinson’s, Alzheimer’s and even cancer, arthritis and heart disease. But the prevalence of depression is really just an opportunity to take action. The data show that fully 80% of depression in older adults can be effectively treated with either medication or talk therapy or a combination of both. If you are a caregiver to an older loved one, however, encourage them to see a mental health professional who can offer the best of both medical and talk therapy. About 55% of older adults who do seek help for their depression reportedly go to their primary care physicians. While PCPs care prescribe, they are not schooled in talk therapy. If you suspect an older loved one in your orbit is depressed, don’t leave it to them to make their decisions on their treatment alone. The majority are likely to just “manage it” themselves which is not the way one addresses a genuine health problem. And don’t discount it as “just depression.” It’s bigger than that, but it can be addressed! 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.
It has been over a year since my first posting when I started this blog by talking about why a person should call a Geriatric Care Manager (GCM). Since I have answered this question with almost everyone of the calls I get from people looking for our help, it seemed like a good idea to revisit our “job description.” GCMs are:
1. Local professionals who know what resources are appropriate for your older loved one and which are most appropriate. What I often tell people is that we are “option-makers” for the decision-maker.”
2. Eyes and ears that can help long distance caregivers be aware of any changes that may affect an older parent’s independence or well-being. The long distance family caregiver may have bought mom the walker, but the local GCM can be there to see whether mom is using it.
3. Bridges to help an older family member make life transitions from fully independent living through home assistance and ultimately to assisted living at the appropriate times. Earlier involvement with a geriatric care manager also can help your elder family member develop a rapport with a professional who can facilitate the bigger changes later because they have been there earlier for the smaller changes.
4. Peace of mind by being the professional buffer to a long distance caregiver for some of the minor or major crises that may otherwise be very stressful for the entire family.
Finding a GCM is easy. The national association that certifies GCMs, the NAPGCM, has a comprehensive, searchable list of all the professionals in good standing. You can search geographically by simply entering a zip code or you can search by name. The search tool also asks you to check what kind of GCM you are seeking; check the “Certified GCM” box to see a complete list of professionals in good standing. Here is a link to another site that offers a range of resources, including care managers, Aging Care. Finally, Caring.com offers a listing of GCMs specifically in the state of Illinois.

As you make contact with a potential GCM for your elder, I encourage you to look for a good communicator, because this professional is going to be your loved one’s advocate. You also want to ask about their experience, and check professional references who can speak on their behalf. Finally, it is important to ask about fees since insurance does not cover a GCM. A recent article in Reuters suggested that fees nationally range from $60 to $300 an hour.

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.