Chicago's Geriatric Care Manager Center of Excellence – Since 1991 | Chicago's Geriatric Care Manager Center of Excellence

Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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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

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Chicago Assisted Living Experts
Assisted living residences are housing facilities meant specifically for those with a need for daily supervision and/or assistance. Making a decision to move your elder loved one to assisted living is not easy and comes with so many questions. Is it the right choice? What type of paperwork is involved? Which assisted living facility is best, given our particular situation? Creative Care Management helps you find answers to all these and many other questions about your elder loved one’s care. Our elder care service specialists begin by conducting a thorough assessment of your loved one’s condition physically, mentally and socially. Then, considering every aspect of your needs from level of care necessary to budget concerns, we put together a geriatric care plan and then help find your loved one an appropriate community of the highest quality. We grade our facilities based on three factors below and only recommend the top assisted living care providers.

Responsiveness

Quality of service

Facility and staff qualifications

Contact us today and learn for yourself what makes Creative Care Management, the top-rated Chicago geriatric care management company. We will work together to improve the life of your loved one by finding them the expert care they deserve.
Life in Assisted Living
Assisted living communities are staffed with professional caregivers and healthcare providers, that monitor and assist residents with their personal health needs including assistance with medication management and daily routine as needed. An active, social life is encouraged among residents, and planned activities are often provided by staff members, but residents are not fully independent like those living in a retirement community, nor are they under the 24 hour supervision that nursing homes provide.
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Yesterday, we talked about dealing with stress and melancholy during the holidays. Here are even more tips that you can use to cut down on stress and post-holiday blues while caring for a loved one. Remember, it is okay and understandable to feel down during and after the holidays. But the more you are prepared, the better your holidays may be.

It’s okay to say no. When it comes to holidays, if you feel the need to cut down on the amount of gatherings you’ll be able to attend this year – there’s no need to worry. Pace yourself – you’ll have a much better time, especially you tend to feel overwhelmed when running around place to place.

Keep gatherings small. You may find that scheduling festivities with smaller groups is much easier to manage as well as much more comfortable for you and your loved one.

Communicate. If you plan to host a gathering or go to one, be sure to talk to your loved one about it often so he or she is able to anticipate being social. In addition, talk to your guests beforehand about your loved one’s condition if they haven’t visited in a while.

Give yourself and your loved one a break. Realize that it is okay to take time out for yourself as a caregiver. You may find that setting aside a bit of time to relax is just what you need to reduce stress levels. Recognize that your loved one may need some quiet time too.

Last but not least, monitor how you’re feeling as you go through the holidays. If you’re feeling melancholic during festivities because you’re remembering how things were in the past, understand that this is okay and you should let yourself feel them. However, it may be a matter of focusing as much as you can on positivity, your loved ones, your happiness, and the present moment. You can find more these tips at Caregiver.com.

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.

For a very long time scientists have told us that there are no cures for Alzheimer’s Disease and that even the approved medications do very little to slow the progression of the disease. But researchers at the University of Copenhagen, Denmark, are onto what they suspect may be a preventive measure. It’s lithium. Lithium is the lightest of the metals among the elements, and you may have seen it as a component of some of the longer-lasting batteries, but for dementia? Well, it actually has been used historically to treat the manic episodes of bipolar disorder, but it can have side effects and it is dosed in extremely small quantities – micrograms. Yet, some new research holds promise for treating Alzheimer’s disease. Animal studies reported by scientists have shown that Lithium has neuroprotective qualities that improve learning and memory. In humans, observational studies suggest that it could be beneficial in slowing the progression of dementia in patients with bipolar disorder. The Danish researchers collected data on more than 800,000 citizens going back to 1986. About one in ten of these people had been diagnosed with dementia since 1986 and the rest were the “control” group. They examined “naturally occurring” levels of lithium in drinking water across geographic residences of the study subjects. Since most of the study subjects did not move around over their lifetimes, this worked reasonably well. Their conclusion was statistically clear. Individuals with the higher levels of lithium in their natural drinking water were simply less likely to develop dementia that those with lower levels. Some observers are already making comparisons to the fluoride that has been added to public water for generations in order to prevent dental caries. Could this be another “easy fix” as well? While the results of these early efforts are statistically compelling, a bit more research is encouraged to be sure that it is not something else entirely that is making the difference for the Danish subjects or if Lithium just happens to be in the right water at the right time. We will keep you posted. And we also will need to keep this and subsequent studies in mind for a second edition of our recent book, How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. Please check it out, and please also be so kind as to review it for Amazon and for us. In the book, we cover what we know about dementia, what can be done to stave off the effects of dementia and most importantly what caregivers can do for their loved ones with dementia and for themselves. We also offer a lot of resources, many of them accessible on-line. 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.
We had significant enough response from a recent post ("Singing is a Breath of Fresh Air for Caregivers") that we thought it important to provide readers with more information. CCM caught up with Jonathan Miller, who conducts Encore Illinois, a choral organization specifically for older adults. Additionally, Maestro Miller will be launching the Good Memories Encore Chorale, intended for people with dementia and their care partners, in the fall of 2018. CCM: Tell us a little about Encore Illinois. How do people find you? And what should anyone who’s interested expect? JM: My wife (Sandy) and I founded Encore Illinois in early 2016. Encore Illinois is an independent not-for-profit organization based in the Chicago area. We provide choral-music education and performance opportunities for older adults under the direction of professional artists. We sing challenging, eclectic 4- and 3-part repertoire with piano in a supportive, encouraging environment. Encore is tuition-based. Encore choirs are non-auditioned, and we make it really fun. We are the local affiliate of Encore Creativity, which is based in the Washington, DC area. Encore is the nation’s largest choral-music organization for older adults (55+). Encore in DC alone has 21 choirs and 1200 singers and is now operating choirs in New York City. Encore in DC has been around since 2001 and is a fantastic organization with which to be affiliated. Encore Illinois in Chicago offers 7 choirs in the city and suburbs, and we’re happy to announce that we now have more than 300 singers currently singing in our Spring 2018 session. People can find out more about us on our website, www.encoreillinois.org. Our choirs are in Hyde Park, the Gold Coast, Evanston, Oak Park/River Forest, Arlington Heights, Glen Ellyn, and Hinsdale. Rehearsals are once a week, during the day, for 90 minutes and start with stretching and vocal warmups. CCM: You’re impressive! You founded Chicago a cappella--an ensemble with a fantastic reputation nation-wide and a premier Chicago ensemble--and remain its Artistic Director. No doubt, skill levels vary greatly among your membership for Encore Illinois. How would you encourage folks who really want to sing but are afraid they aren’t good enough? Likewise, how do you challenge those with more choral experience? JM: You are very kind. We’re finding that word of mouth is bringing more and more people to us, and people are encouraging their friends to give Encore a try. Yes, the skills levels among our singers very widely, and that’s part of what makes it fun. We have many people who are brand-new to choral singing, many others who are back after a break (with the break lasting from 2 to 65 years! – my 82-year-old mother hadn’t sung with us since high school), and of course lifelong choral singers. The repertoire is a big challenge – targeting just the right sweet spot so that, as you way, experienced people are still stretched while newcomers are able to hold their own. We also create a setting where the stronger singers help out others who might need someone singing in one or both ears. Some people prefer a higher-end experience and go back to other choirs, but most people seem to keep coming back over and over. We’re in our seventh session now, and many of our singers have been with us since the very beginning. CCM: What’s your range of repertoire? But also, what kind of music does Encore Illinois like to sing most? How often do you put up a show, and how long do you rehearse it before it’s ready? JM: We have three sessions a year—a fall/holidays session with concerts in December, a spring program with concerts in May, and a rock ‘n’ roll choir in the summer (with only 2 locations) that performs in late July or early August. The current spring program is all American folk songs and spirituals. The range of repertoire is pretty wide; I’m Jewish and like to make sure we do some Hebrew at Chanukah, and we do sing in other languages from time to time. Probably the most difficult thing we’ve done so far is a piece I wrote for Christmas called “Clip, Clop,” which has tricky rhythms that illustrated the donkey’s bumpy ride down the road to Bethlehem. CCM: From your vantage point on the podium, what is it about choral singing that makes it particularly supportive for caregivers? JM: We're launching our choir for people with dementia and their care partners to sing together (Good Memories Encore Chorale – see more info here) in fall 2018 on the Gold Coast and will ramp up to other locations as resources permit. That choir is for people with Alzheimer’s and related dementias to sing along with their care partners – and the idea is that we target people who are still living in the community, outside of care facilities, because that is where the most social isolation tends to happen and where the need for meaningful, regular social contact is the greatest. The Good Memories choral experience is based on the model of the Giving Voice Initiative (GVI), based in Minnesota (www.givingvoicechorus.org). Encore Illinois is a member of GVI. In the GVI/Good Memories model, the care partner sings in the choir along with the person who has dementia. The care partner gets to do something fun, exhilarating, all-consuming, and joyful – something that is sometimes in short supply when you’re caring for someone else. Our model also provides volunteer singers who receive special training about ways to communicate well with people who have Alzheimer’s or related dementias. The volunteer singer is available in case the care partner needs a break and doesn’t want to sit with the person who has dementia. Volunteer singers help make sure that the person with dementia is:

comfortable in the rehearsal environment,

tracking with what the music director is asking the choir to rehearse

safe and tended to during bathroom breaks, etc.

getting as much as possible out of the choral and social experience

Some care partners who sing with their spouses say “it’s like going on a date.” Other family members say, “Our week pretty much revolves around choir rehearsal.” CCM: Since caregiving seems so all-consuming, I imagine a lot of caregivers who would like to join a choir are worried are worried about emergencies, or not being able to commit. Does your organization have any methods for coping with that? JM: We don’t hear a lot about that, though surely it happens. Even in our regular Encore Chorales, we have emergency contact information on file for every singer. What seems to happen is that the choir becomes central to people’s experience of well-being and that they attend whenever they can! CCM: What kind of change do you witness in people who become associated with Encore Illinois? JM: Joy is pouring out of people at rehearsal. Singers are making new friends and making existing frienships stronger. People are astounded at what they are able to accomplish musically. The jubilation at the end of a concert is palpable—you yourself know this as a performer. There are unexpected blessings. One woman, who records for the blind, told me with shining eyes recently that she now can get through very long phrases of reading out loud without having to do re-takes nearly as often as she used to. She said, “I know it’s because of all the breathing exercises we do in here.” Another is that kids and grandkids (and great-grandkids) of our singers come to concerts to cheer them on – that is one of the sweetest things you’ll ever get to witness. CCM: Thank you so much first for offering your significant gifts to the caregiving community and also for chatting with me. This is your chance to plug any projects you’re working on right now as well as to let us know how to keep up with or contact you for more information. JM: You’re welcome! I’m also composing and arranging a bit and always interested in commissions for new works or arrangements, so if there are other conductors out there looking for good new music, please be in touch. The Good Memories choir is taking a lot of my and Sandy’s attention and will be exciting to have up and running. I’m also doing pop choral arrangements for www.musicnotes.com (I’ve transcribed about 20 Pentatonix charts) and staying active with Jewish music. Also, anyone is welcome to attend any of Encore’s free concerts that we offer to the community in May, July/August, and December; visit www.encoreillinois.org to see our current concert schedule. Interested singers can always visit a rehearsal or two to see if it’s a good fit before they register.

In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Roadmap to Alzheimer's Learn what to expect when you're caring for someone with Alzheimer's. Inside find tips for detecting dementia, how to best communicate with a loved one with Alzheimer's, and more.Download

There is a lot of news about the "older market" or other stories featuring someone who has reached the landmark age of 100 years and more. In my geriatric management experience, while working with elder adults and their families, all of what I see in the news is just snapshots of people at a certain age. What I have found is that who a person is at 80 or 90 is really a product of experiences that preceded the present. A long term study of aging by the Harvard Study of Adult Development followed a cohort of Harvard sophomores along with a group of young men in Greater Boston since the 1930s. My title stretches their findings a bit, because of course no one lives forever, but the study did offer some great insights into living long and living well:

Get rid of the cigarettes. The Harvard Study showed that men who did not smoke clearly out-lived those who were smokers. Other research continues to show that giving up smoking is a positive influence on health and longevity at almost any age.

Practice competent coping. It is not about the hand that life dealt these study subjects; it is about how they played the hand they were dealt. People who adapted to the events of life overall have lived longer than those who did not.

Waistline leads the lifeline. The researchers found that those subjects who maintained a "healthy waistline" and weight fared better than their obese counterparts. It is not about being stick thin, but it is about avoiding the other extreme.

Regular exercise contributes. Any kind of regular exercise improved both the physical and mental health of the men the study followed. Exercise also likely contributed to that healthy waistline and positive attitude.

Be mentally engaged. It starts with pursuing an educational degree, but those who lived longer also always seemed to have something they were excited to explore whether it was keeping a journal or studying a new subject. Intellectual activity seemed as important as physical activity.

Make and keep friends. That also includes the person one marries. The researchers found that those who were the most socially engaged also tended to live longer.

I have not talked about how old one's parents lived or one's cholesterol. These factors did contribute to longevity, but the researchers noted that they contributed less than expected. Even stress in a study subject's life was not a negative predictor of longevity as much as how the subjects coped with the stress. Charlotte Bishop is certified in geriatric management and founder of Creative Case Management, led by professionals who are advocates, resources, counselors and friends to elder adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
In my first of this two part series, I talked about how Thanksgiving as well as the holidays that follow can be opportunities to give a helpful wellness check on an older loved one's home. A lot of my suggestions were focused on preventing falls around the home for an older loved one who may not be as nimble as they once were, and home may actually be less safe with the natural wear and tear in an aging household. But there are other health risks for aging adults in America, with dementia, depression and dietary insufficiency forming the three D's for caregivers. Starting with dementia, less than 1 percent of adults between 60 and 64 years of age suffer from some sort of dementia. But by the time adults reach age ages 80 to 84, that prevalence is about 12 percent, and it doubles once they exceed 90 years of age. Depression is one of the most common conditions of aging adults with estimates of about one in five adults over age 65 suffering at some point with clinical depression. Diet can be even higher than this with one group of researchers pegging the prevalence of malnutrition among older adults at nearly 23% across 12 developed countries. So, if you are a caregiver visiting an older loved one during the holidays, look for the following signs:

Dementia...

Without being prying, check your loved one's refrigerator; look for how well-stocked it may be as well as signs of decay or mold

Take note of their overall hygiene; are they bathing with enough frequency or laundering their clothes regularly.

If your loved one owns a pet, how well groomed and fed is the pet; note also, however, that your loved one may be taking better care of Fido than themselves.

Depression...

This one also encourages a trip to the frig to see if the low supply may indicate a loss of appetite; in fact a lot of what may appear as dementia in the list above actually may be masking a depression.

Talk to them about their sleep patterns; inability to sleep through the night or difficulty falling asleep may be signs.

Get a sense of how active your older loved one is; are they staying active socially, are they still involved in clubs or hobbies?

Diet...

The refrigerator should be a stop on this check-up as well; an older adult may not admit they cannot afford all that they should eat - but an under-stocked refrigerator may be a tell.

Share more than one meal with your loved one; sometimes malnutrition can be attributed to lack of appetite (refer to signs of depression here as well as medications that may be suppressing appetite or causing nausea)

Note any more pronounced weight loss; clothes that appear to be looser particularly around the collar or waist band.

Be alert to bruises or wounds that are not healing well or problems with teeth; regarding teeth, be sensitive to particularly bad breath that may be a clue to poor diet or tooth and gum decay.

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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We’ve all seen the ads on television about the lawyers who will stand up for our older loved one if they are abused or neglected in a nursing home or other facility. A bruise, a bed sore or maybe loss in weight can be pretty conspicuous warning signs, but there is another pervasive abuse of older adults in America, an abuse that has no telltale bruises. We know from the statistics that one in nine older adults in America has been abused, but financial abuse specifically is substantially under-reported. Experts at the National Adult Protective Services Association report that only about one in 44 cases of financial abuse of seniors ever gets reported. Exacerbating this under-reporting is the simple fact that senior financial abuse doesn’t leave a mark on the abused victim. But it does raise a flag if you know what to look for. Look for telltale changes in your older loved one such as:
1. Sudden changes in a will or other document that now includes a new beneficiary.
2. The “live-in” caregiver who seems to be “living off” their client.
3. An unexpected increase in credit card debt or an unusually large line item.
4. Money spent that has a wild or outlandish explanation.
5. More frequent withdrawals on a bank account or new accounts with someone else’s name on it.
6. Vague explanations or complaints about a missing credit card.
7. Guarded talking or behavior around a new caregiver that may suggest they are being intimidated.
8. Missing items like jewelry, money, antiques, art or even furniture from their home.
9. That new girl or boy friend…maybe some significant number of years younger.
Older adults are prime targets because they have the money…their savings, retirement accounts, mortgage-free home or other assets. Older adults are also more vulnerable because they may live alone, they may have chronic medical conditions requiring assistance or they are simply weaker than their exploiter. Older women are particularly vulnerable for all of these reasons plus their upbringing was in a time when women were simply taught to defer, to be nice, to be polite. And nearly half of all abusers are family members or friends. Please remember also that the earlier you spot the flags, the easier it is to “fix the problem.” 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.
I have asked our vice president for geriatric care management and senior services, Dr. Steve Steiber, to share a guest posting about the recent Tylenol news. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM about 8 years ago.
By now most of you have heard the latest on the potential for possible deadly skin rashes owing to an allergic reaction to acetaminophen, or Tylenol as the branded medication is called. Before we all suddenly quit using this pain agent, it is important to understand the magnitude of the potential problem. And it all starts with how long Tylenol/acetaminophen has been available here in the United States. Tylenol turns 44 this year following its release to the market in 1969 as an analgesic that was quickly embraced for its ability to turn off the brain pain signals and relieve the consumer with minimal side effects. All drug companies are required by law to report all adverse events that could be associated with their drugs to the FDA. Now, FDA releases information that covers the period from 1969 to 2012 which show three types of significant skin reactions that have resulted in 67 hospitalizations, and twelve of these have resulted in patient deaths. Spokespersons have rightly pointed out that over the 44 year life span of Tylenol, to date, the drug has provided pain relief to millions and millions of people. In fact, it took that many cases of Tylenol use to find this many extreme reactions. To the twelve who died, the drug clearly should not have been used. Tylenol spokespeople maintain that any kind of rash or skin reaction ought to be taken seriously and a person should find an alternative to Tylenol. They conclude, in effect, that the benefits outweigh the costs. Now, the other panic button... Not two years ago, acetaminophen was linked to liver damage when used above certain quantities. FDA subsequently limited the milligrams of acetaminophen per dose to 325 milligrams. But that in itself is not enough. If you are a caregiver to an older loved one, be aware of how many doses within a 24 hour period your loved one is taking; that quantity should not exceed 3,000 milligrams. Sounds like an unbelievably large number, but we need to recognize that acetaminophen is not just a stand alone pain reliever. It also appears in cough and cold medicines, in sleep aids and in other pain medications along with opioids. If one takes two of these every 8 hours, and then takes other medications that may also contain acetaminophen in combination, it becomes very easy to meet or exceed the 3,000 limit. And as I have talked about in other postings, older individuals have less fluid in their tissues and they process foods and chemicals more slowly. So, arguably the total quantity of Tylenol intake ought be monitored more closely than with a younger person. So, let's use the occasion of this most recent panic on acetaminophen to resound the alarm on something we have already known. Maybe it is a good time to have a conversation with your older loved one and maybe even visit their medicine chest with them. Please let Steve know if you have any questions about geriatric care management, drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are elder care management experts, geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
For so many medical conditions, the package inserts - that thin white paper with the fine print - for doctor-prescribed medications say that "diet and exercise" are first line. This applies to medications used to treat high blood pressure, weight loss or even type 2 diabetes. Would it surprise you to hear that diet and attitude are first line defenses against dementia or other cognitive decline? More and more research is pointing to the importance of the foods we eat as well as our outlooks on life as preventive measures to forestall the onset of dementia. Start with cynicism. Researchers in one study started with a group of more than 600 people whose average age was 71.3 years at the beginning of the study. Initially, the researchers collected data on the patients overall health, their levels of cynicism (yes, you can measure cynicism) and their cognitive statuses using validated scales. Over the course of 8.4 years, the researchers continued to assess all patients' levels on all these metrics. At the end of this time frame, 46 of the original number of patients had, in fact, developed dementia. The scientists adjusted for age, gender and depression, but still found that individuals who started out this study interval with higher measureable cynicism were statistically more likely to develop dementia. Moreover, about two years later more than half of the study participants had died, and those who had been classified as statistically more cynical were more likely to be among the number who died. Switch gears now, and another study based out of Rush Presbyterian Medical Center in Chicago found a positive link between people with quantifiable "purpose" in their lives and their ability to live dementia-free. This study followed about 1,000 people age 80 for about seven years. It measured physical, psychological and cognitive aspects of these patients over the duration of the study. These subjects also agreed to donate their brains for further analysis upon their deaths. At the end of the seven years, the researchers found that those with the highest scores on "purpose" were 2.4 times more likely to remain free of any signs and symptoms of Alzheimer's Disease. These subjects also were less likely to develop mild cognitive impairment, one of the early signs of impending Alzheimer's. Those with high purpose also had had a lower mortality rate than the others and had fewer disabilities as they aged. When the patients did die, the doctors performed autopsies of their brains. Even among those who had manifested no signs of Alzheimer's on cognitive tests and had maintained measurably higher levels of "purpose" some still had the plaque of AD on their brains. The conclusion was that the patients with purpose could more readily work through the deficits and maintain higher functioning cognition. The moral? We often hear people talking about the importance of attitude. And a good attitude certainly enhances the quality of life of those around the people with good attitudes. Evidently, it is also very good for the health, mental functioning and longevity of those with the positive attitudes too. 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@cr eativecaremanagement.com.