Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • in home care for seniorsChicago's Geriatric Care Manager Center of Excellence

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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Until the Vaccine?
We have all been following the news on vaccine rollouts, and frankly you may have been as disappointed as...
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January 26, 2021
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Distance Caregiving Through a Wall
I’ve written numerous times about distance caregiving, and one of the observations I have offered is that distance is...
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May 19, 2020
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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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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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In the Caregiver's Words

Recent Client Praise

There is an epidemic going on, and it involves that butterfly shaped gland in the neck call the thyroid. Since 2002 the prevalence has doubled in the US, but this is not because twice as many people have developed hypothyroidism as it is that the professional society that represents endocrinologists established new standards. The new standards for defining hypothyroidism have reduced the TSH (thyroid-stimulating hormone) range to be .3 to 3.0 from the earlier standard that had been about .5 to 5.0. And this is not just a trivial matter of definitions when what had been about 15 million people with hypothyroidism suddenly becomes about 27 million Americans. This is about one in ten Americans, and the prevalence of hypothyroidism is about twice as high among women over 60 years as it is for their younger counterparts. (Just for what it's worth, this is more people than the number diagnosed as diabetic in America.) Hypothyroidism is important also because there is a big connection between the thyroid gland in your older loved one's neck and their brain and heart. For anyone whose TSH levels are out of range, the impact on the heart would be through the potential for significantly elevated cholesterol levels. It is estimated that this could be as many as 10 million Americans. So, for people whose thyroid condition has not been diagnosed, but they have been put on lipid-lowering agents like the statins, their cure may be even easier. By taking a thyroid supplement, suddenly cholesterol levels may become better managed. Yet, fewer than half the adults with diagnosed elevated cholesterol levels in a recent survey were aware if they had ever been tested for elevated TSH levels. I had mentioned the brain connection, and there are two significant brain manifestations of hypothyroidism. Patients who are out of range on their TSH levels may be depressed or they may display signs of delirium. The former may have led to treatment with antidepressants, treatments that may now prove unnecessary, and the latter may be confused with dementia if the delirium goes unchecked over time. And there are other symptoms of hypothyroidism that you should be looking for if you are a caregiver to an older loved one: • thin, brittle, dry hair or skin • increased sensitivity to cold • fatigue • muscle or joint pains • constipation. You don't need to remember all the signs and symptoms of hypothyroidism, but you should remember to ask your loved one's physicians at the next annual physical what your loved one's TSH level is. If the number is too high or too low, begin advocating for help to avoid the other conditions. Yes, your loved one may take home one new prescription, but they also may get rid of one or more existing prescriptions...and feel a lot better. 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.
This is not going to be a course in economics, but quite often caregivers of family members get more focused on how much respite care casts instead of on how much everyone benefits. Talking about costs first, there are three kinds of costs for respite care: dollars you pay, dollars someone else pays and what you can get for free. Starting with the dollars you pay, give careful consideration to the level of care you need for the older adult for whom you may be the caregiver. If the adult in your charge needs help with a whole range of activities of daily living such as eating or toileting, then there will be a higher hourly rate in order to get qualified respite care. If, you are closer to the other end of the continuum and mom or dad can get around quite well, but need to be watched so that they do not wander, then you may be able to save significant dollars by simply engaging the services of an aid or similarly-trained individual. Getting respite care for free? First, don't forget to consider other members of your own family. Even a brother or sister who has a day job can offer respite care in off hours or on weekends. Get to know other caregivers in your own circle of friends so that you can get some respite when one of them is willing to watch your mom or dad along with their own and vice versa. It is good for everyone when your respite becomes their chance to socialize. Check out resources for Chicago senior services, local community colleges or even high schools for students who either need to generate hours for community service or need hours toward course requirements in social work or other helping profession. And consider the following resources that may subsidize respite care:
Most important, don't forget the benefits of respite care. The most important of which is you will do a better job caring for someone else when you care for yourself.
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. Learn more about What We Do and how we can help you support your loved one.
I have posted before that the currently approved therapies for treating patients with Alzheimer’s disease are not really very effective. And they cannot change the ultimate course of the disease. In news released just this last week, however, medical researchers have data on an FDA-approved medication that shows great promise in at least slowing…maybe stopping…the progression of Alzheimer’s disease. Well, it is true, but there are a couple catches. Alzheimer’s affects someone in the United States every 65 seconds, and the clock seems to be speeding up. Currently, that translates into 5.8 million people, 5.6 million of those over the age of 65 or one in every ten 65+ year olds. As more Alzheimer’s patients are diagnosed the real challenge may be to find enough caregivers to help this new kind of “boom” generation. When it comes to treating a progressive disease, scientists sometimes sound a bit like fly fishermen when they talk about working upstream to try to make a more fundamental difference in a disease progression. It is like that with the medications that are not very effective with Alzheimer’s now. To date, physicians have used therapies that control the symptoms of the disease or other behavioral issues. They typically do this by reducing the amount of beta-amyloid in the brain, but this just is not enough. Just this month researchers at the University of Alabama at Birmingham publishing findings from two mouse model (yes, mice) and human tissue that offer an alternative to blocking the ill effects of the disease progression. Okay, that is as complicated as I will make this. As one of the researchers explains, they have turned to a medication originally developed to treat depression, but ultimately came to market for treating schizophrenia. The medication, idazoxan, was used to treat mice induced to develop Alzheimer’s. The idazoxan appears to be helpful in slowing or even halting the transition from normal function to the earliest stages of Alzheimer’s disease. Other treatments currently only treat the disease once it takes root. This also may explain why the medications aimed at reducing beta-amyloid are not effective, because halting this activity is simply too late in the process to do any real, sustainable good. Upstream trumps downstream. I will keep you posted of more developments on this particular treatment, because there are yet at least three clinical trials…and a lot of time…necessary before human results can be accurately determined and FDA-approval received. Stay tuned. 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.
What human organ weighs about half a pound and pumps about 2.4 liters per minute and is indispensable to the body's circulatory system? It is not the organ I have pictured here; it's your kidneys. And the older we become, the more important it is to take care of this "other" pumping organ. Not to mention March is National Kidney Month. So what can you do to promote the healthiest kidneys possible? The following are recommendations from the American Kidney Fund help us to understand how to take care of our other vascular organ. 1. Less Salt and Fat Intake. Steer clear of processed and fast foods. When cooking, don't add salt to give flavor; add new herbs. Eat fresh fruits and vegetables. 2. Stay Physically Active. Exercise helps to flush the system as well as relieve stress which in turn lowers blood pressure. High blood pressure is as hard on the kidneys as it is on the heart. 3. Maintain a Healthy Weight. Speak with your health care provider about your target weight. Added mass around the middle is the worst place to put your excess. IF your weight is stressing your heart, it also stresses your kidneys. 4. Manage Your Cholesterol. Watch what you eat so that your overall cholesterol will be under 200, your "bad cholesterol" (LDL) is less than 100 and your "good cholesterol" (HDL) is over 40. 5. Take Medicines as Instructed. Talk with your provider to be sure they know everything you take, even over the counter medication. And just because you don't feel your blood pressure does not mean you can ignore your medicine. 6. Reduce Alcohol Consumption. The limits are different for men versus women, but stay to two drinks if you are a guy and less if you are a woman. 7. Don't Smoke. That goes for chewing tobacco as well, because any amount of tobacco use elevates your blood pressure. Tobacco use also is a risk factor for certain types of kidney disease. 8. Limit Your Sugar. If you are a diabetic, sugar makes your blood sticky and begins to shut down the micro-vascular system within the kidneys. Even if you are not diabetic, too much sugar intake will either make your kidneys work harder or add to fat deposits. 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.
Everyone who is a caregiver to an elder or other person with special needs has to be an advocate also. In my first blog posting, I spoke about what a geriatric care manager does on behalf of the elder or their families, and one of the principal duties is to advocate on behalf of our clients. In this posting, I offer a few of the ways that all caregivers can advocate on behalf of their loved one to assure the best healthcare and quality of life.

As an advocate for an elder, you need to be more than just the person who gets an older parent to and from a provider’s health care appointment. As long as the elder confirms that you can attend the appointment, you can be present, and you should use that opportunity to take notes and ask questions.
1. As an advocate, you will want to be as knowledgeable as
  
  possible about any medical issues that affect your loved one, and that includes
  
  asking questions of physicians and others as well as doing searches
  
  on-line. And be organized. Write your questions down before an
  
  appointment, and don’t be shy about asking them. If you don’t understand
  
  the answer, ask for clarification. It is the responsibility of a caregiver
  
  to be a “knowledge partner” in the health care of a loved one.
2. As an advocate, another important function you can provide is
  
  continuity of care. On an ongoing basis, attend all visits to the elder’s
  
  primary care physician as well as any specialists they may see. Ask
  
  questions when a health care provider observes something or makes an assessment
  
  that may conflict with what another physician has said or is at odds with what
  
  you have observed day to day. And this latter part is key. Because a
  
  caregiver or a geriatric care manager can be there day to day, they will see
  
  things that a health care provider may not observe at an annual or semi-annual
  
  visit. Speak up.
3. As an advocate, the records you keep may not be medical files like a health care provider’s office keeps, but as a caregiver you become the central depository of everyone’s information and inputs. Keep current on all prescriptions as well as over the counter drugs your loved one may be taking. And have that information – or a distillation of it – available when you meet with providers. And you may also have to be the one to discreetly let a provider know if your loved one is unable or has been unwilling to comply with prescriptions or other directions.
The common thread here for all of this advocacy is that a caregiver should not – and a geriatric care manager – will not keep quiet. Ask questions, provide information and be persistent if you feel you are not being heard.

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.
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.