in home care for seniors

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

“I really appreciate everything [CCM is] doing/can do to serve.”
A satisfied client
But in this particular case, it is not about the firmness of a mattress; it is about how much time you spend on your mattress. We all probably knew that too little sleep is a bad thing. Never mind that it makes us feel pretty awful and act pretty grouchy when we do not get enough sleep. It also reduces our cognitive function if we get too little sleep. But researchers now report that the other extreme is not healthy for cognitive function either. People who sleep overly long also show statistically significant decline in cognitive ability later in life. So, it is the zone in the middle of too little and too much that appears to be the sweet spot for normal brain activity. The zone that is “just right.” Dutch researchers have found that people who have sleep disturbance in their middle years are more likely to show signs of the amyloid deposits that are the hallmarks of Alzheimer’s Disease later in life. They liken this process to a kind of fast forward of the amyloid in the brain. They tracked nearly 3,000 people, most of whom were in their mid-forties, from 1995 forward. They established a baseline of overall cognitive function as well as their self-reported sleep patterns. They then contacted them about every five years to repeatedly assess their cognitive patterns. By about 2007 they charted cognitive capabilities by sleep duration and found that it traced something of a U-shaped curve with the people at the lowest and highest sleep duration patterns showing the greatest compromise to their cognitive abilities. The people on the low sleep duration side probably need the most help, because staying asleep is more difficult that setting an alarm to waken earlier. Experts suggest the following for better sleep hygiene:
- Don’t take your cell phone to bed with you. The light is stimulating and texting and reading with the artificial light of the phone are far from ideal for winding down.
- Television in the bedroom also has the same effect on winding down. It is best to shut down any electronic stimulation at least 30 minutes before settling down to sleep.
- Avoid certain sleep agents like diphenhydramine (Benadryl) that may be associated with an increased risk for dementia or Alzheimer’s later in life. Doctors recommend melatonin as an alternative.
- Think about bed-time back in the middle of the day by stopping your caffeine intake by 1pm or maybe 2pm in the afternoon. The effects of the caffeine linger into your evening and will agitate your sleep patterns.
I add one more – make a list of what you’ll do tomorrow well before lights out. You don’t want your brain working out tomorrow while you’re trying to shut down today. 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.
It’s a disease that affects about 26 million Americans. If untreated it will kill these people. And more than a third of patients who have been diagnosed with it and counseled about it do not even know they have chronic kidney disease; it's a disease that nobody sees. That is not a typo; I did say they do not know they have the disease, at least according to research recently conducted at Vanderbilt University and reports from the specialists who treat kidney disease. Kidney disease is a concern to me as a geriatric care manager, because it affects disproportionately more older adults and because it can be an outcome of poorly controlled of diabetes or high blood pressure and just more birthdays.

A research team headed by Dr. Kerri Cavanaugh of Vanderbilt surveyed 401 patients with various stages of chronic kidney disease. The patients were being treated at the university’s nephrology clinic, and the majority had actually seen a nephrologist within the past year, and many had even attended “education courses.” Yet, when they were asked if they had chronic kidney disease, more than one in three said “no.” This speaks to my top two rules about visits to a health care provider:
- Always take along a prepared list of questions and get answers from your provider;
- Always take a caregiver, friend or family member along to ask questions,
  
  listen and take notes along with you.
I mentioned in my title to this posting that this is “the disease nobody sees.” Now, the five things you should know if you or someone for whom you care may have chronic kidney disease, because the end stage of chronic kidney disease is renal failure which leads to dialysis as your kidneys simply stop doing their clean-up job on your blood:
1. If you have diabetes, hypertension, a family history of the disease or are over
  
  60 years old, get a kidney function test every year.
2. Maintain good control of your blood sugar and cholesterol levels and keep your weight down.
3. If you have even stage 1 kidney disease, stay away from acetaminophen, ibuprofen and aspirin as well as laxatives, antacids, ulcer medications, certain decongestants and even enemas.
4. Stay away from foods that are high in salt as well as anything that may contain magnesium or aluminum.
5. Be alert to changes in urination, swelling of the extremities and face, fatigue, a metallic taste, dizziness, shortness of breath, nausea, leg or back pain or feeling cold even when it is warm.
For more information on what to be alert to as well as how to preserve kidney function, I recommend the website of the National Kidney Foundation.

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.
In the spirit of total transparency, the definitive answer to this question is still a work in progress. There is a new study that will soon be hitting the press…but it is funded in no small part by companies who produce alcoholic beverages. There have been some studies lately that suggest moderate drinking can enhance one’s health and even contribute to a longer life. Well, moderate intake can lower the risk of heart disease, diabetes and dementia. And a study last month showed a relationship between moderate alcohol intake and longer life spans, but research also has shown modest coffee consumption, staying active and socially engaged and keeping a healthy weight are important. Although no one has scientifically given us the definitive answer, the truth may be somewhere within the range of moderation in all things can benefit one’s health. Based on a review of the research, let me offer some general observations. Moderate alcohol consumption can be healthful, but measure what someone says is their “moderate” dose. Physicians generally double what a person claims as their consumption when they evaluate their consumption. Another factor is history. Have the moderate consumers always been moderate consumers, or do they have a history of what some euphemistically refer to as “hard living?” Some researchers point to some elements in, for instance red wine, that are healthful. So, is the older individual always drinking what is the healthful alcohol? Set aside all talk about moderation. If an older individual drinks in excess, the health benefits of that red wine are not going to help. Let me offer what one should consider…not necessarily what one should do:
1. Since our bodies process liquor differently as we get older, reconsider what may have been a healthful or safe amount of consumption in younger years.
2. Carefully assess what medications are going to be mixing with the alcohol…does the alcohol dilute the health effect, amplify the side effects – allergy and sleeping meds are a real issue?
3. Alcohol is not a one and done; it can have a cumulative negative effect on the immune system, the brain, heart, bones, digestive system and the senses.
4. Alcohol makes a person sleepy, but it is a real sleep disrupter; “night caps” are a myth.
5. Alcohol can create socially-disturbing situations; no one ever regretted saying something because they drank too little.
By all means, wait for the next study. Note who has sponsored it, who the study subjects were and how long term they studied the subjects. And take note of how healthy the subjects were so that you can be as fit on all dimensions in order to consider if you want to be moderate on others. 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.
“We are what we eat” is an old adage that takes on new meaning with some research recently published by a nutritionist at Rush University Medical Center. According to findings reported by Martha Claire Morris, a Ph.D. nutritional epidemiologist at Rush University, a diet high in the right fruits and vegetables among other foods is a significant deterrent to late onset Alzheimer’s Disease. The researchers in Rush’s Memory and Aging Project followed a group of 954 patients whose average age at the study outset was 81 years, tracking their diets and also monitoring their mental abilities for five years. It is important to point out that with this older age group – unlike younger adults - genetic issues play a very small role in developing AD, but the researchers found that diet did. Participants who followed a “brain healthy” diet reduced their risk of developing AD by as much as 35% to 53%. A brain healthy diet includes vegetables, especially green, leafy vegetables like kale and spinach. It also includes beans, nuts, berries and whole grains. The berries that packed the biggest preventative punch were blueberries. Fish and poultry were the primary meats in the diet, and the diet also included olive oil and wine (sorry…only one glass a day). As important as consuming the good foods is avoiding the “bad diet.” On the list of foods to avoid in order to maintain brain health are red meats and fried or fast foods. And if you have a sweet tooth, you may need to retrain it as sweets and pastries are also taboo. Finally, cheese and butter are unhealthy for cognitive health…at least in amounts that exceed about a tablespoon of butter a day. As the researchers reported, it is not a surprise that the “brain healthy” foods are high in vitamin K, but they cannot say it is vitamin K alone or whether something else in combination with this vitamin that helps brain health. They also caution that this is not a predictive study, but given that the results square with other research on “brain healthy” foods their findings suggest that we can use these foods to good benefit. To learn more about the research and how nutrition is part of your brain health, visit the Rush University Medical Center web site (click here). And then head out to the grocer and grab a bunch of kale. 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.
The best estimates suggest that more than 7 million American have experienced and survived a stroke of some sort. Most of these people will be dependent in some capacity on a caregiver or certified geriatric care manager, because full recovery is relatively uncommon. In fact, the percentages break out generally along these lines:
- 10 percent of stroke victims will recover almost completely
- 25 percent will recover, but still manifest small deficits
- 40 percent will require ongoing care for moderate to severe deficits
- 10 percent will depend on skilled nursing care in a facility
- 15 percent fail to recover and will die within a short time of their stroke
Some of what will determine the category of a stroke victim is how severe the hemorrhage or clot was in the first place as well as how promptly medical attention was received. The rest will depend upon the rehabilitation following the acute phase of the stroke episode. Those who have suffered a "mini-stroke" or what are called transient ischemic attacks (TIAs) may recover spontaneously, but for the vast majority active physical rehabilitation will begin as soon as possible in the hospital. If the patient is stable following a stroke, rehab can begin within two days of the event. Once discharged, if you are a caregiver you want to be well-informed so that you can have an effective conversation with the care team at the hospital to get the best match of rehab for your loved one. This is where we often become involved with families of stroke survivors. This is so that the best care is provided and everyone has a clear picture of the goal of the therapy as well as the work that will be required to get there. The principal objective of all rehabilitation is to restore or improve physical function, but rehab also focuses on giving the stroke victim maximal independence and quality of life. To do this, some skills that have been taken for granted may need to be relearned, such as eating, walking or dressing. If you are a caregiver to a stroke patient, you will want to learn the language of rehabilitation in order to be the best advocate you can be for your loved one. The National Stroke Association has created a guide for choosing the right rehabilitation facility as well as understanding who all the players will be and what you should expect from each. It also includes a grading form so that you can compare facilities in order to pick the best program for your loved one. For a download of this Guide, just click here. 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.

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Creative Care Management, Inc.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

847.869.5118 x511 tel
847.869.0410 fax

info@creativecaremanagement.com

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