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

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

As a geriatric care manager, I have the chance to work with all manner of caregivers and the elders or others with special needs for whom they care. Sometimes a caregiver becomes significantly more than the person who may help a loved one with shopping, cleaning or other personal needs. There are occasions when that individual becomes sufficiently frail or mentally compromised that they need the support and control of a guardian.

I recently spoke with an attorney, Gordon Gault, who specializes in trusts, wills and probate among other legal areas. We talked about what a guardianship means and when it is appropriate as well as how it comes about. Gordon first explained that a guardian is substantially different from just a caregiver in that a guardian must be appointed by a circuit court judge. That appointed guardian is then able to act on behalf of the individual who is either under the age of 18 or is deemed disabled in some other way.

How can a guardian be useful? I have talked about elder abuse and fraud in another blog posting. A guardian can be appointed when it is concluded that the individual is giving away money or other assets to individuals who may be manipulating to their own ends. This appointment is intended to protect the individual and only happens after a court hearing complete with a physicians’ or other professionals’ opinions being weighed.

I have talked about powers of attorney for health care and for finances in an earlier blog posting, but a guardianship clearly takes this up a notch. But it is important to recognize that not only must a judge be convinced that the individual in question is unable to take care of themselves, but that judge also will oversee the guardian’s activities. As you can see, a guardianship pretty much takes control of an individual’s affairs, but this whole process does not all have to be left to attorneys. Gordon highly recommends that anyone who has a family member growing incompetent, get the powers of attorney signed as a first step. Anyone over age 60, he says, should sign these POA papers so that they can be available should a need arise. And later if you have to get a guardian appointed, you may be able to do it on your own if it is just the individual and their care. If it is an estate worth more than a couple thousand dollars, according to Gordon, you will need an attorney for the paperwork.

If you have questions, please feel free to reach out to Gordon Gault using this link. Gordon is a Chicago-based attorney.

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.,geriatric care manager Chicago,geriatric care Chicago

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Everybody forgets something! There is a heightened awareness - even fear - of Alzheimer's or other forms of dementia especially as we all advance in years, but simple forgetfulness does not inevitably lead to a dementia. And if you are a caregiver, the older adult in your orbit may be very self-conscious or worried at having misplaced the car keys. Or maybe it is blanking on a favorite author or the name of a friend that they happen upon on the store. No one of these events means that dementia of any sort is encroaching on their faculties, but sometimes it is not enough to reassure an older adult that it is not what they fear. It can be helpful, however, to take specific actions that are known to help keep one's brain healthy and sharp.

            Let me share five helpful tips from a well-regarded neurologist named Dr. Majid Fotuhi. You may have seen him on Dr. Oz, if you follow the program. Some say Dr. Fotuhi's advice can even prevent Alzheimer's; you be the judge. At the very least, these steps can help to strengthen the brain of virtually anyone who puts in the effort.

1.    Cross-Train: Anyone who exercises routinely knows that it is important to trade off the activities of your work out; they call it cross-training. Try changing which hand you use to comb your hair or take a different route to the store or use a soup spoon with your non-dominant hand. It is not easy, but it challenges your brain to learn something new, and as the brain adjusts to this shift it rises to the challenge by using areas of the brain that may have been under-utilized before.

2.    Relax: Stress is not just bad for your cardiovascular system; it is harmful to the brain because it releases a stress hormone called cortisol. So, several times each day, go to a quiet, darkened room and practice deep, slow breathing. Change out of clothing that may be restrictive and remove your shoes to signal your brain you are serious about relaxing. Do this for seven minutes.

3.    Mnemonicize Something: Okay, so the real word is simply "mnemonic. Challenge your brain to remember five spices from a recipe by making a word out them: Salt, Pepper, Oregano, Tarragon, Sage. See how long you can make the word or use the first letters to make a silly sentence.

4.    Increase Blood Flow: If your doctor says you are sufficiently healthy, walk up and down the stairs a few times, do ten push-ups, or do twenty sit-ups. All of these will raise your heart rate and increase blood flow to the brain, and that will grow new brain cells.

5.      Infuse DHA: There is a nutritional supplement called docosahexaenoic acid which is an omega-3 fatty acid which just happens to make up a large part of your brain matter. You can get it from fish that come from colder sea water, and it also can be purchased in your drug store or health food store. It has been shown to promote a healthier, even younger brain.

If you want to learn more about any of this, Please check out Dr. Oz's web site.

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.
There is no doubt that being a caregiver to an older loved one can be a positive and rewarding experience and it may be a way to give back. But the caregiving demands can become onerous, and the caregiver can feel stretched between their obligations to their own children and their partners. Or the day job can be demanding in and of itself without the "extra shift" that caregiving heaps on a person. As a certified geriatric care manager, I have seen caregivers who are stressed, but not nearly as often do I see a caregiver who talks about this burden. It brings up too much guilt, or they feel they just need to "get through" the next week or month, but the weight of the added responsibilities can be huge to the point of breaking. It is important to find relief before the caregiver reaches that point, and there is a way to measure caregiver burden before one reaches a breaking point. Consider the following and rate each on a scale where 0=never, 1=rarely, 2=sometimes, 3=quite frequently and 4=nearly always - be honest:
1. He/she needs my help to perform many daily tasks.
2. He/she is dependent on me.
3. I have to watch him/her constantly.
4. I have to help him/her with many basic functions.
5. I don’t have a minute’s break from his/her chores.
6. I feel that I am missing out on life.
7. I wish I could escape from this situation.
8. My social life has suffered.
9. I feel emotionally drained due to caring for him/her.
10. I expected that things would be different at this point in my life.
11. I’m not getting enough sleep.
12. My health has suffered.
13. Caregiving has made me physically sick.
14. I’m physically tired.
15. I don’t get along with other family members as well as I used to.
16. My caregiving efforts aren’t appreciated by others in my family.
17. I’ve had problems with my marriage (or other significant relationship).
18. I don’t get along as well as I used to with others.
19. I feel resentful of other relatives who could but do not help.
20. I feel embarrassed over his/her behavior.
21. I feel ashamed of him/her.
22. I resent him/her.
23. I feel uncomfortable when I have friends over.
24. I feel angry about my interactions with him/her.
Add up your score, and if you are close to or above a 36, it is time to consider help. At least consider help with some of the supportive activities you do for your loved one. You will find senior residential communities or centers who provide respite care to give you the break you may need. Also, look to what you rated "quite frequently" or "nearly always." If you have a cleric, a counselor or therapist, these may be good points for your conversation. Also, do a search of my blog here using the keyword, "caregiver." One of the topics I have addressed a lot is Caring for the Caregiver. Take care of you! For more on this scale (and there are others as well) go to: http://www.fullcirclecare.org/caregiverissues/health/burden.html 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 ccbishop@creativecasemanagement.com.
I have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about some new research which studies what predicts cognitive decline. Steve has more than two decades experience in pharmaceutical and medical device consulting prior to joining CCM about ten years ago. He reports: "Keep you r friends close, but your enemies even closer," is advice that has most often been attributed to Sun Tzu, a Chinese military strategist of 6th and 5th century China. Maybe this is good advice for military matters, but researchers are finding increasing evidence that it is poor advice for mental matters. In fact having stressful friends as early as middle age is a statistical predictor of cognitive decline in later years. Scientists at University College London report that negative interactions with others - which they characterize as "unpleasant social exchanges" - lead to declines in cognitive test scores over the ten-year period of their study. They actually measured the cognitive profiles of nearly 6,000 British civil servants over this period, and those with more negative social relationships reported even more rapid decline in their mental capabilities. Those in the top third of "negative associations" aged cognitively as much as a year more than those in the bottom third. The differences, while small, were statistically significant. In parallel research recently reported by physicians at the Washington University School of Medicine in St. Louis, it is not just the "crabbiness" of others that can precipitate cognitive decline. These physicians were looking for leading indicators of Alzheimer's Disease in more than 2400 patients in 34 Alzheimer's Disease centers between 2005 and 2013. They tested patients for their functional capacity, general depression, a host of other neuropsychiatric conditions and dementia. The patients all started out "cognitively normal" on all these scales at the outset of the study. They found that irritability, depression and disturbances in nighttime sleep patterns preceded mental decline in these patients. But it got even more granular than that. It was like following a road map with first, irritability, depression, and nighttime behavioral changes; these were followed by anxiety, appetite changes, agitation, and apathy. Last came elation and motor disturbances which were followed by hallucinations, delusions, and disinihibition. Rather startling. What do we take away from these findings? First, we should not make any sweeping generalizations without more research to corroborate what these researchers have found. But at the very least, it suggests that if you have a loved one who is middle age or older, be aware of the people whose company they keep. It is not mentally healthy to immerse oneself or your loved one in the company of irritating people. (Maybe that is good advice for us all, regardless.) The second research suggests that we perhaps can seek professional help earlier with symptoms that may precede forgetfulness or other cognitive decline. The list is here. Take seriously the signs of melancholy or poor sleep patterns or changes in mood or appetite. And if a loved one shows consistent signs of irritability, it may be more than their impatience. At the most general, think of these bodies of research to be not unlike the research we have always seen about diet and exercise along with not smoking. The research here, however, is not about physical health; it is mental health we can safeguard with better vigilance. 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.
If you are a caregiver to an older loved one during these holidays, you may have been wrestling with the eternal question of what to give to a person who seems to have everything they want. And most of us have parents who are of an age that they have had the time to accumulate lots of gifts over the years. If we are talking about the gifts that get wrapped and shared at Hanukkah or may be placed under the Christmas tree, you may be right. Anyone with enough birthdays may have had the chance to accumulate a lot of stuff over those years. But psychologists have confirmed that the gifts that mean the most are not the stuff that can be packaged; they are the experiences of shared moments you can share with your older loved one. So, as you think about gifting for your older loved ones this holiday period, think about a shared cup of coffee, a shared moment of just being present, even a walk in the proverbial park. But it gets even more interesting. Psychologists also talk about the difference between experiencing the moments and remembering the moments. The most important part that creates the most lasting impression is the latter of these two. You can share a perfectly average cup of coffee with your loved one, but if the conversation ends on a high note or with a recollection of something in your collective past of particular brightness that you can share, you will have created a very happy memory of the coffee experience (the average coffee fades away). Little wonder that we have these expressions like "save the best for last" or "everyone loves a happy ending." And I guess this also gets in the way of one of the sayings that I always thought made the best sense. It is something about "Life is short. Have dessert first." So, if I am to take the experts seriously, I should plan to spend a meal time with my older loved one...and have dessert last...and maybe first as well. Now, you have a plan to make your time with your older loved one about the experiences of this holiday season. But you should also remember the one item that most caregivers give the least attention. You need also to remember to take good care of the caregiver! So, as you plan the experience, it can also be a perfect gift for you, the caregiver as well as for your care receiver. What could be better than a happy ending, if not a "win-win?" 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.
Why a kidney alert for caregivers to older loved ones? Because nearly half of adults over the age of 70 in America may have chronic kidney disease and many of them may not even know it. That means that for those of you reading this who have an older loved one, about half of you should be paying attention to your older loved one's risk factors for chronic kidney disease. As a geriatric care manager for caregivers and their older loved ones we often get the call only after a crisis has occurred, but chronic kidney disease is one of those silent crises affecting as many as half of our client caregivers' loved ones. Here are the risk factors you should be looking for if you are a caregiver who wants to avoid the crisis in the kidneys:
1. Does your older loved one have high blood pressure? We tend to think of hypertension as a condition that affects the heart and the circulatory system, and it does. But it also affects the kidneys' ability to filter the fluids in your loved one's body. If kidneys are impaired, all the other major organs of the body are compromised.
2. Does your older loved one have diabetes? If the diabetes or even prediabetes is not well-managed by diet or insulin, the kidneys pay the price. Those extra glucose molecules that stick to the red cells begin to gum up the kidneys, and that again puts everything else at risk.
3. Does your older loved one smoke? We all have heard about how smoking is bad for a person's heart and lungs, but a lifetime of smoking also compromises the kidneys. It does this, because the smoking raises blood pressure, and as I said, high blood pressure will compromise the kidneys' ability to filter fluids.
4. Does your older loved one have a weight issue. It's very simple. Extra pounds translate into elevated blood pressure, and you can see where that takes your loved one.
5. How old is your older loved one? Birthdays are not exactly the problem that can result in kidney compromise, but a lifetime of exposure to any of the risk factors I have highlighted will harm the kidneys' function. As a caregiver, you should help your older loved one also appreciate that kidneys do more than just filter the fluids we consume each day. They clean the blood and help to regulate blood pressure. The kidneys also help in regulating the calcium that is available to your older loved one's bones which can be why some people develop kidney stones (which are calcium oxalate). So, all of this is to help show that geriatric care managers also help families use nutrition to improve the health of their older loved ones which translates into not only increased quantity of life, but also enhanced quality of life.
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.