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

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SHE WROTE THE BOOK:

A family crisis doesn't make an appointment. Therefore, you've got to be ready when it shows up. In excess of 8 million Americans have some form of dementia, As a caregiver to a loved one with dementia, it can wear you down, stress you, worry you and make you sad. It may create a financial hardship for you or your loved one. It can become your other full-time job. And it can burn you out! This book focuses on what we know that can be your lifesaver to ease your pain and help you find the best way to address your problems. It also will help you to care for you, the caregiver. There is no "one size fits all" plan, but we think you will find parts of your plan in the case studies we share in this short book. The key to peace of mind is to have a plan, even if you have to make adjustments along the way. Let us be your companion and guide as you navigate this challenging time…

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I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I am happy to say that I can share good news about both! Let me start with the first part - a quick story for folks who have a harder time hearing, then I'll tell you what I heard about the herd. First, the heard news. A church-going friend of mine comments on the upside of not being able to attend in person religious services at his place of worship. Yes, this is someone who has become a Zoom fan! He talked of so many areas in his place of worship where the sound quality was virtually non-existent, but at his home computer all the speakers and singers were positioned properly with their mikes, and he had control of the volume. He considered that something of an upgrade. But the upgrade doesn’t hold true for everyone during this time of masks and social distancing where some older adults just are out of reach and out of hearing range. With the sound quality dampened by masks and distance posing a hearing obstacle, they are at an even greater disadvantage in this pandemic. But there is a new hearing device that a lot of people are bragging about, and its success owes as much to the ear bud’s popularity as it does to the cool technology of the new device. Oh, sure, there have been cool hearing technologies in micro before, but unless one has as much as $5,000 in discretionary funds, improved hearing is rather out of reach. Enter the Olive Smart Ear. The really great part is not only the apps for getting the setting just right for anyone’s hearing needs, but the price is less than a tenth of some of the micro-technological devices previously available. And everyone wears an ear bud these days for their smart phones and for their music and more. The Olive Smart Ear blends into the fashion and taste of the 21^st century really well. If you have an older loved one whose hearing and attitude could use a bit of a boost, please check out www.oliveunion.com. And then there is the herd news. You may recall early on in this pandemic that there was talk of herd immunity. Well, it is not the kind where the COVID is going to just disappear, but there was talk about when we would get to the point that about 70% of a community had had the disease with or without symptoms, and then the rate of spread would dramatically drop off. Scientists had estimated that the magic 70% mark was the point at which any given individual who contracted COVID would spread it to less than one person on average. Now, it seems that the threshold is as low as 45 to 50% of people having been exposed to confer “herd immunity.” Cities like New York City or London or other European cities or even Mumbai may not see a second wave after all. And while there still is no guarantee that we will have a vaccine before the end of the year, our herd may be a lot closer to turning the corner on this pandemic than we initially had thought. Until then, keep your distance, wear your mask and practice really good hygiene, and be something that you may not have been for some time…be hopeful! 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 talked in some of the recent blogs about when decision-making may transfer to another person from an individual whose own faculties may be failing. Such is the case with powers of attorney as well as guardianships. There also are decisions which need to be facilitated by a caregiver, but we need to know the difference between deciding for the older loved one or individual with special needs versus facilitating their own good decision.

In my role as a GCM I had a conversation with one of my clients recently about her car. She is an 84-year old woman who has been living on her own since her husband died about six years ago. Her husband had surrendered driving responsibilities to her some several years before his demise, and it was his initiative and his choice.

Recently, she asked me what I thought about her giving up driving. The fact that she brought it up suggested to me that there may have been a precipitating event for her question. She admitted that increasingly she had experienced vision difficulties driving at night, so she was limiting her driving to daytime.

On further probing she admitted, however, that she recently had lost control of her car and skidded off a road near the independent living facility she called home. It had frightened her. Her facility manager at the residence had suggested she consider selling her car and rely instead on their complimentary shuttle service to get about town for shopping and such. Simply put, she did not want to give up her independence. If you were the caregiver to such an individual what would you do?

The one thing you ought not do is immediately decide for the older individual under normal circumstances. You can, however, talk about the frightening moments the older individual may have had. In my case here, I used that experience as an opportunity to discuss what might have happened if her accident had involved another vehicle or worse, a pedestrian. I said "normal circumstances." If the individual is mentally or physiccally compromised to such an extent that it interferes with safe driving, you have a moral and legal obligation to deny them access to a vehicle. Check with your own state department of motor vehicles for the actual wording on the books in your locale.

On the positive side, it was also an opportunity to discuss how using the facility shuttle could be liberating. She would now have the benefit of transportation without the increasingly challenging responsibility of driving. In the end, I also encouraged her to talk with her adult children to discuss their opinions and what they could do to help. Although both her children lived at some distance from her home, they were in a position to assist in selling her car. That proved to be the last string for her to cut in order to part with her car and to move forward with “her own chauffer” as she came to call the shuttle.

In my next blog, I will talk about another big decision-point many older adults face – whether to move into a facility for elders and others with special needs. I also have spoken with elderlaw attorney Eric Parker, whom you may remember from an earlier blog on advance directives. He has some great advice on how to select a nursing facility.

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.

Copyright ©2011
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Life in a Retirement Community
If you are considering transitioning your elder loved one to a retirement community in Chicago area area, you know that choices are plenty and oftentimes it’s not clear what is the right choice. That is where we come in. Our Chicago elder care specialists work to ensure the best living arrangements possible for your loved one.
What is a retirement community?
A retirement community refers to a housing complex or building of older adults living independently surrounded by their peers, without any extensive outside assistance. Life in a retirement community is about convenience and the independent freedom to connect socially with other retirees in a safe and relaxing environment. Residents are free to explore their surrounding communities, and many of them maintain and operate their own vehicles.
Is retirement community right for you?
If your elder adult is interested in the freedom of independent living with the benefit of being surrounded by their peers, a retirement community may be what they are looking for. However, to make sure this is the ideal arrangement for your loved one, we always begin by conducting a thorough evaluation of their lifestyle preferences, their physical and mental state, and even an associated budget. Then, based on the information we uncover during evaluation, we develop a personal geriatric care plan for your loved one and present top choices for retirement communities in the area. We even take care of the application paperwork for you. We know that trying to maintain a balanced lifestyle, while taking care of an elder loved one is difficult, but if you have the right people helping you, it is doable. So, contact our geriatric care managers today for a free initial consultation and let us help you make your life and the life or your elder loved one balanced and stress-free.
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I have talked in this two part series about changes you and your older adult can expect, but there is one thing that should not change. Your older adult should continue to feel in charge of their own lives, despite the benefit that they may get from some “leverage.”

Make It Easier. Before kids learn to tie their own shoe laces, they get the benefit of Velcro shoe bindings. These can be a good option for older adults whose manual dexterity may be on the wane as well. And Velcro is not limited to just shoes; you will find jackets and other articles of clothing with Velcro, making life a lot easier for those whose digits are not as nimble as they once were.

It Takes A Village. Mom or dad may want to stay in their lifelong home, but they only mow their own lawn because the last of the teens went off to college leaving them a bit short-handed in the yard work department. It may not be something they look forward to each week during summer, nor is the snow accumulation on the walk such a great experience either. Talk with the parents about what they may still enjoy doing for themselves – for instance, the hands-on gardening and the chores they would not mind delegating. Aside from services that do everything for the yard, you may also find job boards at local community centers or in congregations where volunteers or young kids looking for work. This extends to inside chores such as cooking, laundry and light cleaning as well.

Balancing the Books. You do not want your parents’ credit ratings to suffer because they are not as on top of their bill-paying as they once were. You do not have to be involved in their money matters personally because there are bonded professionals who can help keep your parents’ finances in good shape. Check out our Support Tools page to read more about their association and how to find someone near your parents’ address. Your parents also would benefit from an elder law specialist to advise them in making certain their finances do not create any obstacles to qualifying for Medicaid years down the road when they may need to make the move to long term care.

Caring for the Caregiver. In the midst of all the caring for an older mom or dad, it can be easy to overlook your own needs.   It is only too true that you as a caregiver will do a much better job being a care giver if you also take care of yourself. And do not let guilt get in the way of seeking help when you need it or delegating some of the chores when you just cannot do it all alone. You will see a lot of postings here that echo this theme, so browse a bit for some of the resources available to you as a caregiver.

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. Visit our For The Caregiver page for more information and resources.

Lauren Weldon is a partner in Margolis Weldon, a law firm specializing in estate planning and elder law. We have invited Lauren to post on what we all need to know about Long Term Care. She offers this: Even the best of us can be overwhelmed when someone we love is in the middle of a stint in rehab due to a fall or coming out of the hospital for the third time in a short period of time. We often don’t think about the financial, legal or even practical considerations that are part of what can become a long term care crisis. Here are three things you need to avoid; you could call them the three “NOTS” that can tie you in KNOTS:

Not knowing who will pay for it: One of the most common misconceptions regarding long term care is that Medicare or private health insurance will pay for it. To be fair, this is true to a certain extent, in some circumstances. Medicare pays for up to 100 days of rehab in a skilled care facility, provided the Medicare recipient meets certain qualifications. Any days after the 100^th day are not paid for by Medicare, nor are they paid for by a supplemental policy. For long term residents of nursing homes, their bills are being paid by Medicaid or privately (i.e., self-funded through assets, income or a long term care insurance policy). You and your loved one need to get schooled on Medicaid.

Not having a plan: Charlotte Bishop talks about “The Trifecta:” being old, sick and broke. Nobody wants to be any one of these things, let alone all three. The reality is, if we are lucky, we will get old. Yet, many of us will outlive our money - in part due to expenses related to chronic illness. Despite knowing these things, many people don’t plan adequately. They don’t inquire about or even consider long term care insurance until they are too old or sick to qualify. They don’t have an estate plan or the legal documents necessary to protect themselves, their loved ones and their assets from crisis.

Not consulting with an advocate: Unless you work in healthcare or senior care, chances are you have no idea how to go about finding the best rehab facility in your area. You don’t know how to negotiate the private pay period at a nursing home. You have no idea what to look for in a caregiving or caregiving company, and you have never heard of spousal impoverishment. In addition to an elder law attorney who can advise and guide you, geriatric care managers, patient advocates and private social workers can all represent your interests and provide unbiased feedback regarding your long term care choices.

There is a fourth NOT; do NOT put off planning. The best time to start planning is right now; don’t wait until a crisis occurs. In addition to giving you peace of mind, thinking through these issues and coming up with a plan now will save you significant time and money. 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.

Deciding on whether to move and then deciding which senior residential option is best can be stressful for a senior and a caregiver, and then comes the move. It is not as easy as packing a son or daughter off to college, because relocating an older adult is really about packing up the possessions of a lifetime. Moving day and its run-up can be challenging with all there is to organize and coordinate, but fortunately there actually are experts trained in helping to make the move smoother and less stressful. These professionals know that the move and its associated packing is more than just moving furniture.

As a geriatric care manager I am not only called on to help facilitate good choices of a facility, but also to lend a hand or an ear in my role as resource, counselor, advocate, and local friend throughout a move. There also is the National Association of Senior Move Managers (NASMM); check out their web site. NASMM (pronounced NAS-em) is – in their words - a not-for-profit, professional association of organizations dedicated to assisting older adults and families with the physical and emotional demands of later life living including downsizing, relocating, or modifying their homes.

They offer some helpful advice to elders considering a move along with their caregivers. For instance, they suggest considering an option that focuses on the older adult simply “aging in place” rather than moving to a new physical environment. In either case, a change to a downsized living environment can be in order, and they assist in developing a space design.

When you as a caregiver alone or with the assistance of a senior mover help an elder in this transition think about what you will do or contract for:

Arranging for the profitable disposal of unwanted items through auction, estate sale, buy-out, consignment, donation, or a combination of the these

Interviewing, scheduling and overseeing movers

Arranging shipments and storage

Supervising and overseeing of professional packing

Unpacking and setting up the new home

Coordinating cleaning, waste removal, shopping, senior escort

Assisting with selection of a realtor and helping prepare the home to be sold.

As you look to possible help from the outside or what you will do as a caregiver, it is important to remember that it is not just about moving things - it is about relocating memories. One caregiver I know recounts the story of helping his mother transition to an independent living community and the entire day it took to empty and organize just one closet. The explanation was simple. Every file and every box had a story, and having someone available to share the stories, putting some to rest and packing others carefully for the move required time.

So, while some may think of moving day as a lot of heavy lifting, it really is more about helping to preserve a biography and to share a history of place and life.  Make sure you plan enough time for transitioning all the memories.

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.

Copyright ©2011

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.

Caregiver Counsel on First Aid for the CaregiverIt is no secret that caregiving can be an everyday challenge, especially when managing a full time job and other family responsibilities. Discover tips about how caregivers can limit stress, boost energy, and stay positive in our latest white paper.Download

This is the third in a series of posts on dementia in advance of the release of my new book, How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. It will be released through Family Solutions Press of Los Angeles and available from Amazon the week of July 17. We will keep you up to date on details. Who are the experts on dementia? There are some incredibly useful on-line resources that families with an older loved one suffering from dementia can turn. We offer a lot of wide-ranging resources in our book, but here are the links on a couple of the more outstanding among them. Consider these national resources available to support the individuals who may need help when dementia rears its head. In these and other resources, there also are local or regional chapters that can be that personal touch that makes such a difference.: 1. Alzheimer’s Disease and Dementia Caregiver Center is an arm of the Association that has done the most to help patients with the disease as well. The Center provides training and other resources to caregivers as well as a 24-hour telephone hotline. http://www.alz.org/care/alzheimers-dementia-support-help.asp 2. Aging Care offers answers and support from those caregivers who also are facing the challenges of caring for a loved one with Alzheimer's or Dementia. The site allows you to “ask your questions and get helpful answers from caregivers, and memory care experts.” They also offer a free guide, "Life as an Alzheimer's Caregiver". The guide draws upon the experiences of elder care experts, caregivers to those with AD and patients themselves https://www.agingcare.com/Alzheimers-Dementia/Questions-1 In my 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, amny 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.

In my last posting, I talked about how a caregiver can facilitate an older adult’s decision around when it is time to surrender driving their own car. As I said in that blog, it is important as a caregiver to help facilitate the older adult’s decision about something like driving a car versus retiring a car rather than make the decision for them. It is no less true of decisions on living at home versus moving to a senior residential community.

Let me help you with some of what I have learned in talking with hundreds of older adults who have wrestled with this decision.

Let me start by saying that yes, it is in part a decision based on financial means. Even selling one’s home and the financial windfall that sale can represent may not provide enough funds for a couple or individual to move into a senior residential community – especially some of those that feature resort-like amenities in the Sun Belt or elsewhere.

Research among individuals who are “age-qualified” to reside in a senior residential facility offers some amazingly consistent findings. First, only about one in twenty to one in ten individuals with enough income and assets actually want to live in a community of seniors. What attracts these few to senior communities is fairly consistent.

Older adults most often are looking to give up the heavier duties of living in their own homes. They value having someone else mow the lawn, shovel the walk and otherwise maintain the grounds. They also like the idea of handing over the responsibilities for heavy cleaning and even regular upkeep. And the security of having a place in which they feel protected from strangers while still enjoying the freedom of coming and going is also key.

Where the community is located is not quite as important as knowing that they will have easy access to shopping and entertainment. One of the draws of some of these communities is the religious sponsorship that means the individual will be among others of similar spiritual orientation. And they want to know that they will continue to be as active as they wish.

So during the holidays if the conversation with elders in your midst begins to turn to some of the responsibilities of home ownership that weigh upon them, they may be ready to discuss alternatives. It starts with what they may not want to do….not what they cannot do any longer.

In an upcoming blog, I will be talking with Eric Parker on a more medically-driven decision - how to select a nursing facility.

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.

Copyright ©2011

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We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the long-haulers, the after effects among those who survive COVID and more. We don’t hear much about the other big side effect among even those who don’t actually come down with the disease – depression. In the years leading up to the pandemic and quarantine more than 18% of people 65 years of age and older showed signs of depression. Dr. Kathleen Rogers of the Cleveland Clinic warns that depression or anxiety may be something akin to their own pandemic as a consequence of the isolation of 2020 and beyond. If you have an older loved one with whom you are only just now beginning to restore contact, be watchful:
- Those who have lost friends or loved ones to the pandemic are highly likely to be depressed.
- If your loved one talks with you about loneliness, isolation, lack of socialization...be attentive for a “down countenance” or even suicidal ideation.
- Signs of disorientation or memory lapses also can be indicators for depression owing to disengagement.
- Don’t be misled by the mom who always took care of things; women are almost twice as likely to have depression.
Signs of depression ought not be taken lightly, because depression is linked to other conditions like cardio-vascular health, dementia and more. People do not just “snap out of” a clinical depression. If you see or hear any signs of depression with your older loved one – and this is harder to discern over the phone or on ZOOM -reach out to:
- Your loved one’s primary care provider who is able to schedule an appointment for an initial assessment.
- The social worker or community case manager of the setting in which your older loved one may live.
- Your local city or community health department; they are likely to have a social worker or an advocate who can go to bat.
- The hotline - The National Substance Abuse and Mental Health Services Administration or dial 800.622.HELP.
We’ve talked before about “if you see something, say something.” Well, we are working with blinders still on as we all move back toward a new normal, so we may not visually see things as we once did. Follow your instincts and emerging from the pandemic and quarantine may actually be a return to “normal.” Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.