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

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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If you are like millions of folks in this country, you might be counting the days until Thanksgiving. Typically this creates a minor panic considering all the preparation most of us put into making the holiday happen. If you are a caregiver, it can be about more than meal preparations; it can also be about taking the opportunity for a "wellness check" on an elder mom or dad or other elderly loved one. I will talk about special food considerations in another posting, but let me offer some tips on what you can check to make sure the senior in your orbit is still in great shape.

First, it is important to recognize that we all - and I mean all - forget some things some of the time. So this short check list goes beyond the normal slips that will affect us all, regardless of age. Here are six suggestions on what to note when you all gather for the feast:
1. If you are gathering at your elderly loved one's place, you have an opportunity to check out what is in their refrigerator. Look for items that are well beyond an expiration date or simply have become a science experiment.
2. If they still drive a car, you may volunteer to run some errands. Use the opportunity to see that the tires are fully-inflated, the oil has been changed, the brakes are in good working order, etc.
3. While I certainly don't recommend a white glove inspection, you will probably be able to see if the place looks as tidy and orderly as you remember it from last year and years gone by.
4. If your senior owns a pet, does the animal appear healthy and well cared for? You may want to check to see if the tags show current vaccines.
5. If you have a chance to talk with neighbors or friends who see your older relative throughout the year, try to enlist their help in looking out for that relative, especially since you may not be around but a few times a year.
6. Holidays are a time for catching up and sharing news. If your older relative repeats the same story within a single conversation, make note of it as short term memory loss is a sign of dementia.
7. Take note of personal hygiene. Seniors are entitled to hang on to a favorite sweater or other item because they simply are attached to it, but you will notice if hygiene is becoming a bit lax.
8. Finally, just ask. You can show your willingness to help in any number of ways and make a list. Keep in mind, they may feel comfortable just letting you know if they have not felt quite right lately.
With all of this, make sure you have a good line of communication with siblings or others in the family so that you all can compare notes. You want to be helpful, not alarming.

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.
In a season with snow already blowing, we may think more about "winter-proofing," but I would like to continue with "fall-proofing." In my last posting, I wrote about how common falls among older adults are and some home improvements that can reduce the risk. I would like to take this conversation a bit further by talking about what are referred to as the intrinsic and extrinsic risk factors for falls. You will see that these offer two more "big picture" ways to both assess an older loved one's fall risk and to safeguard against those risks. Intrinsic Factors: The intrinsic risk factors are those that an older adult carries with them wherever they go, the most common simply is age. With more birthdays will come a decrease in muscle strength and tone, diminished vision and a decline in agility. And with age will come some chronic conditions that may not have been an issue when a person was younger. Increased age also translates into decreased bone density which simply means that the falls that a younger person can incur without complications now can become a hip or long bone fractures for a more mature adult. All of these risks conspire to create challenges to an older person's ability to maintain their balance. Extrinsic Factors: The extrinsic risk factors are those that are introduced to the older person. Many medicines or treatments can cause dizziness by either reducing blood pressure or by interfering with the inner ear's balance. I talked about loss of strength as an intrinsic issue, but a loss of muscle mass in the feet for an older person whose shoes therefore do not fit as snugly can pose its own imbalance and fall hazard. Alcohol consumption can be an extrinsic risk as older individuals' tolerance for alcohol is diminished. And the dehydration that can come from alcohol or any diuretic consumption may cause dizziness. So, if you are a caregiver to an older loved one, what can you do to address what seem to be the human forces of nature and aging? Here are some suggestions from the Centers for Disease Control. Encourage your older loved one to: • Exercise. Regular exercise strengthens muscles and bones for better balance and resilience. • Inventory the meds. Ask a local pharmacist or their primary care provider to review all prescription and over the counter medications for potential interactions or unwanted side effects. • Schedule a regular eye exam. What your older loved cannot see can hurt them, so have their vision checked at least once a year. • Rise slowly. Encourage your loved one to slowly get up from a chair or their bed to avoid the light-headedness that can result in a fall. • Wear shoes. Shoes will give a surer footing both inside and outside. Barefoot or slippers do not give the support or sure footing of properly fitted shoes. • Turn on the lights. Check throughout your loved one's house to upgrade where possible to brighter bulbs and add lighting to any dark or shadowy areas. 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.
What could be worse than a COVID pandemic? How about the uptick in depression and anxiety that mental health experts have been reporting? Or how about the just, plain negative feelings that enforced quarantine, less social connectedness and social isolation or loss of a job can cause? We have heard from a number of studies over time that depression and anxiety contribute to a person’s likelihood of developing Alzheimer’s disease. Well, some recent research from University College London, McGill in Canada and the French National Institute of Health and Medical Research suggests that even negative thinking can increase the chance of developing Alzheimer’s disease. Over a four year study time frame the researchers followed one group of 292 people in what was called the PREVENT AD study and another smaller group and a group of 68 people in another study all over the age of 55. During those two years the researchers asked about people’s experiences, their anxieties, and their depression. They were looking for patterns that could tie in to what scientists call Repetitive Negative Thinking (RNT). They also measured cognitive abilities like attention, memory, spatial awareness and language and more than a third even had PET brain scans. The scans were used to chart any build-up of the amyloid and tau deposits on the brain. They sorted the people into groups and found:
- Higher RNT people had more cognitive decline;
- Higher RNT folks also had more deposits of amyloid and tau;
- Higher depression and anxiety people may have had more cognitive decline, but not necessarily beta and amyloid deposits.
If you tie these together it suggests that it is repetitive negative thinking that may cause the dementia, not depression or anxiety alone even though RNT can predispose people to depression and anxiety. It is well-established that mental health and physical health are linked, but these researchers get more specific about what mental health can do to physical or cognitive health. If you have an older loved one in your orbit, there is a distinct likelihood that they have had a lot less social contact during our extended quarantine. As you have been in communication with them have you noticed negative comments…and not just one negative comment, but a pattern? A short period of negative thinking is not going to cause Alzheimer’s disease, but it can begin a pattern of negativity. Make it part of your mission not just to call and see if mom or dad need groceries or help with their internet. Make it a point to be part of their regular – maybe daily - “positive fix.” Maybe it’s a humorous anecdote, an inspirational quote or a cool Netflix comic segment. Every positive boost to your loved one’s mental health is a boost to their long term cognitive and physical health. Protect your loved ones from not just the COVID, but also from the toll that negativity can take. And while you are at it, protect yourself also. Just because the researchers focused only on 55+ year-olds does not mean that RNT is not bad for anyone of any age…get positive. 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.
As we age, our bodies give us feedback we’re not used to. Activities that never required a second thought suddenly take some planning. Sometimes it’s hard to know if a new pain or sensation is something that we should worry about, or just a natural part of the aging process. We’ve compiled a list for you. If you or someone you love experiences any symptoms on this list, take them seriously and consult a physician immediately.
1. Confusion/Speech Difficulty. Call 911. These two symptoms are the most common manifestations of stroke. As the difficulty recovering from stroke depends heavily on the speed of attention to the event, it is wise to take this very seriously. Other reasons to suspect stroke include numbness, weakness, paralysis on one side of the body, or further difficulty with balance.
2. Vision Issues. Blurry, double vision? This is also a potential warning of stroke. Additionally, if you experience pain in your eyes, you should seek urgent treatment.
3. Chest Pain. This is a big one. If you have pain that lasts longer than a minute or two, it’s no time to wait. Treating a cardio event in the early stages is key.
4. Shortness of Breath. Any sudden difficulty catching your breath for longer than a few seconds should be your cue to get to the emergency room.
5. Stomach Pain. If it’s sudden, intense, and lasts longer than 30 minutes, a visit to urgent care is called for. Unresolved pain needs dealt with, and abdominal pain could need special attention. Don’t take the risk.
6. High Fever. If an adult has a fever that has reached 104 degrees, they need to be seen by a physician. The same is true for a newborn (up to 3 months) with a fever that reaches 100.4F. Excessive fevers need to be brought down. Let the professionals help.
7. Unusual Vomiting. When abdominal pain is unrelieved after vomiting, or if there is blood in the vomit, the situation needs caution and monitoring. If the unusual vomiting is accompanied by a high fever and lasts more than a few hours, children should be seen immediately. Adults should be seen if the episode lasts longer than a day.
8. Seizures. If seizures are part of your medical history, follow your doctor’s orders for managing; however, if seizures increase in occurrence, this is call to revisit your care plan. A first-time seizure requires immediate attention, as does a seizure experienced by anyone who lives with diabetes, or who is pregnant.
9. Head Injury. Take even a head bump seriously if you have a lingering headache. Head injuries can cause seizure, difficulty with speech, and confusion. Loss of sensation, strength, and coordination are also key indicators that any issues with head injury should be taken seriously.
If your symptom is something not listed above, be seen sooner than later. Aging happens differently to everyone, and health is high priority. Finally, trust your instincts. If something feels “off”, check it out. You’re right that it probably is nothing, but it’s much better to know than to worry. 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.