Chicago's Geriatric Care Manager Center of Excellence – Since 1991 | Chicago's Geriatric Care Manager Center of Excellence

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...
Read more
May 19, 2020
0
0
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...
Read more
February 4, 2020
0
0
GOOD NEWS FOR CHRONIC CARE
Associate Care Manager Gregory is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), and Medicare Counselor, whose work...
Read more
August 6, 2018
0
0
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...
Read more
June 24, 2018
0
0

In the Caregiver's Words

Recent Client Praise

There are an estimated 30+ million cases of dementia worldwide according to the latest statistics. That amounts to a new case diagnosed about every 7 seconds, and the prevalence is projected to increase to more than 100 million people by the year 2050. This represents all the manifestations of dementia, not just the most dreaded dementia, Alzheimer's Disease. With this rising prevalence, you won't be surprised to hear that one of the more common questions I get from the people with whom I work as a geriatric care manager goes something like this: "Is it dementia in my parent or is it just forgetfulness?"

Let me start by reassuring you that we all forget some things some of the time, so just forgetfulness is not the cause for alarm we may think. But at the same time, the forgetfulness or other early manifestations of dementia can be hard to spot, because loving caregivers tend to cover for their partners so that outsiders will not know. Let me share some of the signs that your older loved one's memory may deserve some attention by a professional.

1.     Is the forgetfulness obvious in the form of an accumulation of unopened mail or newspapers and magazines piling up, seemingly unread? Does your loved one miss appointments with increasing regularity or have prescriptions that have gone unfilled? While no one case like this should be a huge cause for alarm, a pattern can suggest the beginning of something more serious that just forgetfulness. Be careful to look for larger patterns, not just the occasional slip.

2.     If you are at all involved in your loved one's finances such as helping to pay bills or to balance the check book, do you notice irregularities? Have they paid a bill more than once or missed a recurring bill entirely? Are they losing money or hiding stashes of cash? Beware, because some of these may also be signs that your loved one is being financially exploited.

3.     Do you notice telltale burns or bruises that show some lack of attention to kitchen duties or other work around the house? Yet, don't make a lot of a little as these may also be signs of weakness that are just part of getting older.
          If you have noticed any of these warning signs, please appreciate that they may be warning you of something other than dementia. Has your loved one's alcoholic consumption changed recently, or are their medications manifesting some side effects or interactions? Something as basic as your loved one using diphenhydramine (Benadryl) can cause forgetfulness the day after using it for allergies or as a sleep aid. And alcohol consumption can exacerbate this fuzziness. One of the more common ailments of older individuals is depression which can distract them from the attentiveness they may have shown when they were younger. Be alert to recent losses or changes that may have precipitated the blues as an explanation for forgetfulness or absent-mindedness. 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.
The next time anyone tells your older loved one to take it easy, be sure to clarify that taking it easy does not mean just sitting around. Medical research has begun to document that too much sedentary time is bad for one’s health. It leads to obesity, elevated blood pressure, elevated blood sugar and metabolic syndrome, and all of these lead to cardiovascular disease and even cancer. Researchers compared the health of adults who spent less than two hours a day in front of a television or other screen format versus those who spent four hours or more as the proverbial couch potatoes. Those who spent more screen time had dramatically elevated risk for cardiovascular events like heart attacks as well as death from any cause. Screen time is simply unhealthy. It may be no surprise why some are calling sitting the new smoking, likening it to the health risk of cigarettes. For any of you who are caregivers to an older loved one, this health risk is particularly worrisome, because older adults risk being isolated as they age. The 2010 U.S. Census found that 28% of people 65 years of age and older, or about 11 million people, lived alone. Granted, living alone does not automatically mean a person will be isolated, but it makes it easier to slip into that rut. Older adults outlive their friends with whom they have socialized in the past, and they may be less able to get out and walk or drive themselves to social events. They may resign themselves to just sitting and taking in the only seemingly accessible entertainment available – the screen. In fairness, we cannot tie all of this to television; any prolonged sedentary activities such as reading, sewing or knitting also can be a risk to the sitter. The same researchers who did the study of the health consequences of sitting offered some advice you can pass along to your older loved one:
- Encourage standing over sitting for small tasks like a phone call or even lunch.
- Use a higher counter so paying the bills can be a standing task.
- For social visits, consider walking and talking rather than sitting and talking.
And there are a lot more benefits; people who sit less are less inclined to depression, cognitive decline and dementia. Your more active, older loved one also will be less likely to be a target of elder abuse and less likely to need long term care. So, a lot less sitting and a lot more of everything else. 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.
We are into the season of giving, but for some dishonest scammers, it is a season for taking. Older adults are targeted more often because they answer their home phones, they have more cash available and the services scammers purportedly offer are more often the services older adults may want. Older adults may be more trusting as well. So, if you are a caregiver to an older loved one, here are some of the scams you should alert your loved one to and be on the lookout yourself: • Great Investments - If there is one thing that older adults fear more than losing their mental faculties, it likely is running out of money. They may have made solid investments in safe securities, but they may be easy prey for someone calling to let them in "on a limited time offer." It may not be huge investment, but it promises a hefty return. Just remember, if it seems too good to be true, it most often is. • Cheaper Medications - With the changes of the Affordable Care Act, older adults will have the chance to save more money on their expensive prescriptions, but the allure of cheaper meds offshore is still present on the internet. Make sure that the pharmacies making the offer are legitimate - and many are - but ask for substantial verification before ordering scrips; your loved one's primary care physician may be of help. • Fake Charities - This is another one where you want to verify the legitimacy of the cause. Especially on the heels of the tornado disasters recently, there may be callers posing as agents to get money to victims of disasters. Verify! The IRS posts lists of tax exempt charities on its web site, and there is another great site called Charity Navigator (http://www.charitynavigator.org/). • Pleas for Help - What grandparent does not have a soft spot for their grandchildren? Scammers can call older adults with just enough information to appear as one of the grandchildren in some kind of trouble that requires an immediate cash transfer. Caution your older loved one not to respond to calls from "their favorite grandchild" that offer no identifying name. Verify! • Bad Checks - If your older loved one is selling anything on-line, beware of the scammer who just happens to have a cashier's check that is for an amount much greater than the purchase price. They will ask if the excess can be wired to them along with transfer of the item. This is the part where the original check turns out to be bogus, so your loved one is out the sale item and the cash difference. All of these are just some of the examples that have played out in holidays past, but be prepared for the next new scam. And know that it will be too good to be true. 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.
I have talked before about the FDA-approved medications indicated for Alzheimer’s disease. The short answer is that they are not very effective – statistically effective, yes – but not appreciably effective and not for very long. That all deserves some clarification and specificity that I won’t get into, because I want to share something that literally has withstood the test of time. I have mentioned a London health panel study call the Whitehall II Study before. This was one of those really big population studies over a very long time. By very big, I mean they followed over 10,000 people, and the study began in 1985-88 with those thousands of people in the civil service between the ages of 35 and 55. They took measurements six times over this roughly 30 years. The measurements included dementia assessments at three of the time points and cognitive ability (verbal memory and reasoning) was measured at five time points. They linked all of this to clinical and mortality data bases as well as documentation of all of the civil servants’ age, gender, ethnicity, socioeconomic status, education, health behaviors, employment status, and marital status. They also measured “social contact;” this was contact with friends and could not be with family members or friends who lived with them. In a nutshell what they found was that more frequent social contact – after taking into account all those variables – in mid-life was associated with better cognitive function. It gets better. By age 60, those with better social contact had a statistically significant decrease in their dementia risk. You read the list of the other factors. Of course people with better socioeconomic health and better overall health tend to be in better cognitive shape as well. But even after taking into account all of those variables I cited earlier, social contact with friends made a positive additional statistical difference in cognition and dementia incidence. So, yes, friends don’t let friends have dementia. Please note that this is not a case of if you hang with friends, you will not have dementia. It is a pattern where people who hang with friends regularly are less likely to have cognitive issues or dementia. It’s is like if you don’t smoke you have a lower risk of lung disease. It’s not a guarantee; it is a better chance at better health. There is an author named Neil Pasricha who has a number of books out about living better and mental health. One of my favorites, The Happiness Equation talks about the importance of four S’s…sociability, structure, story and stimulation are the “S” cornerstones for Mr. Pasricha:
- sociable – engage with others
- structure – have a routine that engages you every day
- story – have a reason, a calling for what you do
- stimulation – challenge yourself and your friends.
In a break from my usual focus on what you can do for your aging loved one, this one will be good for you also if you are the caregiver. And it will be fun! 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.
That depends on what you mean by “slow” motion. It was just a couple years ago that I noted in my book on dementia that a new case of Alzheimer’s disease is diagnosed in the United States every 67 seconds. I received a solicitation from my state chapter of the Alzheimer’s Association yesterday, and an opening sentence informed me that “every 65 seconds someone in the United States developed Alzheimer’s disease.” I paused for a moment, and then it really struck me. The train wreck is gathering speed. Two seconds less is no big deal, but that is three percent faster; three percent is higher than the current inflation rate. Would you invest in a financial instrument that guaranteed you three percent less each year? I think the takeaway is that we all need to be vigilant with our friends and loved ones when it comes to “forgetfulness.” The Alzheimer’s Association offers some very basic tips on the most common early warning signs of Alzheimer’s disease:
1. “Memory loss that disrupts daily life,” like recently learned dates or events
2. “Challenges in planning or solving problems,” such as recipes, paying bills, etc.
3. “Difficulty completing familiar tasks,” because familiar no longer is familiar
4. “Confusion with time or place,” is like having no clock, no map
5. “Understanding visual images and spatial relationships,” such as a clock’s hands
6. “New problems with words,” but it is not just “word-finding”…it’s sentence-making
7. “Losing the ability to retrace steps,” and then blaming someone for the problem
8. “Decreased or poor judgment,” like giving up on self-care or donating in excess
9. “Withdrawal from work or social activities,” because they just can’t keep up
10. “Changes in mood or personality,” like confusion, paranoia or depression.
The challenging part when we may take stock of a loved one is that all of these in some minor ways are simple products of just having more and more birthdays. I strongly encourage you to visit this page to see not just the warning signs, but also the “normal signs.” But I also add that the first steps one should take when the signs begin to seem real include getting specialized assistance in a proper diagnosis from a neuro-psychiatrist…and then, don’t go it alone. There are numerous resources in almost every community and on-line that help all of us with a loved one with “that diagnosis” … and to find the support that you as the caregiver need. You will do a much better job of caring for a loved one if you first take care of you! 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 promise that I am not going to get up on my soap box about diet and exercise and all the health benefits owing to not sitting around so much. I have a different soap box today. Doctors often refer to this problem as nonadherence, but we also more commonly talk about noncompliance. You often see this on the label of a medication: “Take as directed.” That means two things, and the first is don’t take more or less of it and don’t take it more or less frequently. It also means just plain take it. Only in baseball is it considered really outstanding to have small percentages of success like a batting average that is .250 to .330. (That translates into getting on base 25% to 33% of the times a player is at bat.) But when it comes to taking statins, the numbers are really low. In a study of 5500 patients presented recently at an American College of Cardiology conference recently, researchers followed the adherence of patients who recently had had a heart attack and who had been prescribed a statin to reduce their low (bad) cholesterol. These were “typical” heart attack patients with an average age of 57 years, and 80% of them were male. As the researchers followed these patients they discovered that 25% did not fill the prescription the doctor gave them. And another 25% did not refill their prescription the next time it was due … but it gets worse. Only a bit over 6 percent of the patients took the medication as it was prescribed 80 percent of the time. The small group who took their statins “as directed” had a 48% lower incidence of another heart attack. This matters even more for your older loved one. As a matter of practice, a fair number of doctors take their patients off a statin when they get to their mid-seventies. Doctor must know best, right? But a European study of over 120,000 people over age 75 has shown that stopping statin therapy is a bad idea. As researchers followed these people the group who went off statins had a 46% greater likelihood of a coronary event like a heart attack and a 26% increased chance of a stroke. And this is why I am raising this issue today, because we are Aging Life Care Advisors. I am not setting aside diet and exercise, but I want to underscore that if your older loved one’s doctor prescribes a statin, pester them about taking it. It does make a difference. 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.