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

When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
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May 17, 2022
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Heavy Drinking Helps?
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: ...
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April 19, 2022
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Making Your Holidays Happy Again
Yes, “holidays” is a plural word here. Please allow me to digress on this plurality and simply point out...
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November 16, 2021
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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

I recently had the opportunity to speak with Dr. William Krowinski of Life Works Erie (link) about something I have noticed over the years. That is, during all of this holiday period, there are a lot of folks who just seem pretty down. So, I asked him about this thing with "holiday blues," or is it actually depression? Here are his answers.

Is there such a thing as holiday blues or is it just another name for depression?

"Holiday blues as a psychological condition is distinct from clinical depression. We tend to think of the holidays as a joyous time, getting together with family and friends, preparing and exchanging gifts and well wishes, fixing and partaking of traditional desserts and meals. However, for some, particularly the elderly, they can also be a time of sadness with a sense of loss.

Why is that?

Our mind is always referencing the past to make sense of and guide us in the present. We don’t invent Christmas or Hanukkah each year. It’s an annual celebration whose meaning and rituals are largely derived from past celebrations. So this holiday is in many respects a reflection of past experiences. Whether consciously aware of it or not, we ask ourselves where was I last year, who was I with, who was there, what did we do, how did I feel and so on. For many elderly, this referencing inevitably involves realizing who isn’t here this year, including spouse, friends and family members; and what did I do in the past and am I able to do it now? Recognition of these significant losses and limitations produce feelings of loss and sadness.

Do all elderly suffer from holiday blues?

If they have experienced significant social losses and physical limitations, I would say yes but with some qualification. Some people are psychologically resilient so loss is not as devastating and their sadness isn’t as severe. Some people have a large social network full of friends and family members, which tends to offset any one loss.

Is there a difference between holiday blues and depression?

Yes. Examining the duration and severity of the sadness, as well as identifying other symptoms allows us to differentiate between the two conditions. Regarding duration, holiday blues end when the holiday is over. Clinical depression continues for months and sometime years if left untreated. With depression, a person’s ability to socialize and take care of him or her self is negatively affected. Other symptoms tend to include loss of appetite and weight, insomnia, anxiety, difficulty concentrating, feelings of discouragement and hopelessness, lack of energy and motivation, and sometimes-suicidal thoughts.

What can be done to help a person experiencing Holiday Blues?

First let me say what you shouldn’t do. Don’t tell the person “you shouldn’t feel that way” or “just snap out of it.” We don’t choose our feelings. People suffering from the holiday blues or depression need to be treated with empathy and compassion. In addition to recognizing the person’s feelings, ask, “Is there anything I can do to help?” Offer to take the person shopping, to church, for a walk and other activities. Offer to include him or her in holiday preparation activities such as baking cookies, buying a Christmas tree, decorating the house and so on. Even if the person declines your offer, they know you are thinking about him or her.

Do you have any suggestion for the person who is experiencing Holiday Blues?

First, recognize that there is reason to feel sad. Accept the sadness and view it as a messenger. Frequently our sadness informs us of the joy that a deceased loved one has brought our life. Next, try not to isolate yourself. Don’t turn down opportunities to be with family and friends. Regarding physical limitations, grieve the loss of what you once could do; while at the same time do what you can do. Remember that life is a about transitions – the athlete becomes the coach, the actor the director, the mother the grandmother and so on. Celebrate the past but let go and embrace the season of your life. And remember there is always someone who needs your help. Helping others, even in small ways, creates meaning and purpose in our lives.

Dr. William Krowinski Ph.D., LCSW, a psychotherapist specializing in marriage and family and a guest speaker at LifeWorks Erie (www.wjkphd.com). Lifeworks Erie, located in NW Pennsylvania, is a partner of CCM. They provide services and resources for seniors interested in staying mentally and physically active.

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.
I have spoken with Matt Margolis, an Elder Law attorney with Heartland Law Firm recently about VA benefits to which people may not know they are entitled. In this posting, he shares some valuable insights that may expand your options for care cost coverage.

            One very common question that comes across my desk on a daily basis is “Are there any benefits, other than Medicaid, to help pay for the care of my ___________ (insert: mom, dad, husband, wife, brother, sister, etc.)?” Typically, this is being asked because Medicaid is only available for someone in a Skilled Nursing Facility. Because of this, we refer to Medicaid as “nursing home financial aid.” My follow up question to this prospective client is usually asking whether the person they are calling about or their spouse was a Veteran.

            The Veterans Administration (VA) Aid and Attendance Benefit program is the benefit I will discuss with them. In the overwhelming majority of situations, the prospective client has never heard of this benefit. This benefit is actually classified as a “pension” by the VA and is a great source of funds for financially constrained wartime Veterans and/or their surviving spouses to use for their long term care costs such as living at home with a caregiver, adult day care, independent living with a caregiver, assisted living, and/or skilled nursing.

            While family income is one of the determining factors of eligibility, it is important to be aware that the VA allows individuals to deduct their unreimbursed medical expenses, which includes their health insurance premiums, home care, assisted living, adult day care, caregiver, and nursing home costs from their income. As a result, many Veterans who may not have previously qualified might now qualify if long term care has become necessary for them or their spouse.
As a general rule, to qualify for the Aid and Attendance benefit, a family's total assets (excluding their primary residence and vehicles) cannot exceed $80,000. Fortunately, many clients I meet with have assets in surplus of this number. The good news is that with the right strategies and planning, we can still position them to qualify.
            A few things worth mentioning:
In the end, the VA Aid and Attendance pension is a heavily untapped, but much deserved, benefit for those Veterans and/or their surviving spouses who served and fought for our country.

Heartland Law Firm is a holistic elder law and estate planning firm. Heartland Law Firm concentrates in assisting seniors and those in transition with understanding the landscape they are in and what protections and benefits are available to them and their loved ones. Visit their web site at: Heartland Law Firm.

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.
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.
Confusion usually means we're not getting something right, but in physical training and even physical therapy, muscle confusion can be the best thing to help your body stay on your feet, lift properly, and more. We got a lot of insights on “muscle confusion” from our guest writer today, Victor Colon, a professional trainer here on the Northshore. Victor has his B.S. in kinesiology, the study of human movement, and he is certified as a personal trainer with the National Academy of Sports Medicine, and he also is certified as a corrective exercise specialist and performance enhancement specialist. Throughout the COVID quarantine and beyond, Victor also makes house calls ala ZOOM. Let Victor tell you the rest of what can be done to help an older loved or yourself confuse your muscles into helping you be in better shape: It comes down to “use it OR lose it.” But how do you “use it?” There are 6 core movements to use to keep fit and nimble: 1. Push - vertical and horizontal – these are the basics like pushup ups for the vertical and variations on the same movement for the horizontal complement. 2. Pull- vertical and horizontal – for the vertical part, think of pull-ups or a modified form and for the horizonal think of a rowing machine. 3. Squat – well, squat is just squat, but for someone just getting back to fit, these4 can be modified to avoid knee or ankle strains. 4. Lunge – some people forget that walking in kinesiology terms is really just controlled falling, so a lunge is really just an exaggerated stride…without falling also. 5. Hinge – these movements require muscle groups to work together like when we “curl weights” and this can be contracting in or relaxing out to reverse the motions. 6. Rotate – this is where we use some of those unique neck, shoulder or hip muscles to do 3-D exercises that make us so uniquely human. Do you have difficulty hoisting your carry-on luggage to the overhead compartment, keeping your balance as you rise from sitting in that comfortable chair or jogging up a flight of stairs? An effective training program will redevelop the mobility of all these basic motions and then proceed to do these movements more times and perhaps lift more weight by adding repetitions and sets of multiple repetitions. Only weight lifters focus on just the amount they are lifting or pressing. An effective training program that is about being more versatile, strong and nimble is built on the number of times and the variety of types of movements. At the end of the day, have a program, work with someone to educate yourself, make it fun for you to continue for a lifestyle, and reap all the benefits that you want and didn’t know you could achieve! When taking on a serious training protocol, think of it as learning to crawl before you can walk and before you can run. Give your mind and body something to work toward, because it’s good for you physically, mentally and emotionally. Your activities of daily living will seem far easier, you’ll be more durable, you’ll be stronger and your quality of life will be extended along with your quantity of life – your age. If you’re looking to level up from where you are at today please feel free to contact Victor for a free fitness consult and from there we can plan out your training program and get you closer to winning in the game of life!! 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.
Barbara Bush, wife and mother to presidents, has taught us another lesson this past week, and it is about how she chose to die. She taught us that palliative care and hospice care are different concepts, but she also taught us about the importance of an end of life plan. Let me start with the first. Let me clarify that hospice care is reserved for patients who will face an end to treatment and wish to be comfortable. Palliative care is simply the “comfort care” we saw requested for Ms. Bush, but it can be for any patient about to embark on a difficult or painful treatment regimen. We deal with a lot of families of older loved ones who are faced with difficult diagnoses. If the diagnosis has a treatment option that may prove difficult or painful, doctors may suggest palliative care. And that is when some family members may freak out just a bit… not an exaggeration. Yes, they may freak out because there is an association between palliative care and end of life, or hospice care. So what we saw for the former first lady was a care plan that included anything she needed to simply die comfortably, hospice care, but they did refer to it as comfort care. Ms. Bush was able to make her own decision at the point when a choice needed to be made, but so many people will not get that chance. This is also why it is important for families to have a discussion about the “what if scenarios” that families may face. What if there is no hope for recovery? What if the patient will not regain consciousness to make a decision about how to cope with a potentially painful end of life? As an Aging Life Care professional, we talk about the importance of a care plan. A key element of a comprehensive care plan will be what to do if. ….If mom cannot make the choice for ending treatment…If dad’s dementia precludes dad’s own decision for comfort care. We were told in Ms. Bush’s eulogies that she ended life pretty much on her terms. I would encourage us all in this country to make plans with family members that will assure the same level of comfort…that we should all end life on our own terms. If you have not already, it may be time to speak with your older loved one about what “their terms” are. You and they will be very gratified that you were sufficiently bold to start the conversation. 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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a prevailing topic of our discussion. I have asked Gregory Peebles to talk about this topic from the vantage point of his experience. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life - at home. An Associate Care Manager, Gregory has been a part of my team for over a decade. - Charlotte
Home. There’s no place like it, but it’s also very conveniently located wherever you hang your hat. As nice a thought it is that “home” is a physical place we can go, when we look at that thought more closely, it turns out to be not nearly as nice as we first imagined. Our insistence on home being an actual place isn’t just silly misstatement; it’s a false belief that can easily get in the way of our ability to discover new happiness. We imagine “home” existing as it always has in our memories: strong, immovable, untouched by time. It holds us safe inside, protecting us while we watch the world transform at a dizzying speed into a place we no longer recognize. It’s easy to see why we yearn for such a harbor against change. That place doesn’t really exist, though. Even if there remains a physical house from childhood where parents still live, “home” is not a physical building: it is a mental place, constructed not of wood or stone, but of our memories and feelings. Consequently, when we visit the mental place we call “home”, safety is usually one of the first feelings to come to mind. When folks say, “I want to go home,” what they’re really telling us is that they want to feel safe again. We feel safest when we know. Not surprisingly then, where we once lived for a long time feels the safest. But, like the false idea that “home” is a literal place, is it possible that we could also be wrong about being safe in our own homes? Absolutely. In case you can’t tell yet, this post is gently getting us ready to talk about denial: denial that change is a necessary part of living; denial that our circumstances are ultimately beyond our control; denial that we are at last, mortal. As we age, inconveniences in the home can turn into safety hazards. As we watch our parents age, we begin to feel deeply our own mortality and—if we’re not careful—to slip into a pattern of denial, the manifestation of which is the attempt to keep life as it exists in our memories perhaps longer than is advised. However, while this may feel psychologically safe, it may also be physically the most dangerous choice to make on behalf of our loved ones. Yet we rightly want to keep our lives free of disruption for as long as we can. So how can we strike the balance and keep our loved ones safe and in that special place we call “home”? In our next blog, we’ll talk about what makes a home a safe place for aging adults, including how to continue to ensure protections for the loved ones who depend on you. Be sure to come back and we’ll give you what we know. 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.