in home care for seniors

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

With this posting, I am introducing a colleague and guest blogger, Pamela Holtzman, who is a therapist I know locally. Pamela is an R.N and L.C.S.W. who combines her medical background with a combination of cognitive therapy, traumatic release with EMDR and EFT and integrative psychotherapy, to facilitate wholeness and wellness, in her clients. Her perspectives on being well while getting older are worth sharing:

“Have you had that birthday yet which made you suddenly realize that you really are getting older? I don’t mean older in a decrepit, breaking down way. I mean older in a wiser, stronger, and more mature way. I had discovered that I had reached that phase during my recent 60th birthday “initiation by storm” as I came face to face with IRENE, the Class 3 hurricane that wreaked havoc at the doorstep of our home in the Bahamas. What followed was a week-long power outage, and a chance to do a lot of soul searching.

As a result of a life-long practice of maintaining a healthy mind and body balance, I was able to remain calm, peaceful, and resourceful throughout this life altering and potentially devastating experience. How can you stay balanced through life’s unexpected challenges:

Be Present – learn and practice living in the here and now, don’t worry about the past or future. No matter what life is offering, take time to do a morning quieting practice. Good options are yoga, Tai Chi, meditation, or anything that includes a level of mindfulness.

Be Healthy – have regular medial check-ups, and use a preventative approach to health. A good place to start is by eliminating the four poisons from your diet: hydrogenated fats, high fructose corn syrup, processed foods, and sugar. Develop and maintain a routine of ample rest, and follow a Mediterranean diet (high in fruits and vegetables, whole grains and cereals, nuts and seeds, oily fish, and olive or avocado oil, keeping red meat and diary to a minimum.) Try some new grains like farrow and quin. Make sure to drink plenty of water, and, of course enjoy a daily treat of dark chocolate.

Simplify – let go of what you don’t need. Clear that which creates clutter and/or complicates your life. This includes identifying and spending less time with ‘maintenance friends’ who rely upon you, but don’t offer reciprocity in your friendship. Decrease or eliminate activities that drain your energy, as opposed to replenishing your reserves. Remember balance.

Get Moving – of course there’s the physical benefits of exercise (increased bone density, muscular strength, endurance, energy, and better posture), but exercise also provides stress relief and improves mood. I have learned as I age –if I want to move, I’ve got to keep moving! It’s fun to mix up your routine and keep learning. Try Zumba, Nia, Barre, go to a dance class, or water aerobics. Keep exercise fun and playful, and do it every day.

Have a Massage – many enjoy getting one. But you don’t need to pay someone to enable your body to relax, detox and stimulate the lymphatic system. You can do reflexology for yourself on your hands or feet (it’s as good as a whole body massage.) Or try “dry brushing” before your shower, which natural detoxifies and is very stimulating.

Embrace Change – and recognize that change is good. It keeps your mind active, challenges flexibility, and opens up new ways of being in the world. Remember to soften into life, rather than contract in fear whenever you’re not familiar with a situation or are uncomfortable in life. Let go of the need to be right, to be heard, or be acknowledged. As you mature, you can learn to be comfortable with who you are without the need for outside validation.

Fill Your Soul and Spirit – learn to have fun. Think about what fills your reserves, what feels cohesive to your sense of self. For me, it is being with my grandchildren, or doing anything in nature. For you, it may be travel, volunteering service work, or just being home with a good book. You will be able to tell you’re being true to yourself because you will feel happy, rejuvenated and renewed.

If you want to continue to improve and grow as part of your aging process, it is necessary to continue working on balance and integration as part of your daily healthy lifestyle practice. Then, no matter what life challenges you face – you’ll be ready for them. For more information and techniques on healthy living, refer to my book Healthy Lifestyle Path of Wellness."

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 Charlotte Bishop.
It is the season where we hear about “making a list…and checking it twice.” My kids think I get a little too carried away making lists, but having the right list at the right time can save the day when the unexpected occurs. Life has a habit of throwing the unexpected at us, but even then we can be prepared.

As a geriatric care manager, I regularly coach families of an older loved one or someone with special needs in list-making, especially if that loved one lives alone. You may recall in an earlier blog, I started with a list of activities of daily living to use as a way to inventory the functional capacity of a loved one. Once we see the deficits it becomes easier to develop an action plan.

But think ahead to the phone call you may one day receive that your loved one has fallen or had a stroke or some other debilitating incident. The first responders or a neighbor may know enough to call you, but now you have to be the voice for the incapacitated loved one. Do you know their meds and daily doses? Do you know where they keep their medications? Do you know who their primary care physician is or if they have a cardiologist, neurologist, or other health care provider who should be called?

Your responsibility as a caregiver is to plan ahead…hopefully for an event that will never happen. A vital step to this is creating a list of key telephone numbers and other information for your loved one. Write down a list for yourself to keep in your home and at work that includes emergency contacts as well as neighbors, relatives, clergy and others who will need to know. It can also be helpful to notify close friends so that if a hospitalization follows the incident that your loved one will have the benefit of visitors.

Make copies of insurance cards, keys, electronic openers, combinations, and more. To avoid confusion, make sure to label keys, so that if access is needed immediately, you’ll be prepared. You also should have access to any legal documents like the advance directives I mentioned in an earlier blog. And if your loved one has been living alone, you may need to know the telephone contact information for stopping delivery of newspapers or the mail as well as when the rent/mortgage and other bills are scheduled to be paid. Having gone though just this short list may now give you a headache as well as a sense of why I think it is important to keep lists. Write it down…

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.
What do hearing aids, exercise, support groups and travel have in common? They all are ways that individuals suffering from Alzheimer’s Disease, specifically, or dementia, generally, can fight these diseases’ progression. Even more important, they help to fight the personal isolation that accompanies these frightening conditions.

We often associate dementias with older adults and the stereotypic confusion that can characterize the individuals with the diagnoses. But it is not just a condition of older adults as the recent public disclosure of The University of Tennessee women’s basketball coach, Pat Summit, highlights. Ms. Summit is just 59 as she goes public with her diagnosis, and it helps others to understand that it can happen as early as 30 and 40 years of age. Younger onset Alzheimer’s Disease technically speaking is the manifestation affecting those under age 65, and there are 250,000 new cases in America every year. Yet, there are ways to fight the downward spiral of dementia.
1. Hearing aids may seem an unlikely fix for dementia. Yet, it is simplybecause hearing aids enhance the clarity of communication and therefore the connection between dementia patients and others that they help alleviate the isolation and bolster memory. When dementia patients can hear more clearly, that connection also helps calm the anxiety that they may otherwise feel when living in a world that is confusing. Hearing aids cannot “cure” dementia, but they can help a patient navigate more confidently.
2. Exercise can be a helpful boost as well as it improves the blood flow and releases calming endorphin into the bloodstream. For a variety of medical conditions, health care providers often talk about the role that “performance status” plays in a patient’s ability to cope. Being more fit helps dementia patients cope just as being fit also helps cancer patients while they fight a tumor or surgical patients as they recover from a procedure.
3. I had mentioned the importance of being connected for a person with dementia of whatever sort. Support groups become the new circle of friends who can truly understand what it is like. This is common across a whole host of medical predicaments from grieving widows and family to returning wounded warriors or recovering cardiac or orthopaedic surgery patients. Somebody else who has been there understands what co-workers, friends or even family cannot quite fathom.
4. Travel is a bit of all these. It is a way to have fresh new experiences that challenge a patient cognitively. When a person experiences what should be familiar settings like home as frighteningly unfamiliar, it can be reassuring to share travel experiences to strange and different places that – well – everyone will find strange and different as well.
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.
It ended with almost uncontrollable laughing. That’s how one of our team describes his conversation with his mother about making her funeral plans one day not long ago. Yes, you heard that right…they talked about her memorial service and had a great laugh together. My take on that is that once the incredible stress around a topic that no one wants to talk about is addressed, the relief is almost giddy. We laughed too when he relayed the part about Googling funeral hymns and singing along with his mom the ones she particularly liked. Trust me; this is not a unique story, and it is only one of the “difficult conversations” families can have. According to AARP, 70 percent of Americans say they feel that it is important to have an end of life conversation with their family members, but only 30 percent have had that conversation. The younger generation in the family may not hear the conversations that older adults have among themselves about death and dying, and parents may not want to “burden” their adult children with talk of end of life. But that will not change the fact that death is a universal event for all of us. If you are that adult child who would like to help your parent with the conversation, there are some ways to “break the ice” in order to have a productive conversation. First, you don’t have to start with end of life questions; you can start with some of the more mundane issues about health or medical issues. Every professional painter will tell you that there is a whole lot of prep work before they even put the brush to the paint. Start with mentioning perhaps a friend whose parent had a medical episode, and the adult children were not even aware that their parent had a problem with their (fill in the blank…heart, lungs, etc.). So those same children could not even supply their parent’s physician’s name or the medications they were taking or any of the other details that the paramedics or emergency room personnel had asked. Or you may even point out that your significant other has all the details on your medical health “just in case.” Would your parent also wish to have you in the know about their health…just in case? And there may be certain circumstances…
- Mom, if your medical professional makes any kind of new diagnosis, do you want to know every detail, treatment options, prognosis, or just the big picture stuff?
- Dad, if the doctors have treatment options for a condition, do you want to know all the details, or just what your doctor recommends?
And there are some issues that can be clearly laid out in documents for the medical record. Called POLST in Illinois (Practitioner Orders for Life Sustaining Treatment), it is considered a legal document that becomes part of a patient’s permanent record which states what kind of measures they wish to have applied in emergency situations. It is more than a Do Not Resuscitate (DNR) order; it covers the extent to which medical professionals should work to sustain them in an emergency. The Illinois site for this legal document also has suggestions for how to have the conversation. Obviously, the conversation can get into details like the one I started this post with, but it may not be the first conversation. We as Geriatric Care Managers also get the call to help families cover these kinds of issues, and we have made this into a form called the Life Span Care Plan(SM). 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.
In a recent post, I shared what Allyn Rawling said about what to consider when mom or dad are moving out of the family home. Ms. Rawling addressed some of these factors, especially the benefits that assisted living can provide – eliminating possible isolation, ensuring safety, among others. Here are some other aspects to look for when you next visit your loved one.

First, you may notice and overall unraveling of your loved one’s quality of life. For instance, the home itself isn’t well kept and there are safety hazards that have gone unnoticed. You may find that your loved one isn’t taking care of themselves as well as they should, especially when it comes to grooming, bathing, and feeding themselves. Bills might be going unpaid. It is important to note however, that some of these factors may be fixable with some caregiving consultation and changes around the house. However, moving out of the home may be an option that your parents might have to consider.

Second, the family home may simply no longer be safe for your loved one. If the stairs are too steep or if help is not readily available when there is a need, a safer residence may be in order. If mom or dad show bruises, but do not admit that they have fallen - perhaps more than once - it may be time to talk to your parents about independent living. Remember to underscore the "independent" in the living option, because they may have images of the last generation's "old folk's home" or some other outdated stereotype.

Third, it is a tough topic to bring to your parents as they’ll want to keep their independence as long as possible, again a reason to emphasize the "independent" in independent living. Be patient. Start the conversation well before an immediate decision is required. Also, help to make it their decision, their process and their terms. If your older parent does not own the decision, guess who will own it, and that will be a costly bit of ownership for 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.

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Creative Care Management, Inc.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

847.869.5118 x511 tel
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Long-Term Doesn’t Mean Put It Off Until Later

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