In Home Caregiver

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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Caregivers and their Medicare?
Yes, you read it right. I am posting this one about what caregivers should know about their Medicare. But...
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September 12, 2013
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In the Caregiver's Words

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In our book, How Do I Know You?: A Caregiver’s Lifesaver for Dealing with Dementia, we say: Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed. Stop the presses. New research suggests that there may be ways to slow the onset of the disease, if not prevent it. Let me repeat that. Some early results from a cognitive training regimen show that it may be possible to delay or slow the onset of Alzheimer’s disease. It may even be preventive, but that will take a very long term waiting game to see if the delays that are evident in the clinical studies can be sustainable. The results from this research show that a computerized cognitive training program in which patients were enrolled was able to reduce the risk for onset of dementia by 29% at ten years! In scientific jargon, that’s not nothing! Here is the other great part: those subjects who engaged in the most training got the most benefit. Does that sound like what we see in professional athletes …or professional anything? Those who put the most work into the program get the most out of it. Please let me tell you the rest of the story…Existing research has demonstrated that mental training that focused on retaining memory or processing did not reduce any risk for dementia. This present research was a study in Toronto among nearly 2,800 older adults whose average age was 73.6 years and who were living at home. They were assigned to three groups with three types of cognitive training: • memory, • reasoning and • processing speed. It was the processing speed groups which showed the results. Compared with a control group, those who went through this training had a 29% lower risk of developing Alzheimer’s. The memory training and reasoning groups were not different from their respective control groups after 10 years. All of this held true even after the investigators adjusted for any differences in other conditions or characteristics like gender, diabetes, depression or cardio-vascular health. Researchers are not sure why processing speed works this way, but it may be that working on processing speed builds up mental reserve. Maybe it’s like interval training for athletes. Mastering speed…bursts of work…grows their overall capacity. When the dementia erodes some of their cognitive capacity, they simply have more capacity on which they can draw. Clearly, a couple next steps will include following these people longer…but also trying to tap into what really is happening in the brains. That said, it stands to reason that if you can work on your “processing speed,” you will retain more ability over the long run. Get processing! 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.
…and when to not say anything…read further. It seems like such a waste of talent…the energy and brains that scammers invest in finding new ways to bilk people of their money, and older adults are more susceptible than others. Let me start with that part first. Older adults more often get scammed, because they answer their phones, they tend to be more trusting and they have more liquid assets. Let me share the short version of a number of relatively new scams targeting seniors. For more details, please also go to the U.S. Federal Trade Commission web site (https://www.consumer.ftc.gov/scam-alerts ). 1. A Government program that will pay bills. The scammers have been selling this “government program” at places of worship. The scammers at first appear legitimate as they take enrollment information from enrollees. The first bills appear paid, but the scammers cancel the transactions and keep the funds. When the bill comes the next month, it will have late fees, and the scammers will have the credit card and personal identification and financial information of the enrollees. 2. The “good-looking” bad check. This one actually seems to go back to the faxes that used to come across from a Nigerian prince, but it is still being used. The scammer asks you to deposit a check for a substantial amount of money because they do not have access to their own local bank. But could you please write a check for a much smaller amount in the meantime? Well, by the time the check bounces, so does the scammer. 3. More taxing issues. With the tax filing deadlines approaching, some people will be approached by email or even conventional snail mail with notices that the government demands more. If the email has a link, do not click it; it may have malware or worse. If the written letter asks for a wire transfer, prepaid debit card, gift card or other form of payment than a check, it also likely is a scam. If the request is to make payment to I.R.S., that also is a scam, because Uncle Sam asks for checks to be made payable to the U.S. Department of Treasury. 4. I cannot hear you now. Sprint used to famously ask, “Can you hear me now?” Well, there are robocalls going out with the same question…do not say yes! Scammers will be recording your answer to be used later as confirmation in what may sound to be a legitimate solicitation that has your “yes” answer as the reply and that now will have a price tag associated with it. Don’t say anything! How do you help protect your older loved one? Well, for phone callers, you can still request that their numbers be placed on the “no call” registry: 888/382-1222. To report suspicious activity, the Federal Trade Commission can be reached at the site I listed at the top of this post or called at 877/382-4857. 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.
First, I want to thank everyone who helped get the word out on our recently-orphaned therapy dog, Annabelle. I am happy to report that Annabelle has found a new, adoptive home and that dog and master are doing great. Thank you for making our internet community work. Now, shifting gears… Hospitalization seems to figure prominently in most of the new clients we see. It is either a recent trip to the hospital that triggers the call to a care manager, or it also can be a surprise discharge from the hospital that sets everything in motion. You may ask, why should a discharge be the urgent situation? Well, the practical side of health care as we know it these days revolves around a big push to discharge patients “sicker quicker.” It can happen with the nurse or an aide walking into the hospital room and simply announcing to the patient and whomever is at their bed side that it is time to leave…often for a nursing home. Most patients and their families will scramble to comply. Nobody really wants to be hospitalized, but how prepared is the patient or the family for a return home or a quick departure for the nursing home? The fact is you need to know your rights. A family in this circumstance can file what is called a “fast appeal” of a pending discharge with a Medicare Quality Improvement Organization. Make that telephone call on the spot, and the patient can stay in the hospital until an independent physician reviewed the circumstances. Every 65+ year old adult admitted to a hospital as an inpatient has the right to challenge a discharge if he or she feels unprepared to leave. But few people understand the process that’s involved. In fact, all Medicare patients upon admission should receive a written notice of their rights. It will be labeled: “Important Message from Medicare” and in it you will be supplied with the name and a phone number for your Medicare Quality Improvement Organization (QIO). These are the people who handle fast appeals and other quality of care issues. Once you make a call, you or your loved one may be asked to fill out a form that allows the QIO to act on their behalf. Once that fast appeal has been filed, the hospital cannot transfer the patient. But you don’t necessarily have to be surprised. Ask on a daily basis what the expected departure date may be. Now, there is fast and there is really fast. Make sure that if a patient is to be discharged under the 24 hour mark, the stay may not be considered an inpatient hospitalization. It may simply be labeled as “observation” and therefore may not be covered as a hospital stay. Make certain of your rights here so that you are not billed inappropriately. Make sure that your primary care physician and possible also a care manager are in the loop so that you will have an advocate. 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.
The most common question I hear after "What is a geriatric care manager?" is, "When do I know that we need a GCM?" It may actually be more accurate to frame the question as 'When would my family benefit from a care manager working with us?" And that is when I usually respond with a question of my own, "What is it that encouraged you to reach out to me now?" Usually there is an event or a culmination of events which encourage a person to look for a solution to a problem, an answer to a question or just plain help. Here are five of the common circumstances people with whom I speak talk about:
1. There has been a sudden event in your older loved one's health, and you are wrestling with what to do. This can be a stroke, a heart attack, a fall or just the most recent trip to the hospital with a condition that has been worsening. It represents one of those forks in the road where it seems that keeping on with the way things were will not be adequate, and the caregivers need to know their alternatives. GCMs have answers.
2. The caregiver in your family seems to be approaching "burn out." Caregiving usually falls to one of the adult children in a family, typically the daughter or the one who lives closest to mom or dad. This lead caregiver wants to do all they can, but there may not be enough hours in the day, and the guilt about not delivering may keep them from asking for help until you see the signs: fatigue, forgetful ness, irritability, depression or other signs they are overwhelmed. GCMs help the older loved one, to be sure, but they also are there for the caregiver.
3. It may be clear that something needs to be done on behalf of your older loved one, but the family does not know or cannot agree on what to do. A GCM has answers, because this is what they do. Think of a GCM as a "wedding planner" for getting older. A GCM does not bake cakes or cater meals, etc., but they can lead you to the best professionals who do. A GCM also can be a helpful mediator to help get everyone back on the same page for mom or dad.
4. If your older loved one does not seem to be getting the benefit from their care providers or they seem anxious around the care attendants, follow your instincts. A GCM can spot elder abuse and respond with the advocacy necessary to assure your older loved one's safety and well-being.
5. Your older loved one may just be confused, but it may also be signs of a more serious deterioration of their faculties. A GCM will help by finding a diagnostician to assess your older loved one's capabilities. A GCM also will help to assess if your loved one would benefit from social activity, better nutrition, exercise, etc.
These are just a handful of the kinds of first conversations I often have with those who reach out to us. You will find much more on the web site for the national association who accredits us as geriatric care managers. If you are a caregiver to an older loved one and you have questions, visit: CareManager.org 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.
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It has been over a year since my first posting when I started this blog by talking about why a person should call a Geriatric Care Manager (GCM). Since I have answered this question with almost everyone of the calls I get from people looking for our help, it seemed like a good idea to revisit our “job description.” GCMs are:
1. Local professionals who know what resources are appropriate for your older loved one and which are most appropriate. What I often tell people is that we are “option-makers” for the decision-maker.”
2. Eyes and ears that can help long distance caregivers be aware of any changes that may affect an older parent’s independence or well-being. The long distance family caregiver may have bought mom the walker, but the local GCM can be there to see whether mom is using it.
3. Bridges to help an older family member make life transitions from fully independent living through home assistance and ultimately to assisted living at the appropriate times. Earlier involvement with a geriatric care manager also can help your elder family member develop a rapport with a professional who can facilitate the bigger changes later because they have been there earlier for the smaller changes.
4. Peace of mind by being the professional buffer to a long distance caregiver for some of the minor or major crises that may otherwise be very stressful for the entire family.
Finding a GCM is easy. The national association that certifies GCMs, the NAPGCM, has a comprehensive, searchable list of all the professionals in good standing. You can search geographically by simply entering a zip code or you can search by name. The search tool also asks you to check what kind of GCM you are seeking; check the “Certified GCM” box to see a complete list of professionals in good standing. Here is a link to another site that offers a range of resources, including care managers, Aging Care. Finally, Caring.com offers a listing of GCMs specifically in the state of Illinois.

As you make contact with a potential GCM for your elder, I encourage you to look for a good communicator, because this professional is going to be your loved one’s advocate. You also want to ask about their experience, and check professional references who can speak on their behalf. Finally, it is important to ask about fees since insurance does not cover a GCM. A recent article in Reuters suggested that fees nationally range from $60 to $300 an hour.

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.

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In Home Caregiver

Tips for Distance Caregiving: Up Close and Personal at a Distance

Caregivers and their Medicare?

Free White Paper: How to Manage Time and Stress While Caring for the Elderly

Our passion rests in helping families, friends and caregivers achieve a better quality of life for both themselves and their loved ones. Our most popular white paper to date gives the tools you need to maximize wellness.

Inside "Caring for the Caregiver"

Get the Support You Need Now! Call 847-869-5118 x511

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