Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • In Home CaregiverChicago's Geriatric Care Manager Center of Excellence

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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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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Dementia: We’re Not Post-COVID Yet
If you have a family member or loved one with dementia, this pandemic and its restrictions have been exponentially...
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May 26, 2020
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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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Caregiving During COVID: Four Tips for Reengagement
You may recall that I have recommended limiting your news consumption, because it really does add to our stressed...
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May 12, 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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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

Recent Client Praise

We all know that Boomers - who began reaching age 65 just two years ago - are the largest segment of the U.S. population. Aging boomers are expected to total about 71.5 million by the year 2030, but what you may not know is that as many as one in ten of the Silver Tsunami will be lesbian, gay, bisexual or transgender (LGBT). This is important, because the generations that preceded them who were LGBT simply accommodated the "closet" when they aged. Never mind the ageism and racism we still find in some quarters, a lot of the institutional providers for seniors may not yet have embraced a welcoming culture for people of alternative gender preferences. As a geriatric care manager, I see this as a perfect storm with three fronts, a storm which has the potential to create one of the largest threats to aging well - social isolationism. If you are a caregiver to an older LGBT partner or loved one, you will need to be alert to the potential challenges. For instance, there are likely to be limited or no programs for alternative lifestyle older individuals in rural or suburban areas. And the gay male experience of aging is exaggerated among men where there is a more pronounced premium on being attractive or desirable. Generally speaking being 40+ among gay men can be seen as equivalent to being 80+ in the straight community in terms of being marginalized. The social isolation that is a consequence of "premature aging" and marginalization also increases the gay population's risk for depression, substance abuse, low self-esteem or even suicide. The rate of suicide among gay men is about six times that of straight men. LBT women may have it even worse. More than one-third, according to recent surveys, say that they have not divulged their sexual preferences to their health care providers. They also are less likely than gay and bisexual men to have purchased long term care or life insurance. About one in five LBT women are caring for an aging partner, but they also feel less prepared financially than gay men for retiring. Put all these factors together, and the LGBT community is less inclined to seek attention for health issues for fear of hostile or judgmental providers. Poor health care translates into even earlier institutionalization in long term care facilities. Also, it is ironic that in national surveys that nearly three in four LGBT individuals anticipate that they will be caregivers to another person, but one in five are unsure they will be cared for themselves when the need arises. Adding to this potential caregiver shortfall, many gay couples simply do not have conventional family to care for them. If you are a caregiver to an LGBT elder, encourage the following: • They have a Last Will and Testament that is really according to their "will" o With clear advanced directives/living will • Their partner/spouse has Durable Power of Attorney (health and finance) • Informal caregiving arrangements are clear and followed • Priority rights for hospital visitation are followed • There is Joint Ownership of Property with Rights of Survivorship And for us all: Recognize that all humans deserve compassionate care which respects their personhood and their definition of family and their wishes. 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.
According to research reported in the New England Journal of Medicine, approximately one in five Medicare beneficiaries discharged from a hospital will end up back in the hospital within thirty days. It usually is for the same reason they were admitted originally. This means that it not only is bad for the patient who has to go back to the hospital, but it typically represents an expense that could have been avoided. And it is these sorts of statistics that give me a chance to talk about a question I get asked a lot: “What is it that geriatric care managers do?” Let me explain.

The typical picture of an older patient who is readmitted is one without a lot of social support locally, and this older patient:
- May not fully understand their discharge instructions.
- May not be taking their medications as instructed.
- May have complications they cannot handle.
In most of these cases, if the patient had had someone to be the information processor, interpreter and implementer, the readmission would not have been necessary. A geriatric care manager would be available to make sure the discharged patient understands any limitations on activity that the medical professionals have stipulated or understands how active they should be to recover from being in bed for the number of days they were in the hospital. A care manager can help to make sure that all the patient’s medications are organized or that a new prescription gets filled and its dosing gets integrated into the daily regimen. (Remember that seniors are about 13% of the population, but they represent about 30% of all the prescriptions written.

The National Transitions of Care Coalition offers a checklist your care manager or you as a caregiver can use with an elder for whom you are responsible as they leave the hospital:
1. Have a method in place to assure safe use of all medications.
2. Have a plan to facilitate the big change from hospital to home.
3. Engage all members of the family and personal network of the patient.
4. Share important information with all care providers and caregivers.
5. Find and read any educational materials about the patient’s condition.
6. Facilitate any follow-up provider visits, therapy, etc.
As a caregiver (or through your care manager) advocate for the patient to physicians, discharge planners or other providers responsible for the continuity patient’s care.

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.
Career Opportunities at CCM

Open Positions:
Creative Care Management is looking for full- and part-time professionals to provide geriatric care management services to our clients. CCM was founded more than twenty years ago and is a team of certified professionals providing answers to older adults in Northern Illinois and their families.

Qualified applicants should have:

a nursing, social work or other degree in the helping professions

experience with older adults or others with special needs is a plus

GCMs will evaluate an older person's situation, identify solutions, and work with the family to design a plan for maximizing an elder's independence and well being. Geriatric care management involves an in-depth assessment, developing a care plan, arranging for services, and following up or monitoring care. A GCM can also assist in the medical management of a client and suggest potential alternatives not considered, and they assure a loved one receives the best possible personalized care and all the benefits to which they are entitled.
Please send a bio and credentials to:

Steve Steiber

ssteiber@creativecasemanagement.com

or call 847-869-5118 x 511.
Associate Care Manager Gregory Peebles returns with a talk about hidden signals of aging that need our attention. 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. Gregory has been a part of my team for over a decade. – Charlotte Call it self-reliance, gumption, stick-to-itiveness, or fierce independence, but most of us are very proud of this aspect of our national character. We manage ourselves and try to not bother our neighbors. We may need help, but we try to not ask for it. There’s plenty to be proud of in taking care of ourselves, but no matter how hard we try to remain staunchly independent, we ultimately need each other, and most of us don’t get much practice asking for help. Consequently, when we do need to ask, we can feel like a failure (we’re not!) and don’t want to reveal our vulnerability. Please allow me to share three signals that your older loved one may be in need of help but not be able to ask. Older adults embrace their independence and hate admitting they need help as much as anybody else. More often, they are told they need help. After some type of health scare (statistically, an in-home fall), a doctor or loved one gets tasked with “The Talk”. Life will be different. There will be more physician visits. There will be more caregiving. There will be less self-rule. The defining incident, which has usually been a long time coming, may register as a shock to the adult children or other loved ones of an older adult who may be focused on their hectic lives. After the life-changing incident has occurred, everyone’s eyes are opened to what they couldn’t see before. Here are three warning signs your loved one may need your help but hasn’t asked.
1. Presentation.– “Keeping Up Appearances” isn’t just a show on BBC. This is how individuals and families signal health and success in all aspects of their lives. When self-presentation declines, something is wrong. It’s that simple. Look for changes in housekeeping habits. Lack of interest in hygiene or grooming can signal depression, or a change in body mechanics. Weight loss can be because meals get forgotten, or because they are just harder to prepare. It doesn’t matter which one.
2. Mood and Memory. – We’re not talking about minor lapses of judgement or awareness. Everybody has a bad day or two in a row. Everybody forgets stuff. If, however, your loved one is more irritable than usual for longer than usual, or is more emotional than usual, that’s a signal of change. Losing one’s glasses or forgetting the day of the week are not necessarily causes for alarm. Even procedural memory loss (temporarily forgetting how to do something) is more common than we think. It’s always time to talk, but it’s probably not time to call a doctor until your loved one moves from forgetfulness to inability to process events into memories…instead of where are the car keys…what are the keys for?
3. Mobility.– It’s hard to ignore a body that has slowed and become harder to maintain. So don’t. When offering an elbow on the stairs just isn’t good enough anymore, it’s time to talk about the logistical changes necessary to keep your loved one as independent as they can be. Walkers, chair lifts, in-home caregivers, ride services, and a host of other options can facilitate.
Seeing these signals gives you an advantage for continued health and high quality of life for your older loved one. If your loved one lives at distance, services like those CCM, Inc. can identify and coordinates can help ease your mind and provide your loved one with just enough support to preserve their independence and their safety. 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.
I have talked in some of the recent blogs about when decision-making may transfer to another person from an individual whose own faculties may be failing. Such is the case with powers of attorney as well as guardianships. There also are decisions which need to be facilitated by a caregiver, but we need to know the difference between deciding for the older loved one or individual with special needs versus facilitating their own good decision.

In my role as a GCM I had a conversation with one of my clients recently about her car. She is an 84-year old woman who has been living on her own since her husband died about six years ago. Her husband had surrendered driving responsibilities to her some several years before his demise, and it was his initiative and his choice.

Recently, she asked me what I thought about her giving up driving. The fact that she brought it up suggested to me that there may have been a precipitating event for her question. She admitted that increasingly she had experienced vision difficulties driving at night, so she was limiting her driving to daytime.

On further probing she admitted, however, that she recently had lost control of her car and skidded off a road near the independent living facility she called home. It had frightened her. Her facility manager at the residence had suggested she consider selling her car and rely instead on their complimentary shuttle service to get about town for shopping and such. Simply put, she did not want to give up her independence. If you were the caregiver to such an individual what would you do?

The one thing you ought not do is immediately decide for the older individual under normal circumstances. You can, however, talk about the frightening moments the older individual may have had. In my case here, I used that experience as an opportunity to discuss what might have happened if her accident had involved another vehicle or worse, a pedestrian. I said "normal circumstances." If the individual is mentally or physiccally compromised to such an extent that it interferes with safe driving, you have a moral and legal obligation to deny them access to a vehicle. Check with your own state department of motor vehicles for the actual wording on the books in your locale.

On the positive side, it was also an opportunity to discuss how using the facility shuttle could be liberating. She would now have the benefit of transportation without the increasingly challenging responsibility of driving. In the end, I also encouraged her to talk with her adult children to discuss their opinions and what they could do to help. Although both her children lived at some distance from her home, they were in a position to assist in selling her car. That proved to be the last string for her to cut in order to part with her car and to move forward with “her own chauffer” as she came to call the shuttle.

In my next blog, I will talk about another big decision-point many older adults face – whether to move into a facility for elders and others with special needs. I also have spoken with elderlaw attorney Eric Parker, whom you may remember from an earlier blog on advance directives. He has some great advice on how to select a nursing facility.

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

Not Just Spring…

Can I Have A Hug?

COVID’s Other Deadly Toll

Dementia: We’re Not Post-COVID Yet

Distance Caregiving Through a Wall

Caregiving During COVID: Four Tips for Reengagement

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

Caregivers and their Medicare?

Career Opportunities at CCM

Open Positions:

Qualified applicants should have:

Please send a bio and credentials to:

Steve Steiber

ssteiber@creativecasemanagement.com

or call 847-869-5118 x 511.

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