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

Why AND Is the Most Important Word
Do you recall the 1991 movie called City Slickers? It was another great role for Billy Crystal, but it...
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July 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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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

42 million is a big number. That is how many caregivers to older loved ones AARP estimates there are in the United States, and no surprise, the number of sons and daughters and husbands and wives of older adults with needs is growing. We do not see this mushrooming segment of the population, but it is changing the lives of the caregivers in fundamental and often unhealthy ways. One of the reasons we do not readily see caregivers is that the AARP survey reported that 44% of the caregivers simply do not talk about the unpaid job they do. No one, it seems, wants to look like the unloving family member who is having difficulty performing their caregiving tasks. As a result, about one third of caregivers report they are either sad or just plain depressed. Another third avoid any decisions that might give them a break or better leverage their time with their loved one. And another third simply go it alone, isolating themselves from their friends, colleagues or any support networks. Fully 38% report they are sleeping less, and nearly a quarter are eating more on top of that. Caregiving can be bad for the caregiver's health! Most of this symptomatic profile of the stressed caregiver owes to the simple fact that caregiving is their "other job;" more than six in ten caregivers age 50 or older also have a full-time salaried job. As geriatric care managers (GCMs) caregivers are the people with whom we work in support of their care receivers, and the services we provide to the caregivers can be every bit as important as those that we offer their older loved ones. If you or someone you know is a "stressed caregiver," please consider the following from a professional "stress reliever" to stressed caregivers:
1. Ask AARP. The AARP website is a veritable wealth of information for caregivers to older loved ones, and they have a dedicated portion of their web site devoted to caregiver resources.
2. Involve the Family. Don't try to go it alone if you have siblings or other family members. Not only can many hands make fast work, but fresh perspectives and energy can help the caregiver doldrums that arise from too much solo stress.
3. Catch a Break. If you do not have siblings, check your community for respite care services. If there is a senior residential community in your locale, they often have drop off facilities for non-residents...which gives everyone a break.
4. Talk to Your Employer. This is in step with not going it alone. If you are stressed with caregiving it will show at the workplace. Rather than be judged as a suboptimal producer, talk to human resources about possible flex time or a leave.
5. Call a GCM. To more fully explore your options, call the option-makers for the decision-makers. You can find a GCM in your locale by going to the association web site.
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@cr eativecaremanagement.com.
Dr. Oliver Sacks explains neuroplasticity in his editorial, “This Year, Change Your Mind,” in the New Year’s Day editorial page of the New York Times. As a geriatric care manager, I have encountered clients whose injuries have induced deficits of some sort from which recovery plans are designed and executed. Physical injuries such as lost limbs, vision, hearing or others have fairly clear rehabilitation trajectories, and the injured individual can learn and work through them to recover as much of a productive life as possible.

Neurological injuries like those Dr. Sacks offers as examples require remolding an organ that we do not see from injuries that also may be invisible. As Dr. Sacks explains, neuroplasticity offers the means by which the brain can remold itself to overcome a deficit. For a geriatric care manager, the deficits do not have to be as dramatic as a spinal cord injury, the onset of blindness or even a stroke. We see every day the consequences of older adults’ inactivity and the cumulative deficits that can grow out of the under stimulated life. The brain does lose some of its pathways through natural attrition, and it is critical for a vibrant life for the aging individual to keep working in order to maintain the pathways they already have as well as to create new ones as some of those may become unavailable. A colleague likens it to commuting in the brain. There may be detours and rerouting, but an active individual will always find a route home.

There is a case of a 70+ year old client whose spouse is suffering from Alzheimer’s inexorable progression. While there is little to do to forestall that condition, he takes it upon himself to exercise at his facility’s gym three times a day, he is a voracious reader and he is an active participant in his wife’s care team so that he can be both physically and mentally able to care for his wife to whom he is entirely devoted. Or the 90+ year old woman who will keep up with her grandchildren when they come to visit – as exhausting as it may be. She is a brilliant conversationalist, she rarely repeats herself and she completes the New York Times crossword puzzle. What do they have in common? They both push the boundaries of the envelope.

They both are pushing the plasticity of their brains.

Dr. Sacks exhorts us to “change our mind” this year as part of our 2011 resolution. I would expand that to include all of those on whom an elder or person with special needs depends, and encourage those caregivers to help push the envelope for those in their care in order to effect a change of mind and a robust life in 2011 for all.

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.

Copyright ©2011
We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to retreat periodically from the frenetic work pace, the demands of family or just the congestion of living in the 21^st century. But for older adults, being alone can become their way of life with the loss of friends or a life mate, no longer being employed, perhaps unable to move easily about, a lapsed driver’s license…and life becomes very, very small when it is just one. It’s a bigger problem than many people may think. The National Institutes of Health estimate that 28 percent of older adults live alone; that’s nearly 14 million people on their own. Living alone can lead to depression, poor self-care and ultimately an exacerbation of pretty much every other chronic condition that a person can have. A 2010 study found that socially-isolated older adults were 509% more likely to die prematurely. Being alone too much can contribute to other health issues, so much so that some health insurers are developing more comprehensive and holistic models for caring for our older adults. One of the major insurers of Medicare Advantage programs that will offer “enhanced” care, and they have come up with a model that can be imitated by all of us who may be caregivers to and older loved one. We all may look in on mom or dad, make a regular call or accompany our older loved one to their physician office visits, but there is more you can do. Consider:
1. Checking your loved one’s refrigerator for variety of food as well as expired products. Food insecurity is one of the big threats to health and well-being among older adults.
2. Ask about your older loved one’s friendship network, and get specific. Think about how often you make connections – probably daily – and help your loved one to do the same….be creative.
3. Be sensitive particularly to hospital discharges when an older loved one will be lest ambulatory. Help them even get to a “silver slippers” program at a local gym or to respite care so that they not only physically recover, but also socially recover.
4. Use tech. A Miami-based company called Papa connects older adults with local college volunteers that they sometimes refer to as “grandkids on demand.” Check it out to see if a campus near your older loved one can offer that support.
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.
A small percentage of us may be coping with symptoms of COVID-19 or we know someone who is, but all of us are coping with “sheltering in place.” While we all at some points in our live may have wanted “some time to ourselves,” this is not what we had in mind. It is a bit ironic that a professional who spent nearly a year without gravity has some very concrete tips for the very weighty notion of surviving isolation. Retired Astronaut Scott Kelly spent nearly a year in the International Space Station, and his experience in a job that you truly cannot just walk away from offers some great advice.
1. Schedule Yourself - Mr. Kelly talks about how his day was entirely time-blocked by his employer, NASA. You may not have a boss telling you what to do, but you need to keep regular bedtime and waking hours, have meals on schedule and set aside time for leisure and time for work and working out.
2. Keep Pace – You are not going to clean your entire home top to bottom the first day in isolation. You are not going to become a top flight runner the very first week, and you are not going to catch up on all those movies you have wanted to see. Build a calendar that includes explicit work and reward times.
3. Get Out – You will be surprised that even on some of our cold days the birds feel and singing Spring. What has amazed me is what I call COVID Cordiality; 95% of the people I see who are walking their dogs or just themselves make eye contact and greet you…maybe even ask about your well-being and you reciprocate.
4. Hobby Time – Do something just for you. Maybe it is reading a designated number of minutes each day or learning a new language or starting seedlings in your well-lit kitchen window. This is “you time,” and you will find something that is special to you to fill it.
5. Journal It – Astronauts are required to keep track of all manner of things so that their environment continues to sustain them. You may start a daily diary of thoughts and experiences that are part of your story. And given that this is a truly momentous event unfolding, you will be writing history.
6. Connect Time – My husband and I had “dinner” with friends earlier this last week, and we had Happy Hour Sunday afternoon with all of our adult children and their partners who wished to attend…and they all said they would like to do it again next Sunday-go figure. All thanks to ZOOM-the picture here is a screen shot.
7. Experts Count – People who understand this disease are worth hearing. They will tell us how long to wait before surfaces can be touched after someone else has been there. They will tell us what the arc of this epidemic is shaping up to be, and we should and should not do to get through this.
8. Self Care – The bottom line for all that we do with families caring for an older loved one also apply to our current pandemic. Take good care of yourself if you are a caregiver to someone. It is the only way that your care receiver will be safe and the only way that you will be safe.
Take care of yourselves...be kind to yourselves. We will all look back on this someday soon, and I believe we will be impressed with how much real humanity emerged in a time of potential crisis. 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.
Back in May I posted about how May used to be called National Geriatric Care Manager Month, but with a change in our association’s name it has become National Aging Life Care Professional Month. People have asked me what has changed, and I am reminded of a columnist here in Chicago who used to write for the Sun-Times, but switched over to the Chicago Tribune when the Sun-Times changed ownership. When people asked him what he changed with that move, Mike Royko replied, “My socks!” Aside from the fact that “socks” are not my idea of a fashion statement, I would have to echo what Royko said those many years ago. Aging Life Care Professionals – you can still call us Geriatric Care Managers – still deal with the aging person and their families and the challenges of aging. I say families here, because almost invariably the person who gives us a call is the adult child of an older mother or father…or uncle or aunt…for whom they are a caregiver. And what weighs upon that caregiver most heavily is not just a medical diagnosis, but a quality of life issue. So we most often are focused on reducing the worry, stress and time the caregivers must take from their day jobs…or their family lives…or their personal lives. So what does an Aging Life Care Professional actually do? The short answer is: Whatever it takes. But let me elaborate; it is the same as we formerly did under the label Geriatric Care Manager: • Assess and Monitor-does the older loved one’s current home and their current capabilities work together, or are we seeing the kind of rehabilitation from a fall or illness that we should rightfully expect? • Plan and Problem-Solve-if home is no longer a good fit for the older loved one’s capabilities, what can be done to make it so or what are the alternatives to the current environment, or if an older loved one’s medical condition is not responding to current treatment, what are the options? • Educate and Advocate-when an older loved one does not feel they can ask their physician the important questions or when the living facility is not delivering appropriate care or service, who should be informed and who will stand up for that person? • Coach Families-this is most families’ first time down the path of aging, and a professional with training and experience can help everyone find optimal solutions and facilitate the best outcomes. • Option Making-and as I always tell our clients and our staff, we are not the decision-makers; we are the option-makers for the decision-makers. Charlotte Bishop is an Aging Life Care Professional and 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.
If you are a caregiver to an older adult, don't be surprised if your loved one is asked if there is a gun in their home during the next doctors' office visit. In the past. such questioning was usually out of concern for young children in a home who may find a loaded weapon in the house. And we have all seen the reports in newspapers across the country when a youngster discovers a sidearm in a parent's room. Now, as geriatric care managers, our profession also involves talking about gun safety among our clients. Why? In an article published just this past week in the Annals of Internal Medicine, doctors are now being encouraged to ask their older patients about firearms in their homes. Doctors are rightly pointing out that the higher rates of dementia, depression or memory issues place older adults at a high risk for suicidal behavior. According to the latest data available, firearms account for more than seven of ten suicides among adults 65 years of age and older. This is compared with just 51 percent among the population as a whole. For those 65 and older, the suicide rate is 14.6 per 100,000 versus only 11.4 per 100,000 of the population overall. And suicides with handguns outnumber homicides with handguns. There is no denying the second amendment rights of all citizens, but the suicide risk is a matter to address. Physicians are now being encouraged to ask about guns in the home among their older patients, which places this at the level of a national health issue. I recently heard a local official talking to an audience of older, middle-aged and younger business professionals about what we may call geriatric suicide. He asked for a show of hands for all those who at some point in their lives have owned motorcycles. I was a bit surprised by the relatively large number of hands that went up. He asked those that no longer had motorcycles to lower their hands, and it was mostly the older contingent who took their hands down. He asked one of the older folks why they no longer owned a two-wheeler, and then another and another. The answer? It wasn't safe for them anymore. A lot of heads nodded. Some may feel that the same reasoning should be applied to those who own firearms. I am not pro-gun or anti-gun, but I am a professional advocate on behalf of older adults. Give the medical guidelines a read to see if this may be a discussion you wish to have with your older loved one. Also, please comment on this posting if you have an opinion you would like to share. Like so many issues that are important for us to address, there are no easy answers. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers and certified professionals who are advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.