Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • senior home care servicesChicago's Geriatric Care Manager Center of Excellence

Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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Looking Out for Your Older Parent 24/7
There will come a time for everyone with an aging parent that the question will arise, “Is it still...
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July 11, 2022
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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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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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No Vaccine for the Other Plague
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine,...
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February 16, 2021
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 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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Mittens Before the Frost
I was asked today about the “mitten test.” It was one of our colleagues who had remembered something I...
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September 18, 2018
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In the Caregiver's Words

Recent Client Praise

There is no doubt that being a caregiver to an older loved one can be a positive and rewarding experience and it may be a way to give back. But the caregiving demands can become onerous, and the caregiver can feel stretched between their obligations to their own children and their partners. Or the day job can be demanding in and of itself without the "extra shift" that caregiving heaps on a person. As a certified geriatric care manager, I have seen caregivers who are stressed, but not nearly as often do I see a caregiver who talks about this burden. It brings up too much guilt, or they feel they just need to "get through" the next week or month, but the weight of the added responsibilities can be huge to the point of breaking. It is important to find relief before the caregiver reaches that point, and there is a way to measure caregiver burden before one reaches a breaking point. Consider the following and rate each on a scale where 0=never, 1=rarely, 2=sometimes, 3=quite frequently and 4=nearly always - be honest:
1. He/she needs my help to perform many daily tasks.
2. He/she is dependent on me.
3. I have to watch him/her constantly.
4. I have to help him/her with many basic functions.
5. I don’t have a minute’s break from his/her chores.
6. I feel that I am missing out on life.
7. I wish I could escape from this situation.
8. My social life has suffered.
9. I feel emotionally drained due to caring for him/her.
10. I expected that things would be different at this point in my life.
11. I’m not getting enough sleep.
12. My health has suffered.
13. Caregiving has made me physically sick.
14. I’m physically tired.
15. I don’t get along with other family members as well as I used to.
16. My caregiving efforts aren’t appreciated by others in my family.
17. I’ve had problems with my marriage (or other significant relationship).
18. I don’t get along as well as I used to with others.
19. I feel resentful of other relatives who could but do not help.
20. I feel embarrassed over his/her behavior.
21. I feel ashamed of him/her.
22. I resent him/her.
23. I feel uncomfortable when I have friends over.
24. I feel angry about my interactions with him/her.
Add up your score, and if you are close to or above a 36, it is time to consider help. At least consider help with some of the supportive activities you do for your loved one. You will find senior residential communities or centers who provide respite care to give you the break you may need. Also, look to what you rated "quite frequently" or "nearly always." If you have a cleric, a counselor or therapist, these may be good points for your conversation. Also, do a search of my blog here using the keyword, "caregiver." One of the topics I have addressed a lot is Caring for the Caregiver. Take care of you! For more on this scale (and there are others as well) go to: http://www.fullcirclecare.org/caregiverissues/health/burden.html 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 ccbishop@creativecasemanagement.com.
I have again asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about some new research which studies what predicts cognitive decline. Steve has more than two decades experience in pharmaceutical and medical device consulting prior to joining CCM about ten years ago. He reports: "Keep you r friends close, but your enemies even closer," is advice that has most often been attributed to Sun Tzu, a Chinese military strategist of 6th and 5th century China. Maybe this is good advice for military matters, but researchers are finding increasing evidence that it is poor advice for mental matters. In fact having stressful friends as early as middle age is a statistical predictor of cognitive decline in later years. Scientists at University College London report that negative interactions with others - which they characterize as "unpleasant social exchanges" - lead to declines in cognitive test scores over the ten-year period of their study. They actually measured the cognitive profiles of nearly 6,000 British civil servants over this period, and those with more negative social relationships reported even more rapid decline in their mental capabilities. Those in the top third of "negative associations" aged cognitively as much as a year more than those in the bottom third. The differences, while small, were statistically significant. In parallel research recently reported by physicians at the Washington University School of Medicine in St. Louis, it is not just the "crabbiness" of others that can precipitate cognitive decline. These physicians were looking for leading indicators of Alzheimer's Disease in more than 2400 patients in 34 Alzheimer's Disease centers between 2005 and 2013. They tested patients for their functional capacity, general depression, a host of other neuropsychiatric conditions and dementia. The patients all started out "cognitively normal" on all these scales at the outset of the study. They found that irritability, depression and disturbances in nighttime sleep patterns preceded mental decline in these patients. But it got even more granular than that. It was like following a road map with first, irritability, depression, and nighttime behavioral changes; these were followed by anxiety, appetite changes, agitation, and apathy. Last came elation and motor disturbances which were followed by hallucinations, delusions, and disinihibition. Rather startling. What do we take away from these findings? First, we should not make any sweeping generalizations without more research to corroborate what these researchers have found. But at the very least, it suggests that if you have a loved one who is middle age or older, be aware of the people whose company they keep. It is not mentally healthy to immerse oneself or your loved one in the company of irritating people. (Maybe that is good advice for us all, regardless.) The second research suggests that we perhaps can seek professional help earlier with symptoms that may precede forgetfulness or other cognitive decline. The list is here. Take seriously the signs of melancholy or poor sleep patterns or changes in mood or appetite. And if a loved one shows consistent signs of irritability, it may be more than their impatience. At the most general, think of these bodies of research to be not unlike the research we have always seen about diet and exercise along with not smoking. The research here, however, is not about physical health; it is mental health we can safeguard with better vigilance. 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.
There will come a time for everyone with an aging parent that the question will arise, “Is it still safe for mom (or dad) to live alone?” And then there will be the checklist to be certain the solution to your older parent’s solitary risk is feasible:
- Is the caregiver I hire trustworthy?
- Is the caregiver I hire affordable?
- Is the caregiver I hire someone whom mom or dad will like?
- Is the caregiver I hire vaxed and healthy?
- Is the caregiver I hire willing to work overnight or weekend shifts?
Your own list may grow even longer as you sort through your prospects owing to your parent’s medical status, challenging personality or isolated geography. But technology may be central to your solution on virtually all counts. We’ve all seen the ads for the portable device that accepts that call of “Help, I’ve fallen and I can’t get up.” But for the majority of incidental needs for the older loved one living alone, being able to summon a first responder may not be the only solution they need. But Alexa may be…or technology with attributes like those ever-present audio monitors a lot of folks use to play their favorite music or to turn down the room temperature or draw the curtains and more. A company called SmartCompanion is taking responsive monitoring to the next level. Set-up in your loved one’s home is actually quite inexpensive - $250 – and includes battery backup and a video screen. Small two-way speakers can be placed strategically throughout the home, and some companies also offer robotic dogs, cats and even birds to stand in for just a piece of tech. The devices can be programmed to offer a veritable menu of outbound calls including which family members as well as first responders. The tech companies that provide these techno-companions are riveted on making them more responsive to a host of unique needs for the hearing-impaired, those with poor eyesight and more. Besides their affordable responsiveness, these technologies are also addressing the larger demographic shift which forecasts a substantial labor shortage of caregivers as the percentage of 65+ year-olds begins to dwarf the available labor force. And your mom or dad’s “Tech Friday” can be programmed to not just respond to urgent or mundane requests, they can be programmed with daily or weekly or longer calendar reminders for pill regimens, medical appointments or family events. From what I’ve seen, these new technological companions may outgrow their intended target market of older and isolated individuals and eventually insinuate themselves into everyone’s households like the George Jetson’s family tech support. “Jane, stop this crazy thing!” 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.
In my past two blog postings I have talked about some recent warnings from the Food and Drug Administration (FDA) that concern me as a geriatric care manager, and they should concern caregivers and the elders in their charge as well. This most recent and third warning was about some of the dosing for drugs that are used for people who may be anemic or suffer from chronic kidney disease or be on chemotherapy of some sort. As you may suspect, this is a relatively smaller segment of the adult population, and as you will see here, it gets even smaller as we are mainly talking about people with chronic kidney disease. But one of these medications has been part of one of my client’s standard monthly routine for some time, so it struck closer to home.

You may know these drugs by their brand names if you or a loved one has one of the conditions. The brand names are Procrit, Epotin or Aranesp, and they help the body increase the red blood cell count for people with some types of anemia. These drugs, referred to as erythropoiesis-stimulating agents or ESAs, are also now known to increase patients’ risk of cardiovascular events. As with the other two warnings I have posted, these risks only became known over time as more and more people were given these medications. This is because the actual cardiovascular events they can cause are still fairly rare.

All of these drugs already had had warnings of one sort or another on their packaging, so doctors have been aware of those. The new warnings, in fact, are most particularly a danger for patients whose medications move their hemoglobin levels above a given point. These drugs were intended to replace the need for certain patients to have red blood cell transfusions which also pose their own risks. The new guidelines have been made clear to doctors in new warnings on the package inserts of these drugs, and they specifically make it clear that patients with chronic kidney disease and on dialysis should be treated differently from patients who are not on dialysis.

As with any warning from an agency like the FDA, this may call for a conversation with your provider. If you or an elder or other special needs person for whom you are a caregiver have chronic kidney disease, you should talk with your specialist about steps that may be taken to minimize any unnecessary heart risks.

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.
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.
When you consider the place a typical senior calls home, it has not changed a lot since it was full of kids and a much younger family. But what may not have been a fall hazard back in the day might become one as parents age in place. This is a list of just some of the senior care precautions one should take to make home as safe as possible for an older adult whose feet just are not as nimble as they once were. Throughout the home:
In the bath:
In the bedroom:
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. Learn more about What We Do and how we can help you support your loved one.