senior home care services

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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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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A House is not a Home (Unless You’re There)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 5, 2017
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In the Caregiver's Words

Recent Client Praise

…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.
It’s not just about being lonely. Isolation may be a bigger senior health issue than even dementia – never mind that research has shown a clinical link between these two. I had a client a few years back who responded to a question from an attendee at her 100^th birthday about how it feels to be 100 by saying simply, “Not so much peer pressure…” Now, this individual was surrounded by friends and family, but what she highlighted was the attrition of social connection that accompanies aging in most individuals. As one ages, one loses friends and loved ones and one also loses the ability to physically get out and about. As one becomes increasingly isolated, there are mental, physical and emotional correlates of the loneliness:
- Research published in 2012 showed a clear relationship between social isolation and death among adults 52 years of age and older. One cannot say that isolation kills people, but one’s chances of dying from any cause are greater if living alone.
- Research from the University of Chicago has found a clear link between levels of loneliness and poor cognitive function and even dementia risk. In other research reported in 2016 older patients with the amyloid markers of Alzheimer’s were 7.5 times as likely as those without the markers to report feeling isolated or lonely.
- The National Center on Elder Abuse adds to the bad news by reporting that socially isolated seniors have higher rates of physical or financial abuse. Are they easier targets for predators or do predatory caregivers isolate them to take advantage?
- Isolated seniors also report more of just about every chronic medical condition from COPD to heart disease, poor mobility and, of course, depression. Loneliness is even linked to high blood pressure. This, after taking into account gender, ethnicity and other factors.
Most of these can give rise to the proverbial chicken and egg arguments about loneliness as a cause of the problems or the problems themselves giving rise to loneliness. So, let’s turn it around and look at what you can do if you are one of the circle of caregivers for an older loved one. Loss of a spouse leads to isolation. Be present in the weeks and months (not just days) following such a loss to help an older loved one re-integrate into a new social support system. Transportation challenges can lead to social isolation. If you have a loved one without transportation, look for alternatives like para-vans, carpooling and volunteers. Caregivers are at risk for social isolation. Find respite care resources, lay volunteers from religious organizations and home care options to give these caregivers a break. And don’t forget the isolation of that caregiver’s care receiver. Loneliness can be contagious. Volunteering can go the other direction also. Encourage your older loved one to engage in community activities, take a class or seminar, join a club, etc. And appreciate that with these added social activities you are helping to prevent a slide into unhealthy behaviors for your older loved one, such as smoking, drinking or just poor diet. Now is the best time of all to engage an older loved one in new activities. It is, after all, the New Year. And it is the season of long and cold nights. Encourage activities that can be part of the good habits of the new year. 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.
Okay, so it has been five days since you received that box of chocolates from your sweetheart on Valentine’s Day. And if you did not consume truly massive quantities of chocolate all at once, how do you feel? The answer is you should feel the calm that comes from lower blood pressure. This, according to a group of physicians headed up by Dr. Dirk Taubert who did a clinical study on generally healthy people who had elevated blood pressure to find out what happens to their blood pressure if they eat dark chocolate over a period of time. Very simply, they found that it statistically significantly lowered the people’s blood pressure. I bring this up because as a geriatric care manager, a lot of the clients I see have blood pressure that is above what it should be. And I can tell them that the doctors say they should have a diet that regularly includes some amount of dark chocolate. People with dietary restrictions, however, need to check with their physicians.

This dietary recommendation does not take the place of the other recommendations we routinely get from medical professionals about fruits and vegetables and maintaining reasonable portions, but it does offer us a chance for a “healthy” dessert. And the science in their clinical study is pretty solid. Most other studies that have cited the beneficial effects of chocolate have done that based on simply observing some people over time, but Dr. Taubert and his colleagues actually set up a clinical trial with a placebo group and all the customary scientific controls.

This study was particularly relevant to me as geriatric care manager because all the study subjects were 56 to 73 years old. Half the group received 30 mg daily of polyphenol-rich dark chocolate, and the other half of the adults got no polyphenol in their chocolate. Polyphenol is the stuff in dark chocolate that is supposed to confer the benefit. Well, 18 weeks later, Dr. Taubert and colleagues found what a lot of people have been claiming all along. Without any changes in their body weights or their lipid or glucose levels, the group who got the good stuff in their chocolate had their incidence of hypertension decline from 86% to 68%.

To add to the credibility of Dr. Taubert’s research, it was published in 2007 in the Journal of the American Medical Association. You can click on Cocoa Intake and Blood Pressure to see the article. But seriously, don’t eat chocolate just to lower your blood pressure. Do like I do: eat chocolate and savor the flavor.

geriatric care Chicago

…and Happy Belated Valentine’s Day.

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
Recently, I had the good fortune to speak with the chief executive of a national specialty, Monarch Specialty Pharmacy, who has advice for caregivers who may be trying to help manage the prescription drug costs of an older parent or other loved one who has Alzheimer's Disease. Stephen Cichy's advice distills down to four tips, one of which is to take advantage of a new discount prescription offering from his company. He talks about Alzheimer's Disease specifically, but you can see that this can apply to a lot of the chronic medical conditions older adults face. Please give it a read.

"I was recently browsing the internet and came across a published report regarding the problem of medication compliance with persons living with AD. Turns out that when persons living with AD get their prescriptions filled, they take their pills as prescribed only about half the time*. (*Curr Med Res Opin. 2010 Aug;26(8):1957-65).

In addition to the challenge of dealing with multiple daily pills and the persistent problem of memory loss, an important factor contributing to the problem of medication use for persons with AD is the high cost of drugs themselves.   Let’s face it, the price of prescriptions continues to soar. In fact, drug prices are the fastest growing chunk of consumers' healthcare expenses, according to the non-profit Families USA.

If you have health insurance, your plan may or may not pay for prescription medicine. It depends on what kind of insurance you have. For example, if you have private health insurance through your employer, some or all of the cost of your medicine may be covered. If you have the traditional Medicare plan (sometimes called fee-for-service), you'll need Medicare Part D to make sure your medicine is covered. If you have Medicaid, the Medicaid plan in your state may cover the cost of prescription medicines with certain restrictions.

As someone who cares for a loved one living with AD, you may know first-hand the complexities of dealing with the high cost of medication. What might not be so evident is the risk of not taking medication as prescribed. When a person’s AD goes untreated, they run the risk of their medical symptoms becoming exacerbated and may end up in the hospital emergency room, or worse, get admitted for conditions that could have been avoided had medications been more readily available earlier.

This problem is vexing, although I’ve learned several tactics that are helping persons living with AD pay for their medications, and that may be useful for you:

1.             Look Beyond Brand Names

Generic drugs can cost as much as 70% less than brand name prescription. Always ask your doctor or pharmacist if there is a generic equivalent for your prescribed medication!

2.            Leverage State and Community Programs

Some state governments offer affordable medicine programs for seniors, people who are disabled and people who have low incomes. Community health centers, Area Agencies on Aging, free health clinics and other community programs may also offer help. Some social agencies, such as the Salvation Army and some private hospitals, offer financial help for people who cannot afford prescription medicines. To use these services, you may need to show that you don't qualify for private health insurance or that you don't make enough money to pay for your own medicine.

3.             Maximize Prescription Assistance Programs

Patient-assistance programs (also called PAPs) are sponsored by companies that make prescription medicine. Each company has its own rules about who qualifies for its PAP. In many cases, you will need to show that you don't qualify for private or public health insurance (such as Medicare or Medicaid). You may also need to prove that your income is below a certain level.

Each PAP has its own application process. In many cases, your doctor, nurse or social worker will need to apply for you. For some programs, your doctor or nurse can submit an application online. For others, the application must be mailed in. It's important to keep in mind that applying for a PAP does not guarantee that you will get your medicine for free or at a lower price.

4.             Tap the GoRx Prescription Savings Program

Prescription savings programs are an innovative new approach to access to free savings on prescription drugs for persons without prescription coverage or for persons with prescription coverage who may require significant out-of-pocket expenses for their medications.

One such program is GoRx™ (www.GetGoRx.com). The GoRx prescription savings program is free and available to every person and family living with AD, with no age, income or health restriction. All commonly prescribed prescription medications are eligible for a discount. The discounts are available to consumers who do not have prescription drug insurance or the particular drug they need is not covered by their insurance. The average savings is 32 percent off the regular retail price the consumer would otherwise pay at the pharmacy. A majority of participating retail pharmacies will honor the GoRx Prescription Discount Card.

Simply put, GoRx™ is a simple and easy way to reduce your cost of prescription medication. The program covers practically any drug, including vitamins and supplements, so you don’t have to worry about checking if their prescription medication is part of the program. "

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.
I have written a lot about caregiving, who the caregivers are, how to cope with caregiving and how to take care of the caregiver. Now, consider an important fact about older caregivers, besides the simple fact that 25% of older caregivers are attending to the needs of their older spouses. The fact is that the older spouse who is receiving the care ultimately will die, leaving the caregiver to cope with the grief and the guilt.

As a geriatric care manager I often find that while I am part of the care team for the older adult with health needs, I also am part of the support group for the family caregiver. This is particularly true when the care recipient finally does die. As a society we do a pretty good job of rallying around the surviving spouse when there is a death in the family. When the caregiver loses their spouse, the extended family and friends gather round to offer their support. Eventually, however, everyone goes back to their homes, their families and their jobs. The surviving caregiver is then left to cope with a now very quiet home and the sudden absence of familial support.

It is typical to see the grieving caregiver manifest any of a number of symptoms including head and muscular aches, weight loss or gain, depression, episodes of crying, difficulty sleeping, memory lapses, lack of focus, or loss of interest in social activities or friends. Research has shown that these symptoms - particularly depression - can last as much as two years with some caregivers. But it does not need to be this bleak in the aftermath of the funeral and the departure of family and friends.

In fact, we as GCMs find that we are often engaged to just "look in" on mom or dad by a member of the family who now may be a distance caregiver to the survivor. But there are some preventive measures families can also employ to help in the coping and then the healing for the survivor:
- When the illness has a longer trajectory, it is important to make efforts to prepare the caregiver for their loss ahead of time, in part by helping with the "goodbye" while the care recipient is still alive.
- During these conversations also help the caregiver to attend to any "unfinished business" with their spouse; it helps to limit the regrets and self-recrimination.
- Support a grieving process that begins while the care recipient is still alive; this includes helping to create a support network of people who will also be there after the death.
- Prepare the surviving spouse for what life will be like without their partner, particularly the financial responsibilities of living alone; this is something of a rehearsal of what the role will be, a rehearsal that allows for trial and error before they must go it alone.
- Appreciate that grieving is a gradual process and it can take at least a full year to get through all the "firsts;" this includes the first trip to their place of worship alone, their first wedding anniversary and other calendar events.
- Help the surviving spouse to appreciate that withdrawal of emotional attachment to their deceased spouse dose not dishonor their spouse; it is expected that they will go on and have a socially-rewarding life after such a loss.
If you know an older caregiver who lost the person they’ve cared for, contact us for a free consultation. We offer three 1-hour sessions to help the older caregiver transition through their time of grieving.

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.
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s a frequent topic in our discussions. I have asked Gregory Peebles to talk about home safety from the vantage point of his experience. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping older adults and those who are less independent by providing resources and support to help them live their best life. An Associate Care Manager, Gregory has been a part of our team for over a decade. – Charlotte Home. Not only is there no place like it, conveniently located wherever you hang your hat, but it also fits--like an old, comfortable shoe. One of the things that makes “home” high on our list of favorite places is that home is where things work the way we expect them to work. Reach for it, and whatever it is will be their at your fingertips. We don’t have to think! (or so we (don’t) think…). We just do. But comfort can be a slippery slope, and it can get us into all kinds of unplanned trouble. As our older loved ones age, inconveniences in the home can turn into safety hazards. As we watch our parents age, we begin to feel deeply our own mortality and—if we’re not careful—to slip into a pattern of denial, the manifestation of which is the attempt to keep life as it exists in our memories perhaps longer than is advised, all to maintain comfort and status quo. Ironically, this attempt to maintain status quo may end up as a major catalyst to change in our lives unless we bring some consciousness to our scenario. So we need to look around, and I mean Really Look – not with the eyes we had when we were children in the house, or the eyes we had while we were rearing children, because those eyes both literally and figuratively no longer exist. What do we see? Here’s what I see most when I’m asked for advice: Stairs
- Steep stairs are not only difficult to manage for less-abled bodies, but they are a huge fall risk.
- Depending on where the family is in its journey, hand rails may be enough, but a stair lift may be necessary.
Cords
- The serpent of the salon, these may be “hiding in plain sight” ready to cause a fall.
- Make sure all floor surfaces are clear in trafficked areas, and, if carpeted, no holes worn through.
Mats
- Scatter rugs become “shatter rugs” if not well-secured to the floor.
- Use adhesives to secure in place, or get rid of any unnecessary rugs.
Washroom
- Water, rugs, and ceramic or steel surfaces all in one place make this the most accident-prone room in the house.
- Make sure it’s well-lit and that the shower has grip bars for balance, or even a chair for stability.
Kitchen
- Timers for appliances are a godsend in this room; auto-off coffee makers and the like will relieve fire anxiety.
- When cabinets are too high to reach, or too low, they may stretch an older adult’s limits. Make sure everything important is in easy reach.
If you’re all set from this list, but still unsure, call us! We’ll be glad to come out and give a look to ease your mind, or to begin the next conversation. In the next blog post, we’ll give you CCM’s best practices for when a change of address for a loved one may be imminent. 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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Creative Care Management, Inc.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

847.869.5118 x511 tel
847.869.0410 fax

info@creativecaremanagement.com

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senior home care services

Mittens Before the Frost

A House is Not a Home (Part 3)

A House is not a Home (Unless You’re There)

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