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

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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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

You’re seated with your frail mother in a jet at about 28,000 feet, row 15. You had volunteered to fly out to meet her and fly her back to your home, and you just took off moments ago. Mom had been unable to use her right side to any good effect for some time, and you are bringing her to your home so you can better care for her. You haven’t made specific plans yet, but you’re certain it will be a good move for her and for your family at home. The plane suddenly lurches downward. The air masks drop from the ceiling. What do you do? If you had paid attention to the in-flight talk as you got settled before taking off you would know that you are to secure your own face mask first, and then help someone with you if they require any assistance. Anyone who has traveled with any regularity has probably heard this so many times that they could probably recite the pitch themselves. But who thinks to apply the same lesson to the rest of their lives? The New York Times carried an opinion piece this past weekend by an author named Lorene Cary. Her book has a title that pretty much tells it all: “Ladysitting: My Year with Nana at the End of Her Century.” She digs deep into the unsavory aspects of caregiving in the 21^st century. It’s often not just transporting a loved one to the doctor or picking up groceries and doing a load of laundry. Caregiving usually starts with no training and then quickly moves into bathing the family member, learning the nuances of adult diapers and all of the other assorted “Activities of Daily Living.” It’s hard, unpleasant and seemingly relentless. One person who came up to me after I had spoken to a gathering some time ago introduced himself as having “recently graduated from four hours of uninterrupted sleep to four hours of interrupted sleep a night caring for his mother.” And did I mention that most caregivers to family members do all of this without pay? Ms. Cary cites a figure that I still find staggering. According to AARP’s Public Policy Institute this cottage industry we call caregiving would total nearly half a trillion dollars in revenue if all the voluntary caregivers were paid just minimum wage. Ms. Cary also raises a point that can easily get missed if we just translate this “caregiver crisis” as some call it into dollars and cents and hours spent. She says, “Too many people have to reconfigure their lives around a loved one’s disability.” She goes on to talk about a different kind of national debt based on what she labels our “Gross National Happiness Index.” If you are a caregiver, try a little exercise. First, in one column list all the activities you have directed to your care receiver this past week….the trips to the store, the in home tasks…everything. Next, make a list of all the activities in which you have participated just for yourself? If that second column looks a bit wane, start today to rebalance your books and begin by caring for the caregiver. It will actually make you a better caregiver as it also makes you a healthier and happier person! 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.
Last week, we talked about how to overcome depression and melancholy after the holidays as a caregiver. For some, the emotions and attitudes of those around them can affect state-of-being as well. If the person you’re providing care for is also feeling down, it might weigh down on you too. We’ve said previously that it is important to take care of the caregiver in order to provide the best for your loved one. However, sometimes assessing the loved one’s emotional needs might help everyone in the household survive post-holiday blues. Here are a couple of quick tips on how to approach a senior or loved one that is feeling down after the holidays.

Sometimes a little bit of rest helps. You may not have to do anything out of the ordinary other than be there for each other and take a break. After the holidays, everyone – including the person you’re caregiving for – is probably exhausted. This can contribute to being down and out for a while. Sometimes it’s best to just let those feelings live while allowing everyone to wind down and rejuvenate after an exciting holiday time.

Feelings of nostalgia of how things used to be can affect the person you’re caring for too. After the holidays is a prime time to reflect on year’s past and about how the holiday just doesn’t feel the same. Even without engaging in feelings of nostalgia, emotional stress regarding health and finances may take its toll. Providing a positive distraction for both you and your loved one might help with these feelings. For instance, taking them out for a relaxing stroll, engaging in some form of activity, or simply having a quiet meal together may help tremendously.

Above all, simply understanding you and your loved one’s feelings– recognizing it, and doing your best to overcome them will help get you through those tough times.

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.
How about a free genetic test to learn more about your ancestors? Free… And finding out about the people who no longer are alive to tell their stories? And your older mom or dad figure why not... Well, identity theft is why not. How many of you have taken the test to find out more about your ancestors? You know, the one where you offer a sample of your saliva in a tube, mail it off and they return a “report” to you that details what they know about where other people with similar genetic profiles call “home.” Most people find they have ancestral roots that go back to a lot of places, not just the family homeland they heard about as children. So, of course, scammers would be finding a way to use this test which is supposed to put us all on the map in order to defraud unsuspecting elders. The U.S. Department of Health and Human Services Office of Inspector General has sent out an alert. Scammers are offering people qualified for Medicare to get the same test that you or I may have paid for on-line. You may have thought your older parents were pretty insulated from this kind of scam, but here is how it works. We’ve all been to the public health or “aging well” events where a roomful of professionals are giving away books on senior residential options, refrigerator magnets, sticky note pads and a cool bag for carrying home the haul of freebies. There are other ways like telemarketing and door to door calls, but scammers are offering the unsuspecting older individuals a free cheek swab by simply providing their Medicare identity, and the target who does not recall that they no longer need to provide their social security number don’t hesitate to offer that in exchange for an ancestral map. Well, it becomes an access point to a different kind of map, your loved one’s financial map. And with the address and social information, scammers can begin the kind of work they do all too well. So, prepare your older loved one to be vigilant about:
- If a testing kit arrives at your loved one’s home, tell them to not do a thing if their physician did not request a test. Better yet, take note of the address of return and report it to the authorities.
- If a stranger offers a genetic test and…by the way…asks for a Social Security or Medicare number, stop. In fact, anyone other than a physician’s office or lab should not be given any of these pieces of identification.
- If anyone asks for Medicare information, and they are not a medical provider to your loved one, beware. So, this is more than saliva in a test tube. If you suspect Medicare fraud, depart the Office of the Inspector General of the Department of Health and Human Services.
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.
Perhaps you have now had the chance to once again be together with family and older loved ones for the holidays or maybe the visit is still on your calendar? If so, you may have noticed or soon will notice that some things are not quite the same, and the changes may be subtle. You may notice that your older loved one's reaction time behind the wheel is more than a bit slow or tentative. You may see evidence that your loved one is more than just "behind on housekeeping;" there may be signs that taking care of home is just more than they are up to. Or you may notice that they have some difficulty standing after sitting for a time or that there is a shuffle to their walk. What can you do? Driving. Talking about giving up the car keys may be premature, but the per mile rates of auto accidents escalates rapidly after about age 70. So, you have to ask yourself if you would prefer to have this hard talk before or after a collision. Then, you need to ask how you would want to be approached if you were the questionable driver. Ask them about how safe they feel on the road with "drivers these days." And do not hesitate to reach out to your loved one's primary care provider as someone who may be able to speak with more authority. Housekeeping 101. This one is more than keeping tidy in the kitchen. If you have done a surreptitious check on the quality and quantity of food your older loved one has in the pantry or refrigerator, you may have found limited quantities as well as staples beyond their expiration dates or making their way to a science experiment. This may be as simple as getting a shopper for your mom or dad, and you can offer to help them find someone to help with the "heavy lifting." Another "heavy" may be in the housecleaning category. No one really relishes pulling out the refrigerator to vacuum or to get under the bed to chase out the dust bunnies. Getting your loved one to agree to help with the heavy lifting on this front may be a nice step toward getting more help as needs change. Fall Risks. Housekeeping may help in beginning to eliminate some of the fall risks your older loved one may face at home. Every year about one in three adults over age 65 have a fall, fortunately not all of them serious. But look for worn carpeting whose frayed edges are a trip risk, particularly on stairs. Scatter rugs also are a big risk as are cords for electrical devices that may be blocking walkways. These may be easy suggestions to make, but you may also wish to bring in a professional like a geriatric care manager who can walk through a veritable checklist on what to look for along with many of the easy fixes. With all of these facets of "home improvement," it is important to remember that you do not have to go it alone in the conversations with mom or dad. You may enlist the support of your siblings so that the whole family is trying to lend a hand, particularly if you collectively have a history of working together around the house. Barring that, you also can raise these subjects in a less threatening way, such as in the kitchen while helping with serving or preparing the next family meal...just one on one. Or if it is the older father, a walk around the yard or block may be an easier venue for a conversation. People tend to talk easier if the talking accompanies a task. There is always that family friend of your older loved one who has been like the extra aunt or uncle who can help facilitate a conversation. And here again, talk with a geriatric care manager about your concerns and how best to bring them up to an older loved one. It does take a village. 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.
Too much caregiving can be harmful to your health! I have talked in the past about how important it is for us all to help care for the caregiver and that caregivers deserve to take care of themselves in midst of all the other tasks of caregiving. And if they do not attend to their own needs, what then? Well, they run the risk of becoming the proverbial “toast.” I have never seen an actual case of caregiver burnout, but I have seen a fair bit of toast in my years as an aging life care consultant or geriatric care manager. For instance, the middle-aged gentleman with whom I spoke a while ago about his care giving duties for his ailing mother. He summed up his situation by saying, “I’ve gone from five hours of uninterrupted sleep each night to five hours of interrupted sleep each night.” And he very much looked it. If you are a caregiver to an older loved one or know someone who is, look for the warning signs of the “caregiver toast” syndrome:
- The Joy is Gone: caregivers often report how rewarding it is to “give back” to a loved one, but as the time goes by and grind threatens to wear them down, they tire of it. Getting tired of caregiving is not a reflection on how “good a person” you are. It is a sign of burning out.
- Everyone’s capacity is different: Don’t compare your caregiving capacity with anyone else’s. It is not about a cup half full versus empty question. It is about how big your cup is, and yours may empty faster than another person’s.
- It may be how much care you are giving you. The caregiver is often the last person in line to get a break or a rest. If you are a caregiver, you cannot take proper care of anyone if you are not attending to your own needs.
The symptoms of “caregiver toast” syndrome are really tangible. Look for signs of the following in yourself if you are the caregiver…or in someone you may know who is a caregiver:
- Muscle aches in the neck, shoulder and back, headaches
- Impatience, distraction, irritability, diminished drive, guilt, melancholy
- Tiredness, sleeplessness, susceptibility to illness, memory loss
- Withdrawal from regular engagement like clubs, religion or social circles
What is a symptom or a diagnosis without a remedy? The toasted caregiver needs to start some healthy activities along with perspectives on themselves. Key will be a healthy diet and sleep cycle; acceptance of any shortcomings and credit for the accomplishments; seek help in regaining perspective, insight and even humor; seek out conversation, companionship and just the touch of others. Find resources with whom to share the load and the journey. Turn down the heat to avoid becoming toast. 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.
It’s not just about forgetting how to get to where they are going. Older adults – even in the early stages of dementia – are simply at a much higher risk of accidents while driving. While adults over the age of 85 make up only about 9 percent of the population, they are involved in 13 percent of the fatal crashes and 17 percent of the pedestrian accidents resulting in death. Overall, the fatality rate of 85+ year old drivers is 17 times that of drivers 25 to 65 years of age according to the National Highway Traffic and Safety Administration. Is dementia a part of that? Yes, but only a part. Aging is a process that not so subtly erodes an adult’s visual capacity for judging distance, recovering from glare and distinguishing objects in dark or semi-dark conditions. Add to that the physical limitations that osteoarthritis can impose along with slower muscle reaction time and yes, memory deficits, and 85 plus year olds have the highest per-mile accident rates of any cohort beyond the teens. If you are a caregiver to someone within this older cohort - 85+ - this is not a mandate to talk about the car keys just yet, but it is important to be alert to what may be unfolding. Medical surveys of outpatients suggest that as many as 30% of older adults who have dementia may still be behind the wheel. What to look for? Dementia does not simply mean that an older driver gets confused in the parking lot at the mall or gets lost on the way home. Dementia in the driver’s seat translates into unexplained dents or scratches on the car. If you have occasion to drive with the older adult watch for difficulty in lane changes or lane wandering, challenges on turning or difficulty judging distances. Accidents typically are the result of a growing series of mistakes and near misses on the road. Early stage dementia patients may actually be safe drivers, but you should talk to your older loved one’s primary care physician. They will not be able to speak to you about your loved one’s medical condition without sign-off from the patient, so that is a starting point. And appreciate that not all physicians are well-schooled in diagnosing dementia, let alone treating it. If you are concerned about dementia as it may be affecting your loved one’s driving, start by asking the physician about your loved one’s ability to pass a mini-mental exam or other cognitive tests such as the Clock Drawing Test that help assess executive function. If the physician is not able to help, ask about possible referrals. You may find that there are hospital providers who have actual testing programs or driving schools to help assess your loved one’s safety behind the wheel. If the decision is made that your loved one is not safe driving, begin immediately to explore your transportation options. Some older adults will be relieved that the stress of uncertain navigation is no longer a challenge, but others may view it as a significant loss of independence. Be prepared to be an empathetic listener. Steer clear of sentences that start with “at least” such as “at least you did not have an accident…” Picture what you might feel in a similar circumstance and go from there. Don’t try to gloss over the genuine loss your loved one will feel. What are the public transportation options? That may depend on how advanced the dementia is, because navigating train or bus routes can be as challenging as driving. Paratransit and chauffeur services may be an option if they are affordable, but be careful on vetting the services. Check with your local ombudsperson on aging for a secure option. 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.