senior care

Plug In and Light Up the Holidays
Who doesn’t love indulging during the holiday season? Rich food, delicious drinks, and decadent desserts make every gathering something...
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December 16, 2015
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Thanksgiving Clean-up
“It has been forever! You look so different!” Joyful cries of greeting such as these are so common at...
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November 30, 2015
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In the Caregiver's Words

Recent Client Praise

We have all been following the news on vaccine rollouts, and frankly you may have been as disappointed as I have been with how slowly this mobilization has been progressing. With the exception of West Virginia, the state by state rollouts have fallen short of most experts’ hopes or expectations. Yet, we are making progress. If you live in Illinois and qualify as a category 1B or 1C, it is important to now reach out to your local departments of public health and get on their electronic lists. Once you do that you can expect to receive an email or text of the next opportunity to become vaccinated. The first group to have received vaccinations, category 1A, included healthcare workers and residents of long-term senior living facilities. Category 1b now includes frontline essential workers and 75+ year-olds, but CDC has added 1C to this next tier of availability, which means 65-74 year-olds, younger people with underlying medical conditions and other essential workers qualify. You need to get on a list to be called, so check with your local departments of public health on-line to get on those lists. They will ask how you wish to be notified, text or email, and you simply need to be watchful. A colleague recommends that you may also consider going to vaccination sites at end of day just to see if they have excess vaccine because some who have been called simply did not get to the site. And there is other “good news.” Eli Lilly, the Indiana drug maker, has tested a monoclonal antibody as a prophylaxis against COVID, and the results are promising. In nursing homes, residents and staff showed a 57% lower chance of getting COVID-19 than those who had been infused with placebo. Among the residents specifically, the risk was reduced by 80%. Only four residents died of complications from COVID, and these all were folks in the placebo group. As a result of this in population trial, Lilly has received emergency use authorization for this antibody cocktail. It is not a vaccine, but it can be used to help supplement vaccine where there is simply not enough vaccine to cover all of the populations. What is remarkable is that this infusion was to be used in treatment of infections, but it also seems to have a genuine level of protection against infection as well. Another company, Regeneron, has been authorized for emergency of bamlanivimab, an antibody cocktail to be used in treating COVID in individuals more at risk for severe COVID disease. There is added good news also with one of the approved vaccines. You may have heard of the more virulent variants of the COVID virus that are surfacing. At least Moderna is adapting a second shot of their vaccine to be particularly attuned to this variant. The latest "breaking news" is about a trial using an oral anti-inflammatory called colchicine. In the past it has been used for rheumatoid disorders like gout, but with COVID it seems to tackle the "cytokine storm" you may recall being discussed in the news...particularly with younger patients. In topline data from these early trials on more than 4,000 patients, researchers found that those who received doses of colchicine had:
- 25% fewer hospitalizations
- 50% less need for mechanical ventilation
- 44% fewer deaths.
We will continue to keep you apprised of late breaking news about our global pandemic, and I personally hope we continue to hear promising news as we all look forward to "rounding the bend." Please continue to exercise all precautions and stay safe. 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.
You all have heard about the side effects of FDA-approved medications that make their sales pitches on your television. First, however, you see perhaps a bleak picture of what a medical condition can represent for a patient, but once the medication is brought into the picture, everything brightens and you want to look as healthy and happy as the person on the screen. A voice then slips in a sometimes substantial list of side effects that may be associated with the branded medication being pitched. Research among consumers tells us that the more significant the side effects can be the more confident consumers are that the therapy will be effective. But the side effect that is never a part of this 30 of 60 second advertisement is the bite it will take out of your wallet…although some vague promises often are made about how “if you cannot afford ___, the manufacturer may be able to help.” With the most recent FDA approval that the last two installments of my Blog have focused on, the conversations around what one physician calls the “financial toxicity” of therapies is ramping up. This particular physician was referencing some of the cancer treatments currently being used, treatments that had some positive potential, but had hefty price tags. The Alzheimer’s drug’s (Aduhelm) annual sticker price is estimated to be $56,000, but that dollar amount is likely to vary widely depending on the insurance coverage of a patient. The folks at the Centers for Medicare and Medicaid Services are looking at an annual cost of $29 billion a year for just Medicare patients. So, even Congress is now looking at the price of this medication that was approved based on mixed reviews of its efficacy at best. So, my takeaway for all of you who have an older loved one is to have a serious conversation with your loved one’s physician any time a new prescription is mentioned. Do your due diligence on line to understand as best as you can the efficacy of this new drug, its potential side effects and how it stacks up against what is available currently (recognizing the current drug likely is available generically…and cheaply). Then ask the doctor about price…after you have researched the price yourself. I don’t ever question the doctor’s prescriptions, but I often ask about what they know of price, of the head to head comparisons…and what they would recommend were it their older loved one. And, in fairness, the pharma reps who call on physicians don't talk about price if they can help it, so everyone is in the dark. You may be surprised at how rarely they know what the price actually is. But it’s worth asking. 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.
Alzheimer’s Disease affects nearly 6 million Americans and despite having some clinical therapies that modestly impact the disease onset or progression, there is not yet a cure. Yet, there is accumulating evidence that the best “cure” for Alzheimer’s may be a lot like the cure for other chronic, degenerative diseases. That is, the best cure is in prevention, according to research reported in JAMA, Psychiatry. What I have to share today is not truly new, but the findings reported by some researchers in China suggest that certain “intellectual activities” can protect aging adults from the onset of Alzheimer’s. Other studies have shown that engaging in games and social contact is associated with lower rates of Alzheimer’s. This study, however, is noteworthy because it follows a very large number of subjects – more than 15,000 – and the researchers followed them for nearly seven years. The scientists further controlled for other factors that have muddied the research waters in the past, factors such as physical activities, other psychiatric issues and some social and demographic traits. The intellectual activities that had the effect of reducing the number of people who succumbed to Alzheimer’s disease were as simple as reading or playing card or board games….even betting on horse races. Active participation in intellectual activities, such as reading and playing board games or card games, may delay or prevent dementia in older adults, even if these activities take place in late life, this new research suggests. All subjects in the study were at least 65 years old, and the researchers found that by year three they could identify individuals who had some measurable cognitive decline. This decline continued with those who measured lower on the equivalent of the mini-mental health scale. Those who declined were involved in about half as many of the intellectual activities. They also tended to more often be women than men, they were less educated and they had poorer diets and physical activity than those who scored higher on cognition. An interesting side note is that there were comparable rates of smoking and other psychological diagnoses across the dementia and non-dementia groups. As with most research into dementia’s onset, there are still questions. For instance, how much did a better diet affect the outcomes. Or did people who engaged in more intellectually healthy activities also more often engage in other healthy activities. Clearly, there is more to come. I would conclude that engagement in more intellectual activities is good for your brain, but I would add that you may not wish to bet too much on the horses! 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.
It seems that you cannot watch the evening news without getting a pitch on why older men should be paying attention to their potential for “Low T”, or low testosterone hormone levels. And a pharmaceutical company just happens to have a supplement to take care of it! This is why I have asked our Vice President, Steve Steiber, Ph.D. to talk to us about what we may not know - but should know - about “Low T” and the new treatment. Steve has over twenty years of experience as a consultant to the pharmaceutical and biologic industry prior to joining us at Creative Care Management: First, of all, it is important to understand what normal testosterone levels in men are before we can really talk about what has been described as “Low T.” Low ranges have been associated with decreased bone and muscle strength as well as lower fertility in men. But it gets a bit complicated, because the testosterone level itself is affected by obesity and by age and it ranges rather widely among men. Researchers from Harvard Medical School have recently compiled data on blood assays of testosterone levels in panels of thousands of men in eight European countries and the United States. Without getting into the specific metrics, they calculated the overall range from the normal low to the normal high end for men 19 to 39 years old. It was 264 to 916 on their scale. Adding the obese subjects lowered both of these numbers. Men ages 40 to 49 had a range of 208 to 902. What I find remarkable is that as they tracked all the way of up to ages 80 to 89, the range was 119 to 902. The upper bound was unchanged, but more men slipped lower. So that is “normal.” How to “naturally” improve testosterone:
1. Exercise regularly and add weight training
2. Eat a balance of protein, fats and carbohydrates
3. Supplement with vitamin D and some sun to activate it
4. Add a balance of other vitamins and minerals
5. Reduce stress which releases cortisol
6. Sleep well.
If that older man you may know wants to consider adding the hormone, there also are some cautions. In clinical trials against placebo, older men taking the hormone had twenty percent greater build-up of non-calcium plaque in their arteries than men who did not take the hormone. In other words, the improved testosterone levels came with increased risk of a cardiovascular event. Another study looking to see if there is improved cognitive ability in men taking testosterone supplements found no improvement in men who had started with Low T and moderately impaired cognitive function. There also is a demonstrable increase (63%) in risk of venous clots in men taking a testosterone supplement. It appears that this effect is transient, only lasting for the six months following the start of treatment. The lesson appears to be simply that anyone considering testosterone hormone supplements needs to talk with his physician…and perhaps consider the “natural aids” versus the hormonal supplement. 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.
If I were to ask you what you or an older loved one had for dinner yesterday, the chances are 90+percent that the meal included foods that you or they have had before. In fact, raise your hand if it was a mom’s or dad’s recipe…or grandma’s or grandfather’s recipe. And if I were to ask about your diet for the past entire week, it’s also a pretty safe bet that many of your meals include repeat performances of the same old same old…and then there is leftovers which are the ultimate in “same old.” Yet, dieticians say one of the best things you can do for your health is mix up your fruits and vegetables. Here's where you stretch yourself a bit if you follow researchers’ advice and include more than 30 plant-based foods within you week, because mixing up your plant-based foods mixes up your gut biome. Your gut biome is the composite of all the elements of your diet that continue to reside in your digestive tract and variety is not just the spice of life. It is life itself, especially as it improves your immune system and helps strengthens your bones and muscles and brain and more. There are countless plants from around the world, but here are just nine that can give you a start on upgrading your gut biome:
1. Breadfruit, for instance, gives you 50% of the fiber your body needs in just a one cup serving and it’s rich in both vitamin C and potassium. Check it out as well as look for where you can get foods from the Pacific islands.
2. Culantro is like the better known cilantro, but is much richer in vitamins A and C, important antioxidants. It also has lots of calcium which is good for both bones and your heart. Google “sofrito,” a very popular Caribbean dish from Dominican Republic for a recipe that include culantro.
3. Taro Leaves are an abundant source of vitamins A and K to boost your blood’s health as well as bolster your immune system. It comes from dasheen bush in Trinidad and Tobago, and is the defining part of callaloo soup.
4. Eddo leaves are a lot like spinach and also contain large amounts of potassium, folate and vitamins A and C. You’ll have to find where eastern South Americans shop for their produce.
5. Plantains may look like bananas, but they have much less sugar. They give your body a big boost to your gut biome with healthy bacteria as well as potassium and magnesium for better cardiovascular health. It’s one of those rare foods that are good for breakfast, lunch and dinner.
6. Chapulines – if you’re looking for a break from vegetarian fare – are a great source of fiber, potassium, phosphorous and protein. If you Google this one you’ll find these grasshoppers are a great part of Mexican snacks as well as a tasty part of tacos.
7. Dandelion greens are closer to home and are high in A, E and K…they’re also rich in folate. Fresh leaves can be a tasty accent to salad with its high iron, magnesium and potassium and provides a great antioxidant.
8. Huitlacoche is commonly called corn mushroom and is the central ingredient in what is sometimes called “Mexican truffle” or “Aztec caviar.” This mushroom/fungus can be bought canned and online is full of antioxidants and vitamin C.
9. Acerola cherries could be called “super cherries,” because a half cup of these tasty fruits provides 900 percent of the vitamin C you require daily. You can access these Caribbean fruit more easily in powder form to use in smoothies.
You may have found one in this list that sounds quite enticing, but the key is to branch out from just one food and into more variety and to keep consuming more and different foods. And, yes, you can take a pass on grasshoppers. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
Let’s talk about travel…time travel! We all are capable of travel at almost any age. But what you may not know is that we all can travel back in time at almost any age…and we will become younger if we take that trip. All of us know someone who just exudes a younger self than the rest of their acquaintances of the same or even a younger age. Let me explain. You may have heard of a Harvard study among graduates that began back in 1979 under the watch of Ellen Langer, a Harvard psychologist. Granted, her original research was never peer-reviewed and published, but it has been at the center of a lot of subsequent research, most of which supports her mind/body connection. Some say it was just a “placebo effect,” but even if so, it was a substantial placebo effect. Dr. Langer’s team invited a group of Harvard grads from the 1950s for a weeklong retreat. The retreat venue had been set up to remind these older men of their younger years in the 1950s, so the art, the music, the games, the décor and even the food were all mid-twentieth century. There was a baseline test establishing everyone’s memory, posture, physical facility and overall sense of well-being. They were tested again at the end of the retreat before returning back to the “real world,” and significant gains were documented. The average man on this retreat seemed to have become younger? Some have called it a simple placebo effect…mind over matter. In her new book, The Mindful Body, Dr. Langer makes the case that the mind and the body have real connections that can be exploited to create a better mental and physical state of being. Wouldn’t you take a “placebo effect” that put a spring in your step, offered the right answers in a trivia game or improved your dance moves? Dr. Langer refers to these cascading placebo effects as the outcomes of a mind-body unity. Clinical trials of anti-depressants, digestive aids or pain medications routinely deliver substantial placebo effects. Mind-body unity cannot cap a chipped tooth or set a broken arm, but mind-body can improve your jogging time, support a better night’s sleep or lift your mood. Dr. Langer says, “When we open our minds to this idea of mind-body unity. New possibilities for controlling our health become real.” For instance:
- Always ask your provider how a “new medication” actually improves your health over your existing regimen.
- Caregiving for an older family member can be onerous, but if we look at the good we are doing and the love we are sharing, there is a real upside.
- Don’t accept every physician’s recommendation at face value; ask for research that supports the choice or seek a second opinion.
You already know that you are what you eat. You also are what you think! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.

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Creative Care Management, LLC.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

855.455.5118 tel

info@creativecaremanagement.com

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