senior care services

Medicare Doesn’t Cover WHAT?!
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP) and trained Medicare Counselor, whose work focuses...
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June 18, 2018
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In the Caregiver's Words

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We all know that an object at rest tends to stay at rest, and that is as true of older adults as it is younger ones if you look at the frightening statistics on the obesity epidemic in America. Habits developed over the long run tend to be harder to break, but the fact is that appropriate exercise for older adults can get easier and easier just by the simple fact of dong it. Because the corollary to my first scientific law is that objects in motion tend to stay in motion. And exercise gets easier. Doubtful?

Here are nine reasons:
1. Starting a new exercise routine may feel clumsy at first, but so did dancing, riding a bike and a lot of other physical work we have all gotten better at with time. Muscle memory will help, because your body will make new nerve pathways to make your exercise easier with time.
2. Blood flow improves when you exercise at any age. The smallest vessels actually can increase in number fueling all parts of your body as your heart rate routinely increases with practice.
3. We all have seen body builders grow muscles into sculpted works of art. Well, we do not see the heart, but it gets stronger also with workouts that are even modestly strenuous. This is true of older adults as well as college athletes.
4. With the muscle memory and greater cardiac capacity comes increased confidence among elders who exercise. Physical confidence, in turn, creates greater overall confidence and a sense of “can do.” Older adults with a regular workout routine also will sleep better.
5. We have heard from too many fanatics about “no pain-no gain.” The opposite is, in fact, true. As an older adult works out over time, the body raises its threshold for working. With time, an older adult can do more and more without that shortness of breath or even the soreness afterwards.
6. Take that last one to a higher level, and if the older body begins a regular regimen of moderate exercise, the body’s hormone system will reward it with cocktails called endorphins. Endorphins are basically a homemade version of morphine to help the body feel better and better.
7. The power plants in your cells also will begin to grow in number with exercise over time. You cannot see them, but the mitochondria, as these power plants are called, become more numerous so that your body can burn more carbohydrates and fat to create more energy.
8. Exercise will encourage better eating habits. It is true, because a lot of those bad habit foods – comfort foods – are linked to stress, anxiety or even depression. Since exercise works against these negative emotions, some of the craving for the junk food will ebb as well.
9. Exercise actually makes a person happier. Tied to some of what I mentioned in #8, exercise really lifts the spirits, and it does it in part through releasing chemicals called serotonin, dopamine and norepinephrine. These chemicals can be as effective as some of the drugs often prescribed for depression.
Before you exercise or encourage an elder to exercise, see a doctor to sign off on your fitness to exercise.

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.,geriatric care manager Chicago, geriatric care Chicago

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In the past two posts, I have discussed ways to ensure safe in home care. But we should also look to helping an older parent to be in the best shape possible to avoid even the unforeseen hazards. In this post, I offer nine tips to help “fall-proof” a mom or dad. It is a different way to think about being in the best condition one can be.
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. Visit our For The Caregiver page for more information and resources.
This week I asked Gregory Peebles to talk about the topic of ridesharing 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 aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life. An Associate Care Manager, Gregory has been a part of my team for over a decade. – Charlotte Ask any teenager in the US, and they’ll tell you when a person becomes a functional adult. The legal driving age in our country is 16, and the license signals independence, freedom, and increased responsibility, including driving to and from a new job. Conversely, it seems also that when it’s time to “give up the keys” we finally start to come face-to-face with the reality that our time as a sovereign individual is finite. Becoming a “rider” instead of a “driver” signals dependence, limited options, and isolation. Getting out of the driver’s seat doesn’t mean all the fun is over, though. The US is just a culture of drivers, and when we lose that one identity, if we don’t substitute another healthy vision of ourselves, we experience unnecessary loss and grief. For example, aging adults stop driving for all kinds of reasons. Because it’s a big conversation, at CCM, we have tended to focus on the cognitive decline aspect, but loss of night vision, reduced hearing, and prescription side effects are still among the top reasons that seniors become “riders.” That means that there are plenty of folks with a lot of life left who may be sitting at home trying to fill the day with meaning when they could be in the world connecting. Caregiver schedules are already often stretched to breaking, so asking for a ride from a caregiver to go to something “fun” is much less likely than securing the ride to a medical appointment. Ridesharing services continue to cover more ground, and in our Chicagoland area, Lyft and Über are the most visible brands offering service. Here are 5 things you should know as you consider ridesharing for your older loved one:
1. It’s safe. – While safety comes down to the specifics of the driver, vehicle, and driving environment, of the two main rideshare choices, Lyft “vets” drivers and vehicles most strenuously. Problems with either service provider however are statistically very low.
2. You don’t have to have a smart phone to benefit from ride sharing. – If you have a technology-loving senior in your care, that’s awesome, but many seniors balk at the idea of a smartphone. So how could they benefit from a service that requires the technology? Your smartphone. You can set the pickup and destination in the app.
3. You keep some control. – There’s a map to follow, so if you’re a worrier, there’s visual evidence of where the car is coming from, when it picks up your loved one, and when they have arrived at their destination. You can keep doing what you need to do while staying connected.
4. It’s usually cheaper than a cab. – Depending on the time of day and how in-demand drivers are (rush hours tend to trigger “surge pricing”), the cost can be as little as $8 for a significant distance. A line share (like a carpool) can bring that price down even to $5.
5. Client assistance is common. – Though it’s not in the contract, drivers are used to helping passengers with luggage or other inconveniences. Your loved one needing a little extra help probably won’t be a problem. However, if you’re truly worried about it, GoGo Grandparent (https://gogograndparent.com) is prepared to help more than Lyft or Über might be. They also make deliveries and will schedule a pick-up, where most rideshares are more spontaneous.
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.
Everybody forgets something! There is a heightened awareness - even fear - of Alzheimer's or other forms of dementia especially as we all advance in years, but simple forgetfulness does not inevitably lead to a dementia. And if you are a caregiver, the older adult in your orbit may be very self-conscious or worried at having misplaced the car keys. Or maybe it is blanking on a favorite author or the name of a friend that they happen upon on the store. No one of these events means that dementia of any sort is encroaching on their faculties, but sometimes it is not enough to reassure an older adult that it is not what they fear. It can be helpful, however, to take specific actions that are known to help keep one's brain healthy and sharp.

            Let me share five helpful tips from a well-regarded neurologist named Dr. Majid Fotuhi. You may have seen him on Dr. Oz, if you follow the program. Some say Dr. Fotuhi's advice can even prevent Alzheimer's; you be the judge. At the very least, these steps can help to strengthen the brain of virtually anyone who puts in the effort.

1.    Cross-Train: Anyone who exercises routinely knows that it is important to trade off the activities of your work out; they call it cross-training. Try changing which hand you use to comb your hair or take a different route to the store or use a soup spoon with your non-dominant hand. It is not easy, but it challenges your brain to learn something new, and as the brain adjusts to this shift it rises to the challenge by using areas of the brain that may have been under-utilized before.

2.    Relax: Stress is not just bad for your cardiovascular system; it is harmful to the brain because it releases a stress hormone called cortisol. So, several times each day, go to a quiet, darkened room and practice deep, slow breathing. Change out of clothing that may be restrictive and remove your shoes to signal your brain you are serious about relaxing. Do this for seven minutes.

3.    Mnemonicize Something: Okay, so the real word is simply "mnemonic. Challenge your brain to remember five spices from a recipe by making a word out them: Salt, Pepper, Oregano, Tarragon, Sage. See how long you can make the word or use the first letters to make a silly sentence.

4.    Increase Blood Flow: If your doctor says you are sufficiently healthy, walk up and down the stairs a few times, do ten push-ups, or do twenty sit-ups. All of these will raise your heart rate and increase blood flow to the brain, and that will grow new brain cells.

5.      Infuse DHA: There is a nutritional supplement called docosahexaenoic acid which is an omega-3 fatty acid which just happens to make up a large part of your brain matter. You can get it from fish that come from colder sea water, and it also can be purchased in your drug store or health food store. It has been shown to promote a healthier, even younger brain.

If you want to learn more about any of this, Please check out Dr. Oz's web site.

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 came across some recent research that is - to say the least - counterintuitive. People drink diet carbonated drinks because they are being careful about their sugar intake and their health, right? Well, recent research reported in the Journal of the American Geriatrics Society says the opposite is true among older adults. A group of scientists at the University of Texas Health Science Center in San Antonio, Texas, studied the link between diet soda consumption and weight and waist size in 750 patients over age 65. What they found seems to be the opposite of what one would expect from people consuming "diet" beverages. The scientists measured the waist, height and weight of these 65+ year olds along with their diet soda intake over a ten year period. For their analysis they divided the patients into three groups: those who consumed at least one diet soda daily, those who drank less than one soda daily and those who drank no diet soda at all. The first group showed an average increase of 3.16 inches in their waistlines over the decade of the study. Those who consumed less than one diet soda a day increased an average of 1.83 inches during this ten years, but older adults who drank no diet soft drinks increased their waistlines by only about 0.8 inches. Ironically, the increase in waist size was not tied to an increase in overall weight. It was the belly fat associated with diet sodas that resulted in growing waistlines. As I have written in other posts, the weight we put on around our middles is the most unhealthy, and it has a direct and negative impact on cardiovascular health. And while the researchers cannot explain exactly why this increase in waistline was tied to drinking low calorie carbonated beverages, it is pretty clear that diet soda should be off the menu for older adults. I also have mentioned in other postings that carbonated drinks have a negative effect on a person's esophagus resulting in a higher likelihood of gastro-esophageal acid reflux, GERD, owing to the carbonic acid in sodas. Carbonated drink consumption also is associated with calcium depletion in the bones and ultimately osteoporosis. So, if you are a caregiver to an older loved one encourage them to find alternative beverages to their diet sodas. At the very least help them to cut their intake of these caustic libations as even getting most of the way to a zero soda goal will have its benefits. 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 common topic of our discussion. I have asked Gregory Peebles to talk about this topic 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 aging adults and folks with limited independence by providing resources and support to help them discover and lead 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, that fits--like an old, comfortable shoe, but it’s also a place that once we leave, to which we can never return. While most find this very stressful, some are secretly happy for a new chapter. Indeed, lots of people confirm they like adventure, but small is the number who enthusiastically embrace major residential change. So what’s the difference? Well, for one, the direction of action: people elect to go on adventures, but change just seems to happen to us. This is a major life change, and those inclined deserve the opportunity fully to grieve their loss of home sweet home. However, once the initial grief has been addressed, we’ve got work to do! Change isn’t the end, and there’s plenty of life and happiness yet to be found no matter the location. Where that happens is up to you. The diversity of the experience of aging can be exciting, and, with the number of Americans joining the group of aging adults, the kinds of communities that now exist will only become more varied. Right now the kinds of accommodations available generally fall into a few groups.
- Active Adult Communities – Often neighborhoods with individual bungalows, these communities are based on the model of so-called “snow birds” who opt to transition to such a residential community rather than maintain a larger space. Living in one of these communities requires a high level of independence (and income). Individuals or couples with highly social personalities thrive in this setting.
- Independent/Congregant Living – Facilities of this type, while slightly less luxurious than an Active Adult Community, feature many of the same accommodations with a denser population. In an urban setting, they are often high-rise apartments indistinguishable from nearby housing, with dining, health care, and leisure activities on the premises. If considering this type of facility, be sure to keep nearby entertainment and accessibility in mind.
- Assisted Living – A senior for whom it has become difficult to care for themselves either because of physical limitations or decreasing independence will often find an exciting new life in such a facility, either through public assistance or private pay, where skilled staff are present to provide diverse care. If the care receiver is also living with cognitive decline, such a facility with a “Memory Unity” may be advisable.
- Skilled Nursing – On average, aging adults who become residents within skilled nursing facilities – SNFs - are those who have health problems, who require 24-hour care, and whose ability to manage the Activities of Daily Living is severely impaired. Nursing home care, too, is expensive, but public assistance programs such as Medicare or Medicaid relieve the cost.
Change is difficult, but not unmanageable. New identities await us and are only limited by our willingness to embrace them and the imagination we bring to our experiences. Change is scary, and rightly so, but when we weather even the most difficult transitions together, and our lives are no longer recognizable from before, we may--if we choose to--learn that home is something that we take with us wherever we go, and that it is recognizable not by its address, but by the love shared and the people with whom we share it, common to both our memories and our futures. One final thought: This is when people often reach out to Aging Life Care Professionals to help smooth the transition to a new residence and to ensure ongoing care. CCM has helped countless families like yours succeed in this new chapter. Contact us today and let us assist you. 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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