Chicago's Geriatric Care Manager Center of Excellence – Since 1991 | Chicago's Geriatric Care Manager Center of Excellence

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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Trusted Voices on COVID-19
The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a...
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March 17, 2020
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One is Number One Threat to Seniors
We’ve all had times when we desperately need our own space…time to ourselves, just ourselves. And it’s good to...
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March 10, 2020
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Helping Your Older Loved One – AND You – Avoid COVID19
All of us here know how to prepare for a blizzard, people in the South know how to prepare...
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March 3, 2020
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Part 2: Five Important Tips for Caregiving and Self-Care
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000...
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February 18, 2020
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Tips for Distance Caregiving: Up Close and Personal at a Distance
If you think being a caregiver to an older loved one is hard–with all the trips to help them...
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February 4, 2020
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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

Recent Client Praise

Actually names can hurt you…sticks and stones can break your bones, but ageism affects the health of older adults. When older adults are at the receiving end of ageist comments they internalize what they hear, so much so that this lower self-concept results in a slower walking gait, brain changes of Alzheimer’s disease and even a shorter life span. Researchers with the World Health Organization and the Yale School of Public Health have demonstrated a negative link between ageist labeling and senior mind-set. But the good news is they have shown that a positive mind set makes a positive difference in health like walking speed, balance, memory and longevity. This last one comes from what one of the researchers says is a person’s “will to live” which actually results in longer lives. And the individuals who benefit may not even be aware of the positive or negative self-concepts they have developed; it’s often subliminal. In one study adults between 60 and 90 years of age were randomly divided into two groups, but all were first administered a memory test. One group was placed in front of computer screen that flashed positive words about aging and the other group was shown negative words. The words flashed faster than anyone could read, but they made a difference subliminally. Those in the negative exposure group were flashed words like “decline” or “decrepit” and more. The others were flashed words like “sage” and “accomplished.” Both groups then took a memory test again, and the first group showed a decline in ability to recall versus those in the positive group who showed an improvement in their recall. In a separate study in Ohio with about seven times more subjects over 20 years they showed that negative attitude participants died an average of 7.5 years earlier than those with a positive attitudes. Some explain this as part of an evolution of how we look at “seniors” in our culture. Language has become increasingly negative in our literature over the past 200 years and age has come to be viewed as a medical condition. So, what do you get for a medical condition when you visit a doctor…most often another prescription to add to what you already are taking? And what do most medications have? …side effects. Did he jump or was he pushed is a question that comes to mind. Back to the study with computer exposure to negative or positive language. Those who had been exposed to the positive language were interviewed again three weeks after the original experience, and they were significantly better still at the memory and physical tests. This is where it gets to be both a half empty and a half full glass. If through actions or words older adults are reinforced with negative language or behavior, they won’t let you down…they will go downhill in their abilities and their sense of themselves. Those who are exposed to positive situations and affirming language actually become happier…and healthier. So, please think about how you talk with your older loved one next opportunity you have…what you say…and how you act will have a measureable impact on their quality of life. 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.
We all have seen the news stories in which older adults who are in a senior residential facility or dependent upon caregivers who come to their homes are intimidated by the people charged with their care. It can be physical abuse, emotional abuse, abuse by neglect or theft of the older residents' valuables and money. But we do not often think of identity theft as an abuse targeting older adults. If you are a caregiver to an older loved one, you need to be a vigilant advocate and be prepared to report any suspicious behavior. How can identity theft pose a threat to an older adult? Because someone has to look the part to get away with that, right? A growing number of cases nationwide suggest that older adults are perhaps even more likely as targets of identity theft than other younger people, and the reason very simply is that the person using a credit card in any number of transactions will rarely be asked for photo identification as they use the card. Even so, there are just too many "faceless transactions" for photo identification to pose any kind of barrier to abuse. Filling the tank at a service station or making a purchase on-line or purchasing by phone order are just a few examples. But why target seniors? Well, that is where the money is. By the time one retires, the house typically is paid off and they have accumulated their nest egg for the "golden years." And seniors are not likely to be making those big purchases for which a credit check is necessary, so they are not vigilantly tracking their credit scores nor is a lender. They may also not be using their credit card daily, so if it goes misses from a purse or wallet, it may be days before the loss is discovered. There also are more interactive scams that can defraud seniors. There are fake phone solicitations by what seem to be worthy charities or the call from someone posing as a grandchild or other family member with an urgent need while in another town. There are investments for which they may be "prequalified" with rates that will always be above what the older investor is earning from bonds or other safer investments. And who has not had an opportunity to help retrieve prize or inheritance money from someone in western Africa? As a caregiver, how can you help protect your older loved one?
1. Warn your loved one to the possibility of this kind of abuse.
2. Be alert to caregivers in your loved one's home and limit their access.
3. Suggest a credit card statement audit by a money manager who can spot fraud.
4. If your loved one is already having difficulty keeping up with bills, step in to help organize their finances and give everything due scrutiny.
5. If not you, personally, there are daily money managers who can fill this role (check the top listing on our resource page). 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.
Chicago Home Care Service Experts
When looking for Home Care service in Chicago area for an elderly loved one, it’s easy to feel overwhelmed and vulnerable. That is where Creative Care Management comes in. We work with you to completely understand your elder loved one’s needs and then manage the process of selecting and placing your loved one with the right kind of care from a reliable and trustworthy provider.
Finding the Right In-Home Care
Our four step process allows us to guide you from our first meeting to the continued monitoring of your loved one’s in-home care, by developing a thorough Home Care Management plan that is unique to your specific caregiving needs.
Step One: Meeting and Assessment
Everything starts with a meeting. By establishing a personal connection during our initial meeting, we aim to fully understand your concerns. We conduct an assessment of the physical, mental and social health of your loved one to determine the ideal type of elder care service at the moment.
Step Two: Creating a Home Care Plan
Based on our assessment, we work with you to collectively develop a Home Care Management plan that covers everything from the type of care provider required to preparing for changes that may occur in the future.
Step Three: Setting the Plan in Action
When we recommend a care provider, we only offer the best. We hold our providers to the highest standards in regard to responsiveness to a client’s needs, consistent quality of service and level of training and certification required of the provider’s employees. We provide recommendations for a wide range of in-home care options including, but not limited to:

Home companion

LPN (licensed practical nurse)/LVN (licensed vocational nurse)/ CNA (certified nurse’s assistant)

Live-in caregiver

Step Four: Overseeing The Plan
As in-home care is an ongoing process, the Home Care Management plan includes our continued involvement and oversight in the care of your loved one. When conditions and needs change, we will be there to help with any necessary adjustments to the plan. If you are concerned for a loved one, but feel overwhelmed tackling caregiving on your own, our geriatric care services are exactly what you need to lift that weight from your shoulders. Contact us today for a free initial consultation.
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Recent Client Praise

As a geriatric care manager, I work with court-appointed guardians. You may recall from a blog last December, Caregiver or Guardian, we talked about guardianship. I had the really good fortune to speak with John Wank, President of the Illinois Guardianship Association. Mr. Wank also is General Counsel of the Illinois Guardianship and Advocacy Commission, a state agency. He answered a lot of the questions I have heard from our clients. This is going to take a few postings to get through them all. Here are some questions and his answers for a start.

What is a guardian?

A guardian is a person appointed by a court to make personal or financial decisions for another person who has been found by the court to be incapacitated (a disabled person, under the Illinois definition) and unable to make decisions. All guardianship in Illinois is governed by the adult guardianship provisions of the Probate Act of 1975, 755 ILCS 5/11a-1, et. seq. Other laws also apply.

Does the individual get to choose his/her guardian?

An individual may state a preference, but the final decision as to the choice of a guardian is made by the court. Under Section 11-a-6, "(a) person, while of sound mind and memory, may designate in writing a person, corporation or public agency qualified to act under Section 11a-5, to be appointed as guardian or as successor guardian of his person or of his estate or both, in the event he is adjudged to be a disabled person. The designation may be proved by any competent evidence, but if it is executed and attested in the same manner as a will, it shall have prima facie validity. If the court finds that the appointment of the one designated will serve the best interests and welfare of the ward, it shall make the appointment in accordance with the designation. The selection of the guardian shall be in the discretion of the court whether or not a designation is made." Illinois law creates no preferences or priorities as to whom is appointed guardian for a person with disability, other than the requirement that the court give due consideration to any preference of the respondent. Section 11a 12(d). The criterion used in selecting a guardian is the prospective guardian’s capability of providing an active and suitable program of guardianship for the ward. Section 11a 5(a).

Can the individual rescind the guardianship?

Only a court may rescind a legal guardianship. Guardianship is terminated when a person under guardianship (a ward) is restored to legal competency. Section 11a-20. Otherwise, the guardianship continues until the death of the ward. The court may also change the terms of guardianship, making it more (plenary guardianship) or less (limited guardianship) encompassing, or by appointing another person as guardian after the removal or resignation of a guardian. Section 11a-12 defines plenary and limited guardianship; Section 5/23-1 sets out procedures for removal and resignation of guardians.

We will pick up with more of Mr. Wank’s Q and A in the next posting.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management; please e-mail your questions to Charlotte Bishop.

Copyright ©2011 Charlotte Bishop

We already have begun to see polling regarding the candidates for the 2020 National Elections. Most pundits suggest that it is too early to call who will be the candidates of our major parties, let alone who may win. But researchers at the University of Michigan Institute for Healthcare Policy along with AARP recently conducted a national survey of more than 1,000 50 to 64 year olds about their health concerns regarding aging. Almost half said they fear developing some sort of cognitive issues, and many just plain said dementia is their fear. No surprise that it is closer to three quarters of those with a family history of dementia who fear dementia in their own futures. About one third of respondents with no family history still had concerns about their own brain health as they age. You may recall that in past posts on my book, How Do I Know you: A Caregiver’s Lifesaver for dealing with Dementia, the care managers we interviewed reported dementia as a tie for the number one issue for which they are engaged to help families. That was about two of every three engagements, and the same number were for helping families to assure home safety for an older loved one. So, the 50 to 64 year olds in the national survey are looking perhaps to their present caregiving duties as a crystal ball on their own future. Across all groups in the survey about three in four say that they are taking vitamins or supplements or engaging in “brain games” to keep their mental health sharper. But that is only part of the game plan to stay mentally acute today in the hope of a better brain tomorrow. Researchers recently published a Top Ten list of what we all can do to have a healthier brain tomorrow in the journal Psychology Today. They suggest:

Stop Smoking – there are a ton of health benefits to this step.

Social Engagement – having a spouse of close friend actually gives us a chance to hone our transactive memory skills…kind of a team memory exercise.

Keep you Sunny Side Up – Yes, having a positive outlook improves brain function.

Sleep Well – not just long – although 7 to 9 hours are recommended – but the kind of quality sleep where your dreams are just part of your brain’s daily work.

Eat Well – there are entire books written on healthy diet, but protein and vegetables are at the core – processed foods not so much.

Mindfulness – Okay, please go back to last week’s post to get a handle on the importance of meditation and relaxation therapy.

Physical Workouts – Increasing your heart rate and muscle coordination force your brain to sort out the latter while receiving a boost in oxygen and glucose.

Brain Workouts – It is not just reading, but reading to someone else or sharing are great ways to engage and exercise your gray matter.

Back to School – Never mind what reservations you have about some school days issue, learning something new is good – a craft, a language, etc.

Brain Coaching – There actually are specific gaming activities that sharpen the senses and the brain’s ability to process new challenges.

As with any workout regimen, you don’t have to do it all at once or right now…start with one thing and build…toward a better cognitive future. 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.

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I was asked today about the “mitten test.” It was one of our colleagues who had remembered something I had said about how to use mittens to facilitate a better test of how well home is still working with their older mom…not against her. Most of us look at our childhood home and our parents’ present home as the same place we grew up, but the difference is that mom or dad have grown older and maybe less able to negotiate the same space as they used to do. I call it the “mitten test.” If you live in the upper portions of the U.S., your winter mittens may just about be ready to come out of the storage closet. Besides keeping you warm, your mittens have another useful purpose that can help you make home an easier place for your older loved ones. You can use them to identify spots in your loved one’s home that can be adapted to fit their changing capabilities. As our bodies age, certain of our nerve pathways begin to fail, and the human anatomy uncannily reroutes many of the circuits as they stop firing. But with age, more and more of those pathways may slow or fail for a variety of reasons, and it just makes it harder for older adults to do the simple manual tasks they used to do without even a thought. Turning a door knob, turning on a lamp or taking the lid off a jar become challenging, maybe even impossible. It is hard for those of you who may be in the prime of your lives to really get this, no matter how empathetic, so I recommend an easy exercise to help you experience what this erosion of manual dexterity and fine motor skills feels like. In doing so, you can also help identify challenging hardware or activities that can be more easily managed with a bit of creative help. With a pair of mittens, walk through each of the rooms in your elder loved one’s home and go through the normal activities of the person who lives in those rooms. As you enter a room, it is may be more challenging to flip a light switch or twist the switch on a lamp with your hands in mittens. These can be remedied by retrofitting wall switches with the larger rectangular switches that one merely presses on and off. Likewise, the lamp twist switches that are challenging with mittens can be replaced with wider winged grips. And even before you enter a room, the door knob may be your undoing if the knob is too small or too slippery. Handles may be an appropriate replacement. The mittens are effective barriers to everything from opening the ketchup bottle to a twisting the lid on a jar of apple sauce or beverage bottle and more. And if a key itself is hard for an older loved one to grip when opening a door, hardware stores have over-sized sheaths to make gripping easier. With your mittens still on, try tying your shoe laces or buttoning a shirt or blouse. It may be time to get creative with Velcro-equipped shoes or other substitute hardware for buttons. And go through the motions of other self-grooming activities to determine what challenges are manageable and which are just out of reach. The number of what are called “assistive devices” will amaze you as you look to television remote controls, computer access and more. Check out the Department of Health and Human Services Assistive Technology site. 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.
In my last posting, I gave a checklist of the preventive health touchstones for men over age 65, and you will see some fairly predictable parallels to women's health as they hit 65 as well. But take note of the differences if you are a caregiver to an older woman. I am going to start Bone Health - all women need to have their bone density tested even before age 65, and it is largely because of the hormonal changes that are associated with aging. the bone density test is called a DEXA scan, and if you are a caregiver to an older woman, you should approach her doctor about having it done as well as ask about what amount of calcium supplement will be a helpful part of her daily intake. Again, exercise will be important as well. Breast Health - there are risk factors that every woman ought to know, but on average, a mammogram every year or other year depending on their risk factors. All women of any age should learn self-exams as part of their monthly ritual as well. Pelvic Health - once a woman stops ovulating, and 65 is well beyond that, PAP smears are no longer part of the annual routine unless they have had a positive test result at some point along the way. The rule is that three negative tests within the past decade makes for a safe future but check with the physician. Blood Pressure - women should have their blood pressure documented annually as with men. With diabetes or heart disease, this maybe more frequent. If blood pressure is above 135/80 blood sugar levels should be tested regularly. Oral Hygiene - as with men an annual cleaning and exam is a must. Again, oral health tracks with heart health, so twice a year has more benefit that just a great smile. Cholesterol Levels - if cholesterol has been within normal ranges, a check about every three to five years is adequate. With heart disease or diabetes, this should be more frequent. Colon Health - up to age 75 a "virtual colonoscopy" every five years. A stool test every year, a sigmoidoscopy every five years and a colonoscopy every 10 years without a history of family colon issues or cancer. Eye Health - again, a vision exam is recommended every two years as a screen for glaucoma and visual acuity. If the older patient has diabetes, more frequent testing. Immunizations - as with older men, keeping current with all immunizations is important. For pneumococcal vaccines, every five years; flu shots annually. And the shingles vaccine if she has had chicken pox when younger. A tetanus booster every ten years is recommended, and talk to the primary care provider about anything else. Everything else - as with men annual exams are a time to weigh in, record height and test hearing. And women as much as men are prone to depression as they age. A physician can offer an assessment as well as a consult on all medications and any possible interactions . 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 was the extended family that took care of the children as well as mom and dad as they aged during much of the last century. Today life is both different and complicated. The family has changed in numerous ways to challenge the old models of caregiving. Everyone lives anywhere but “here,” the rates of divorce approach 50%; intimacy lasts well into older loved ones lives and non-traditional families have earned their rights. Consider:

Who takes care of mom or dad when they are divorced. Appreciate that when one of your parents cannot be there for the other once they are divorced. That may mean that your role as a son or daughter caregiver may come into play earlier than otherwise would be the case. Be alert to home safety issues as well as how well mom or dad ambulate, how fresh the food in the fridge is and either attend doctors’ visits with them or engage the services of a care manager to help with any of these.

Will residential care options be welcoming for gay families. New options to accommodate all lifestyles are becoming available every day, but be aware of old biases that can persist. If the care you need does not accommodate the individuals you are or your gay parents are, then take your business elsewhere. Consider the places that have been welcoming for your younger needs will have connections to similarly welcoming places for aging needs. Many cities have devoted directories of such vetted services. In Chicago, it’s the Pink Pages for the LGBT community.

How do we address intimacy among older adults as they age? Remember the “awkward conversation” you may have had with mom or dad as you were coming of age? Well, now it’s your turn to be the intimacy advocate for your older loved one. You may have to ask the tough questions of their caregivers or the facilities to which they move once they leave their homes. Today’s 80 may be yesterday’s 60 in more ways than you had considered, so be prepared.

Distance caregiving is the stress of anyone with older parents and a family, or job, or a life of their own. Based on our experience, distance caregivers need to focus on the things that can be done at distance. Arrange for what can be delivered by a third party, like meals; help by becoming a signer on mom or dad’s account to help pay bills and balance the check book; or find a local care manager who can be your eyes and ears when you can’t be around. And keep in touch with neighbors and friends.

I will be coming back to these themes in future postings, but I also strongly encourage you to attend a caregivers’ forum addressing these issues this Thursday, November 19 at St. Matthew’s in Evanston, Illinois. It will be an ecumenical program in the main Parlor at 7 p.m. CST. Enlarge the map on this page or go to: http://stmatthewsevanston.org/. Two of CCM’s staff will be co-hosting the event. Bring your questions…and contact us if you need help with respite care because you are caring for an older loved one and need that help to get to the event! 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.

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As a geriatric care manager, I am always alert to changes in people's eating habits and proper diet. As people age they naturally experience a decline in their appetite in part because their taste buds are not as responsive as they were when they were younger. Loss of appetite is also a potential sign of depression, and depression is one of the most common conditions older adults experience owing to the losses associated with their stage in life and aging. But if the diminished appetite leads to anemia owing to low iron intake, then there may also be a risk for dementia according to scientists. These scientists started with a group of over 2,500 mentally healthy women and men whose average age was 76. They then followed these people for 11 years testing them regularly for their blood counts and other mental function tests. At the outset of this study 392 people were clinically testing as anemic. By the eleventh year of this study 455 people had developed clinical dementia. These researchers also measured all study participants' age, gender, education, blood sugar levels (and diabetes diagnoses) and more than a dozen other biologic metrics. In statistical analysis they controlled for all these other variables and found that anemia still was a strong predictor of dementia beyond these other possible causes. In fact, of the people who started the study with anemia, they had a 49 percent greater risk of developing dementia during the 11 years of the study. What makes this study very compelling is that it is a prospective design. It is not one of the many studies we often see where scientists can ask questions about a person's background in an effort to explain a current condition. It also is a large panel of people for a study, so the chances a statistical error are reduced. What the study cannot tell us is what kind of treatment for anemia could "prevent" dementia. If you are a caregiver to an older loved one, what is the lesson to be learned from this research. At the very least it seems that caregivers should be watchful of their older loved ones' diet as a relatively easy way to rule out at least one potential cause of dementia. I have written about other steps that can be taken in other postings. Exercise and keeping mentally active are among those other steps that people of all ages can engage in to stave off mental deficits like dementia. 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.
If you will be heading home for any of these seasonal holidays you will find that it can be a wonderful trip back in time as you revisit your own family history in the context of your mom’s or dad’s house. But when you visit, take a closer look at how safe that house may still be for your older parent living there. Some parts of the home interior landscape may be just like you remember them, but they may now pose hazards to your older parents.

    Start with electrical fixtures. Check for where the cords to lamps or telephones and other household appliances are. If they are in the flow of traffic, consider arranging furniture differently. Also, remember that extension cords are really only meant for temporary use, so it is a good idea to move fixtures to be closer to outlets. If you must use an extension cord, place it against a wall to reduce the trip hazard. If there are electrical cords under furniture, check for wear on the insulation to avoid fire risks. Cords under carpeting or rugs also can wear to the point that the floor covering becomes a fire hazard. And, of course, frayed or cracked cords should be replaced. Finally, check to see that all outlets have secure cover plates so that no wires are exposed. Do the hands-on test as well to be certain no outlet is unusually warm to the touch, a sign of potential overloads and therefore a fire risk.

    The Consumer Product Safety Commission has estimated that thousands of people 65 years and older each year are treated in hospital emergency rooms for falls associated with rugs or floor runners. Older adults have less agility and some shuffle as they walk making the trip hazard even greater, so remove rugs that cannot be securely attached to the floor. It is easy to use double-sided adhesive tape to secure rugs or use rubber matting under the rug cut to size is an alternative.

    In addition to replacing batteries in smoke detectors, make sure there are enough detectors placed throughout the house. Especially if one of your older parents has any difficulties with hearing, you will want to have multiple detectors, and they typically come with instructions on where they optimally should be placed in the house. Adding a carbon monoxide detector also is important if there are any fuel-burning appliances in the home. Even homes with electric kitchen appliances may have gas-burning heating units or water heaters.

Because accidents can still happen despite all these preventive measures, make sure emergency numbers are close to every telephone in the house. Include the local Poison Control Center along with a trusted neighbor’s number and your own family ICE (in case of emergency) contact. Write these telephone numbers in large print and tape conspicuously near each land line. Check also that phones and contact numbers are accessible to your parent in the event that an accident leaves them unable to stand.

    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 Charlotte Bishop.
Over the years I have devoted a lot of space to talking about what a Geriatric Care Manager (GCM) does. And that is because we as a profession have a long way to go before people know what we do as clearly as they know what a doctor, lawyer or accountant do. In this post, I am going to give two examples of when to call a Geriatric Care Manager, because unfortunately we often get the call later than we could. The call comes after a family crisis instead of before a crisis when we could have been the professionals who help avoid the crisis. Here are two examples of when... The Big Fall. After age 65 approximately one in three older adults will take a fall, not just a stumble or a trip, but a fall where they hit the ground hard. Beyond the age of 80 the chances increase to fifty percent. As geriatric care managers, we certainly can be part of the team who helps your older loved one recover, rehabilitate and get safely back on their feet. Much of that process will be in the hand the medical providers who may repair the broken hip, arm or other bone. And the physical therapists will do a wonderful job of helping to rehabilitate your loved one back to full or nearly full recovery. What a GCM can help with is putting together the lifestyle recovery plan with the family. We assess not just the individual, but also the home in which they live. We help the family to get everything for the recovering loved one that they perhaps used to do for themselves. We also help to make home a safer place for getting about, eliminating further fall hazards and helping everyone to navigate the path to recovery. But, what if the family had called when they first noticed that their loved one's gait had eroded from a stride to a shuffle, and what if the GCM had received the call to come by your loved one's home and help make it safer for getting about and avoid the fall? Dementia. Older adults fear losing their mental capacity more than they fear dying itself. As geriatric care managers we can certainly be called upon to counsel the family in how to manage a crisis once your older loved one has actually wandered away from home and given everyone the big scare. We can give family members by coaching in how to deflect instead of confront a confused older loved one during conversation. And much more. But we can be more effective if we get the call before your loved one has walked aimlessly into the night. We can help the family to make your loved one's home safer against "breaking out" just as you would want security from burglars breaking in. There are also ways to sharpen mental acuity at the first signs of confusion through social engagement and other intellectually challenging therapies. Working toward social engagement in meaningful ways is a high priority. The list is longer than just these two crises to which GCMs respond. How is your older loved one's driving? How safe is home from fires? How safe is your older loved one from scam artists? Is your older loved one getting the best medical care and support for a chronic medical condition? and much more. I would be remiss if I did not also add where you can find a professional Geriatric Care Manager. There are a lot of people who offer services to "help older people," but many lack training or certification. The best place to find a GCM is at the professional association's web site. Click on the button that says: "Find a Care Manager" to locate a professional near 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@cr eativecaremanagement.com.