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

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

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.
If dementia were a foot race Alzheimer’s would be number one, but the first place finisher of this race might not even be able to see the runner-up on the track to the rear. The Alzheimer’s Association estimates that there are about 5.8 million Americans of all ages currently living with the second place condition. Lewy Body dementia, considered to be number two in prevalence in America, totals only 1.3 million people, to date, but researchers at the Mayo Clinic suggest that this number may be a profound underestimate because of the nature of the disease. The “Lewy Bodies” which are the hallmark of the disease of the same name accumulate in the neurons of the brain and affect both cognition and movement. As a result, it often is misdiagnosed as Parkinson’s disease. And the cognitive part of the decline often confuses it with Alzheimer’s disease or even vascular dementia. To make it more confusing, Parkinson’s disease has its own dementia manifestation. So, what does one look for that can be a clue that a loved one may have the onset of Lewy Body Dementia? First, this is a diagnosis for a neuro-psychologist, not a family member, but be aware of changes like the following so that your loved one who may have the second place dementia can get the best help as early as possible:
1. Hallucinations may be one of the early signs, and note that hallucinations can be more than just visual…like hearing what is not there or even smelling what is not present.
2. Movement issues that can be like Parkinson’s like rigid muscles or tremors, shuffled walking, etc.
3. Autonomic changes that can cause dizziness or falls and curiously digestive changes like constipation with no changes in diet.
4. Confusion and memory loss also come along with the package and account for some of the difficulty in distinguishing this condition from other dementias.
5. Difficulty with sleep such as intense dreams with associated physical movement or just plain drowsiness throughout the day.
6. Mood changes that show a clear downward trajectory like depression or apathy or even more aggressive behavior.
If you’re thinking that all of these symptoms look like other dementias or like Parkinson’s, then you can appreciate why Lewy Body Dementia can be misdiagnosed. So, it may be number two, but it may be a lot closer to the first place in this category than we know. 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.
I have really lost track of how many conversations and/or blog postings I have had about Caregiver Stress. As a certified geriatric care manager, we work with families, and a substantial part of my focus is upon the stress of a caregiver trying to both deal with a loved one's eroding health, but also the demands on them from the others who depend on them. I would like to devote a bit of space here to addressing the stress of the aging loved one and how a caregiver can help them to cope with what life throws their way. Retirement is a break from the stressors of a workaday world, to be sure. But as one lives to do what one wishes as a reward from a long career, there comes a time when new stressors emerge. There can be increasing physical challenges from a medical condition that is not going to get better. Many of these conditions like arthritis, cardiovascular or pulmonary issues just get worse with time. As a person becomes less and less able to do the things they used to do to take care of themselves, the stress mounts. Other very common stressors are those that come with needing an elder caregiver, a spouse or partner to help with every day tasks; it takes an increasing toll. With general changes in health status can come a profoundly diminished sense of well-being and just plain depression. So much for the Golden Years. As a caregiver, look for these warning signs of excessive stress in one or both of your older loved ones:
- signs of anxiety, undue worry or outright panic attacks
- irritability or angry outbursts
- sadness, melancholy or lethargy
- indecisiveness or difficulty focusing
- difficulty getting to sleep or staying asleep
- an array of aches, pains or other issues of nonspecific origin
- rashes, breathing problems or other "new" allergies
- drinking or eating too much or too little; or
- an increasing number of prescription or OTC medications on hand.
As a caregiver, you can help by helping your loved one to find a remedy for the stress. There is no absolute way to rid ourselves of all stress at any age, but the key is finding help to cope more effectively with the stress in our lives. For your older loved one, consider:
1. Gently and persistently encouraging your loved one to be more socially engaged with friends, clubs or outings in order to get a break from the stress cycle;
2. Help your loved one to find seek out talk therapy; it is not about getting another prescription nearly as much as "unloading" to a trained therapist;
3. Seeking a physical aid in the form of gentle massage therapy, exercise classes like yoga, relaxation therapy or just getting out for longer walks.
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@creativecasemanagement.com.
…which is to say that there is new research that shows exercise can help keep the brain healthy and able to produce and retain memory function! I have had a number of posts over the years on the importance of diet and exercise and their beneficial effect in helping to avoid medical issues or just in being healthy. This one is back to the healthy effects of physical activity in actually reducing the progression of Alzheimer’s disease. Recent research presented at the last meeting of the Alzheimer’s Association showed a direct link between regular exercise and an improvement in blood flow as well as reduction in the amyloid and tau levels in the brain that are the hallmarks of Alzheimer’s erosion of cognitive function. All of this works to not only stave off the debilitating cognitive impact of Alzheimer’s disease, but other forms of vascular dementia as well. Every 67 seconds in America, another person is diagnosed with Alzheimer’s disease, so how can exercise help in warding off this condition? Research reported by scientists in Perth, Australia, followed individuals and their “brain amyloid load,” a measure which increases with the progression of Alzheimer’s disease. They grouped these patients into two types based upon level of exercise. The exercise group was comprised of those who exercised 150 minutes or more a week, and the low exercise group was those individuals who reported fewer minutes of exercise weekly. Overall, there no differences in amyloid between the two groups, but when researchers looked specifically to those who had the genetic potential for Alzheimer’s, they found that those with this genetic marker in the low exercise group were significantly higher in their levels of brain amyloid. As they more closely examined both exercise groups across those with and those without the markers, it appeared that those who exercised more were able to slow the accumulation of amyloid despite having the genetic predisposition. All of this is preliminary information, and it is yet to be seen if exercise can really delay the ultimate onset of Alzheimer’s among people who have the genes that predispose them to the condition…or for how long and by how much. It also is yet to be determined what kind of exercise may be most beneficial, but it appears that cardiovascular exercise may show the most promise. One physician at the conference also adds that so far there are no side effects from exercise which is a lot more than can be said of most FDA-approved medications for cognitive impairment. That this kind of rigorous exercise also manages blood sugar levels is an additional benefit, but the lower blood sugar levels may also be reducing another risk factor for reduced cognitive ability – reducing risk for type 2 diabetes. There is more “lifestyle” research in motion, so please stay tuned…more to come. These early results show real promise. 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.