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

What You Can and Cannot Change About Dementia
Let me start with the short answer to a question we raised in the email announcement of today’s post. ...
Read more
June 21, 2022
0
0
Age and “Long Covid”
There seems to be a cliché for everything, so we’ll start with this go-to for COVID: “We’re not out...
Read more
June 7, 2022
0
0
When Being in Demand Isn’t Healthy
If you’re a musician, you want to be busy, because gigs represent a better living. If you’re an actor...
Read more
May 17, 2022
0
0
HDL Graduates from “Good” to Better
You may have had the conversation with your physician about your cholesterol levels during your annual physical; there are...
Read more
April 26, 2022
0
0
Heavy Drinking Helps?
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: ...
Read more
April 19, 2022
0
0
When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
Read more
April 12, 2022
0
0
Consult Your Lifestyle Physician
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral...
Read more
March 29, 2022
0
0
Dementia from a Pet’s Point of View
Fetch! Come! Sit! Stay! Remember! So, I’ve given away that I’m a dog owner rather than a cat or...
Read more
March 1, 2022
0
0
The “Other” Health Concerns for Older Adults
It was just two weeks ago that I underscored the fact that “older adults have a greater fear of...
Read more
February 1, 2022
0
0
The Fear is Mutual: What Caregivers to Alzheimer’s Patients Need to Know
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any...
Read more
January 25, 2022
0
0

In the Caregiver's Words

Recent Client Praise

Illinois long term care has been ranked at about number 24 out of the 50 United States on a number of dimensions by AARP, The Commonwealth Fund and The Scan Foundation. So, does that mean that Illinois’ long term care glass is half full or half empty? Let me share my perspective as a geriatric care manager on some of the details of this national study so that you can be the judge not just about the national study, but also about facilities you may be investigating for an elder or other special needs individual in your orbit.

The report is enlightening in how it rates and ranks what it refers to as long-term services and supports (LTSS) on four important dimensions. And this is the first of its kind multi-dimensional scorecard on state-level performance. When I mentioned that Illinois ranks number 24, that is an average across all four dimensions. In reality, the state ranks:
1. Number 12 in affordability and access which they calculate based on a numberof indicators such as the private pay cost of nursing home or home health care, other measures of insurance coverage and just how easy it is for those who need LTSS to receive them ;
2. Number 33 in choice of setting and provider which is based upon the diversity and number of provider options available for both public and private pay individuals with needs;
3. Number 24 in quality of life and quality of care which recognizes that it is not just the quality of care, but also how individuals who need LTSS can still preserve their safety, freedom from abuse and human dignity; and
4. Number 27 in support for family caregivers which recognizes that there has been a decline in recent decades in non-family care and services such as respite care that help preserve quality of life for the caregiver as well as the elder or special needs individual.
With our own state ranking about the middle of the pack, the scorecard tells us that there is tremendous variability in the quality of care available to elders and others with special needs in Illinois. It is also important to appreciate that when the need arises for long term care, it usually is following an accident or sudden event like a stroke, a fall with hip fracture, etc. So, when you are looking for a facility or home service for someone in your orbit, remember the key dimensions in this report as guidelines. Check out the full report to get a better sense of the details of how they measure these attributes at Raising Expectations. If you are looking to evaluate nursing homes in Illinois, you also will find a great web resource that will help you facility by facility in Illinois.

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.
I get asked a lot of times what we do as geriatric care managers, and you can go to our national association's web site (caremanger.org) for their answer. But since we most often get called in to address a life crisis or other life-changing event in the life of an older loved one, I thought it would be helpful to offer what it looks like in action to be a geriatric care manager (a GCM) when the call comes in. As a GCM, what we do best is assess a situation, make a plan and then assist in executing the plan. Most of the caregiver calls we get, however, leave very little time to assess and plan, because it is a family emergency when our phone rings. Mom or dad has fallen with a resulting hip fracture or mom or dad has had a stroke or a heart attack or some other medical emergency. A geriatric care manager is not the first responder, but we are the second responders who help the older loved one's support system find their options and recover some sense of normalcy. Sometimes it becomes a new normal, because life has changed for everyone. Caregivers may not realize how "normal" has changed so instantly at first, because the hospital providers have done a remarkable job of stabilizing the patient and averting a life-ending disaster. And even the course of the hospital trajectory seems normalizing. A discharge planner comes to the older loved one's room and explains how home health will be prescribed or how physical therapy will be ordered and the road to recovery seems pretty clear. At this point, please do not mistake what I am saying for a criticism of hospital discharge planning, but look closely at what they call the process. They do not call it normalizing planning, they do not call it the new normal planning, they do not call it life planning; they call it discharge planning. Their major focus is on getting the patient safely out of the hospital and into the next level of care - it may be a rehab center in the case of a broken hip or a nursing home in other cases or home with a provider coming to them for their care. But who is looking to help create a plan for regaining and optimizing quality of life? Who is there to help make home a safe place for an older loved one with some new physical or health deficits that were not there before? I have just given the job description for a geriatric care manager. GCMs are the people who help make home safer...or if not home, then help to offer the options for a safe place for your older loved one. We are the people who help to find and coordinate the services or physical assists for a person whose life-changing event will not allow life to go back to what it once was. As I tell our clients, we are the option-makers for the decision-makers, and "quality of life" is our goal not just for the older loved one, but for all the caregivers as well. We also are the voice of the caregiver and the older loved one. We are the advocates who will speak up when a referral is not to the appropriate medical specialist or when something in the medical record does not make sense. One of my clients once observed that we "translate medical speak" for the family. And we even go one beyond that by asking questions not every lay person would think to ask. We also recognize what a tough path an older loved one's care trajectory can be for the caregiver. We are there to help care for the caregiver as much as for the older loved for whom they called us in the first place. 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.
In my last post, I gave you some tips on distance caregiving that arguably could be called the 30,000 foot perspective on distance caregiving. But even from afar caregiving is deeply personal and the caregiver needs to be as much a focus as the care receiver. You might call this my “do unto yourself as you do unto the other” post. I’ll start with the “other:”
1. Caregiving is a team sport – to be successful you have to be part of your care receiver’s team. Most health care providers, especially the residential ones, have what they call a “Care Team.” That could include a nurse, a physical therapist, a social worker, and a physician, and this last could include any number of specialists. You are part of the team, and you do not have to have power of attorney to be a team member…but you do need your care receiver’s written permission for the rest of the team to talk with you.
2. Successful teams bond with one another – you need to have a relationship with key members of the Care Team. And everyone needs to own their position on the team. Regular check-ins happen…well…regularly. Everyone keeps notes and lists of “to do” items. You also need to get into that habit.
Now, about you.
1. Take care of you - If you know anyone who is a therapist or social worker seeing clients in an office, they do not work all their hours in one-on-one therapy. They take time to process, and they take time to recover. In short, they take care of themselves. The lesson here is that self-care is very important to successful “other-care.” I recall an individual who confided in me that he had gone from six hours of uninterrupted sleep a night caring for his mother to six hours of interrupted sleep a night caring for mom. That is not good self-care.
2. Avoid burnout - When you have a call with your care receiver or members of the care team, set a time limit as you begin. Make notes following the calls, and these include assessing how you feel about what you have heard. Have the local care team take care of what happens locally…you cannot.
3. Set loving limits – I followed this advice when I was raising my children as well. You have to recharge your batteries. Some people workout, others write in a journal, some people go to the art museum, and some listen to their favorite music. Do what feeds your spirit so that your spirit will be there for both you and your care receiver.
In the end, everyone on the team wins. If you are a caregiver, it’s important to be part of a winning team. 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.
This marks the 100^th posting on our blog since its inception October, 2010, and it gave me pause to stop and reflect on what one learns at 100. So, whom better to ask than people who have had 100 birthdays, made it to that milestone and have been paying attention along the way. I have gathered together here a short compilation of wisdom from some centenarians whom I felt had something to offer the rest of us. You tell me what you think.

    Ruth offers advice on life and style. Appreciate that Ruth lifts weights everyday and practices Pilates weekly, an activity she just picked up when she was 92. Perhaps her most memorable piece of advice is about time and age; she says, “Don't look at the calendar just keep celebrating every day.” This, from a lady who does not wear blue jeans and makes herself get up and out every day for at least a short walk. (And she is a real believer in the values of skin moisturizer.)

    Ephraim is a doctor still in practice at age 100 His advice to all of us starts with choices. The two important choices that top his list include “choosing the right parents” and then “choosing the right spouse.” The doctor still has a sense of humor, and you will appreciate that if you go to his site to see the rest of his advice which include “keep breathing.”

    Jessie is the other side of 100 at 105. She commends that peace is the root of happiness. She does not count her time in years, but rather in minutes and the promise that each minute holds for her. She also stays active and only just recently gave up her favorite activity, swimming, at the age of 101.

    Patsy is a quiet man at age 100. His secret is to simply enjoy life. Part of that includes his weekly treat from the local pizzeria, one slice of thin crust sausage pizza. And when he is asked what he means by enjoy, he responds: “I like to be sociable with everybody.”

    Fauja finished the Toronto marathon last year. This stands as a Guinness record, and Mr. Singh was very excited to make the distance on behalf of local charities. Perhaps the secret to being able to run that far at age 100 is to not start, as Mr. Singh did, until you are 80 years old and also to surround yourself with friends as Fauja did for his run.

So, the common thread? Maybe the lesson we can take from centenarians is that it is not about a destination as much as it is about a journey. It is not about having lived to 100; it is about having lived each day along the way.

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 .
Last month, we talked about conversations with older loved ones about residential living choices. While might find this is a suitable option, others may be able to retrofit their houses for senior living in Chicago, to keep daily living familiar to their local location and make it more comfortable for their aging loved ones. It is only a matter of making certain adjustments in your home, though this task might not be as easy for some as it is for other. Below are some pointers on how you might be able to make your home a positive environment for your loved ones.

Fall-proof

Leg strength wanes as people get older. Because of this, even the most innocuous fixture or furniture, or the most routine activity in the home can cause a fall. Start fall-proofing your home by making sure that all the walkways inside your house are well-lighted, and the spaces in your rooms are cleared of clutter, to provide ample space to move around. Reroute wires, should you find them crossing walk paths, and remove unsecured decorative rugs. It’s important to fix worn carpeting on which one might trip.

Fall-proofing your home works both ways. Talk openly with the elders on ways they can avoid fall accidents. Ensure that they get their vision and hearing regularly checked, and help them keep their senses sharp so they cannot miss fall hazards. Encourage them to use canes and other aids if you feel that these will help them.

Sleeping Arrangements

It is most ideal to situate their room in the first floor of your house. This gives them easy access to the main parts the house such as the living and dining rooms, and the common bathroom. Not only will that save them from straining their legs walking up and down the stairs, but will also keep them safe from fall risks.

Emergency Kit

Aside from keeping your emergency kit stocked with bandages and medicine, make sure that you keep phone numbers handy in case of medical emergencies. Include your mobile number, the number of the local hospital and your loved ones’ physician, and the contact information of your neighbors. Leave these close to the telephone, on the refrigerator door, or other visible spots.

Hire Help

Hiring a caregiver in Chicago can help lighten the load. As a care manager, I’ll be able to help assess the home and provide a plan in order to make the environment safer. Enlisting help can ease your worries about getting professional care for your parents and loved ones while you’re away.

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.