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

No Vaccine for the Other Plague
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine,...
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February 16, 2021
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What Tony Bennett Can Teach Us
Tony Bennet has arguably been one of those “one in a million” kind of musical talents, but sadly he...
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February 9, 2021
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Scamming as a Superspreader
We have all seen the advertisements for the on-line services that will help you find your ancestry by taking...
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February 2, 2021
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Until the Vaccine?
We have all been following the news on vaccine rollouts, and frankly you may have been as disappointed as...
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January 26, 2021
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Better than a Resolution
After nearly a year of a pandemic and its quarantine, we are all ready to get back to normal. ...
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January 12, 2021
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None of the Above…
While everyone is awaiting the next vaccine to prevent COVID-19 or help in the treatment of the condition among...
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September 29, 2020
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COVID’s Other Deadly Toll
During this pandemic, over 13,000 more Alzheimer’s and other dementia patients have died than expected from these cognitive disorders,...
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September 22, 2020
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That’s Not A Senior Moment
We all hear the phrase used as an excuse for a bit of memory lapse … that it’s just...
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September 1, 2020
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Heard or Herd?
I am really, truly, seriously, absolutely in need of good news – heard news and herd news. Today, I...
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August 18, 2020
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Hold Your Friends Close and Stangers Closer
Miss your friends, your older loved ones and those summer get togethers in the backyard? We can get together...
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August 11, 2020
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In the Caregiver's Words

Recent Client Praise

Earlier this month I had a chance to talk about some of the questions I most often get asked as a geriatric care manager. In Chicago, there is a radio talk show on Chicago senior care and other topics that are relevant to elders. It is called – appropriately – AgingInfoRadio, and the program airs every Thursday. You can actually listen to our give and take by going to the archives of this program at AgingInfoRadio

Some of the questions we discussed in that 25-minute conversation included:
- What should I look for in a geriatric care manager?
- Is there a central directory to help find a geriatric care manager?
- How would you sum up what a geriatric care manager does that people cannot already do for themselves?
- When is home no longer the best place for an aging family member/loved one?
- What elder resources are available to help an older adult in their home?
- What can be done to make home “secure” for an older adult?
- What services can be brought home to maximize independence?
- How do I guard against an accident at my parent’s home?
- What are the best alternatives to home?
- What is the difference between independent living and a nursing home?
- What is a Continuum of Care Facility?
- What questions should a family member ask to get the right facility for a loved one?
If you would like to hear the answers I shared on the air, please check out the conversation I had with the host Sue Zawacki at Radio Talk with Charlotte Bishop

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.

Copyright ©2011
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
The holidays have gone by in a great rush, but you may have noticed someone in your orbit who seems a bit down during these past days and beyond. We have all heard somebody comment that New Year's or Chanukah or Christmas are hard because that is when a mother or a father or other loved one died. And it becomes a poignantly sad moment when that date on the calendar rolls around each year.

It has been my experience that it does not even have to be a specific date that can bring a spouse who has lost their partner or a caregiver who has lost the individual for whom they cared down. It is the memory of holidays with that person who is no longer here to share in festivities. This makes the time of year particularly hard. And if it is the first Christmas or the first New Year's or any other "first," it can be all the more difficult.

Not everyone will be willing to share the sources of their holiday sadness with others, but you can be alert to some of the common signs:

1.    Sadness that just seems to settle in. Everyone has the occasional bad day. This sadness will be over an extended time, and you may notice the deep sighs as your loved one tries to break the hold that the reminder of loss can inflict.

2.    Fatigue that sleep does not cure. You may notice that your loved one who is mourning a loss may fall asleep easily, retire earlier or rise later than usual; yet they never seem to be refreshed.

3.    Preoccupation when engaged in conversation. You might need to repeat yourself. You may notice that faraway look – as if they are lost in thought. They are.

4.    Forgetfulness or absent-mindedness. Again, it may be distraction about items on their list of things to do that fade into the background, because they are caught up in the sadness of their memories.

            The single best thing a friend can do for these seasonal lapses is to empathize. You don't need to be their analyst, but you can validate their feelings of sadness. You can also ask about what in particular makes the holiday sad for them. It can be helpful to ask about any special, positive memories or experiences they can recount of their lost loved one. Recalling the positive is not intended to convey that they ought not be sad as much as to give the person an opportunity to balance the context within which they remember their loved one.

            Even good memories may not be enough to offset the blues. If you find that this melancholy lingers well beyond the holidays that now are past, encourage your friend or loved one to seek some help. Their primary care physician may be a starting point or even a clergy member if they belong to an organized religion. Crying can sometimes get one's sadness out and talking can do the same. It helps to lift the weight that some carry through the holidays.

      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.
In our book, How Do I Know You?: A Caregiver’s Lifesaver for Dealing with Dementia, we say: Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed. Stop the presses. New research suggests that there may be ways to slow the onset of the disease, if not prevent it. Let me repeat that. Some early results from a cognitive training regimen show that it may be possible to delay or slow the onset of Alzheimer’s disease. It may even be preventive, but that will take a very long term waiting game to see if the delays that are evident in the clinical studies can be sustainable. The results from this research show that a computerized cognitive training program in which patients were enrolled was able to reduce the risk for onset of dementia by 29% at ten years! In scientific jargon, that’s not nothing! Here is the other great part: those subjects who engaged in the most training got the most benefit. Does that sound like what we see in professional athletes …or professional anything? Those who put the most work into the program get the most out of it. Please let me tell you the rest of the story…Existing research has demonstrated that mental training that focused on retaining memory or processing did not reduce any risk for dementia. This present research was a study in Toronto among nearly 2,800 older adults whose average age was 73.6 years and who were living at home. They were assigned to three groups with three types of cognitive training: • memory, • reasoning and • processing speed. It was the processing speed groups which showed the results. Compared with a control group, those who went through this training had a 29% lower risk of developing Alzheimer’s. The memory training and reasoning groups were not different from their respective control groups after 10 years. All of this held true even after the investigators adjusted for any differences in other conditions or characteristics like gender, diabetes, depression or cardio-vascular health. Researchers are not sure why processing speed works this way, but it may be that working on processing speed builds up mental reserve. Maybe it’s like interval training for athletes. Mastering speed…bursts of work…grows their overall capacity. When the dementia erodes some of their cognitive capacity, they simply have more capacity on which they can draw. Clearly, a couple next steps will include following these people longer…but also trying to tap into what really is happening in the brains. That said, it stands to reason that if you can work on your “processing speed,” you will retain more ability over the long run. Get processing! 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.
Caregivers tend to be very dedicated to caring for others, typically an older parent or disabled member of the family, but they often do not do so well in caring for themselves. It is not that caregivers do not need at least a bit of help themselves, but it can be a very conflicted issue for a caregiver to ask for help. It may stir up guilt about not caring for mom or dad or inadequacy at not being able to do it all. And it is not that caregivers are alone. They have other siblings, they have friends or neighbors, and they also have respite care available to help. Respite care is not just one type of service, it is a whole continuum of in home care services as well as out-of-home services available in most communities. For at home care, respite care can provide a needed break for the caregiver who needs to also work a day job, run their own personal or household errands or simply have some time to recharge. Family, friends or other volunteers can be crucial in giving this time to the caregiver as well as providing stimulation, conversation or some fresh energy to care for the receiver of care. Personal care or skilled care providers also can assist with the "heavy lifting" like activities of daily living (ADLs) such as bathing, dressing, toileting and more. Area residential care facilities can provide an even wider range of support where caregivers can drop mom or dad for short breaks, overnight care, or short intervals to cover vacation time. For more comprehensive needs of those who need help with ADLs, there are facilities in most communities for adult day care that may be a full 9 to 5 or 7 to 7 to help with caregivers who also have work responsibilities. If you are looking to recruit an individual who will be coming to assist in senior care for mom or dad in the home, be sure to ask for references. Also be clear about services you expect, make certain of compensation (and no prepayments), and even consider a background check so that everyone has peace of mind. If you are going though an agency, go through the same process as well as ask about bonding and other assurances you and your loved one will be secure. If you will be looking to a facility with its own personnel, you should ask about:
And you may ask to spend an afternoon or a day at the facility to observe how well they deliver on their promises. Don't be afraid to ask questions of caregivers in order to really assess if the people in place are engaged in the service they provide. People who like what they do will do a better job than those who just have a job. 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. Read more about Our Story and Charlotte's mission.