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

Another Side to the Story
It was just a year ago that Bruce Willis’ family disclosed that the actor would be retiring from acting...
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February 27, 2023
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Ain’t No Sunshine…
…When She’s Gone.” Or how about, “You are My Sunshine, My Only Sunshine?” or “Here Comes the Sun?” or...
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February 21, 2023
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How to Say ‘NO’ to Dementia
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he...
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February 14, 2023
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Long COVID’s Long List of Symptoms
The COVID pandemic is not yet done with us in the United States, and the story certainly is different...
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February 7, 2023
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Happiness is a Long-Term Investment
If I were to ask you to make a New Year’s Resolution for your own happiness, what would your...
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January 17, 2023
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To Sleep, Perchance to Dream
No, this isn’t a refresher course on Shakespeare and the famous Hamlet soliloquy. (Spoiler Alert – Hamlet was ranting...
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January 2, 2023
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A Viral Trifecta?
To get to the question in the email first, the Spanish flu of 1918 did not get its start...
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December 13, 2022
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One More BIG Addiction?
If you’re old enough to remember 1969, then you are old enough to remember this bold addition to the...
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December 6, 2022
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Would You Want to Know?
National Geographic has a new documentary series, Limitless with Chris Hemsworth, starring, of course, Chris Hemsworth of Disney’s Marvel...
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November 29, 2022
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Doing Your Homework on Medicare Coverage
If you or an older loved one are at that age in the magical transition – otherwise known as...
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November 8, 2022
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In the Caregiver's Words

Recent Client Praise

As a geriatric care manager, we have knowledge of Alzheimer’s Disease and its progression, less about its causes and its treatment, but we cannot know Alzheimer’s like a patient with the condition can. I recently was introduced to the writings of an “expert” who has gained his insights by being an Alzheimer’s patient since he was first diagnosed with dementia which has been presumed to be Alzheimer’s at age 58. Now 65 years old, Richard Taylor, Ph.D., a psychologist, has written a book titled Alzheimer’s from the Inside Out, and he issues a monthly newsletter on the subject. The following is an excerpt from his most recent newsletter. For those who are caregivers or family members of a patient with Alzheimer’s, this may offer some sense of living with the condition from the patient’s point of view:

“I am Richard, an individual living with the symptoms of dementia, probably (maybe) of the Alzheimer's type. This is my monthly newsletter for February, the month of my birth (Chicago, Illinois/Jackson Park Hospital 4:30 PM), at least that is what my Mom told me. This really isn't a newsletter; it's more like a report of what's happened to me in the past 30 or so days. It is sort of like my book, Alzheimer's From the Inside Out, except this newsletter is free and without charge (at least for now). It will soon be published in five languages - the newsletter that is. Through it, I have made and maintained friends with kindred spirits all over the world.

We all share more than a failing memory and slipping cognitive skills. We all want to know as much about what we "have" as possible. We all want to understand the research that is going on. We all to a greater or less degree are hoping for a cure - whatever the hell that means to each of us- within our lifetime, affordable to our families, with side effects that are significantly less than the symptoms of dementia with which we now live, and oh, by the way, could it reverse at least some of the more intrusive symptoms of this or that form of dementia.

I have spent a lot of time this month thinking and writing about this. I am not a researcher; I am not a physician or a pharmacist. I am just, Richard, a tall guy with a beard who is living with the more and more intrusive and more insoluble symptoms of dementia with which I have to cope if I want to live a purpose full, joy filled, love filled, and complete life. Most times this is much harder than I want it to be. It's not fair, it's not right, it just is. So I most times try to cheerfully embrace today, live in it as fully as I can by myself, and live in it more fully as a result of the enabling support of my family and those who love/like me.

Welcome to my inner and outer world more and more defined by dementia, probably (maybe) of the Alzheimer's type.”

Richard

Please check out Dr. Taylor’s newsletter and more about his book on his web site Richard Taylor PhD

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.

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I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights, this time about diabetes and some late-breaking news. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM.
More than 11 percent or, or nearly 27 million, Americans have either diagnosed or undiagnosed diabetes according to the most recent data. We include the "undiagnosed" in this figure, because anyone who has a consistently high A1C level (the measure of long term blood glucose) is creating an opportunity for other medical problems. For anyone who is a caregiver to an older loved one, this "diabetes epidemic" should be all the more alarming, because the prevalence of diabetes and what is termed "prediabetes" more than doubles to nearly 27 percent of those 65 years of age or older. The reason for the title of this posting is that diabetes is one of those medical conditions that seems to almost invariably be part of multiple diagnoses or medical conditions. So if your older loved one has been diagnosed with either diabetes or prediabetes, you need to help them to manage diabetes as well as the other companion conditions. For instance:
1. Diabetes is associated with higher levels of chronic fatigue. A recent study in the Netherlands found that these two conditions seem to go hand in hand, but they could not conclude that high blood glucose "causes" fatigue. It is just more likely to be there if a person runs "high" on a consistent basis.
2. Chronic kidney disease (CKD), a condition in which the kidneys progressively lose their ability to filter body fluids, is twice as common in people already diagnosed with diabetes. Scientists suggest it is the glucose that binds to red blood cells in the blood stream that block and break down the micro-vascular tissue of the kidneys leading to CKD.
3. High blood pressure and diabetes also tend to go hand in hand. For the same reasons that the kidneys suffer from high blood glucose levels, all the other circulatory system is adversely affected. And the negative synergy of poor circulation along with further hindrance to circulation create the potential for a real cascading of medical complications.
4. Retinal eye compromise and its ties to diabetes complete the circulatory issues caused by consistently high blood sugar levels. By blocking the tiny vessels that nourish the retina of the eye, diabetes effectively starves the eye causing a loss of vision or diabetic retinopathy.
5. People with diabetes have a higher risk of depression than those without. There is some speculation on how this happens,. but most professional agree that depression does not cause depression. A fair number, however, state that the feeling of the unfairness of the disease or the loss in control over their diabetes and the associated anxiety cascade into depression.
Please let Steve know if you have any questions about diabetes, drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com.
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 who need geriatric care management services in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
“[Charlotte has] been down this road before and will know just the right questions to ask.”
A satisfied client
Barbara Bush, wife and mother to presidents, has taught us another lesson this past week, and it is about how she chose to die. She taught us that palliative care and hospice care are different concepts, but she also taught us about the importance of an end of life plan. Let me start with the first. Let me clarify that hospice care is reserved for patients who will face an end to treatment and wish to be comfortable. Palliative care is simply the “comfort care” we saw requested for Ms. Bush, but it can be for any patient about to embark on a difficult or painful treatment regimen. We deal with a lot of families of older loved ones who are faced with difficult diagnoses. If the diagnosis has a treatment option that may prove difficult or painful, doctors may suggest palliative care. And that is when some family members may freak out just a bit… not an exaggeration. Yes, they may freak out because there is an association between palliative care and end of life, or hospice care. So what we saw for the former first lady was a care plan that included anything she needed to simply die comfortably, hospice care, but they did refer to it as comfort care. Ms. Bush was able to make her own decision at the point when a choice needed to be made, but so many people will not get that chance. This is also why it is important for families to have a discussion about the “what if scenarios” that families may face. What if there is no hope for recovery? What if the patient will not regain consciousness to make a decision about how to cope with a potentially painful end of life? As an Aging Life Care professional, we talk about the importance of a care plan. A key element of a comprehensive care plan will be what to do if. ….If mom cannot make the choice for ending treatment…If dad’s dementia precludes dad’s own decision for comfort care. We were told in Ms. Bush’s eulogies that she ended life pretty much on her terms. I would encourage us all in this country to make plans with family members that will assure the same level of comfort…that we should all end life on our own terms. If you have not already, it may be time to speak with your older loved one about what “their terms” are. You and they will be very gratified that you were sufficiently bold to start the conversation. 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.
As a geriatric care consultant, I field a lot of questions from people concerned about memory issues in an older loved one. Alzheimer's Disease is a condition currently affecting over 5 million people in America, and it is estimated that one in three seniors will die with either Alzheimer's or one of the other forms of dementia. It is the sixth leading cause of death in the U.S. Now comes the cost part. The Alzheimer's Association estimates that the disease will run up a $213 billion dollar bill this year, and that figure will climb to $1.2 trillion by the year 2050. So who is going to foot the bill for this frightening condition? Even among those over 65 years of age, Medicare does not come close to covering the entire bill for Alzheimer's care. The best estimates are that about 60% of the costs associated with the care of an Alzheimer's patient will be paid by the patient of family of the patient. And the total annual cost for the typical Alzheimer's patient will come to about $57,000 each year. Here are some costs that you need to watch:
- - Make sure you understand what status your loved one is being hospitalized. They may be staying overnight, but it may be labeled "observation" instead of inpatient.
Don't pull out your hair; there is help. You can call 1-800-MEDICARE or you can go on-line for answers. You will find answers at Medicare.gov. There also is a group called the Medicare Rights Center. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric care consultants, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.