Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • senior healthChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 2

When That Doesn’t Stink…
There are a lot of tests and exams we all know that are important to catching a condition early...
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April 12, 2022
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Respect and Inclusion
I was very pleased this past weekend that my son and his wife invited my husband and me along...
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April 5, 2022
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Consult Your Lifestyle Physician
You, or your older loved one, have a consistent pain in your hip, and you finally get a referral...
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March 29, 2022
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Gaining More than Birthdays
We’ve all heard someone explain…typically referring to that paunch around our middle…that their “metabolism has slowed” from what it...
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March 22, 2022
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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...
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March 1, 2022
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It All Begins with a Mouse
I don’t know how many of us would like to live full-time in Disney World, but most of us...
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February 22, 2022
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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...
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February 1, 2022
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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...
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January 25, 2022
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It’s Not a Resolution – It’s Self-Care
A caregiver to an older loved one or other person with special needs takes care of everything, right? A...
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January 13, 2022
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Not Where You’d Expect Protection from Dementia
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there...
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December 28, 2021
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In the Caregiver's Words

Recent Client Praise

Everybody eventually learns to accommodate the “empty nest” that inevitably follows the busy days of child-rearing and child-launching. And then – maybe after a rather substantial wait – there is, once again, the prospect of more little ones in the house. This time, however, they are grandchildren, and as much as everyone who raises kids knows how not to drop a baby, the world has changed. It translates into a new kind of child-proofing different from a generation ago. This is advice for seniors who may be hosts to little ones for the first time in a lot of years.

1.    First, it is important to start with an open mind. It is too easy to slip into a mindset of “what was good enough for my kids,” but times have changed and so has safety. So, some of the old toys may still be considered safe, but the old car seat, play pen or infant swing may not be just outdated; they may be dangerous. Defer to the new mom and dad for advice on what will still work and what needs to be replaced by the next new thing. This approach is also politically helpful in empowering the new mom and dad.

2.    Remember also that when you raised your own children, you may not have had any of the chronic conditions you now have. And you also would not have the medications associated with those conditions, so develop a plan to store medications safely and out of reach of kids. While you may not want the nuisance of those safety bottles, you really need to be certain that medications that will be attractive nuisances to little ones on the prowl are locked up. This is especially true if one of the older grandparents uses the “day of the week” pill reminders that often are stored in the kitchen as a reminder for prescription schedules.

3.    For an add layer of safety, go to the source. The Consumer Product Safety Commission has a twelve-step approach to fully kid-proofing your home, and a number of their recommendations like smoke alarms and carbon monoxide detectors which are great safety measures for everyone. They have a downloadable two page brochure to walk you through the steps (click here for brochure).

4.    This last one is making the grandparents house safe from what the toddlers or young children will bring with them. Falls among seniors are often caused by the unexpected, and there is nothing so unexpected as the little dolls, cars or a myriad of other items that you will buy for the kids or that they will bring with them. Make it a habit of picking up after play time, because you may not see the little hazard on the floor…especially after sunset.

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.
"It has been forever! You look so different!" Joyful cries of greeting such as these are so common at the holidays that we don't notice them. However, if someone has changed but we don't feel comfortable mentioning it, that's a very important change. Modern families see each other less and less. Work and/or geography get in the way, and the most face-time many of us get with our extended families is at the holidays. We all want to keep an eye out for the ones we love, and the line between wanting to honor the autonomy of adults and wanting to prevent problems is difficult to walk. However:
Did you notice anything like this over your holiday visit?
1. Are there bruises? Signs of a fall? Noticeable loss of weight?
2. Are they wearing messy, baggy clothes? Poor hygiene? Smell of urine anywhere?
3. Is the refrigerator full of spoiled or moldy food?
4. Do they have trouble finding words used regularly in conversation?
5. Are they moodier than you remember them? Not interested in their hobbies anymore?
If you did, you're not being nosy. These are real signs of decline, and you need to address them with your loved one with respect and care. They could be fixed as easily as adjusting medication, but they could also be real indicators that it's time to sit down and have a serious talk. It's never easy, but change rarely is. The good news, is that we've done all this before, and we're here to help if you want to talk. If you just found out that this is your life, and you suddenly need answers, I can help with a consultation. If you don't know what to do, just call. We'll figure it out together.
According to the Centers for Disease Control (CDC) adverse drug reactions or overmedication result in more than 700,000 hospitalizations a year. And many of these could be avoided by following advice offered by the American Geriatrics Society. The AGS’s Foundation for Health in Aging offers advice for all of us who care for older parents or adults in our orbits. Here is a summary of the six major recommendations.
1. Ask before taking OTC drugs: Never assume that just because you can buy a medication in a drug store without a prescription that it will be harmless. Most of these drugs started out as prescription meds. Ask the doctor or pharmacist if an OTC drug is a risk by itself or in combination with a prescription your elder may already be taking.
2. Make/update your List: A lot of medical offices are very good about asking patients on every visit what medications they are taking and keeping it in their records. With every visit the provider needs to add new medications so that everyone is aware of what your elder is taking.
3. Question your provider: When you or your elder receive a new prescription ask questions about when to take the drug, with or without food, what to do if a dose is missed, is it available in generic form and what are the common side effects?
4. Read the labels and follow them: There is a fine print insert of patient instructions that comes with every prescription. Don’t be intimidated by the scientific jargon; look for the indications and usage section as well as the adverse events sections. And then take them as directed – don’t add a dose for better effect or stop just because you feel better.
5. Report any ill effects: There is a saying in geriatric circles that every symptom in an older adult should be considered a side effect of a drug until proven otherwise. Especially if there is sudden difficulty breathing or swallowing, light-headedness or irregular heart beat. If you cannot reach your loved one’s provider call 911.
6. Review your medications with your provider: At least once a year you should talk with your elder’s provider about the medications, the doses and any changes you may have noticed. And do not leave out vitamins, supplements or herbals.
For more information go to the American Geriatrics Society web site as well as refer to a list of drugs that have known side effects or other issues. This is called the Beers List .

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
We see the numbers on a daily basis. How many have died from COVID, to date, we all probably know is more than 372,000 in the United States alone. The number who have had the disease and survived is a bit more murky, because not all cases are detected or reported. We know how many have been vaccinated: about 40% of eligible Americans have had at least one dose so far and about one in four Americans have received both doses. We all have been making the push to that finish line to be rewarded with a 94% immunity from COVID. The number that has not been broadcast as much, if at all, is the number of people who have lost a loved one to COVID…not just known of someone as almost all of us do. The number of people who have lost a dear family member or friend is estimated to be about nine individuals for every person who has succumbed to COVID. Do the math for our own domestic turf, and that is well over 3 million Americans who have been … and likely continue to be … grieving for a loved one who has died. Some people may say that these losses … well … just happen, and people eventually get over it or through it. Hold that thought, because scientists have studied the biological effects of grief and found that grieving is actually life-threatening. Sure, we probably all realize that grief can lead to depression which is not to be taken at all lightly. But it also leads to changes in the immune system and it triggers inflammation in the entire body. Chronic inflammation in the body also can lead to cardiovascular disease, diabetes (type 2) and even some forms of cancer. We don’t see this from the outside, but it is analogous to instantly becoming morbidly obese; grieving is the same kind of ticking time bomb. So, what can we do if we have had this kind of loss or know someone who has lost a loved one? A grieving person will not move beyond that sense of loss, but they will – often with professional help – move forward able to retain a loving memory that walks alongside the loss. So, people don’t get over grief nearly so much as learn to move forward with it. Lora McInerny is the host of a really helpful web site whose name speaks volumes. It is titled, “Terrible. Thanks for Asking.” She had been through a deep personal loss, and had just a few too many people ask the wrong question, “How are you doing?” Some even chimed in with the cliché, “These things happen for a reason.” A better question can be “What did you do today…or yesterday?” or “What have you been doing?” You get the picture. If you have not experienced a loss, there is a good chance that you know someone who has. I recommend you visit the web site. Make someone’s day better. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, 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. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
COVID 19 was not in my calendar for 2020, and I strongly suspect it was not in yours either. I often have said that family life crises don’t make appointments; they just show up. And I am usually talking about how to be prepared for the inevitable call from or about an older loved one in your orbit…AND how to be prepared for your and their next steps. Well, this time, preparing for a crisis could be closer to home, because all of us need to be prepared so that the people who may get the call that we have taken ill can be prepared. What do you need to do to make a Plan? When I have spoken in the past, some people back off from talking about a loved one in a crisis. This list is about you, so please forgive me for getting “personal.” Here is my “short list” of the documents you need to have and make them available to your partner, your kids or other close friend … sometimes with no notice:
- Medical Release – the document you need so your medical providers to speak with your loved one’s about your health status, medications and prognosis.
- Power of Attorney (POA) for Finance - a legally binding document that gives a person (referred to as the “agent” or “attorney in fact” permission or power to act on your behalf in matters of property or finance.
- Power of Attorney (POA) for Healthcare - a legally binding document that gives a person power to act on your behalf in matters of medical treatment. The “power” typically is in force when it is deemed the person in question can no longer act for themselves or if they are not conscious.
- Practitioner Orders for Life-Sustaining Treatment (POLST) – a document (varies state by state) that specifies in advance what measures you wish to have in the event you cannot expressly grant permission yourself. These orders typically revolve around life-saving measures; they are sometimes referred to as advanced directives and are placed in your medical files. The forms are downloadable at your state’s web site.
- Health and Life Insurance Policies – the health policy will help everyone involved understand what is covered and which physicians and other providers are available to you. The Life insurance policy should be in a safe place so that it can be readily accessed should that become necessary.
- Estate Plan – is (potentially) a wide-ranging document that let’s everyone know how any real estate or other holdings are titled and what the “plan” is for when your will is executed.
- Trust documents – help to identify how your estate is to be transmitted to beneficiaries. Trust names need to be consistent with life insurance, will and holdings in order to be in effect.
- Last Will and Testament – the legal document by which you express your wishes of how property is to be distributed at death, and names one or more persons, the executor, to manage your estate until its final distribution.
- The Grab and Go – This is a list that typically is sealed in a plastic bag. It includes your medical insurance documentation, a list of allergies, a list of medications, primary care physician contact details and in case of emergency (ICE) contact information.
Please email (info@creativecaremanagement.com) me with any questions on any of these…as well as how to take the next steps which is your plan. Do yourself a favor…don’t wait. 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.
The processed food consumption that has been linked to our global epidemic of obesity is also tied to the rising rates of Alzheimer's Disease world-wide. I don't mean to sound the alarm about sugar, but I came across an article recently that tied together a number of facts and trends that we all may have seen. And we all should be very alarmed! As a geriatric care manager, I often work with older adults who have developed medical conditions that reflect a lifetime of poor health and nutrition habits. We see the elevated blood pressure and the obesity that can arise from sedentary lifestyles and poor diet. One of the more common developments we see is the onset of type-2 diabetes resulting from a lifetime of too many sweets that have resulted in what doctors call "insulin resistance," the pancreas' inability to keep producing enough insulin to process the large doses of sugar it confronts. What you may not know is that the brain also produces insulin, and that when faced with a prolonged assault from more sugar than it can process, its ability to produce insulin may falter and then fail. The result is "type-3 diabetes." The research has been piling up. For instance, people who suffer from type-2 diabetes (type-1 is the form that people are either born with or develop as an immune response) have deposits of amyloid-beta in their pancreas. Sound familiar? Yes, amyloid beta deposits in the brain are the signature marker for Alzheimer's Disease. And this also begins to explain why type-2 diabetics are estimated to be anywhere from 50 percent to 100 percent as likely to also develop insulin-resistant Alzheimer's Disease. Now, it is important to point out that type-2 diabetes does not cause Alzheimer's Disease, but type-3 diabetes is caused by the same over-consumption of sweets that causes type-2 diabetes. This may begin to also explain why the rates of the two conditions both have tripled in the United States in the past forty years. This, along with a lot of other inflammatory conditions related to the heart and the circulatory system. You may have thought that the extra care required for the estimated 5.4 million obese Americans with type-2 diabetes was costing us a lot - $150 billion annually? It is estimated that care for that many Alzheimer's patients is even higher at about $200 billion, the reason being in part because the close supervision for the safety of a cognitively-impaired patient is so much higher than for an obese individual. This is probably one of the situations where I don't have to connect the dots for any of you who are caregivers to an older adult...or attending even to your own well-being. My advice can best be summed up with two words: diet, exercise. Ironically, these are considered first line treatment for people who are obese or who have begun showing the signs of type-2 diabetes. Of all the advice I have digitally-shared these many years, this may be the best for a whole host of reasons. Please pass it on. 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.