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

Scammer v. 23.1
Call it Ocean’s 65+…instead of Ocean’s 8 or Ocean’s 11…but it doesn’t have a caste of Hollywood stars, and...
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March 7, 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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Saying “No” May be the Right Answer
Saying “yes” when someone asks you to do something can be like eating candy. It feels right or good...
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November 15, 2022
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Planning for the Holidays is More than a Menu
The latest news reports suggest only about 10 percent of American Adults have received their seasonal booster for COVID. ...
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October 24, 2022
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What’s Scarier than Halloween?
The short answer to this question is cybersecurity breeches. First, how do you know if that spam in your...
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October 18, 2022
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Diagnosing Alzheimer’s Disease
September is Alzheimer’s Awareness Month, and this is the second of four posts we’ll offer on the subject. A...
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September 13, 2022
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Burn Calories to Reduce Dementia Risk
We most often think about exercise as a way to work off the calories that we may have consumed,...
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August 30, 2022
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Food Fight
When you hear the word cancer a lot can come to mind such as “cancer survivor,” “living with cancer,”...
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August 23, 2022
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The Will To Do the Right Thing
This whole idea to write up a legal document to give surviving loved ones clarity about how to take...
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August 9, 2022
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Before or After the Fall
I came across an informative piece in the Washington Post about a week ago, and it brought to light...
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July 26, 2022
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In the Caregiver's Words

Recent Client Praise

It used to be that people feared public speaking more than dying, but with the increasing prevalence of a number dementia, it seems that people more fear losing their faculties than fear losing their lives. But while prevalent, dementia is not inevitable, and there are steps we all can take - at any age - to stave off cognitive decline. Here are five. 1. Go fishing - You probably have heard or read that fish oil is healthy for your brain, and a number of studies have supported that notion. The antioxidative omega-3 fatty acids in fish oil seem to be an aid to later life brain health. Researchers have quantified this beneficial effect in clinical studies comparing people who consume omega-3 with those who do not, so eat fish. 2. Sound sleep - The estimates of sleep apnea's prevalence range from 25 to 40+ million adults in the United States alone. The most common and obvious product of this nightly disturbance of sleep is the excessive daytime sleepiness that results, a sleepiness that over time not only reduces quality of life, but if unchecked, it also impairs memory as well as general motor coordination, ability to concentrate and a number of other facets of cognitive function. So if you know someone who has sleep apnea, get help. 3. Sleep aids - A good night's sleep is precious, but using a prescription sleep aid may be a mixed blessing. There is evidence that some of the prescription solutions for sleeplessness cause selective amnesia or even hallucinations or sleep activity. People on some of these agents have reportedly engaged in sleep driving, making telephone calls or even preparing and eating food with no recall of the events. The cure for sleeplessness can be worse than the condition. 4. Night caps - It is true that alcohol can make one drowsy, but it does not enhance the quality of sleep. Researchers have shown that alcohol disrupts the formation of memories in the brain. It may not be dementia, strictly speaking, but recurring memory lapses can make day to day functioning a bit shaky. 5. Single Tasking - Multi-tasking may be the hallmark of the 21st century, but far from making us more productive, it actually hinders cognitive productivity. One researcher refers to this as the :dementia of distraction," the kind where you walk into a room while checking your phone for a text, but then forget why you entered the room. This dementia knows no age requirements, because teenagers can be as prone to the distraction of multi-tasking as older adults. As you may imagine, the list could actually go on and on, but the dos and don'ts of this short review highlight what to embrace and what to avoid to enhance cognitive function at almost any age, but particularly as one ages. Can one avoid dementia entirely? Probably not, as there is some research pointing to a genetic component to conditions like Alzheimer's Disease, but following these basic guidelines can preserve brain function to the fullest extent possible. So sleep well, eat healthy and stay focused. 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.
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there had been no new therapies for almost two decades. And honestly, none of the earlier therapies…or seemingly even Aduhelm…provided much help to those whose cognition is failing. There is some breaking news, of late, on at least two fronts that there may be other medical interventions that can suppress or delay the onset of Alzheimer’s disease. Researchers at Cleveland Clinic investigated 1,600 drugs already approved by FDA for other medical conditions to see if there might be a beneficial effect for Alzheimer’s. They found what looks to be a possible winner in the widely-known drug, Viagra. It has some brand awareness for all the ads we all have seen over the years for its treatment of erectile dysfunction. Generically known as sildenafil, this therapy early on was found to be helpful in resolving pulmonary hypertension, and that was its clinical path before reports of a rather pronounced side effect came to dominate its story line. Looking now to the data over time, the Cleveland Clinic scientists documented men and women (not that many in these data) were 69% less likely to develop Alzheimer’s over a six year period than those who did not take Viagra. This is after they took into account the sex, age and other diseases and conditions of the study subjects. This has been an observational study, and the scientists now are in the early stages of clinical trials that will offer a more definitive assessment of the potential added benefit of Viagra. In another unrelated study of people 65 and older a Seattle-based group of clinicians have found another clinical intervention that seems to have a strong preventive effect on developing dementia of any type. Kaiser-Permanente of Washington state has compiled a 5,000 person data base of 65+ year-olds whose health they are monitoring over time, particularly their mental health. The study, called Adult Changes in Thought (ACT), found that patients who had undergone cataract surgery were 30% less likely to develop dementia or any type – including Alzheimer’s – over a ten year period. It’s what clinicians would call a “durable effect” with a reasonably long-lasting difference. The researchers point to the clearer sensory input to the brain that those who have benefitted from cataract surgery will enjoy, and this is taking into account other medical conditions and variables as the Viagra study did. The researchers also went so far as to exclude people who were diagnosed with dementia within two years following cataract surgery to eliminate the potential influence that dementia might have on people’s awareness of their visual capacities. Both of these are observational studies, not clinical trials, so we should wait for better data, but they are nonetheless quite promising. There also is a larger story line here in that people who take better care of all their health needs likely will do better on most measures of health status including cognition. Note to self… 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.
We all hear the phrase used as an excuse for a bit of memory lapse … that it’s just a “senior moment.” It doesn’t seem to be ageist, because in older adult communities the phrase gets tossed around about as frequently as “hello” or “goodbye.” But it’s wrong. This time of COVID places us all at risk for the “Memory Moments,” because they’re not caused by age. Yes, short term recall issues are something to which we all are susceptible, but they are not caused by age. Memory issues like dementia are not caused by age; they have organic causes. There are steps we all can take to stay more mentally sharp no matter our age and despite COVID. During this time of sustained pandemic quarantine – for those of you following the state and local mandates, that is – memory lapses can seem to become more common. Even these “COVID moments” are not inevitable, however, if you keep your mind engaged and active. Here are six tips to help fend off the cognitive impact of COVID 19:
1. Do Something New – We all have heard about “lifelong learning” as it may describe someone who seems always to be pursuing new knowledge, a new language or a new craft. Your brain still has a lot of room to expand what you know, so keep at it.
2. Don’t Cram – Just like the tests when you were back in school, the best learning cannot happen the night before the exam. Spread your learning of a new language or a new musical instrument over a number of sittings and days, and it will more effectively take root.
3. One More Time – The learning takes place over time, and you need to go over the same ground over and over. Repetition is important so that the new language you’re studying becomes like a new habit.
4. More Senses Make More Sense – When you are working a new recipe in the kitchen, you learn by reading, tasting, smelling, touching, etc. With learning a language, you learn by seeing, hearing, writing, saying, and so on. Use as many senses as you can to maximize your cognitive process.
5. Don’t Sweat the Small Stuff – It’s okay to let your devices or your habits free up your brain to work on the new things you want to learn. Make a written list of your “to do’s.” It will free up the brain space to actually determine how to do what you want to get done.
6. Yes You Can – Don’t ever call it your “senior moment,” because that means you have lost confidence in you. While you are practicing what you wish to learn, practice having confidence in your learning. If you don’t believe in a “senior moment,” you are far less likely to have one.
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.
While speaking with Matt Margolis (Elder Law attorney with Heartland Law Firm) recently, he mentioned a common question he receives often: “Why do I need a Health Care or Power of Attorney?” The short answer, he offered, is because only YOU can make a health care decision on your behalf or sign your own name. And he offered to expand on this in our blog with this post:

It is important to differentiate between a Power of Attorney for Health Care (HCPOA) and a Power of Attorney for Property (PPOA). If a doctor or other medical professional cannot communicate with you about your health care needs, whether it is because you are mentally incompetent or physically incapacitated (i.e. in a coma), a HCPOA allows someone else that you appoint to talk to the doctor and make a decision on your behalf. This authorized person is called your “agent.” A key component of the HCPOA is that the agent is making YOUR decision for you. It is not the agent’s decision or based on how the agent feels about a certain situation; rather, it is based on what you noted in your HCPOA and what you discussed with your agent (hopefully) prior to your incompetency or incapacitation.

A perfect example of what can go wrong when not having a HCPOA in place is the Terry Schiavo case from Florida. In 1990, Schiavo suffered major cardiac arrest, and a few months later was declared to be in a permanent, vegetative state. In 1998, Schiavo’s husband petitioned the court to remove her feeding tube, which was opposed by Schiavo’s parents. After many court filings and appeals to the Florida and US Supreme Court, the court’s decision to remove the feeding tube was upheld in 2005, and she died shortly thereafter. The problem was that Schiavo did not have a HCPOA in place. Therefore, no one had the legal authority to instruct the doctors on what to do without court supervision.

A PPOA allows your legally appointed agent to sign your name on your behalf and to handle your financial affairs. If you were to become mentally incompetent or physically incapacitated, who would continue to pay your monthly bills on time so your mortgage is current and your gas and electricity aren’t shut off? If you do not have a PPOA in place, there is NO ONE else that has the legal right to access the proper accounts and take care of your financial matters for you.

If you do not have a HCPOA or PPOA, a legal guardian will need to be appointed by a court to allow someone to make health care decisions for you or to be able to legally sign your name. A guardianship is a costly and time-consuming process. An attorney must appear in court a minimum of three times before the permanent guardian is appointed. Once appointed, the guardian must file an annual accounting with the court every year showing what money has come in to the estate and what money has been paid out from the estate. This can be a very arduous process when the person whom the guardianship is being sought for is not agreeable (typically due to their mental incompetency). This is called a “contested guardianship.”

To avoid the potential of any costly and unnecessary court proceedings, you should consult with an attorney to ensure that you have valid Powers of Attorney for Health Care and Property in place. This will not only protect you, but will save your loved ones a lot of aggravation and expense in the future.

Heartland Law Firm is a holistic elder law and estate planning firm. Heartland Law Firm concentrates in assisting seniors and those in transition with understanding the landscape they are in and what protections and benefits are available to them and their loved ones. Visit their web site at: Heartland Law Firm.

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.
What do ObamaCare and geriatric care managers have in common? You probably have heard a whole lot about what is called ObamaCare - more accurately the Affordable Care Act - but you probably have not heard so much about geriatric care managers...let alone geriatric care managers and the Affordable Care Act. It works like this. The new law that has given more access to more Americans has also worked to have everyone in health care working toward the same goal. Raise your hand if you have ever had an older loved one admitted to a hospital. When that event happened, what you wanted most was to get your loved one safely recovered from what brought them to the hospital and to get them discharged. At the point they were discharged, what you wanted least was to face the prospect of seeing them readmitted to a hospital. Unfortunately for the Medicare-age population, that readmission was happening a lot. So, ObamaCare built in a program where everyone is working toward keeping older people healthy once they are discharged from the hospital. But let me take you back a number of years. There was a time when all health care providers - including hospitals - were paid fee-for-service. Every office visit, every hospital visit, every procedure was a charge, and the providers were paid more for more volume. Then some of the rules changed so that health care was "managed" by insurers who made more money if they paid providers less. The first system rewarded volume, and the second one rewarded cutting care. Under the new model, providers and hospitals are rewarded for working together to improve quality and efficiency. And what do the people running these new organizations say is most instrumental in making all this work? In a survey conducted this last year among executives of ACOs, they were asked what was most effective and most important in keeping people healthy and out of hospitals: telemedicine, pharmaceuticals, electronic medical record-keeping, pharmaceuticals, home health care or care managers? It is not computers, it is not the providers, it is not new medicines; it is care managers who are viewed as both more effective and more important. What makes it all work better are the care managers who can assess a person's health and their home, and then develop a plan to help a person get back on their feet. That same care manager is the one who will advocate on behalf of an older patient to get help at home or to get in to see a doctor to help avoid an unnecessary trip to the hospital. This is not to toot our own horns; we will leave that to the CEOs at the new health plans to do that for us. 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.
As you prepare for the big holiday feast and potentially the big snowfall that may come your way, we at Creative Care Management wanted to take time out to wish you happy holidays, good health, and an encouraging start to the New Year. This past month we’ve explored all the setbacks that might prevent maximum holiday cheer for the caregiver and how to overcome them. However, I cannot stress enough that the best way to overcome all of these obstacles is to remind yourself what these times are all about. It’s okay to be nostalgic about the past and allow yourself to feel what might be sadness and loss. But try to focus as much as you can on the present. Enjoy the time you have with your family and friends. Laugh, smile, and give yourself credit for making it as far as you have this year. Take time for yourself as needed – to breathe, to reflect, to remain centered.

If you know someone who is also a caregiver, here are some gifts you can give them in order to make their holidays easier.

Someone to listen. The best relief for a caregiver might be just having someone there to listen to their frustrations .

Support. The holidays can be more of a hectic time for caregivers. If you’re visiting a caregiver, offering to help around the house or taking care of some of the tasks on the caregiver’s plate might be an excellent present.

“Thank you.” Sometimes caregivers aren’t able to hear or see how much of an impact all of their hard work makes in tangible ways. Letting the caregiver know that their work is appreciated and that they’re doing so much good for their loved one may brighten up their holiday. It will serve as encouragement to keep going well into the New Year.

All of this said, whether you’re a caregiver or friend of a caregiver - take care of yourself and allow yourself a moment to rest during this joyous time.

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.