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

Are You in the First Half or the Second Half of Your Life
A philosopher/theologian whom I regard quite highly talks about the first half and the second half of life. Life...
Read more
April 2, 2024
0
0
Another Side Effect of COVID: SCAMS
Just when you thought you’d heard everything about COVID! We early on learned how to be vaccinated, and most...
Read more
March 12, 2024
0
0
If It’s All in Your Head, Are You Out of Your Mind?
You know what makes a real difference between grade school children and adults over the age of forty? We...
Read more
February 6, 2024
0
0
It Only Works If It’s YOUR Resolution
How many New Year’s Resolutions have you broken in your life? Be honest. Now ask yourself how many of...
Read more
January 9, 2024
0
0
I Miss the Scams That Used to Be Easier to Spot
It was probably ten years ago that my husband’s mother was caught up in a telephone scam on her...
Read more
September 26, 2023
0
1
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...
Read more
March 7, 2023
0
0
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...
Read more
February 7, 2023
0
0
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...
Read more
November 15, 2022
0
0
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. ...
Read more
October 24, 2022
0
0
What’s Scarier than Halloween?
The short answer to this question is cybersecurity breeches. First, how do you know if that spam in your...
Read more
October 18, 2022
0
0

In the Caregiver's Words

Recent Client Praise

No, this isn’t a refresher course on Shakespeare and the famous Hamlet soliloquy. (Spoiler Alert – Hamlet was ranting about death, not slumber.) Do you find that despite how tired you feel, you still can’t get a full night of restful sleep? You’re not alone, because the older one becomes, the harder it is to get a good night’s sleep. Dr. Abhinav Singh, the medical director of the Indiana Sleep Center, suggests we view our sleep as if it were an older car that just doesn’t work quite as well as it once did. Ready for a tune up? As we age…especially if you’re a woman, it takes longer to fall asleep, we may have more wakeful times throughout a night and we may make up for these by napping during the daytime. Older adults’ sleep is not as deep and rejuvenating as younger people’s sleep, and that negatively impacts our immune system, our brain’s ability to organize memories and our ability to grow or repair bones and muscle. And all of this cascades into some real health issues the older one becomes. How about you? Is it trouble falling asleep, staying asleep or just feeling refreshed when waking from a night’s sleep? It may owe, in part, to checking out of the workforce which means we no longer have the demands or structure or early risings of work life. It also may be attributable to the loneliness or loss or just plain depression that can become part of the older brain. Older adults may also have medications for their blood pressure that give a nightly wakeup call to visit the bathroom. Women also have menopause that will exacerbate all of these elements that affect both men and women. Here are some tips from those like Dr. Singh who have devoted a lot of focus on what can go wrong with healthy sleep and what can be done to make your sleep more … well, restful and restorative:
- Recreate a daily routine that has you waking and sleeping at the same times;
- Avoid late afternoon caffeine – my husband makes 2pm his cut-off point;
- Walk every day with a goal your phone can track…10,000 steps maybe;
- Exercise more aerobically for 40 minutes 4 to 5 times a week;
- Soak up sunshine or use a Seasonal Affective Disorder lamp daily; and
- Schedule breakfast, lunch and dinner around the same time each day.
And maximize the effectiveness of your sleep time itself by:
- Ask your doctor about CBD or melatonin or other aids to a good night’s sleep;
- Keep your phone off and away from your bedside;
- Stretch and/or do some yoga each night prior to hitting the bed;
- Replace your pillow with one that truly supports your neck and head; and
- Purchase a new mattress that supports you and doesn’t squeak.
Some folks even recommend an upgrade to your sheets or a white noise machine to cancel disruptive night sounds. Wow, that’s an exhaustive list…maybe we all can sleep better having laid all the issues to rest? Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.
You have heard about how “brain teasers” or other “brain games” like crossword puzzles are helpful in keeping a brain healthy, and they are. Working an older person’s body – and for that matter the body of a person of any age – also improves cognitive function. I did say “any age.” Getting into better physical shape to also be in better mental shape works for caregivers and for their older care receivers. If you are a caregiver to an older loved one, you may want to encourage their physical – and mental – fitness by example. Researchers have studied individuals across the age spectrum to measure this association between physical fitness and mental fitness. What they consistently find is that even small changes in physical fitness can improve cognitive function at the same time the individuals improve their strength and muscular conditioning. The mental component where they see the difference is the executive function, the part of the brain responsible for focus, adaptive behavior and sorting short and long term memory. The area in the brain where much of this happens is the hippocampus, an area that sadly shrinks with age starting in later adulthood. As the hippocampus goes through this natural regression, the individual’s memory becomes increasingly impaired and they may also become at risk for dementia. Hippocampus atrophy is considered inevitable as a person ages, but research has demonstrated that aerobic exercise can regrow the hippocampus by adding the proteins that aid in the growth of new brain cells. Now, the scientists are not saying that if you go out for a brisk walk or jog today that you will be smarter tomorrow…at least not measurably so. What they have found, however, is that people who consistently embrace even a modest exercise program for as little as a year can make a measureable difference in their cognitive fitness. Can this reverse the effects of dementia? Unfortunately, in cases where amyloid beta plaque already has begun to form, there can be no reversal. But there is every indication that a consistent exercise program can slow the progression of a dementia, and this is all that is promised by any of the medications currently available from your physician. So, just as you would not wait until you are ill to begin exercising to get fit, you should not wait until there are significant signs of cognitive decline to start an exercise program. The other takeaway from this growing body of research is that the “fitness message” is for caregivers every bit as much as it is for the older loved ones for whom they care. It is never too early to take steps to care for the brain, and the more steps the better. 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.
Every 25 seconds, somewhere in America someone experiences a coronary event, most typically a heart attack. Although 70 to 90 percent of these sudden coronary events are among men, heart attack is the leading cause of death in women 65 years of age and older. If you are a caregiver to an older loved one, this is an important risk to understand...but for a reason you may not expect. Ageism! The care that older adults receive may be different from the care a younger individual receive, but age should not deny care that will offer better health and quality of life. Yet, that can happen. If you are that caregiver to an older adult who has just suffered a heart attack remember first that time is critical. A heart attack happens when the small vessels that bring blood to the heart muscle are sufficiently blocked that an area of the heart muscle is being starved of oxygen. The longer that vessel remains blocked more of the muscle will die. Ageism may be the obstacle to surgical intervention that can not only save an older adult's life, but also restore better quality of life. Listen for the three words: "Not a candidate." Many physicians practice medicine by the birthdays, and there are still physicians who will look at an 80 year old patient as someone who is not a good candidate in their opinions. But, as Harrison Ford once said, "It's not the birthdays; it's the mileage." In fact, there is perhaps greater variability in the relative fitness among 80+ year olds than any other age bracket. They should not all be lumped into the "unqualified" category. You may very well find one patient who truly is frail, but another who still runs marathons. The procedures to revascularize an older patient's heart can be successful, but patients must be carefully selected. If you are the advocate for your older loved one with a heart attack, listen for ageism, but be sensitive also to gender differences. Women tend to be smaller than men, and they also tend to have smaller blood vessels. This may preclude their being good candidates for surgery. A patient who has already had bypass surgery also can be a relatively poor candidate for revascularization. Some patients with other comorbidities like diabetes or dementia or pulmonary conditions also may not be good candidates. But it is not their birthdays alone that may disqualify them. Even in such cases, there are some relatively new and less invasive procedures that may be very appropriate for those who otherwise may not be good candidates for conventional revascularization. There are new laser procedures that do not require a full "open procedure." And we all have heard of balloon angioplasty or implantation of stents. There is even catheter-based aortic valve replacement as a new option for certain patients. You do not have to be a heart surgeon to be able to speak with your older loved one's doctor about options. But as a caregiver you need to be very attentive to the ageism that may harm your loved one more than their medical condition. 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@cr eativecaremanagement.com.
"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.
We have heard forever that carbohydrates are a major source of added (and unwanted) body fat, but dementia? So, when I came across this research, I thought to myself that well, there always is a New Year's resolution about dropping weight by decreasing sweets and grains, but if a person also can reduce the long term risk of dementia, why not get on board? Well, it turns out that a doctor named Perlmutter has been documenting a wide range of medical literature that shows a link between blood glucose levels and risk for dementia. It seems that as early as 2005, researchers were finding a link between blood glucose levels and brain atrophy and cognitive decline. I won't get into all the technicalities, but it seems to follow a path back to increased body inflammation and free radicals and "oxidative stress." Okay, I said I would not get into technicalities. But you see a lot of the familiar language on real problems on the loose in one's bloodstream. And this is not in the radical fringe of medical journals. As recently as last summer, researchers reporting in the New England Journal of Medicine showed that continuous elevated blood sugar levels as measured by HbA1C were associated with higher risks for dementia. Reading between the lines, diabetics whose long term sugar levels are not in good control are not just at risk for diabetic retinopathy and other vascular compromise, but their brain function also may suffer. All of that said, researchers do not show a direct causal relationship between elevated blood sugar levels and dementia. So, let's retrace some of the steps. Increased carb consumption does lead to elevated blood glucose levels. People with elevated blood sugar levels also have been shown to have elevated heart event risk as well as immune issues. And we encourage people to lower their carb intake to improve heart health and immune system health. The author of the most recent research also points out that there are no experimental trials that show using seat belts reduces casualties, yet we accept that we ought to buckle up. So, at the end of the day, you need to draw your own conclusions. And maybe unlike the seat belt analogy, we can say that we all should practice moderation in our carbohydrate consumption. And that is not something you would see driving safety advocates offering. "Use seat belts in moderation?" So here are some medical citations for those who want to see the research. For your brain's sake, read what you will and draw your own conclusions:
1. Enzinger C, Fazekas F, Matthews PM, et al. Risk factors for progression of brain atrophy in aging. Neurology. 2005;64:1704-1711.
2. Crane PK, Walker R, Hubbard RA, et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369:540-548.
3. Erickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108:3017-3022.
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.
I like Simple. If you do also, then you will like the American Heart Association’s and American Stroke Association’s “Life’s Simple Seven.” In short, what they find is: what works well for cardiovascular health also shows the promise of working really well to stave off dementia caused by strokes, vascular dementia, and even Alzheimer’s disease. If you have an older loved one whom you would like to see have a healthier heart, you will get the added benefit of a healthier brain by encouraging the Simple Seven. And there is a bonus...it also will work for you! The seven steps that have been recommended to improve heath health now also are considered as important to improving your brain’s health. "Life's Simple 7" are considered to help prevent dementia caused by strokes, vascular dementia, and Alzheimer's disease. They have been chosen by AHA and ASA as metrics to help confer brain health. "…the same risk factors that cause atherosclerosis are also major contributors to late-life cognitive impairment and Alzheimer's disease," commented Philip Gorelick, MD, Mercy Health Hauenstein Neurosciences in Grand Rapids, Michigan, chair of the advisory writing group. The seven steps are a combination of individual characteristics and behaviors that help to foster better brain as well as heart health: 1. Don’t smoke 2. Be physically active 3. Maintain or reduce body mass index to less than a 25 on the scale 4. Have a healthy diet – there are guidelines for this 5. With a combination of exercise/reduced weight have a blood pressure of <120/80 mm Hg 6. Without meds (but with diet and exercise), have a total cholesterol <200 mg/dL 7. Maintain an A1C (fasting blood glucose) < 100 mg/dL Before this most recent analysis, researchers tended to look at brain health and heart health as pretty much different conditions caused by different lifestyle or health behaviors. But "over time we have learned that the same risk factors for stroke that are referred to in Life's Simple 7 are also risk factors for Alzheimer's disease and possibly for some of the other neurodegenerative disorders," Dr Gorelick noted. All of this is a step toward better brain health while at the same time promoting better heart health. This is one of those fortunate opportunities where a person can get two for the price of one. Take better care of your heart and you get better brain health as a bonus. Take better care of your brain, and your heart also gets a benefit. Not a bad bargain for anyone who is a bargain shopper…no coupons required. Be healthy. 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.