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Alzheimer’s from the Inside Out
As a geriatric care manager, we have knowledge of Alzheimer’s Disease and its progression, less about its causes and...
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March 26, 2011
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In the Caregiver's Words

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I have written a lot about dementia over the years as well as other issues that can mimic the losses in cognition that are the hallmarks of dementia. One potential cause of poor recall and attention that does not get a lot of attention is a vitamin deficiency. The vitamin in question is vitamin B12, and the deficiency can occur even among older adults who take multi-vitamin supplements. In fact, it is a common vitamin deficiency in older adults, and it is very common in vegetarians as much of dietary vitamin B12 comes from meat products. Vitamin B12 is important to the body’s function, because it has a hand in creating red blood cells, maintaining healthy nerves and generally regulating the body’s overall metabolism. B12 deficiency can happen to anyone, but older adults are even more at risk for pernicious anemia in general. Their digestive systems become less efficient with age, so even increased consumption of the vitamin will not always result in a proportional increase in effective absorption. Catching B12 deficiency early is important, because some of the effects cannot be reversed if they are allowed to progress too far. The early warning signs of vitamin B12 deficiency beyond include:
- Gradual onset of muscle weakness in the limbs
- Cold or lack of sensation in tips of toes or fingers
- Awkward gait or even stumbling
- Sore tongue or impaired taste and sense of smell
- Low grade fever
- Stomach or intestinal digestive difficulties
- General anemia as diagnosed by a provider.
If you see evidence of any of these issues with an older loved one, it will be important to speak with their provider who can issue orders for a blood test. If caught early enough, normal function can be returned. A question you may be asking is if taking extra vitamin B12 can improve normal memory, and the answer is no. Normal is, well, normal, and vitamin supplements can only move us back to where we have been. So, if you’re asking if this all means that being alert to vitamin B12 deficiency is important for our older loved ones, the answer is a definite “yes.” If you’re asking if it is important for us all to monitor our B12 levels, that’s a “yes” as well. 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.
In my last post, I talked about indoor fire hazards that are specific to the changing of the seasons. But there are some general safeguards that should be implemented in any senior’s home regardless of the season. Here are eight suggestions for seniors, caregivers, or concerned friends.
1.    Make a fire escape plan with your senior and give it a practice run so that they know how to get out of their home safely in the event of a fire. They may say it feels silly, but practice makes perfect…and safe.

2.    Once you have a plan in place – and preferably a plan with options based on multiple scenarios and sources of potential fires – make certain that the paths to the fire exits are not blocked.

3.    Check throughout the house to see that smoke alarms are placed within the air flow of every floor of the house – including the basement. This goes for carbon monoxide detectors as well.

4.    Especially if the house is older, hire a reputable electrician to check out the wiring. If fuses have been blowing with any frequency or if there are any new appliances that may be drawing more current, this is critically important.

5.    I talked about portable heaters in my last posting, but beyond even discouraging those, be very careful around any flammable liquids your senior may have around the house. Keep the containers away from space heaters, water heaters or any source of heat/flame.

6.   Without a doubt, a Chicago senior living near the lake (and anyone else familiar with brisk winters) will be wearing sweaters around the house. Ask them to be careful to roll up sleeves while they are at the stove top to avoid their clothing catching fire.

7.    While at the stove top, encourage the same safety steps one uses when there are children in the house; turn pot handles toward the back of the stove to avoid sleeves catching on them. Get pot holders also, but be careful that they do not unduly hamper easy handling of pots.

8.    Finally, consider installing timers on stove tops, coffee makers, counter top ovens or other appliances so that they turn off after some elapsed time. This avoids fire accidents precipitated by forgetting to turn them off.

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, and providing the best in Chicago senior care services. Please email your questions to ccbishop@creativecasemanagement.com.
How many New Year’s Resolutions have you broken in your life?

Be honest.
Now ask yourself how many of those broken resolutions were your own creation and how many were resolutions other people made or suggested? In hindsight does it seem that some of those resolutions were doomed from the start? (Spoiler Alert: Dry January) Or it simply may be because those resolutions were someone else’s resolutions…so it was like wearing someone else’s shoes or their pink hoodie or anything else that looked or sounded good, but they just weren’t a good fit for you. And how many of your broken resolutions were lacking the key ingredient for success? The key revolves around a sense of urgency or importance or your authorship. The clock is ticking. Think about everyday changes – not resolutions - like:
1. I’m going to change when I work out, because I always run into the end of the day and I give in to appetizers instead of laps.
2. I’m going to get to know the people who also walk their dogs so that I am not stuck knowing the dogs’ names instead of the humans walking with the dogs.
3. I'm going to reach out to that friend who had a health scare during the holidays…instead of waiting for bad news.
4. Go back to that solicitation from a nonprofit that you had intended to vet before donating…and vet them today.
5. Be an active listener – ask questions - in all your conversations so that all of those people with whom you interact will feel you care.
6. Thank the person who shared a tasty treat as a holiday gift this past year…maybe even ask for their recipe if it was homemade.
7. Make a list - written or digital - of the follow-up opportunities so they don’t just sit in your brain where they’ve been archived with a million other good intentions.
Throughout the year track your joy by spending a moment at each day’s end to physically commit to paper or screen what gave you joy that day. You can review your “joy list” other days that may not have given you sufficient joy to help buoy you up. At the very least you can feel good about you for having brought joy to so many others. 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.
Who thinks it’s a good idea to just blow off Valentine’s Day? I am guessing not many hands will go up for that idea…some might even say that their spouse will kill them if they don’t bring forth at least a sentimental thought. Never mind the flowers, candy or sparkler. Just forget about the day later this week. Well, that probably is what some of us do every day … with our hearts…we just forget about our hearts. And that is why heart attack and stroke are the top two causes of mortality in the United States. So, what do you do to remember of your hearts? Earlier this decade the American Heart Association came up with seven habits to embrace to help avoid heart attack and stroke. You don’t have to wait until February 14^th to start:
1. Exercise - there is a new exercise program recommended almost every week, it seems, but the simple fact is that getting your body moving regularly and vigorously supports a healthy heart…and the rest of the body with it.
2. Eat right - we all know what the good foods are and what the bad foods are; make a healthy diet your Valentine’s Day resolution.
3. Lower blood pressure - you will need a medical provider to give you your actual numbers (not to exceed 12/80), and if your numbers are high stick to the prescription you will be given and follow #1 and #2 along with losing weight and cutting your salt or sugar intake.
4. Lower your cholesterol - focus your diet on fruits and vegetables along with fish, nuts and soy; your doctor can tell you if a statin is indicated.
5. Manage your blood sugar - sugar is not your friend, so limit its visits to your body in order to keep down your weight and not beat up your pancreas…your heart will thank you.
6. Maintain a healthy weight - losing weight should be an outcome of the first 5 instead of a goal in itself, but keeping your weight down lightens the workload for your heart.
7. Don’t smoke - smokers have double the risk of a heart attack and triple the risk of a stroke over nonsmokers; it is not just your lungs that suffer if you smoke.
So this list is the short version of a lot of material I have covered in other posts. If you have questions, you can use key words to search the blog for a related post or you can go to the American Heart Association web site. Make February your heart-healthy month! 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.
Once in a while “yesterday’s news” is also tomorrow’s news. Earlier this year you probably heard or read that Medicare is now authorized to negotiate prices directly with drug manufacturers. It’s not a blanket permission to negotiate; it’s focused on single source, patented drugs that may be prescribed for older adults. When drugs go generic, there is competition which generally brings prices down for the consumer, but “single source” is simply code for the company that won the race to be patented gets to pretty much set the price of the “new” drug. I put the “new” in quotes, because it’s not always a truly novel medicine; it may be a combination of two or more existing drugs that can work well together to manage a medical condition like hypertension or HIV or others. This is a welcome relief to older Americans, many of whom are on fixed incomes. A study released just this past week by AARP looked at the top brand name 25 medicines with the highest spending among Part D drugs. They’ve more than tripled since their entries into the market, and they did not start out cheap. We all hear monthly reports on the consumer price index (CPI) and howl a bit when gasoline goes up 32 cents (8 percent) a gallon. Many of these new drugs didn’t start at four dollars per unit as gas may have. Their market entry price has often been in the hundreds of thousands of dollars a year. But all of this restraint by way of CMS’s negotiations will be resulting in howls of “unfair” from drug manufacturers, some calling this move “extortion” to their industry. And we’ll probably be hearing the howls for a while as the negotiations are slated to occur this year into 2024. The negotiated prices will not take effect until 2026, but we are off to the races. If you have an older adult in your family or you, yourself, qualify for Medicare, you have a home work assignment. Look to your loved one’s or your own medication list to see what the list price is for any of your branded meds. Be prepared to perhaps even drop a letter or a call to your federal representative to see where they stand on the new authorization. If they backed it when it moved through congress to become law, thank them. If they hedge on the issue or just admit they did not support the bill, ask them why. Being an active citizen just might turn out to be really good for your health! 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.
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