Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Creative Care ManagementChicago's Geriatric Care Manager Center of Excellence

When Do you Need A Geriatric Care Manager?
The most common question I hear after “What is a geriatric care manager?” is, “When do I know that...
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August 26, 2013
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Geriatric Care Managers Do What?
It’s June, and school is out for a lot of kids and everyone is thinking of taking time off....
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June 3, 2013
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May is National Geriatric Care Manager Month
It’s official. May is National Geriatric Care Manager Month. And that means now is a good time to share...
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May 2, 2013
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Four Tips for the Caregiver To Do List
We all know of someone who has received that call out of the blue that a mother or father...
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March 14, 2013
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A Senior Care Plan Can Make 2013 a Better Year
Perhaps you’re thinking about ways to make caregiving easier in the next coming year. You may have read tips...
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January 9, 2013
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In the Caregiver's Words

Recent Client Praise

First, I want to thank everyone who helped get the word out on our recently-orphaned therapy dog, Annabelle. I am happy to report that Annabelle has found a new, adoptive home and that dog and master are doing great. Thank you for making our internet community work. Now, shifting gears… Hospitalization seems to figure prominently in most of the new clients we see. It is either a recent trip to the hospital that triggers the call to a care manager, or it also can be a surprise discharge from the hospital that sets everything in motion. You may ask, why should a discharge be the urgent situation? Well, the practical side of health care as we know it these days revolves around a big push to discharge patients “sicker quicker.” It can happen with the nurse or an aide walking into the hospital room and simply announcing to the patient and whomever is at their bed side that it is time to leave…often for a nursing home. Most patients and their families will scramble to comply. Nobody really wants to be hospitalized, but how prepared is the patient or the family for a return home or a quick departure for the nursing home? The fact is you need to know your rights. A family in this circumstance can file what is called a “fast appeal” of a pending discharge with a Medicare Quality Improvement Organization. Make that telephone call on the spot, and the patient can stay in the hospital until an independent physician reviewed the circumstances. Every 65+ year old adult admitted to a hospital as an inpatient has the right to challenge a discharge if he or she feels unprepared to leave. But few people understand the process that’s involved. In fact, all Medicare patients upon admission should receive a written notice of their rights. It will be labeled: “Important Message from Medicare” and in it you will be supplied with the name and a phone number for your Medicare Quality Improvement Organization (QIO). These are the people who handle fast appeals and other quality of care issues. Once you make a call, you or your loved one may be asked to fill out a form that allows the QIO to act on their behalf. Once that fast appeal has been filed, the hospital cannot transfer the patient. But you don’t necessarily have to be surprised. Ask on a daily basis what the expected departure date may be. Now, there is fast and there is really fast. Make sure that if a patient is to be discharged under the 24 hour mark, the stay may not be considered an inpatient hospitalization. It may simply be labeled as “observation” and therefore may not be covered as a hospital stay. Make certain of your rights here so that you are not billed inappropriately. Make sure that your primary care physician and possible also a care manager are in the loop so that you will have an advocate. 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.
We’ve all seen the ads on television about the lawyers who will stand up for our older loved one if they are abused or neglected in a nursing home or other facility. A bruise, a bed sore or maybe loss in weight can be pretty conspicuous warning signs, but there is another pervasive abuse of older adults in America, an abuse that has no telltale bruises. We know from the statistics that one in nine older adults in America has been abused, but financial abuse specifically is substantially under-reported. Experts at the National Adult Protective Services Association report that only about one in 44 cases of financial abuse of seniors ever gets reported. Exacerbating this under-reporting is the simple fact that senior financial abuse doesn’t leave a mark on the abused victim. But it does raise a flag if you know what to look for. Look for telltale changes in your older loved one such as:
1. Sudden changes in a will or other document that now includes a new beneficiary.
2. The “live-in” caregiver who seems to be “living off” their client.
3. An unexpected increase in credit card debt or an unusually large line item.
4. Money spent that has a wild or outlandish explanation.
5. More frequent withdrawals on a bank account or new accounts with someone else’s name on it.
6. Vague explanations or complaints about a missing credit card.
7. Guarded talking or behavior around a new caregiver that may suggest they are being intimidated.
8. Missing items like jewelry, money, antiques, art or even furniture from their home.
9. That new girl or boy friend…maybe some significant number of years younger.
Older adults are prime targets because they have the money…their savings, retirement accounts, mortgage-free home or other assets. Older adults are also more vulnerable because they may live alone, they may have chronic medical conditions requiring assistance or they are simply weaker than their exploiter. Older women are particularly vulnerable for all of these reasons plus their upbringing was in a time when women were simply taught to defer, to be nice, to be polite. And nearly half of all abusers are family members or friends. Please remember also that the earlier you spot the flags, the easier it is to “fix the problem.” 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.
In the past two posts, I have discussed ways to ensure safe in home care. But we should also look to helping an older parent to be in the best shape possible to avoid even the unforeseen hazards. In this post, I offer nine tips to help “fall-proof” a mom or dad. It is a different way to think about being in the best condition one can be.
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. Visit our For The Caregiver page for more information and resources.
I don’t know how many of us would like to live full-time in Disney World, but most of us have some very fond memories of maybe the early days with the Mickey Mouse Club or a trip to one of their theme parks. But there is something new from the Imagineers of Disney, and it’s a senior residence designed for those 55 and older. The first of these “Storyliving Communities” is being built in California where they are preparing a community that in their terms “is a little more magical.” This is not a pitch for this megacorporation’s next big way to engage the market with a bit of fantasy. It’s my way of saying that as your older loved ones approach retirement and move into it, encourage them to “reimagine” the next phase of their lives. If you go to your search engine and type in “how to retire,” you will get a ton of advice on how to save, what are the financial vehicles and how much is considered enough to last…and of course, some tips on planning for long term care, etc. But what about how to get to retirement and then find a life that can be fulfilling? Allow me to offer some suggestions for those nearing retirement to anticipate as well as for those already retired to perhaps do some rethinking and tweaking of their plans. Consider:
1. Mind your diet so that you preserve your health and your quality of life.
2. Plan and then refine a daily plan that keeps you busy – at your pace.
3. It’s not a light switch…you can ease into retirement gradually.
4. Exercise your mind as well as your body.
  1. Mind: take on a language, join a book club, embrace puzzles.
  2. Body: your personal record may be behind you, but set goals.
5. Make new friends, join a club, volunteer for a good cause.
6. Get to know your health care provider better…before an emergency.
7. There are two ways to stop working – screaming or smiling.
  1. Don’t obsess…get professional help to let go, if need be.
  2. Keep your work friends…they’re still friends with whom you can share.
8. Don’t make a bucket list…make a pamper yourself list.
9. As we all look at relaxing travel restrictions…relax your own restrictions and get away.
10. Invest in your community – lots of needs can reward your effort with lots of thanks.
It’s really easy to get caught up in what we can’t do as we once did, but don’t fall into that trap. If you need an excuse to do more walking, get a dog who will take you farther and show their appreciation in return. Try some new recipes, plant some new flora, see a new part of the world…and learn just enough of their language to immerse. 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.
May is National Geriatric Care Manager Month, but I am thinking that most of you probably did not get the memo. You may have been following my blog – especially those with an older parent or loved one – and you know what it means to be a caregiver, but not as many may know what a geriatric care manager (GCM) is. Geriatric care managers are the people who work with caregivers to older parents who want time for their own families and confidence that their mom or dad will be well cared for. We also work with older adults who do not want to be a burden to their families as they navigate health care issues and make decisions about where and how they can live as independently as possible.

And a person does not have to really be a caregiver to seek the services of a geriatric care manager. We also work with professionals who want to get help for their aging clients when they have had a life-changing incident and wish to remain as independent as possible. These are professionals who want to help their clients maintain quality of life when life changes and coordinate the medical and other resources that make that happen.

I sum up what it is to be a geriatric care manager by describing the four activities where I am most involved in helping elders or others with special needs:
1. Resource: GCMs make the home of a loved one who is aging in place more secure. We help show families what services can be brought to an elder’s home and at some point identify what are the best alternatives to home. And quite often with sandwich generation adult children of older adults, we can be there at a doctor’s appointment when they cannot be there.
2. Counselor: GCMs help families to reach consensus about how to best care for mom or dad when there are so many options or in cases where it may seem that there are no good choices. We help caregivers to older adults or even spouses to sort out whether it is just tiredness or if it is depression or old age.
3. Advocate: GCMs help to coordinate the care from multiple medical specialists who may be attending to an older adult and make sure they are all communicating with one another and with the caregiver. We also work to document a clear care plan the helps to preserve the life an older adult really wants, and we are the eyes and ears to look out for what is best for an elder if they are living in a senior community, assisted living or nursing home. We are particularly alert to any signs of abuse or exploitation.
4. Friend: GCMs are also good listeners, because it can be really important that a caregiver have someone with whom they care share how hard it really is to reverse roles with the parent who had raised them from childhood. It helps for me to have been a caregiver, so I can personally and professionally empathize with what it is like.
For more information on geriatric care management visit Care Manager.

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.
Let’s take a short quiz. Question: Who prefers coffee…and who prefers tea? Which is healthier for you? Answer: Both together are better for your cardiovascular health than either alone. We see a continuous stream of nutritional information about what colored food is best for us (hint: brightly colored) or that flavonoids are healthy or that high fiber is key to any diet or how many calories should be consumed daily. Yes, the list is seemingly endless. And there can be a lot of accumulated data that are used to support a given position on any of these sources of nutrition, but we don’t always see really large population studies over very long spans of time. Well, in Britain where the government picks up the tab for people’s health care, they invest in broad-based studies to improve health, and what better place to start that with what people eat or drink. Tapping into an existing panel of nearly 366,000 study participants who are part of a panel of the UK Biobank, scientists were able to follow these individuals’ tea and coffee consumption as well as their health statuses for a median of 11.4 years. What they found may be rather surprising, and the statistical significance of the results was even more startling. The researchers found that of these nearly 400,000 people, 2.8% experienced a stroke and 1.4% developed dementia (the vascular, not the Alzheimer’s dementia) over those 11.4 years. These health outcomes were tied to tea or coffee consumption. Those who consumed two to three cups of tea or coffee showed a 30% reduction in strokes and 28% reduction in dementia. Those who drank less than two cups of either beverage had much smaller reductions in either health outcome. The greatest benefit came to those who drank two to three cups of both tea and coffee daily, and the difference from the non-drinkers was slightly better, 32% and 28%, respectively. The odds that these 32% and 28% reductions could have occurred by chance alone were between one and two in a thousand! The researchers continued to follow patients who had strokes and found that the coffee and tea consumption protected them even more from vascular dementia. Again, there was no discernable benefit for Alzheimer’s disease or for that matter hemorrhagic stroke. As a final note, if you were to peruse the 600+ posts to my blog over the years you will find a theme. Paying attention to our diets and exercise are the two best things we can do to live both well and longer. The next time a friend suggests you meet for a cup of coffee or tea, you now have one more reason to say yes…and maybe ask for a refill. 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.