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

What Caregivers Should Know About Diabetes Drugs
I have had the good fortune to connect with Julian Hills, a content writer and blogger for a great...
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September 18, 2013
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It Is Never “Just” Diabetes
I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights,...
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August 21, 2013
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Naturally Sweet Seniors are Better
We hear a lot of news these days about the obesity epidemic, and it is important to appreciate the...
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March 11, 2013
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Three Tips for the Diabetes Caregiver
If you are a caregiver to someone with diabetes – Type 1 or Type 2 – then you know...
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March 4, 2013
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In the Caregiver's Words

Recent Client Praise

One of every three adults over age 65 will have a fall this year. This rate increases to one half of adults over age 80 who will fall during the year, some of them multiple times. On top of this, half of all falls occur in an older adult's home. With these alarming rates, it may come as no real surprise to those of you who may be caregivers to an older loved one that falls affect more older adults than heart attacks and strokes combined. As a geriatric care manager, I commonly get the call from a caregiver to an older loved one who has had one of these falls. And the fall often has resulted in serious injury, most often a fractured hip. One thing caregivers may not know is that unintentional falls result in death of the older adult in nearly 22,000 cases each year. We are not talking about just a bump or a bruise, and even more sobering is the simple fact that most falls are preventable. And, if not preventable, early intervention can make a huge difference in your older loved one's safe recovery from the fall. Here are some tips you can employ to help your older loved one be safer from falls:
1. Exercise. Yes, it is that simple. I have talked in other postings about "use it or lose it." It is not news that older adults tend to lose muscle mass as they age, and with this loss there is a proportional diminution of strength and endurance. There also is a loss in balance and coordination. Encourage your older loved one to take part in an organized exercise plan, perhaps with a fitness instructor who can teach safe exercise to improve balance. Research has shown that this can reduce fall risk by as much as 20% to 50%. And yoga or TaiChi can be a wonderful way to improve balance by strengthening and enhancing muscle coordination.
2. Home Safety. Do a search of my Blog for other postings devoted to "home safety" and you will see a lot more detail than I will give here. But safety at home starts with clearing floor surfaces of scatter rugs, worn carpets or electrical cords in trafficked areas. Go through your older loved one's home at night and look for dark or shadowy areas that may be fall risks. And be sure that a light is within easy reach of your loved one's bed so that getting up at night in the dark does not result in a fall. And be sure to have sturdy handrails in stairways as well as long hallways. Bathroom grip bars are also important as most falls in the home happen in that porcelain minefield we call the bath.
3. All of the Above. The most successful fall prevention efforts incorporate steps toward a safer home environment along with a more fit older loved one. To these I would also add a healthy diet high in protein and complex carbohydrates to help fuel the musculature that will prevent a fall. Although the evidence is not entirely clear yet, there is good reason to believe that vitamin D supplements also can be important as they help to maintain bone density and strength as well. Not sure how to implement these steps? If you are a caregiver to an older loved one, speak with their provider about appropriate exercise or a nutritionist about their diet. And reach out to a geriatric care manager about a home safety inspection. You may find that your older loved one may be much more willing to listen to an expert outside the family that to their son or daughter. We are here to help. 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.
If you are a caregiver to an older, qualified loved one who has not yet applied for Medicare, then December 7 is looming large for both of you. Or if you are a caregiver whose deadline is not this year, but is next year, then it is time for a crash course in what Medicare covers and what parts do what for your older loved one. You can refer to the basics as the ABCs, but you also need to add a D. The rest gets easier. Medicare Part A very simply is the part of the federally-sponsored plan that covers hospitalization for those enrolled. For all those over age 65, this is the longstanding part of the coverage that has no premium to be paid and covers what Medicare will pay to providers for inpatient stays. This is the easiest part, because you will not find too many hospital providers who do not accept Medicare's inpatient coverage. These outsiders are pretty much just military or VA hospitals along with the Shriners' Children's Hospitals. Medicare Part B covers generally the doctors' billings and outpatient care for those who are age-qualified and have enrolled, and it costs about $104.90 a month to enroll. But - and this is a critical but - the providers in these settings have to "accept Medicare assignment." In large part, because Medicare has such strong negotiating power, not every provider wants to accept what they will pay for services. These doctors and others who most likely will be holdouts on Medicare assignment typically are psychiatrists or some specialties. With some exceptions, the Mayo Clinics will not accept Medicare patients, so it is important that you help your older loved one check to be sure the providers they use are on the list. You can do this by going to WWW.medicare.gov and clicking on "Find doctors and other health professionals." Medicare Part C was originally called Medicare Advantage. It is available through private insurance carriers who create panels of physicians in Independent Practice Organizations or Preferred Provider Organizations and more to cover what Part B does not cover. They also will charge a premium. There is an alternative sometimes referred to as Medigap, and you will want to check out which offers the best coverage and access to the providers your older loved one will want. Medicare Part D is an optional plan that offers prescription drug coverage which none of the first three offer. Your loved one will have to "opt in" to this plan as offered by private insurers. Some of this will be changing under Affordable Care Act, so stay tuned for changes that will help to close what often is referred to as the "donut hole," the part that the covered person must pay after the initial coverage is exhausted and before the next threshold of coverage kicks in. So that is your crash course in getting your older loved one enrolled in Medicare, but you need to be alert to some potential landmines along the path: • Just because your loved one's doctors or hospitals are in the covered network this year does not mean they will be in the network next year; • Not every carrier's prescription coverage will be the same - be alert to language about coinsurance versus copays, step therapy and prior authorization, all of which will impact the out of pocket costs of medicines; • Make sure that when your loved one is hospitalized that it is an "inpatient stay" (covered) and not "observation" (not covered); • Know the rules on how you can appeal decisions on coverage. 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.
Fetch! Come! Sit! Stay! Remember! So, I've given away that I’m a dog owner rather than a cat or other pet, but the commands here underscore findings from research reported at a recent meeting of the American Academy of Neurology. In short, the researchers from the University of Michigan reported that pet owners preserved their cognition better than non-pet owners in a six year study that followed 1,369 people who started with an average age of 65. Cognitive decline was slower for older adults who had pets. It has long been observed that pet ownership (some say that this is the other way around) is associated with lower rates of depression. The researchers here decided to delve into a potential relationship between pet ownership and cognitive decline in a large scale University of Michigan study called the Health and Retirement Study (HRS). Of the 1,369 people in this study, 53% owned pets and a majority of these were long term pet owners. People whose cognition was impaired at the outset of the study were excluded from the research. As the researchers followed both pet owners and non-owners, they found a statistically-significant advantage in the cognition measured among the owners. They also found that longer term owners had the edge over everyone else in cognitive retention. Those study subjects who were Black or college-educated or male had a more pronounced positive effect on cognition. While the researchers go on to say that this is not a cause and effect study, the findings favoring pet owners were statistically meaningful. Although the researchers stop short of advising all older adults to rush out and purchase a furry companion, they do point to additional positive effects of pet ownership. Other studies have demonstrated that pet ownership can mitigate loneliness and depressions. Still other research among military veterans not only improved the mental health of those with PTSD and worked to lessen depression as well. I would also add that the study found this positive effect on participants who were responsible for the care and maintenance of their pets. That is, just having a therapy animal show up regularly will not have the same cognitive benefit as hands on pet care and maintenance. Part of pet maintenance are the two or more daily walks for the pet and the owner if this is a dog. Let’s face it: the walks are good for more than cognition if both the furry friend and the owner put in the steps every day. Back to not using this study as a platform for advocating pet ownership. The authors did recommend that the data were sufficiently strong that they could strongly encourage that older adults with pets be supported in keeping their pets. Taking a pet from an older adult who may require alternative housing arrangements should not be considered without also considering how the pet and owner can be supported together. 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.
There are a lot of tests and exams we all know that are important to catching a condition early on or in some cases even before it appears. We know at what age and how frequently to have a colorectal exam, we know to go to our dentist twice a year, our personal physician once a year and a whole host of other regularly-scheduled tests to maintain our health and well being. And then there are the more subtle indictors… subtle because they progress quite slowly and it may be difficult to discern at what point we really do need to have our vision tested, our hearing assessed or our balance scrutinized by a health care professional.
But how many of us notice when our host’s kitchen doesn’t smell wonderful when we arrive for a dinner party, or when the roses are worth stopping to smell or when it is time to take out the trash…I really mean past the time to get the garbage out of the kitchen? And how many of us give a thought to how important our olfactory sense is for not just enjoying what is in the air all around us, but also a very good leading indicator of our living or dying? In an analysis of more than 20,000 patients in a number of studies - this is called a “meta-analysis” - scientists have found that “olfactory impairment,” or loss of smell, statistically predicts risk of dying. There was a lot of news early on in our COVID-19 pandemic about the loss of smell among those infected by the virus. But that was not predicting mortality; it was a side effect of the infection. The scientists who conducted this meta-analysis across a number of clinical studies found that not only is loss of smell linked to a number of chronic diseases, it’s also a general leading indicator of death, especially among older adults. It is enough of a worry that these scientists have now given this condition a name, “olfactory impairment” (OI). (Of course, they give it a label…) As many as half of individuals age 65 to 80 years have OI, and it is linked to a number of nutritional, neurodegenerative, cardiovascular and immune disorders. This is not to say that loss of smell causes these other life-threatening disorders, but the link is statistically clear. It’s not just about being able to stop and smell the roses; it’s about catching a potentially life-threatening medical condition in the early stages when it can be more productively addressed. If you or an older loved one seem unable to discern an odor that others around can smell, the OI may be nothing to sniff at. Want to read more from the scientists who have been investigating this condition, click here. 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.
As a geriatric care consultant, I field a lot of questions from people concerned about memory issues in an older loved one. Alzheimer's Disease is a condition currently affecting over 5 million people in America, and it is estimated that one in three seniors will die with either Alzheimer's or one of the other forms of dementia. It is the sixth leading cause of death in the U.S. Now comes the cost part. The Alzheimer's Association estimates that the disease will run up a $213 billion dollar bill this year, and that figure will climb to $1.2 trillion by the year 2050. So who is going to foot the bill for this frightening condition? Even among those over 65 years of age, Medicare does not come close to covering the entire bill for Alzheimer's care. The best estimates are that about 60% of the costs associated with the care of an Alzheimer's patient will be paid by the patient of family of the patient. And the total annual cost for the typical Alzheimer's patient will come to about $57,000 each year. Here are some costs that you need to watch:
- - Make sure you understand what status your loved one is being hospitalized. They may be staying overnight, but it may be labeled "observation" instead of inpatient.
Don't pull out your hair; there is help. You can call 1-800-MEDICARE or you can go on-line for answers. You will find answers at Medicare.gov. There also is a group called the Medicare Rights Center. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric care consultants, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.

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Posts tagged with ‘Diabetes’

What Caregivers Should Know About Diabetes Drugs

It Is Never “Just” Diabetes

Naturally Sweet Seniors are Better

Three Tips for the Diabetes Caregiver

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