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

An Elder Resource for Caregivers
One of my clients recommended a web resource recently, and I am so impressed by it that I am...
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January 7, 2011
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Alzheimer’s as a Woman’s Disease?
I talked about Alzheimer’s disease in my last posting. Maria Shriver, the First Lady of California has experienced Alzheimer’s...
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November 8, 2010
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A Radio Talk with Aging Info Radio
Earlier this month I had a chance to talk about some of the questions I most often get asked as...
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October 31, 2010
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In the Caregiver's Words

Recent Client Praise

In my past two postings, I know it may have sounded a bit bleak that we don’t have any FDA-approved therapies that can really address the underlying cause of the cognitive decline that is associated with dementia. That said, with so many health care professionals studying this condition, of which Alzheimer’s is a part, it is refreshing to see that we do find promising approaches with some regularity…or maybe I should say with some irregularity, but with reasonable frequency. I did mention a number of healthful steps that should be taken to reduce the risk of developing Alzheimer’s specifically and dementia generally. Let me add one more healthful step that has recently come to my attention - pomegranate juice. Pomegranate juice is an antioxidant that now has been tested against placebo for its efficacy with dementia, and it shows a positive effect in delaying the decline of what researchers term visual memory decline associated with aging. It was a randomized trial in which 261 participants were assigned to receive either pomegranate or a placebo. After 12 months, both groups were administered a standardized test of “visuo-spatial memory.” Memory decline is generally associated with aging and poor health style. This most recent research is part of a larger body of research that has been going on since at least 2013. In addition to this most recent study, scientists have studied pomegranate juice with animals as well as young to middle-aged subjects. In some of the research pomegranate juice did more than prevent further decline; it actually improved memory. Improvement was not seen in this most recent study, but with only eight ounces of pomegranate every day those who had the juice were statistically better off than those who had not received pomegranate juice. Do you see a pattern here? A whole lot of healthy lifestyle interventions seem to work for a whole lot of healthful outcomes…at the very least dodging some pretty difficult bad outcomes…like Alzheimer’s. Back to pomegranate. The researchers are studying the juice more closely, and have found that the juice is not only an antioxidant, it also is an anti-inflammatory and there is reason to believe that it also has specific anti-amyloid effects. This last one is what brings us back to its potential for Alzheimer’s disease. I will keep you posted on this as well as other ongoing research. 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.
The best estimates suggest that more than 7 million American have experienced and survived a stroke of some sort. Most of these people will be dependent in some capacity on a caregiver or certified geriatric care manager, because full recovery is relatively uncommon. In fact, the percentages break out generally along these lines:
- 10 percent of stroke victims will recover almost completely
- 25 percent will recover, but still manifest small deficits
- 40 percent will require ongoing care for moderate to severe deficits
- 10 percent will depend on skilled nursing care in a facility
- 15 percent fail to recover and will die within a short time of their stroke
Some of what will determine the category of a stroke victim is how severe the hemorrhage or clot was in the first place as well as how promptly medical attention was received. The rest will depend upon the rehabilitation following the acute phase of the stroke episode. Those who have suffered a "mini-stroke" or what are called transient ischemic attacks (TIAs) may recover spontaneously, but for the vast majority active physical rehabilitation will begin as soon as possible in the hospital. If the patient is stable following a stroke, rehab can begin within two days of the event. Once discharged, if you are a caregiver you want to be well-informed so that you can have an effective conversation with the care team at the hospital to get the best match of rehab for your loved one. This is where we often become involved with families of stroke survivors. This is so that the best care is provided and everyone has a clear picture of the goal of the therapy as well as the work that will be required to get there. The principal objective of all rehabilitation is to restore or improve physical function, but rehab also focuses on giving the stroke victim maximal independence and quality of life. To do this, some skills that have been taken for granted may need to be relearned, such as eating, walking or dressing. If you are a caregiver to a stroke patient, you will want to learn the language of rehabilitation in order to be the best advocate you can be for your loved one. The National Stroke Association has created a guide for choosing the right rehabilitation facility as well as understanding who all the players will be and what you should expect from each. It also includes a grading form so that you can compare facilities in order to pick the best program for your loved one. For a download of this Guide, just click here. Charlotte Bishop is a certified 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.
We’ve all heard about COVID’s symptoms…the GI upset, the shortness of breath, the fever, the added symptoms of the long-haulers, the after effects among those who survive COVID and more. We don’t hear much about the other big side effect among even those who don’t actually come down with the disease – depression. In the years leading up to the pandemic and quarantine more than 18% of people 65 years of age and older showed signs of depression. Dr. Kathleen Rogers of the Cleveland Clinic warns that depression or anxiety may be something akin to their own pandemic as a consequence of the isolation of 2020 and beyond. If you have an older loved one with whom you are only just now beginning to restore contact, be watchful:
- Those who have lost friends or loved ones to the pandemic are highly likely to be depressed.
- If your loved one talks with you about loneliness, isolation, lack of socialization...be attentive for a “down countenance” or even suicidal ideation.
- Signs of disorientation or memory lapses also can be indicators for depression owing to disengagement.
- Don’t be misled by the mom who always took care of things; women are almost twice as likely to have depression.
Signs of depression ought not be taken lightly, because depression is linked to other conditions like cardio-vascular health, dementia and more. People do not just “snap out of” a clinical depression. If you see or hear any signs of depression with your older loved one – and this is harder to discern over the phone or on ZOOM -reach out to:
- Your loved one’s primary care provider who is able to schedule an appointment for an initial assessment.
- The social worker or community case manager of the setting in which your older loved one may live.
- Your local city or community health department; they are likely to have a social worker or an advocate who can go to bat.
- The hotline - The National Substance Abuse and Mental Health Services Administration or dial 800.622.HELP.
We’ve talked before about “if you see something, say something.” Well, we are working with blinders still on as we all move back toward a new normal, so we may not visually see things as we once did. Follow your instincts and emerging from the pandemic and quarantine may actually be a return to “normal.” 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.
I’ve talked about this often in past posts: older adults have a greater fear of Alzheimer’s than of any other medical condition. In a recent survey, 39% of adults over age 55 feared Alzheimer’s while cancer trailed with 30% of these respondents reporting that as their fear. What we don’t hear as much about is the fear that the future caregivers of Alzheimer’s patient have…and with what they will have to cope. They don’t seem to have done any surveys, about future caregiving to an Alzheimer’s patient, but it’s likely the fear is mutual. When first confronted with a loved one’s diagnosis, caregivers naturally ask what they may now expect from their loved one…but the answer is a moving target. The symptoms of Alzheimer's disease devolve over time which dictates their capabilities and the appropriate interactions from the caregiver. Stage 1: It’s called mild or preclinical, because before the diagnosis is even made a patient’s brain is losing some of its original capabilities. During this first stage, loved ones may begin to see some changes in word-finding ability, name recall or what we can often write off as just “forgetfulness.” My husband’s mother had vascular dementia, but her early experiences were very parallel to Alzheimer’s. One of her go to questions came to be, “How do I know you,” which we used as a title for my book on dementia. Planning became more difficult, so she found it increasingly easier to simply let others organize her days and her life. Loving caregivers responded by simply picking up the slack in order to preserve her quality of life and her dignity. Stage 2: In some ways the progression to this stage is an amplification of the early stage symptoms, but diminished nerve cells take an understandable toll. As a caregiver, one learns to not simply remind the Alzheimer’s love one, but perhaps to also pick up the slack. The forgetfulness also extends to more fundamental activities of daily living. A caregiver will not merely help with finding the right word, but also the appropriate clothing for the season and other choices that earlier were almost done without a thought. Caregivers should also look for psychological withdrawl or moodiness and offer comfort. The patient will still continue with normal activities of daily living, but require more assistance. Stage 3: The final stage is marked by a graduation from anything that could be called mild impairment to more obvious shortcomings. A client once described life with his Alzheimer’s mother as having graduated from getting only four hours of uninterrupted sleep a night to now having only four hours of interrupted sleep each night. In this stage it becomes increasingly important for a caregiver to seek added help for what has become constant demands from their loved one. The patient’s overall health also is affected. It also takes a special kind of love as personality changes also begin to surface to the point that the loved one no longer is herself, but soothing music or loving touches can help. Alzheimer’s ultimately does “take a village” with professional support as well as the loving help of friends and extended family. It also is a significant help to have had a family health care provider engaged from the early stages forward so that they also have monitored as the caregiver sees the changes that need to be addressed. And everyone sees the patient who was and is. Let me also add that it is very important to seek out caregivers and care managers who are certified and accredited in supporting the family as well as the patient. 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.
It's a crime wave. In part owing to the rapid increase in the number of Americans over the age of 65, the fastest growing crime wave is elder financial abuse, and three of every five cases of elder financial abuse reported nation-wide are committed by a relative of the older victim. Nationally, Adult Protective Services agencies report that three out of five financial abuse cases they see involve family members taking advantage of older family members. It may be an adult child who rationalizes that taking money or other valuables is only fair because they are "helping" their older parent or that they would be inheriting it anyway. But it is still abuse, and it is still criminal. Perhaps because more older women live on their own having survived a spouse, they are more often the victims of financial abuse than men, twice as often in fact. The national financial toll of this veritable abuse epidemic is staggering. A recent study by MetLife has estimated the annual cost of elder financial abuse approaches $3 billion. Part of this huge figure is the fact that as older adults age, they will have ultimately require Medicaid benefits in the form of nursing home care of in-home care. If their assets have already been plundered by a family member, then everyone who pays taxes is, in effect, picking up the tab for the scam. There is hope. And there is help on the way. A number of organizations are stepping up to help better protect elders from financial abuse. The Consumer Financial Protection Bureau has issued a guide aimed at educating nursing care facility employees on the signs and symptoms of abuse. If you see something, say something! The American Bankers Association is partnering with AARP to better inform professionals in the finance sector on how to spot financial abuse. The first of these gets the word out to those who care for elders at a stage in life when they are most vulnerable. And since so much of this wave of financial abuse can happen through legitimate channels of finance, getting bankers to recognize the signs of family theft is spot on. Efforts such as these are all the more important, because there is no national law against elder financial abuse. The State of Illinois is not alone in giving everyone a chance to be "their elder's keeper." There is an abuse hotline that will get the Illinois Department of Aging on the case if you suspect financial or other abuse. Share this number so that anyone who sees something can say something: 1/866-800-1409. 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.
In the first of my present series of postings on recent Food and Drug Administration (FDA) warnings, I had talked about new evidence of long term health risks from some pain medications that are available both in prescription and over the counter (OTC). In this posting, I am going to share with you another FDA warning, this one for prescription medications that lower cholesterol. The “family” of medications is commonly called statins and includes some very well known brands that many of you have seen advertised on television and in magazines. Others of you or the people you care for may also be taking these medications.

All Americans have been alerted to the risks posed by increasingly high levels of cholesterol many of us have in our bloodstreams owing to eating foods high in fats or just plain eating too much. One way to address the elevated “bad cholesterol” or low density lipids (LDLs) is through diet and exercise. But for people with persistently high LDL, a physician may also prescribe one of the many statins available. These go by names like Crestor, Lipitor, Zocor, Levacor and Pravachol, and when taken as directed, they do help to reduce LDL levels. Research published in the June 22-29, 2011, issue of the Journal of the American Medical Association looked at a number of individual studies which had showed a link between high-dose statin use and diabetes as well as a risk for cardiovascular events.

The researchers pooled the findings of five different and large clinical studies of moderate- and high-dose statin use among patients. These studies followed patients for a number of years and the results over time were pretty compelling.

When the researchers compared the moderate and high-dose groups at the end of the nearly five years of the research, the high-dose group had 12 percent greater chance of developing type 2 diabetes than the moderate-dose statin users. But the high-dose users of one of the statins, Lipitor, experienced a 16 percent lower likelihood of having some sort of cardiovascular event like a heart attack, stroke or even death. The other statin studied did not offer any cardiovascular benefit. It is not clear how other statins fared in terms of heart health. The diabetes link was the most consistent across medications.

As with a lot of modern medicine, the devil is in the details. It seems that high-dose statins pretty uniformly put patients more at risk than moderate-dose statins for diabetes. It is important to appreciate that these are significant differences, but even then, the numbers of patients who may expect an issue to develop will be quite small. As always, consult with your primary care physician or cardiologist about your medications of those of the elder for whom you provide care.

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 throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.

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Posts tagged with ‘elder resources’

An Elder Resource for Caregivers

Alzheimer’s as a Woman’s Disease?

A Radio Talk with Aging Info Radio

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