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

Building a Survivor Safety Net for the Caregiver
I have written a lot about caregiving, who the caregivers are, how to cope with caregiving and how to...
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October 1, 2013
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That “Other Caregiver Talk” with an Older Loved One
In my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved...
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September 26, 2013
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For Caregivers with Single Senior Parents
There are nearly 40 million people in America 65 years of age or older, and that number is expected...
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September 24, 2013
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Caregivers and their Medicare?
Yes, you read it right. I am posting this one about what caregivers should know about their Medicare. But...
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September 12, 2013
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Caregiver (Sibling) Rivalry
Raise your hand if you ever had a disagreement with a brother or sister as you were growing up. ...
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September 5, 2013
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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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Three Caregiver Signs to Step Up
Caregiving is not like a switch that we turn on or off, that we are either caregiving for an...
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August 19, 2013
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5 Reasons Why Older Adults Need Caregiver Water Breaks
While it has been a fairly temperate season where we live and work, not all parts of the world...
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August 5, 2013
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Doctors Are Asking Older Patients About Guns
If you are a caregiver to an older adult, don’t be surprised if your loved one is asked if...
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July 25, 2013
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Seven Caregiver Trends
You may not have been following the news in China this past week, but China has enacted what may...
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July 23, 2013
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Associate Care Manager Gregory Peebles returns with a series on the Internet and older adults. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte The Internet is a safe place if you know how to navigate is safely. It’s user-friendly if, like the youngest generation, you grew up using it all the time. Most, however, have not had that advantage. We learned on our own, and any self-taught amateur will tell you that without a teacher, you can learn a lot of things wrong. There’s no shortage of helpful information on scams directed at older adults who have ventured onto the Internet. At CCM, we try to feature this type of content as it becomes available. Today’s post, however, is about common, globally unsafe habits from which we’ve witnessed our clients and their families struggle to recover. Have these conversations with your older loved one before you have to clean up a digital mess or reclaim a stolen identity.
1. Passwords. Plural. There should be a different password for each online account, and they should change with some frequency. It’s annoying, but at least it’s easy. You know the “best practices” – upper and lower case letters, numbers and even the “other” characters (@, #, etc.).
2. The Not-So-Funny Joke Forward. Sometimes a dangerous link gets inserted into those joke message forwards. Anyone curious/unlucky enough to click on it gets a nasty surprise. Tell your loved ones Don’t click on links unless they are in a personally directed communication from a trusted source.
3. Oversharing. Social media encourage us to tell everyone everything, first among which is how we feel, where we are, what we’re doing. Older adults - not as fluent in the standard practices of safety - are most likely to fall prey to those seeking to benefit from oversharing, an example of which might include updating a status about leaving town for a while. Predators are looking for exactly this type of information, especially if they know their prey’s address already.
4. Oversharing: The Sequel. Similarly, older adults are much more likely to give out personal information casually in a public forum (as in a comment). Not only will it overwhelm your loved one with junk mail, placing them at higher risk for scams, but someone looking to take advantage can get an incredible amount of information from just a name, a phone number, and an email address.
5. Shopping the Black Market. Non-secure websites don’t even pretend to protect your information. How can you tell if a website is secure? Nothing is 100%, but if the URL you’re shopping at does not begin with [https:], leave immediately. The extra “s” is for “secured”, and without it, online shopping becomes a huge risk. Noting this one thing can save lots of money and trouble.
Internet safety could be its own series, but with these five tips, we’re confident your loved one will be safe exploring all the Internet has to offer. 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.
Everybody eventually learns to accommodate the “empty nest” that inevitably follows the busy days of child-rearing and child-launching. And then – maybe after a rather substantial wait – there is, once again, the prospect of more little ones in the house. This time, however, they are grandchildren, and as much as everyone who raises kids knows how not to drop a baby, the world has changed. It translates into a new kind of child-proofing different from a generation ago. This is advice for seniors who may be hosts to little ones for the first time in a lot of years.

1.    First, it is important to start with an open mind. It is too easy to slip into a mindset of “what was good enough for my kids,” but times have changed and so has safety. So, some of the old toys may still be considered safe, but the old car seat, play pen or infant swing may not be just outdated; they may be dangerous. Defer to the new mom and dad for advice on what will still work and what needs to be replaced by the next new thing. This approach is also politically helpful in empowering the new mom and dad.

2.    Remember also that when you raised your own children, you may not have had any of the chronic conditions you now have. And you also would not have the medications associated with those conditions, so develop a plan to store medications safely and out of reach of kids. While you may not want the nuisance of those safety bottles, you really need to be certain that medications that will be attractive nuisances to little ones on the prowl are locked up. This is especially true if one of the older grandparents uses the “day of the week” pill reminders that often are stored in the kitchen as a reminder for prescription schedules.

3.    For an add layer of safety, go to the source. The Consumer Product Safety Commission has a twelve-step approach to fully kid-proofing your home, and a number of their recommendations like smoke alarms and carbon monoxide detectors which are great safety measures for everyone. They have a downloadable two page brochure to walk you through the steps (click here for brochure).

4.    This last one is making the grandparents house safe from what the toddlers or young children will bring with them. Falls among seniors are often caused by the unexpected, and there is nothing so unexpected as the little dolls, cars or a myriad of other items that you will buy for the kids or that they will bring with them. Make it a habit of picking up after play time, because you may not see the little hazard on the floor…especially after sunset.

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. Read more about Our Story and Charlotte's mission.
My mother used a phrase to put a good face on her moments of leisure. She would say: “Sometimes I sits and thinks, and sometimes I just sits.” I have some bad news for my mother – sitting (thinking or not) too much is not good for your health or your life expectancy. I haven’t missed too many opportunities to talk up the virtues of exercise and diet in not just extending one’s life, but also improving the quality of life. Just when you think that your hearty breakfast this morning and your 60 minutes of cardiovascular exercise will assure your good health, think again. If you took the afternoon off to watch your screen or even read a book and the time spent on that couch over the course of the day totaled 6 or more hours, your chance of dying young just shot up 19 percent over your peers who sat for less than three hours. And the causes of these premature deaths are not limited to just heart issues. There is a whole range of conditions that can get in the way of longevity for couch potatoes. The conditions that can shorten a person’s life can include everything from chronic obstructive pulmonary disease (COPD) to diabetes or lung disease or kidney disease and more. And here’s the part where those of us who are caregivers to older loved ones should pay more attention; it is not just older individuals who run this risk if they sit too much. Researchers have compared transit drivers with transit conductors or prison guards and found that these occupational groups tended to have pretty similar diets and lifestyles. The drivers, they found, were twice as likely to die of a cardiac condition as their counterparts who spent more time on their feet. The scientists cannot claim a cause and effect, but they do point to higher rates of obesity tied to sedentary lifestyles. And the obesity is tied to higher levels of inflammation overall which leads to a host of diseases. But sedentary people also have higher rates of suicide, Parkinson’s disease and Alzheimer’s as well, and this leaves the researchers scratching their heads a bit. The basis for some of these conclusions is a 21 year long prevention study sponsored by the American Cancer Society. Of the 128,000 healthy volunteers who were enrolled in this study, 49,000 died during the succeeding two decades for the causes I have outlined. So, even though they cannot say that sitting kills people, my takeaway is pretty clear. No matter what your age, make it a point to stand up, stretch and walk around every hour and then rinse, repeat. 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.
Because health care – particularly long term care – can be expensive for elders and others with special needs, it is critical that anyone looking for Medicaid qualification take action before June 14, 2011. As a geriatric care manager, we help elders and special needs individuals as well as their caregivers to navigate Medicare, Medicaid and the other entities that provide safety nets for those who qualify.

There are changes in store for Medicaid that may affect who qualifies and how they qualify after June 14 of this year. I had the benefit of sitting in recently on a presentation by an elder law attorney in the Chicago area, Janna Dutton, who helped shed some light on the subject.

Medicaid is mandated by the federal government, but the details of how it applies and how it is financed are the domain of state government. I will be talking in this posting about what we know now about Illinois law as well as what we do not know. So, let’s start with an individual who is seeking to apply for Medicaid in Illinois.

First, of course, that person must be a legal resident, but that part is simple. For Illinois, a resident simply is someone in Illinois (for no specific duration) with no intention of leaving. There is no duration of residency required. To qualify for Medicaid, however, an individual cannot own a home outside Illinois, not even a vacation home. And the individual must be over age 65 or be eligible for Social Security Disability benefits.

Presently, a person will qualify for Medicaid only if they have no more than $2,000 in liquid assets, but this does not include a home (which can be valued at no more than $750,000 if the applicant plans to return home after their stay in a nursing home). State government has a “look back” period of 36 months prior to application. That is, they will “look back” three years at an applicant’s finances to see if there were any expenses or “gifts” that may appear to be efforts to deplete funds for the sake of qualifying for Medicaid. Any suspect monies expended will be added back to existing assets. Anything over the qualifying amount then will be spent before Medicaid contributes to the person’s care.

Exceptions may include “gifts” that have been a longstanding pattern of giving by the applicant (for instance, dollar amounts consistently given to grandchildren upon marriage, graduation, etc.) The date from which the spend-down starts presently is the date of the gift that forced assets to exceed the $2,000. Asset qualifications for applicants may be what will most change after June 14. After June 14 it may be as much as a 60-month look back, and the ineligibility may start at the date of application rather than the gift.

The financial scrutiny also extends to accounts that may be held jointly with a caregiver or relative. The joint account will be considered the exclusive asset of the applicant unless there have been regular deposits to this account by the non-applicant. For this and all accounts, the responsibility for documenting paperwork is that of the applicant.

This is some of what we know, but it is what will change after June 14, 2011, that we cannot fully know. I recommend you seek counsel from a qualified Illinois attorney, and I particularly recommend you go to Janna Dutton’s website for helpful information and advice about this and other elder law issues.

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.
I promised in my last posting to talk more specifically about what can be made safe for seniors who wish to age in place – room by room. I am going to start with the room in the home where most accidents happen, the bath. The bathroom for most elders represents the perfect storm of a confined space with potentially slippery surfaces. Nearly one-third of seniors over age 65 fall each year, and the majority of these falls happen in the bathroom. With basic planning and potentially some retrofitting, however, the bath can be made more safe and accommodating to an older person’s limited mobility and range of motion. Let’s start with surfaces.

There may already be a rug near the shower or bath area, but make certain it has a sticky, non-slip back to minimize falls when an elder enters or leaves the tub. If your older loved one uses a floor mat in the tub area when showering, make sure that the suction cups still offer good sticking poser. You may consider adhesive decals that stick to the porcelain tub surface with soft gripping rubber top surfaces. In the shower area itself, consider having a bath bench or chair with non-slip feet if your elder has difficulty standing for protracted periods or is at all unsteady on their feet. If your elder loved one is challenged by lifting their feet over the tub edge to step in for a shower, it may be time to refit their bath with a stall shower with a low or minimal curb in place of a tub/shower combination.

Having a non-slip, moisture-absorbent surface near the tub is a safety assist, but any other loose rugs should be replaced or eliminated. Look for uneven floor surfaces or thresholds and consider eliminating them, beveling surfaces or highlighting them with paint or tape. Loose cords from radios or hair dryers should be removed from walkways, and other floor level clutter like magazine racks should also be eliminated.

Just as in hallways, consider installing grip bars at strategic points in and around the tub or shower as well as either side of the commode. For seniors with difficulty getting up from chairs, consider also a raised seat for the commode as well as grip bars that flank the sides of the seat like arms on a chair. There even are hydraulic assistive devices that can be installed on the toilet seat with a lift that can help ease the senior into a seated position and then boost them slowly back up as they rise from sitting.

Lighting is as important in the bath area as it is in the rest of the house. If the present circuits allow, it may be as easy as upgrading to a higher wattage bulb in all the fixtures. In old houses, however, it may be safer to refit with new fixtures that can offer more lighting. And also as with other parts of the house, have a night light that automatically goes on when ambient lighting fades.

Finally, make sure that everything that your elder may need with any frequency while in the bathroom is within easy reach. Remove actual glassware or ceramics from the bath and replace with plastic, especially cups that have gripping texture on the outside. And while you are outfitting the bath, keep in mind bright colors and pleasant decoration. Just because your bath is now safe does not require that it look institutional. Next week, I will talk about what’s cooking in the kitchen.

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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