Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • geriatric care manager ChicagoChicago's Geriatric Care Manager Center of Excellence

Eight Questions You Should Ask a Geriatric Care Manager
Over the past couple years on more than one occasion I have talked about what a geriatric care manager...
Read more
June 22, 2012
0
0
Are You Getting Older or Better?
With this posting, I am introducing a colleague and guest blogger, Pamela Holtzman, who is a therapist I know...
Read more
January 27, 2012
0
0
Making Home Safer for the Holidays
If you will be heading home for any of these seasonal holidays you will find that it can be...
Read more
December 23, 2011
0
0
Senior Scams Spike During the Holidays
We are fortunate to have a new contribution from a good friend and colleague, Julie Northcutt of Caregiverlist.com. Julie...
Read more
December 14, 2011
0
0
Four Things a Geriatric Care Manager Is
It has been over a year since my first posting when I started this blog by talking about why...
Read more
December 8, 2011
0
0
Four Ways a Caregiver’s Nose Can Help
I have written in past blogs about some of the inevitable decline of physical capabilities associated with aging, and...
Read more
October 14, 2011
0
0
Four Ways to Fight Dementia
What do hearing aids, exercise, support groups and travel have in common? They all are ways that individuals suffering...
Read more
October 2, 2011
0
0
Illinois’ Long Term Care Scorecard
Illinois long term care has been ranked at about number 24 out of the 50 United States on a...
Read more
September 29, 2011
0
0
Three Ways to Advocate for Elders
Everyone who is a caregiver to an elder or other person with special needs has to be an advocate...
Read more
September 15, 2011
0
0
Five Things to Know about Kidney Disease
It’s a disease that affects about 26 million Americans. If untreated it will kill these people. And more than...
Read more
August 24, 2011
0
0

In the Caregiver's Words

Recent Client Praise

Raise your hand if you haven’t heard enough bad news in 2020. I thought so. We know we are not yet out of this pandemic, but I am not going to talk about any of that today. Instead, let me share the top five good news stories coming out of this past year…news that has been reported, but may not have reached all of you given a plentitude of COVID and related news. This is not my usual focus on elders and the families who support them, but I think good news may be in order. Please let me know which of these you may want to learn more about.
1. Eliminating Cancer: Scientists from Australia reported lab results that perhaps promise a vaccine for a number of blood cancers as well as some malignancies such as breast, ovarian, pancreatic, lung, renal and glioblastoma.
2. Food Insecurity: The Nobel Peace Prize for 2020 went to the World Food Programme for supporting almost 100 million people who have been victims of hunger and malnutrition in nearly 90 countries
3. Artificial Eyesight: A team of scientists from around the world collaborating in the Hong Kong University of Science and Technology have created a spherical eye with 3D vision capabilities. It is being refined for use in humans as well as possibly in humanoid robots.
4. Cleanup on Plastic: This is a list all countries should be on, but so far, it is Ghana, Vietnam and Indonesia who have committed to cut their plastic waste by 100%, 75% AND 70%, respectively by 2025. They are partners in the Global Plastic Partnership.
5. Water on the Moon: Okay, many of you are familiar with the 1968 Movie based on the book, 2001: A Space Odyssey. There is more water on the moon than has been thought, and that means that a sustainable base for humans on the moon may be within reach. By the by, there are plans to launch a woman and a man to the moon in 2024.
Let’s put 2020 in our rearview mirror and look forward to more good news in 2021. Remember your masks, remember your social distance, remember to wash your hands and look to a better future. 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.
LifeWorks Erie is the provider of relevant, contemporary programs, services and lifelong learning opportunities that engage the 50+ individuals who are interested in staying active mentally and physically and want to lead healthy, vibrant lives.
Who We Serve

We serve as a trusted filter and adviser to older adults and their families regarding choices which enable living well, maintaining independence and access to complimentary services throughout the changing needs of aging. Through our programs and services, LifeWorks Erie encourages optimal aging by offering opportunities for wellness in all of its dimensions: intellectual, emotional, mental, physical, psychological, and spiritual. Learn More At: www.lifeworkserie.org
Program and Service Areas

Lifelong Learning
Regardless of age, but particularly during the aging process, stimulates curiosity, exploration, and new experiences that in turn decreases the incidence of various diseases and promotes health and well-being.

Non-Medical Services & Programs
Including the New Horizon Music Project, Return to Work Counseling, Oral History Collection, Creative Aging, Café Service, Computer Usage, and many other services as describe on our website.

Prevention & Health Management
Members of our staff are certified in Chronic Disease Self Management, Reiki, Therapeutic Yoga, Powerful Tools for Caregivers, and Arthritis Fitness. Our staff includes a Recreational Therapist, Nurses, and a Certified Fitness Instructor. LifeWorks Erie offers health screenings, counseling and education, and flu and other vaccinations to the community.
Creative Care Management proudly supports Lifework Erie's work, especially as it relates to elder care services.
Family life crises don’t make appointments; they just show up. For most people that means tackling a crisis with no experience and no plan. (Hope is not a plan!) So, if you are one of the estimated 109 million Americans who have an older loved one in your orbit, what do you need to do to make a Plan? Here is my “short list” of the documents you need to have and be able to put your hands on… sometimes with no notice: • Medical Release – the document you need so your loved one’s medical providers to speak with you about your loved one’s health status, medications and prognosis. • Power of Attorney (POA) for Finance - a legally binding document that gives a person (referred to as the “agent” or “attorney in fact” permission or power to act on behalf of an individual in matters of property or finance. • Power of Attorney (POA) for Healthcare - a legally binding document that gives a person power to act on behalf of an individual in matters of medical treatment. The “power” typically is in force when it is deemed the person in question can no longer act for themselves or if they are not conscious. • Practitioner Orders for Life-Sustaining Treatment (POLST) – a document (varies state by state) that specifies in advance what measures an individual wishes to have in the event they cannot expressly grant permission themselves. These orders typically revolve around life-saving measures; they are sometimes referred to as advanced directives and are placed in a patient’s medical files. • Health and Life Insurance Policies – the health policy will help everyone involved understand what is covered and which physicians and other providers are available to your older loved one. The Life insurance policy should be in a safe place so that it can be readily accessed should that become necessary. • Estate Plan – is (potentially) a wide-ranging document that let’s everyone know how any real estate or other holdings are titled and what the “plan” is for when a will is executed. • Trust documents – help to identify how one’s estate is to be transmitted to beneficiaries. Trust names need to be consistent with life insurance, will and holdings in order to be in effect. • Last Will and Testament – the legal document by which a person expresses his or her wishes of how property is to be distributed at death, and names one or more persons, the executor, to manage the estate until its final distribution. • The Grab and Go – This is a list that typically is sealed in a plastic bag. It includes medical insurance documentation, a list of allergies, a list of medications, primary care physician contact details and in case of emergency (ICE) contact information. Please email (info@creativecaremanagement.com) me with any questions on any of these…as well as how to take the next steps which is your plan. Do yourself a favor…don’t wait for a crisis. 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.
I have written in earlier blog postings about dementia: “preventing” Alzheimer’s Disease, Alzheimer’s from the inside out, maternal genetic links to Alzheimer’s, and women’s predisposition to Alzheimer’s. I would like to share some research that shows dementia to be tied to a number of other chronic conditions we often find among the elderly. This posting is about monitoring and managing other medical conditions in order to reduce the chances of developing dementia, and it underscores one of the most important parts of geriatric care management specifically or caregiving generally.

Dementia is more common among people with diabetes than among the non-diabetic population. Diabetes seems to be more related to vascular dementia, but research shows also some risk for Alzheimer’s among diabetics. One study found that even a 1% rise in long term glucose levels (referred to as A1c) was associated with declines in three different measures of cognitive function. Researchers have long known that poorly controlled diabetes is associated with renal and cardiac complications. These same micro-vascular issues associated with diabetes can lead to brain disorders, with some suggesting that Alzheimer’s disease could be considered “type 3 diabetes.”

Another risk factor associated with higher rates of dementia is elevated blood pressure, or hypertension. And the flip side is true as well with one clinical study documenting that well-controlled hypertension actually reduced the risk of dementia. And blood pressure registering above 140/90 evidently encourage Alzheimer’s or other dementias.

Finally, alcohol use taken to excess can lead to impaired cognitive function for anyone. For older adults, excessive alcohol consumption has been associated with dementias and also have been found to aggravate existing dementia or Alzheimer’s disease.

A care manager or caregiver should always be alert to any signs of impaired executive function in an older adult as this may mean that the diabetes or hypertension are not well-controlled, or that there may be alcohol abuse. Be alert to an elder’s:
- poor organization,
- loss of attention or train of thought,
- poor judgment sorting good from bad ideas,
- faulty short term memory, weak reasoning and even
- lack of awareness of their deficits.
A medical provider can assist in administering a Mini-Mental State Exam to confirm any deficiencies as well as address these other co-morbidities. Acting early can save an elder from the slippery slope that is dementia.

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.
Happy Valentine’s Day…a couple days late. February is American Heart month, so why would I start by talking about your older loved one’s pancreas? Let’s start with the fact that one in four adults over age 65 develops diabetes. And although it is over-simplifying things a bit to say that type 2 diabetes is all about having too many sweets, there is a strong connection between consuming too many carbohydrates over one’s lifetime and developing type 2 diabetes. Unfortunately, there also is a strong connection between diabetes and cardiovascular disease. But wait, it gets even scarier. The combined prevalence of prediabetes and diabetes – both undiagnosed and diagnosed, respectively – is estimated to be between 50% and 80% among older Americans. So, why does this affect the heart? Well, diabetes has a way of making a person’s blood a bit sticky. Well not literally sticky like gum on a sidewalk, but uncontrolled diabetes leaves more sugar floating in the bloodstream, and the sticky cells that have been tangled up with the blood sugar tend to block the smallest vessels in the cardiovascular system. The heart may pump blood through some very big arteries, but the muscle itself is made up of a lot of microvascular pathways that keep it fed and oxygenated. Once we add free sugar to the mix, some of those tiny vessels become clogged. The less well-controlled the diabetes is, the more sugar is roaming the cardiovascular highway, and the more blockage there is. No surprise then, that in excess of 70% of both men and women over age 60 have some level of cardiovascular disease. Now, we could go on about the damage to other microvascular regions of the human body like the kidneys or even the eyes and the feet and the hands, but the lesson is already clear. As we reflect on our past valentine’s day, go a bit lighter on the candy that may still remain in the box and a bit heavier on the love. Because in addition to hurting the little vessels of the heart, the excess chocolates that we cannot burn as energy for our bodies get stored. And you probably already see where this is going; the unused sugar gets converted to fat, and each pound of that unwanted baggage creates another mile of blood vessels. It is a bit crazy to think that we have to feed the fat, but every cell of the human anatomy is no more than one cell away from a supply of blood. So Valentine’s Day has to share the calendar with American Heart Month. And if we all do that, then maybe we can even consider renaming February as American All Around Healthy month? Charlotte Bishop is an Aging Life Care Professional and 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.
I have not taken a real opinion poll, but from feedback I get as a geriatric care manager from my clients what scares them most is not the prospect of dying. It is the prospect of losing their mental abilities. Alzheimer’s disease is high on the list of “feared medical conditions" even though it is down at number seven on the list of overall causes of death among Americans. With “National Memory Screening Day” coming up on November 16, I thought it would be a good time to share a few perspectives on Alzheimer’s and related cognitive conditions.

Alzheimer’s is just one of the three major types of dementia that health care experts talk about. Dementia is any disease that can cause progressive loss of memory or function. Alzheimer’s has a lot of “name recognition,” but there also is vascular dementia. Vascular dementia is a result of the arteries that bring blood to the brain hardening. Just like the kind of hardening of arteries that starves the heart over time, vascular dementia starves the brain. Finally, there is a third category that covers a number of conditions like Lewy Body, frontotemporal dementia and even Mad Cow disease, but these are quite uncommon.

There also are “dementias” that are reversible. Depression can be confused with other dementias, and it is very common among older adults. Other medical conditions like hypothyroidism, Lupus, vasculitis, some venereal disease or B12 deficiency can cause reversible dementia. Substance abuse – common among older adults – is a source of reversible dementia. And other prescription medications can impair recall and cognitive function.

Some of the classic signs of the onset of Alzheimer’s disease you can look for include when the individual:
- Tells the same stories
- Asks the same questions
- Has difficulty with numbers
- No longer does the things they commonly have done (cooking, sewing)
- Gets lost in unfamiliar places (restaurants)
- Neglects their own self-care
- Defers to a caregiver (“Ask my spouse”).
A person can do a small self-check as well. I suggest to my clients that each evening they write down a short list of notable events from that day. The next morning they should review what they wrote the night before to determine if they can remember them. It gives them peace of mind, because we tend to forget that everyone forgets some things along the way.

There is a lot more ground to cover on this, and I will get to more in later postings. For more answers or resources, go to the web site of the Alzheimer’s Foundation of America. I also would like to address your concerns or questions in future postings, so please e-mail me at Charlotte Bishop.

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.,geriatric care manager Chicago,geriatric care Chicago.