Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • geriatric care manager ChicagoChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 2

Not Just Dementia
I have written in earlier blog postings about dementia: “preventing” Alzheimer’s Disease, Alzheimer’s from the inside out, maternal genetic...
Read more
August 17, 2011
0
0
AARP’s Annual Report on Family Caregiving
In many of my postings on family caregivers I have talked about the really hard job of caring for...
Read more
July 18, 2011
0
0
Prescription Drug Risks for Elders-part 3
In my past two blog postings I have talked about some recent warnings from the Food and Drug Administration...
Read more
July 14, 2011
0
0
Prescription Drug Risks for Elders-part 2
In the first of my present series of postings on recent Food and Drug Administration (FDA) warnings, I had...
Read more
July 9, 2011
0
0
Prescription Risks for Elders-part 1
Within the past two weeks the Food and Drug Administration (FDA) has issued a number of warnings that concern...
Read more
July 6, 2011
0
0
Seniors and Side Effects
I have written in past postings about some of the interactions between medicines that older adults may see if...
Read more
June 14, 2011
0
0
Medicaid Changes to Affect Seniors
Because health care – particularly long term care – can be expensive for elders and others with special needs,...
Read more
June 10, 2011
0
0
Summer Visits for a Senior Care Check-up
In this posting, I have invited Julie Northcutt, President of Caregiverlist.com, a company that uses new technology to deliver...
Read more
June 3, 2011
0
0
Making Home into a Gym
I have written in other postings about how “staying active” can be tremendously important for older adults or others...
Read more
May 27, 2011
0
0
Geriatric Care Management is Catching On
We may not be hearing QUITE as much about health care reform of late, now that the political debate...
Read more
May 17, 2011
0
0

In the Caregiver's Words

Recent Client Praise

I’ve posted a lot over the years on the factors that affect aging…and aging well so that when you are caregiving you know about what else may be going on with your older loved one. I have talked about diet and lifestyle, hereditary factors and even how to make home better support an older loved who ages in place. And I have shared what works against men to shorten their life span and add to what can affect their health in general as they age. Race is also one of those factors that in and of itself impacts how long and how well a person will live. The American Psychological Association has recently released some invaluable insights into how to address racial disparities in health and well-being … particularly among older people of color, and it could not be more timely. There are more than four million African Americans, and one of them could be your mom, dad or older loved one, friend or neighbor. And some of what negatively impacts their health is simply being African American. The American Psychological Association suggests some steps we all can take as we support or interact with our older African American loved ones:
- Show empathy – this is different from sympathy; empathy requires a lot more listening and being prepared to not “get” where someone is coming from, but to listen just the same;
- Support their spirit – find out what centers the older loved one … nourishes their spirit and you may be amazed at the strength spirituality provides them; again, listen;
- Steer Clear of Triggers – as much as we may all have been disturbed by the present news cycle, this past week’s news coverage will be profoundly distressing for anyone who has “grown up with racism;” again, listen;
- Get informed – appreciate that your own cultural tapestry comes from growing up differently; find forums and information that can help enlighten you about the culture as well as unique health needs or older people of color; again, listen;
- Celebrate and advocate – the more you learn, the more impressed you will be of the African American heroes and leaders who truly embody the concept of “self-made”; again, listen.
Okay, I have used the word listen a great deal here. I would be very interested in what you hear and what you learn. Please send me an email (click here) or call our toll free number (855.455.5118 ext 511) to share your story. And if you want more insight, please click through to the American Psychological Association’s advice as well as additional resources (click here). 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.
It's June, and school is out for a lot of kids and everyone is thinking of taking time off. In fact, by a certain time of the year most people who are going to take a summer vacation will have made their plans. We all know how to make plans and make reservations to get to where we want to go. If we look beyond what month it is and think about seasons of our lives, we may also be thinking about retirement. By a certain time of life most people will have made retirement plans. We all know where to turn to get advice on how to make plans and maybe even a picture of where we would like to be once we become financially independent. As a geriatric care manager, let me suggest also that by a certain time of life most people will not have made plans for getting older. In fact, the plans that need to be made for getting older typically will not be made by an older adult, but rather by their caregivers. And the typical caregiver will not always know where to turn to make those plans for their older loved one. So, please allow me to share with you what is usually 60% of my first conversations with someone who e-mails us or makes a call as a way of explaining what a geriatric care manager does. Looking at that first example of summer vacations, it would be really great if there were a geriatric care equivalent to Travelocity. Or talking of retirement, it would be really easy if having a plan for getting older would be like following that arrow line in the television commercial. But there is hope. Making plans for getting older can be easier than a lot of caregivers think. The majority of the first conversations I have with clients are a lot about what they are looking for like: • home medical care for an older parent, or • a senior community where mom or dad can move or • where to go for what they see as the onset of dementia in a loved one. As the conversation unfolds, it usually becomes clear that what is needed first is an overall assessment and then a plan for the options available to support a loved one in maintaining their maximum quality of life. One of my associates calls us the "wedding planners" for getting older. To just get home care may be a bit like that wedding planner who just tells you where they have a great stock of wedding dresses when you were really looking to plan that "special day." To just get a list of senior communities in the area may ignore the other options for aging in place that could come from a full assessment leading to a plan. And it may be dementia or it may be interactions among any of the multiple medications that your loved one has been prescribed by multiple providers. What may be more helpful is someone to look at the big picture and help make a plan. If you are a caregiver, think about your concerns for your older loved one, but also consider looking into geriatric care managers. They are essential in providing an overall informed assessment and even more important for discovering all your options. The person who can best do that likely is the person who sees the big picture and knows all the resources available. Charlotte Bishop is founder of Creative Care Management, a team of geriatric care managers, certified professionals, advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecasemanagement.com.
Most of you probably know that Alzheimer's disease is the most common form of dementia among younger and older Americans. One in three Americans dies with either Alzheimer's or some other form of dementia. Scientists make a distinction between what they call late-onset and early-onset Alzheimer's Disease. Very simply, early-onset is a disease that manifests itself among patients younger than 65 years old, and late-onset is among those who are 65 plus. As a geriatric care management professional, you can imagine that I commonly am involved with families who are addressing this frightening condition in a loved one. If you are a caregiver to an older adult or other loved one who has developed Alzheimer's, you are very familiar with short term memory loss as well as confusion, language difficulty or other cognitive issues. But there have been some recent possible breakthroughs in Alzheimer's research, particularly late-onset Alzheimer's. What makes this potentially more exciting is that the specific Alzheimer's manifestation where this research has relevance. It is for the common non-familial kind of Alzheimer's Disease, the one that has seemed so unpredictable. In research published in the journal Nature, scientists at Columbia University seem to have narrowed down the late onset Alzheimer's to two genetic pathways. They then compared the genetic pathways among study subjects who had not manifested Alzheimer's and they did not have these pathways. They found in other subjects that these two pathways were associated with the development of what is called amyloid plaque. And that those without these particular genes did not have the amyloid tissue. While this research is all very preliminary, the good news is that when scientists find these "pathways" are tied to the onset of a disease, they can then begin to research what they can do to therapeutically modify the pathways – in effect, turning off the gene expression. It is going to take a lot more research and testing, but it offers a much awaited bit of good news for the more than 5 million Americans and their caregivers who are living with this disease. For more information on the disease, we have links to the Alzheimer's Association on our geriatric care management Support Tools Tab. 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 ccbishop@creativecasemanagement.com.
Thanksgiving along with all the end of year holidays are great times when all the adult children of older parents get together to have the kids send time with the grandparents. It may also be the time when the adult children who may not live in their childhood communities or may just live in another suburb get their first real chance in a while to check in on mom or dad. As caregivers we may come with something of a "to do" list, and for some of us, it is a chance to sit with our parents to take stock of just how they are doing. In this first of two postings on the "holiday wellness check," I am going to offer some suggested items to have on your checklist as ways to make sure home is still as safe for your older loved ones as it can be. In the second, I will offer some mental and physical wellness suggestions to have on hand for your holiday trip. A home wellness checklist is mostly about preventing falls. Each year about one in three 65+ year olds will fall and half of those over 80 years old will take a tumble. Here is a short checklist to help protect your loved one:
- Front Door/Back Door - If your older loved one has developed more of a shuffle from what used to be a brisk stride, take a close look at the steps leading into the house. At the very least make sure the step[s have non-skid strips or other surfaces for sure footing, and also make sure they are well lit at night by considering installing motion sensors that trigger them in low light situations.
- Halls/Floors - At the very least get rid of an scatter rugs and replace them with nonskid mats or rugs. Look for heavily worn carpeting as another risk for falls. After sundown check for how well the edges and corners of halls are illuminated as older vision has greater difficulty gauging surfaces in low light or twilight. Handrails on halls and stairs are a plus!
- Kitchens - Even for older adults who may not use assistive devices like canes, walkers or wheelchairs, it is harder to reach those high shelves or stoop low enough to load a conventional dishwasher. If the kitchen is ready for an updating anyway, these can be useful upgrades.
- Baths - Grip bars and bath tubs than are easier to get in and out are great preventive improvements. The combination of the potentially slippery and hard surfaces of a bathroom conspire to make this room a real accident waiting to happen.
- Accessible Switches - With older finger joints, the old switches can be harder to manage and you may consider rocker switches for wall switches. All switches should be about 16"-40" off the floor. For the bedroom make sure that a light switch is within easy reach of the bed so that your older loved one is not trying to get out of bed in the dark at night.
- Declutter - Beware of the fall hazards that accumulations of newspapers, magazines or books can represent. Also important will be the lamps or other appliances whose cords may clutter walkways.
Now that you have gone through the checklist, you and your older loved one will have a happier holiday and a safer new year!
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.
We’ve had a nice trend over the recent years, a trend in which hip fractures in America had been declining. Alas, I said “had been”. According to an international study staffed, in part, by researchers at the Harvard Medical School, we are expected to see the rate of hip fractures reverse what had been a downward trend to what is forecast to nearly double from hip fractures 2018 levels to what they are forecast to be in 2050. And it’s even more pronounced among men. This latter part was a bit of a surprise to me as we have always associated hip fractures with osteoporosis which has been the domain of post-menopausal women. This was an international study, so we can even point to Brazil as the country you would have wanted to be born in to “lower” your risk of hip fractures versus Denmark, the high mark. Hip fracture rates are more than three times as high in Denmark than in Brazil. Post hip fracture treatment was lowest in Germany, but almost five times higher in United Kingdom. Talk about adding insult to injury, fracture rates are on the rise and post-fracture care is going down. The analysts point to men’s overall lower treatment with medications for osteoporosis than women to explain some of the gender difference. But my opinion is that the trend down can be explained also by longer life spans in general as well as poorer dietary habits, fitness habits and obesity in a lot of countries. Calcium intake is important for healthy bones, but so is exercise, particularly the exercise employing work on the load bearing legs like walking or running. Remember sitting is the new smoking. As you consider your options, I encourage you to consider being a leader in “living well.” At your next social gathering when others chime in with all their latest ailments or other medical complaints, try this. Mention that you have taken up daily walking, mention how far and mention how you’re sleeping better and that you may even have dropped a little weight. Ask the group who among them would be your walking buddy, because it’s better for both you and a walking or running buddy. Be radical and start a new trend in your social circle. Be radical and be hip! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.