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

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
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
Caregiver Training and Certification
In my experience as a geriatric care manager, I field a lot of questions from people who are suddenly...
Read more
July 25, 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

In the Caregiver's Words

Recent Client Praise

Remember Thanksgiving just a year ago? It was that family gathering when you prepared the turkey and someone brought a vegetable and someone else brought dessert and someone else brought cranberry sauce. But mostly it was the people coming together for family time, and the majority would be perhaps college students heading home for the break, but this year’s college-age kids are the majority of the 100,000+ new coronavirus cases each day. They may be filled with expectation and family happiness, but they also may be asymptomatic or pre-symptomatic So, if your family includes an older generation of particularly vulnerable adults, please know that in a recent analysis of COVID surveillance strategies at 1400 U.S. colleges two-thirds either were not testing or only testing symptomatic students for COVID. On top of it all, we are technically entering the traditional flu season. Infectious disease specialists recommend a four step to protect the vulnerable within your extended family this holiday:
1. Students self-quarantine eight days before schedule departure for home. Revert to all on-line learning, wear a mask, socially distance, and wash hands frequently.
2. Test before travel. Experts recommend a molecular test for viral RNA test; have your student ask for student as for an approved nuclear acid amplification test (NAAT). IF results are positive, cancel the trip this year.
3. If safe to travel, have your student mask-up at all times, and be sure they carry an alcohol-based hand sanitizer. Add some sanitizer wipes to disinfect all surfaces with which they will come in contact.
4. You’re not out of the woods yet. While at home, all who have not been living in a “pod” (self-quarantining) at home need to be vigilant about social distancing. And all guests who plan to join you should follow the above three steps also…okay, they may not need to do the on-line learning part. And no buffet style services, no hugs and kisses (sadly), and have lots of hand washing while preparing and consuming meals.
5. I add a fifth step to encourage some optimism. Keep a focus on safety now and also keep a clear focus on next year with the hope that we will all get through this. Just this week, Pfizer announced 90% success with its two injection vaccine.
Maybe it’s morbid to remind ourselves that the early pilgrims also had their viral scourges: yellow fever, small pox, the plague and more. They had no hand sanitizer and no vaccines. We have a lot more going for us this Thanksgiving if we just follow the steps. Have a great holiday, and start with making it a safe holiday. 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 holidays have gone by in a great rush, but you may have noticed someone in your orbit who seems a bit down during these past days and beyond. We have all heard somebody comment that New Year's or Chanukah or Christmas are hard because that is when a mother or a father or other loved one died. And it becomes a poignantly sad moment when that date on the calendar rolls around each year.

It has been my experience that it does not even have to be a specific date that can bring a spouse who has lost their partner or a caregiver who has lost the individual for whom they cared down. It is the memory of holidays with that person who is no longer here to share in festivities. This makes the time of year particularly hard. And if it is the first Christmas or the first New Year's or any other "first," it can be all the more difficult.

Not everyone will be willing to share the sources of their holiday sadness with others, but you can be alert to some of the common signs:

1.    Sadness that just seems to settle in. Everyone has the occasional bad day. This sadness will be over an extended time, and you may notice the deep sighs as your loved one tries to break the hold that the reminder of loss can inflict.

2.    Fatigue that sleep does not cure. You may notice that your loved one who is mourning a loss may fall asleep easily, retire earlier or rise later than usual; yet they never seem to be refreshed.

3.    Preoccupation when engaged in conversation. You might need to repeat yourself. You may notice that faraway look – as if they are lost in thought. They are.

4.    Forgetfulness or absent-mindedness. Again, it may be distraction about items on their list of things to do that fade into the background, because they are caught up in the sadness of their memories.

            The single best thing a friend can do for these seasonal lapses is to empathize. You don't need to be their analyst, but you can validate their feelings of sadness. You can also ask about what in particular makes the holiday sad for them. It can be helpful to ask about any special, positive memories or experiences they can recount of their lost loved one. Recalling the positive is not intended to convey that they ought not be sad as much as to give the person an opportunity to balance the context within which they remember their loved one.

            Even good memories may not be enough to offset the blues. If you find that this melancholy lingers well beyond the holidays that now are past, encourage your friend or loved one to seek some help. Their primary care physician may be a starting point or even a clergy member if they belong to an organized religion. Crying can sometimes get one's sadness out and talking can do the same. It helps to lift the weight that some carry through the holidays.

      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.
There is a lot of advice that goes around for older loved ones in our orbits when we see the first signs of winter setting in, and most parts of the country have seen some near record lows already this season. But there also are some threats to an older person’s well-being that are more a part of the relentless part of winter the longer the season tests us all. We know to help our older loved ones to dress warmly and to avoid ice and more. Here are five threats to look out for as we all endure more of the season for sneezin’:
1. Be vigilant about depression – The severe and sustained cold can make it for harder for older adults to get out and socialize as much as they can in fairer weather. The toll the isolation takes can manifest itself in a situational depression.” If you live at distance from your older loved one, be alert to changes in their demeanor, their voice, their affect. Call on your way home from work or after your lunch…daily contact can be very cheering.
2. Winter is hard on their car – The human body is not the only body that takes a hit with winter cold. If you are able to drop by, check on your older loved one’s windshield wipers, the tire air pressure and the battery as well. Especially if the car does not leave the driveway frequently, the winter can shut down the car. Be aware of your loved one’s capacity to drive on ice and suboptimal road conditions.
3. If the power goes down – Winter storms can take out the power grid and with it your older loved one’s ability to keep refrigerated food cold or even their own bodies warm. Help by checking to be sure there are enough warm blankets and maybe a battery-powered radio or charge stick for their cell phone. This may be another reason to check on your loved one’s with greater frequency as well.
4. Vary the foods available – It’s easy to not visit the grocery story with the same frequency when the weather is the disincentive. Be sure your loved one has a variety of fruits or vegetables. Milk and fish also are a great source of vitamin D as well as leafy veggies. A varied diet also will help them feel the extra perk that can stave off the blues.
5. When you stop by to visit, especially if there has been a significant snow accumulation, check around the exhaust vents of the furnace, the clothes dryer, the fireplace, etc. And be sure that the carbon dioxide and smoke detectors are in place and with fresh batteries.
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.
Do you remember when you had your last dental exam? Your last annual physical exam? Eye exam? How about flu shot? Or shingles or pneumonia vaccine? Gets to be a rather long list, doesn’t it? Your medical providers’ names and contact information? Now, if you have an older loved one, you now have another list of to dos and information to track. Yet you should have all of this and more at your fingertips, because knowing the stats could very well save your loved one's life ...because they may not have all of that information readily available either. The good news is that most health care systems these days keep all of that in a large data base that is accessible by patients, so you simply have to know your loved one’s user name and password. But you should get organized nonetheless. The categories of information you will want organized (consider an accordion file folder if you are more comfortable with paper or a file folder on your personal computer if you can digitize all information):
- Basic contact information, in case of emergency( ICE) and medical releases (If you need a form for this, please write to our info@creativecaremanagement.com -we will share one we use, powers of attorney (for medical), advanced directives, etc.
- Personal medical history of your loved one as well as relevant family medical history given that many medical conditions are genetically linked - "in the family."
- Current primary care provider information and predecessor providers if there has been any switch of providers.
- Other medical specialists whom your loved one has seen or continues to see, such as OB/GYN, cardiologist, endocrinologist, etc.
- Dentist contact information and a history of dental visits and any conditions of ongoing concern
- Alternative providers which may range widely from chiropractors to podiatrists, from acupuncturists to massage therapists and more.
- A record of all recent lab or other diagnostic tests and screenings.
- A history of all immunizations including the seasonal flu vaccines as well as less frequent TB tests, tetanus immunizations and beyond.
- A list of all medications (dose amount and frequency), over the counter medications (e.g., analgesics, sleep aids, etc.) and nutritional supplements.
- Insurance contact information as well as any forms or recent billing advice forms in order to track who has been reimbursed and who has not or even who has billed inappropriately.
- Allergies to foods or medications or other environmental risks (e.g., bee stings) of note.
- And, of course the "miscellaneous" category for everything else that may be relevant (e.g., pets and their food preferences, passwords, etc.).
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.
You may recall the debate on approving Biogen’s Aduhelm for Alzheimer’s this past year. Prior to this approval there had been no new therapies for almost two decades. And honestly, none of the earlier therapies…or seemingly even Aduhelm…provided much help to those whose cognition is failing. There is some breaking news, of late, on at least two fronts that there may be other medical interventions that can suppress or delay the onset of Alzheimer’s disease. Researchers at Cleveland Clinic investigated 1,600 drugs already approved by FDA for other medical conditions to see if there might be a beneficial effect for Alzheimer’s. They found what looks to be a possible winner in the widely-known drug, Viagra. It has some brand awareness for all the ads we all have seen over the years for its treatment of erectile dysfunction. Generically known as sildenafil, this therapy early on was found to be helpful in resolving pulmonary hypertension, and that was its clinical path before reports of a rather pronounced side effect came to dominate its story line. Looking now to the data over time, the Cleveland Clinic scientists documented men and women (not that many in these data) were 69% less likely to develop Alzheimer’s over a six year period than those who did not take Viagra. This is after they took into account the sex, age and other diseases and conditions of the study subjects. This has been an observational study, and the scientists now are in the early stages of clinical trials that will offer a more definitive assessment of the potential added benefit of Viagra. In another unrelated study of people 65 and older a Seattle-based group of clinicians have found another clinical intervention that seems to have a strong preventive effect on developing dementia of any type. Kaiser-Permanente of Washington state has compiled a 5,000 person data base of 65+ year-olds whose health they are monitoring over time, particularly their mental health. The study, called Adult Changes in Thought (ACT), found that patients who had undergone cataract surgery were 30% less likely to develop dementia or any type – including Alzheimer’s – over a ten year period. It’s what clinicians would call a “durable effect” with a reasonably long-lasting difference. The researchers point to the clearer sensory input to the brain that those who have benefitted from cataract surgery will enjoy, and this is taking into account other medical conditions and variables as the Viagra study did. The researchers also went so far as to exclude people who were diagnosed with dementia within two years following cataract surgery to eliminate the potential influence that dementia might have on people’s awareness of their visual capacities. Both of these are observational studies, not clinical trials, so we should wait for better data, but they are nonetheless quite promising. There also is a larger story line here in that people who take better care of all their health needs likely will do better on most measures of health status including cognition. Note to self… 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.
In the past two posts, I have discussed ways to ensure safe in home care. But we should also look to helping an older parent to be in the best shape possible to avoid even the unforeseen hazards. In this post, I offer nine tips to help “fall-proof” a mom or dad. It is a different way to think about being in the best condition one can be.
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. Visit our For The Caregiver page for more information and resources.