Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • Geriatric Care ManagerChicago's Geriatric Care Manager Center of Excellence - Since 1991 | Page 3

Alzheimer’s Link to Mothers
Scientists have long known that Alzheimer’s Disease has a hereditary component, but new research suggests the predisposition is more...
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March 10, 2011
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Take It To Heart – Chocolate That Is
Okay, so it has been five days since you received that box of chocolates from your sweetheart on Valentine’s...
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February 18, 2011
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How Do You Rate Nursing Homes?
One of the most challenging conversations I help facilitate as a geriatric care manager is to address the prospect...
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February 14, 2011
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Obesity and Aging
As a geriatric care manager, I speak with my older clients who wrestle with weight gain as much as...
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February 9, 2011
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Saying Goodbye to a Loved One
Elisabeth Kubler-Ross introduced her five steps of grieving for a loved one who has died four decades ago in...
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February 1, 2011
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Finding Caregiver Resources
In the past two postings I have been talking about the warning signs of caregiver burnout as well as...
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January 27, 2011
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Elder Resources – Free Legal Advice
I have been hearing that the web resources I have been offering in my postings have been informative and...
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December 30, 2010
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If Not Home, Then What?
In my last posting, I talked about how a caregiver can facilitate an older adult’s decision around when it...
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December 20, 2010
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Who Owns the Decision?
I have talked in some of the recent blogs about when decision-making may transfer to another person from an...
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December 15, 2010
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Identity Theft and Fraud Target Elders and Others with Special Needs
One of my geriatric care clients, an 80-year old widow who lives in an independent living center, came to...
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November 29, 2010
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In the Caregiver's Words

Recent Client Praise

Last month, we talked about conversations with older loved ones about residential living choices. While might find this is a suitable option, others may be able to retrofit their houses for senior living in Chicago, to keep daily living familiar to their local location and make it more comfortable for their aging loved ones. It is only a matter of making certain adjustments in your home, though this task might not be as easy for some as it is for other. Below are some pointers on how you might be able to make your home a positive environment for your loved ones.

Fall-proof

Leg strength wanes as people get older. Because of this, even the most innocuous fixture or furniture, or the most routine activity in the home can cause a fall. Start fall-proofing your home by making sure that all the walkways inside your house are well-lighted, and the spaces in your rooms are cleared of clutter, to provide ample space to move around. Reroute wires, should you find them crossing walk paths, and remove unsecured decorative rugs. It’s important to fix worn carpeting on which one might trip.

Fall-proofing your home works both ways. Talk openly with the elders on ways they can avoid fall accidents. Ensure that they get their vision and hearing regularly checked, and help them keep their senses sharp so they cannot miss fall hazards. Encourage them to use canes and other aids if you feel that these will help them.

Sleeping Arrangements

It is most ideal to situate their room in the first floor of your house. This gives them easy access to the main parts the house such as the living and dining rooms, and the common bathroom. Not only will that save them from straining their legs walking up and down the stairs, but will also keep them safe from fall risks.

Emergency Kit

Aside from keeping your emergency kit stocked with bandages and medicine, make sure that you keep phone numbers handy in case of medical emergencies. Include your mobile number, the number of the local hospital and your loved ones’ physician, and the contact information of your neighbors. Leave these close to the telephone, on the refrigerator door, or other visible spots.

Hire Help

Hiring a caregiver in Chicago can help lighten the load. As a care manager, I’ll be able to help assess the home and provide a plan in order to make the environment safer. Enlisting help can ease your worries about getting professional care for your parents and loved ones while you’re away.

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.
I had the good fortune to speak to a local Rotary chapter this morning. The question they had put to me was simply how does one plan with an older loved one for that moment that no one wants to plan? The answer is simple ... because for any conversation, you just need a place to begin. Here are five tips to BEGIN the work for your older loved one’s (or your own) future... Break the ice. Start the conversation with your older loved one…ask questions about their ideas regarding the ‘What ifs’ of life…ex: if you had to go to a hospital, which one would you like to go to? Does your doctor have my contact information if there were an emergency? Make a list of what those choices are; include them in a Living Will or POLST “Practitioner Order for Life-Sustaining Treatment”. Make sure that your family and your health care providers are aware of the choices. Evaluate the whole person. Use your powers of observation to assess your loved one’s situation and make notes. Think about what they have told you over time regarding their wishes, finances, housing situation, health. Plan follow up conversations to learn more about what they would want in the event of an emergency. Guard against abuse. Begin to gather legal documents including mortgage information, insurance information, bank account locations, account numbers, etc. Ask about finances, investments. Investigate the possible utility of Powers of Attorney. If there are any gaps or documents such as wills that are out of date or non-existent, get new ones drawn up. You don’t have to have everything perfect, but you will benefit if you start the conversations or the personal reflection needed to begin the process. Inside out. Make a list of you or your loved ones health history, get a medical release so that providers can talk to you about your loved one, consult current physicians and create a list of medications, dosing, etc. Nest. Think about the home as safe from the inside out, not just safe from the outside in...If they are living in the house you grew up in evaluate all the years of wear and tear on the infrastructure: stair railing, worn carpet. Take a look around the home for any obvious safety issues that can be easily addressed: since the majority of falls occur at home scatter rugs, poor lighting, expired food in the fridge, extension cords stretched under rugs or in walkways. Also, expired medication or medications that resemble each other…Safety first. 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.
Okay, "Grain Brain" is not something that immediately tells you what it is all about. Grain Brain is the phrase that neurologists and other brain scientists are using to describe a link between blood glucose levels from high carbohydrate consumption and dementia. A book by the same name is going into its 15th straight week on the New York Times bestseller list, so the concept is getting a lot of attention. But what does it mean for you or an older loved one in your orbit? In a scientific study recently published in the prestigious New England Journal of Medicine, researchers followed a large group of men and one of women for an average of almost seven years. During this nearly seven years they regularly measured the individuals fasting blood glucose levels. At the end of the study they found that people with higher blood glucose levels were more at risk for developing dementia that those whose levels were not as high. They found this to be true even with people who did not have diabetes. It is true, that this kind of study cannot say that increased blood sugar levels actually cause dementia, but the link is sufficiently clear that the New England Journal would publish the findings. Scientists also find that not all grains have the same negative effect on cognitive ability. Those with the highest gluten content seem to be the worst offenders. This is not the first research to show negative health outcomes associated with elevated blood sugar. Researchers have well-established proof that a high carbohydrate diet and the associated elevation of blood sugar poses a risk to one's heart and to the immune system. And there are other studies. in a 2012 study in the Journal of Alzheimer's Disease, researchers reported that risk for cognitive decline was 89% greater among those on a high carb diet; those on a high fat intake diet saw a 44% decrease in their risk for cognitive compromise. And researchers in another British journal, Lancet Neurology, estimated based on their findings that as many as 54% of the cases of Alzheimer's Disease in the United States could be avoided with exercise, weight reduction and steps to reducing blood pressure. This last study really drives home a great point. If you are a caregiver to an older loved one, you both will see great returns on a few basic investments of time and effort. Increase the daily amount of exercise, reduce the carb intake and the rewards will be weight loss, reduced blood pressure, a healthier heart, a more vigorous immune system and more acute cognition. Sounds like a really great return on investment to me. So, will you and your older loved ones be among those who avoid the "grain brain?" 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@creativecaremanagement.com.
You have probably put off a vacation or most any travel for more than a year with the threat of the pandemic making taking a flight seem about as safe as jumping into a tank of alligators. But with the majority of adults in America vaccinated and you with your own vax card you can now make plans…and so can almost every other American including your older loved one. Your mom or dad will be anticipating the crowds at the airport, so they are looking to bring their TSA precheck clearance current. They also will perhaps be receiving all manner of solicitations from hotels, resorts, cruise companies and more. But there is cyber danger out there. One of the principal rules of cyber security is the cyber criminals know to go where the people are, and the more people the better the odds of scamming more of them. It’s not unlike fishing where your chances of catching more than one fish are much better if you can find where the fish are gathering. One of the folks in our orbit went on line to renew their TSA status which had lapsed during the pandemic. After all, who needed that when no one was flying anywhere? Having entered “renew TSA” in the search bar they were offered a number of links from which they chose the one that told them what they wanted to see. They proceeded to fill out the tedious government reapplication form and got to the end where credit card information was requested, and they provided that as well only to get an alarm that the information could not be processed. Frustrated, they entered the card information again and received the alert again. They tried another credit card with the same result. The next day both credit card companies called and emailed fraud alerts, both helped them close the cards and both issued replacements. Story over? This is where the story can be just beginning, because the scammers still retained name and birth date and address information. Scammers compile many thousands of such identities so that even when their charges don’t get processed they can merge the data with other scammed data available on the dark web. The size of these data bases gives new meaning to “mega data.” A cyber security expert, Bryant Wallace, CEO of WallScott Solutions, tells us that the first sting of this scam may be just the beginning. Scammers will continue with mail sent to the prey’s home address, to their email address, or they may call. The credit card may have been neutralized, but the scammers are now laying siege to their targets. If you have an older loved one who is starting up their post-pandemic travel plans, Mr. Scott offers these warnings:
- Beware of sites that do not have the right domain suffix (government sites are .gov)
- Beware of unsolicited email offers that seem awkward in their language or logos (English may not be the first language of the scammers)
- Beware of solicitations that know more about you than they should (Because you have shared it with someone in their orbit)
- Beware that the address begins with https:// (It means it’s a secured link)
- Beware of the same issues with mailed correspondence.
Notice that we have not even talked about hacking. These hazards to which older individuals are particularly vulnerable are traps into which they easily fall. Hacking is fraud gone nuclear, and Mr. Wallace can explain the steps that need to be taken to avoid being taken for a ride…and we’re not talking a flight to your older loved one’s paradise vacation. Take care of mom or dad, and travel safely. 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.
You have heard from me before about how there is a new Alzheimer’s Disease diagnosis in America every 67 seconds…about one a minute every day and every night! According to medical professionals it is becoming even more prevalent worldwide. By the year 2050, this rate is expected to double to one new case every 33 seconds. It is ranked as number one in prevalence of all neurodegenerative conditions affecting 5-6 million Americans and as many as 47 million people across the globe. Translated, that means about one in eight individuals over age 65 will be affected by Alzheimer’s and that climbs to almost half of those 85 years and older. It has been studied for more than 100 years with little headway on what causes Alzheimer’s Disease, let alone how to treat it. I am going to talk more about treatment, and there are some avenues that show promise, in a second installment to this two part series on Alzheimer’s. In this part, let’s go over how Alzheimer’s is diagnosed accurately today than ever before. Not that long ago, Alzheimer’s could only be diagnosed after a patient had died when they could actually investigate how much beta amyloid plaque had accumulated in their brain. That is so yesterday. There are now three ways to arrive at an Alzheimer’s diagnosis in a patient. The first starts with a genetic marker that predisposes an individual to developing Alzheimer’s. It’s called the APOE4 gene, and about one in seven to one in ten people carry this gene. Those who have one copy of this gene are about two to three times as likely to develop the dementia as those who do not have the gene. And if a person has two copies of this gene the likelihood shoots up to 12 times that of a person with no copies of the gene. Should everyone get the genetic test? Well, talk to your doctor, but as medical professionals have consistently shown early diagnosis can be the first step toward more effective treatment of any condition. A second step toward diagnosis will be what is termed a neuropsychological test which assesses a person’s cognitive function. It should be conducted by a neurologist, not just a primary care physician. Combined with the genetic test, it can help to pinpoint Alzheimer’s Disease, but not without the third test. Brain-imaging can not only help to look for the signature of Alzheimer’s activity the brain, but also rule out other issues like hemorrhage or tumors that may be causing mental difficulties. It will also more concretely assess the extent of any Alzheimer’s spread in the brain. This latter testing can be done by a number of technologies like CT or PET scanning, but the most common test is MRI. Look for Part 2 next week when I review the existing as well as new, promising treatments for this condition. You all may recall that I have a book that I have co-written on what a caregiver should know about Alzheimer’s…it is noted in the closing paragraph here. If you want to save 20 percent off the Amazon price, please just send me an email and we will send you a copy for $19.97 which includes shipping and handling. 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.
I have again asked our vice president for geriatric care manager services, Steve Steiber, Ph.D. to share his insights, this time about diabetes and some late-breaking news. He has nearly two decades experience in pharmaceutical medical device consulting prior to joining CCM.
More than 11 percent or, or nearly 27 million, Americans have either diagnosed or undiagnosed diabetes according to the most recent data. We include the "undiagnosed" in this figure, because anyone who has a consistently high A1C level (the measure of long term blood glucose) is creating an opportunity for other medical problems. For anyone who is a caregiver to an older loved one, this "diabetes epidemic" should be all the more alarming, because the prevalence of diabetes and what is termed "prediabetes" more than doubles to nearly 27 percent of those 65 years of age or older. The reason for the title of this posting is that diabetes is one of those medical conditions that seems to almost invariably be part of multiple diagnoses or medical conditions. So if your older loved one has been diagnosed with either diabetes or prediabetes, you need to help them to manage diabetes as well as the other companion conditions. For instance:
1. Diabetes is associated with higher levels of chronic fatigue. A recent study in the Netherlands found that these two conditions seem to go hand in hand, but they could not conclude that high blood glucose "causes" fatigue. It is just more likely to be there if a person runs "high" on a consistent basis.
2. Chronic kidney disease (CKD), a condition in which the kidneys progressively lose their ability to filter body fluids, is twice as common in people already diagnosed with diabetes. Scientists suggest it is the glucose that binds to red blood cells in the blood stream that block and break down the micro-vascular tissue of the kidneys leading to CKD.
3. High blood pressure and diabetes also tend to go hand in hand. For the same reasons that the kidneys suffer from high blood glucose levels, all the other circulatory system is adversely affected. And the negative synergy of poor circulation along with further hindrance to circulation create the potential for a real cascading of medical complications.
4. Retinal eye compromise and its ties to diabetes complete the circulatory issues caused by consistently high blood sugar levels. By blocking the tiny vessels that nourish the retina of the eye, diabetes effectively starves the eye causing a loss of vision or diabetic retinopathy.
5. People with diabetes have a higher risk of depression than those without. There is some speculation on how this happens,. but most professional agree that depression does not cause depression. A fair number, however, state that the feeling of the unfairness of the disease or the loss in control over their diabetes and the associated anxiety cascade into depression.
Please let Steve know if you have any questions about diabetes, drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com.
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 who need geriatric care management services in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.