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

Hospital Discharge Needs of Elders
Elders have more health care issues and have more doctors’ office visits and more hospitalizations than their younger counterparts. ...
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May 9, 2011
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More Insights into Guardianship
As a geriatric care manager, I work with court-appointed guardians. You may recall from a blog last December, Caregiver...
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April 22, 2011
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Seniors and Depression and a Fix
One of the most common health issues that seniors deal with is depression. According to the National Institutes of...
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April 18, 2011
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Safer Senior Living – The Kitchen
In my last posting I spoke to ways to improve the safety and accessibility of the bath for seniors...
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April 10, 2011
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Elder Exercise Gets Easier and Easier
We all know that an object at rest tends to stay at rest, and that is as true of...
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March 14, 2011
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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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The Community in Senior Residential Living
I was just reminded of a very important aspect of senior residential options that can get overlooked in conversations...
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February 26, 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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In the Caregiver's Words

Recent Client Praise

With over 300 clinical trials on vaccines for COVID19, it perhaps is not a surprise that at least two are very close to emergency authorization by the Food and Drug Administration this month. Where are you in the line to get a vaccination? Well, if you have a loved one over age 65 still living independently, the answer is behind front line health care workers, other essential services workers, individuals with preexisting conditions that place them at particular risk. Yes, it will be a bit of a wait. Government agencies are coordinating the access to a COVID vaccine, and they are also watching out for scams. Do not fall prey to that call or email that promises you easy or early access to a vaccine. So, how do you tell the good guys from the bad guys? Homeland Security and FDA have some suggestions:
- Vaccines will not be available on the internet…and that goes for any alleged treatments for COVID as well;
- Only sign-up for a vaccine through a licensed medical provider…and even then, be sure that they have been certified to provide a vaccine;
- COVID vaccines may at some point be available through your CVS or Walgreen’s pharmacy, but do not trust online pharmacies, especially those whose names are not familiar to you;
- Avoid any texts, emails or calls about a vaccine you can purchase…there will be no Cyber Monday or offshore providers for vaccine distribution;
- And COVID19 vaccines will not be available through Facebook, Twitter, Instagram or other online feeds.
And be aware that the global rollout of a COVID19 vaccine will not be like in the movies where a convoy of camouflage vehicles arrives in town with uniformed soldiers spilling out to set up tents for administering a vaccine. Hollywood does not get to set the stage here. There may be lines of people – socially distanced – waiting at a pharmacy or clinic for their injections, and get this, there may be no charge. All the details are not available just yet, but appreciate that the federal government already has forked over billions of dollars to a host of pharmaceutical giants to develop vaccines. So, your tax dollars have covered this already. If you receive a vaccine offer that is too good to be true, it likely is too good to be true. If you see (or hear) something, say something. Homeland Security wants to hear from you, and you can go online to report any kind of suspicious activity. Go to: COVID 19 investigations. But please refrain from “dancing in the streets” until at least 70% of the population has been vaccinated. Yes, that would be “herd immunity,” just not the kind that comes from so many people being sickened in order for it to happen. In the meantime, call or ZOOM a friend or family member. We all need some continued support to make it to the goal. 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.
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Caregiver Advice on Bad Medicine Many are unaware of the massive scope of the pharmaceutical market and all the ways in which seniors are taking more and more unnecessary drugs because of it. We discuss how caregivers can look out for signs that their loved one’s medication is over prescribed and how to spot warning signs. Download
Barbara Bush, wife and mother to presidents, has taught us another lesson this past week, and it is about how she chose to die. She taught us that palliative care and hospice care are different concepts, but she also taught us about the importance of an end of life plan. Let me start with the first. Let me clarify that hospice care is reserved for patients who will face an end to treatment and wish to be comfortable. Palliative care is simply the “comfort care” we saw requested for Ms. Bush, but it can be for any patient about to embark on a difficult or painful treatment regimen. We deal with a lot of families of older loved ones who are faced with difficult diagnoses. If the diagnosis has a treatment option that may prove difficult or painful, doctors may suggest palliative care. And that is when some family members may freak out just a bit… not an exaggeration. Yes, they may freak out because there is an association between palliative care and end of life, or hospice care. So what we saw for the former first lady was a care plan that included anything she needed to simply die comfortably, hospice care, but they did refer to it as comfort care. Ms. Bush was able to make her own decision at the point when a choice needed to be made, but so many people will not get that chance. This is also why it is important for families to have a discussion about the “what if scenarios” that families may face. What if there is no hope for recovery? What if the patient will not regain consciousness to make a decision about how to cope with a potentially painful end of life? As an Aging Life Care professional, we talk about the importance of a care plan. A key element of a comprehensive care plan will be what to do if. ….If mom cannot make the choice for ending treatment…If dad’s dementia precludes dad’s own decision for comfort care. We were told in Ms. Bush’s eulogies that she ended life pretty much on her terms. I would encourage us all in this country to make plans with family members that will assure the same level of comfort…that we should all end life on our own terms. If you have not already, it may be time to speak with your older loved one about what “their terms” are. You and they will be very gratified that you were sufficiently bold to start the conversation. 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.
Raise your hand if you are a caregiver and have never misplaced your car keys. Raise your hand if you are a caregiver and have never been concerned that the forgetfulness of an older loved one might be a sign of Alzheimer’s or some other form of cognitive impairment. I am thinking that we went from no hands up to nearly all hands raised. But the practical fact is that for those of you with care receivers of a certain age it is common that there will be keys misplaced or names forgotten and more. Yet, that is not necessarily an indication of anything organically wrong with your loved one’s memory. So, how does one know? Here are some warning signs according to the experts: 1. Experts talk about the differences between “retrieval” and “storage” problems in memory. Forgetting someone’s name is retrieval and it is not a warning sign of Alzheimer’s. Forgetting that you know the person at all, however, is a storage problem, and it can be a sign of a more serious brain issue. Or misplacing the keys is a retrieval issue, but forgetting what the keys are supposed to do is a storage problem that should prompt closer attention. 2. There also is a difference between losing the car keys and losing the ability to do something that always came pretty naturally. Misplacing the keys, according to the experts, can happen to just about anyone, but forgetting how to start the car and put it in gear can be cause for concern. Or the loved one who was always good at math forgetting how to multiply also may be concerning. 3. Just plain confusion with normal daily activities also is a potential sign, according to the scientists who study these things. If your loved one gets confused on the way back to your table from the restroom while dining out, that may be cause for concern. You should also look for smaller signs as basic as their stride. If their steps begin to more resemble a shuffle this may be a sign of a more fundamental uncertainty…or the unexplained fall likewise can be a precursor of cognitive decline. 4. Finally, look for what may be as subtle as changes in personality. The loved one who used to be the animated conversationalist, but who now is more subdued may be responding to their own confusion in trying to follow what everyone is saying. Agitation in a person who was once a cheery individual also can be a sign of changing mental abilities. Against all of these potential warning signs, be careful about a hasty judgment. A change in mental acuity that is rapid in its onset is better classified as a delirium – not dementia. These episodes can arise from urinary tract or other infections, dehydration or even some hormonal imbalances. Certain medications like steroids or combinations of medications can precipitate short term mental imbalances. Caregivers should be alert to these, but not jump to the wrong conclusions. And beware of your loved one’s healthcare provider who prescribes any of the Alzheimer’s agents for “organic dementia” or “delirium” or anything short of a definitive Alzheimer’s disease diagnosis. So, raise your awareness before you raise your hand. 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.
There are a lot of misconceptions about Alzheimer's Disease or dementia in general, and these misconceptions can make simple conversation frustrating for both the person with the condition and the well-intended caregiver. If you are in a position during these holidays to converse with someone with dementia, it is important to follow some basic guidelines so that the conversation can be more positive for you and for the person with dementia.

We may get the notion that dementia means that a person is "losing touch" - yes and no. Dementia can be as varied as people themselves are different from one another, and it does not progress in a straight line decline over time. Most of us have conversations that have a fairly clear beginning, middle and end...or with best friends, it is just a conversation that never ends. Here are some very basic tips that can help you and your loved one with dementia to move beyond what has the potential to be awkward or frustrating for both of you.

1.    Avoid loud or unfamiliar environments when you are selecting a place to have a chat; both of these are very unsettling to a dementia patient and aggravate inherent difficulties in concentrating and conversing.

2.    Be patient and sensitive to your loved one with dementia; they may feel afraid, because they are "lost" and your validation is important.

3.    Be empathic by trying to appreciate what it may be like to be in the shoes of the person sitting across from you who lapses into moments of "talking with a stranger" in a strange place and they cannot remember the way home.

4.    Do not get caught up in whether the person is "making sense;" it is not about winning an argument about what decade it is as much as passing some pleasant time with a loved one.

5.    Keep the conversation light and follow their lead; they may wish to talk about family and happier times, even if they cannot remember family names - let them revel a bit in what is a safer place for them.

6.    Monitor your body language; even though you are carefully screening what you say or don't say, your posture or facial expression may be screaming at your loved one - take calming breaths and relax.

7.    When all else fails, simply ask them how they are; they will always know how they are, and it will give them comfort that they know the answer to that question.

      There is a lot we don't yet know about dementia, but these tips can help you have a conversation that all parties can enjoy. Go to the Alzheimer's Association web site for more information, and be prepared for lucid surprises along the way as well as the occasional recitation of Shakespeare, the Pledge of Allegiance or a prayer from someone who can't remember what they had for lunch. And did I mention, be patient - with yourself. As I have said many times: You don't have to be a perfect. You just have to be “good enough.”

      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.
We’ve all seen the ads on television about the lawyers who will stand up for our older loved one if they are abused or neglected in a nursing home or other facility. A bruise, a bed sore or maybe loss in weight can be pretty conspicuous warning signs, but there is another pervasive abuse of older adults in America, an abuse that has no telltale bruises. We know from the statistics that one in nine older adults in America has been abused, but financial abuse specifically is substantially under-reported. Experts at the National Adult Protective Services Association report that only about one in 44 cases of financial abuse of seniors ever gets reported. Exacerbating this under-reporting is the simple fact that senior financial abuse doesn’t leave a mark on the abused victim. But it does raise a flag if you know what to look for. Look for telltale changes in your older loved one such as:
1. Sudden changes in a will or other document that now includes a new beneficiary.
2. The “live-in” caregiver who seems to be “living off” their client.
3. An unexpected increase in credit card debt or an unusually large line item.
4. Money spent that has a wild or outlandish explanation.
5. More frequent withdrawals on a bank account or new accounts with someone else’s name on it.
6. Vague explanations or complaints about a missing credit card.
7. Guarded talking or behavior around a new caregiver that may suggest they are being intimidated.
8. Missing items like jewelry, money, antiques, art or even furniture from their home.
9. That new girl or boy friend…maybe some significant number of years younger.
Older adults are prime targets because they have the money…their savings, retirement accounts, mortgage-free home or other assets. Older adults are also more vulnerable because they may live alone, they may have chronic medical conditions requiring assistance or they are simply weaker than their exploiter. Older women are particularly vulnerable for all of these reasons plus their upbringing was in a time when women were simply taught to defer, to be nice, to be polite. And nearly half of all abusers are family members or friends. Please remember also that the earlier you spot the flags, the easier it is to “fix the problem.” 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.