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

5 Reasons Why Older Adults Need Caregiver Water Breaks
While it has been a fairly temperate season where we live and work, not all parts of the world...
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August 5, 2013
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Hygiene: A Caregiver’s Warning Signs
Any discussion of hygiene – whether in an older adult or anyone else for that matter – is an...
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April 4, 2013
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Malnutrition: A Caregiver’s Warning Signs
When I get a call about our geriatric care management services, most people are not asking for a geriatric...
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April 1, 2013
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The Biggest Pain in Growing Older
Osteoarthritis (OA) is the most common source of disability in older adults. Specifically, it is OA centered on the...
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March 23, 2013
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Six Tips for Better Sleep in Older Adults
We’ve all used the expression, “Don’t lose any sleep over it.” Turns out that losing sleep is one thing...
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March 18, 2013
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Hearing Loss is a Slippery Slope
Nearly 32 million people in America have measurable hearing loss, and more than one third of those people are...
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February 21, 2013
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Not Your Ordinary Infection
Perhaps you have heard stories about people who are checked into a hospital and develop an infection while there. ...
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February 11, 2013
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Top 10 Heart Healthy Foods
We are what we eat. We have all heard that countless times, but to get down to the details,...
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February 7, 2013
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National Heart Month
Although most of us think of a Valentine’s heart when February comes up on the calendar, it also is...
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February 4, 2013
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Make No Mistake
Nearly 500 Medicare patients die every day from hospital mistakes, accidents or infections acquired while the patient is in...
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January 28, 2013
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In the Caregiver's Words

Recent Client Praise

We don’t often get a chance to use the words “good news” and “Alzheimer’s Disease” in the same sentence. That may be about to change. You may recall that I have reported on numerous studies here as well as in Europe that have tried to combat the cognitive decline that is the hallmark of Alzheimer’s. Even those therapies that have been approved by the FDA have shown very little impact on the disease, and most of what we have seen clinically is just a modest slowing of the decline. As we said in our book last year:
“Alzheimer’s remains the only disease in the top ten causes of death in the United States that cannot be prevented, cured or slowed.”
Chinese scientists now offer us something worth following. A Shanghai-based company called Green Valley Pharmaceutical Company presented phase 3 clinical trial data at the Alzheimer’s Disease Conference just this past week in Barcelona. In the topline results, researchers reported a rather substantial effect from their treatment, called GDV-971. They randomly sorted a bit more than 800 50 to 80 year old mild to moderate Alzheimer’s patients from 34 different sites across China into experimental and control groups. The experimental group received the 450 mg formulation of GV-971 twice a day for 36 weeks, and the control group received a placebo over this same period in the same dosing. Using the Mini-Mental State Examination, a standard test for cognitive ability, the researchers saw an effect as early as four weeks into this nine month trial. The separation between the cognitive capabilities of experimental and placebo patients continued through the duration of the trial. Patients had scored between and 11 and a 26 on the scale at the outset of the trial with placebo and experimental group patients manifesting the same mean score. By the 36^th week, the experimental group averaged a score 2.54 points higher than the control patients. Statisticians rate this a statistical significance of p<.0001, or in lay terms something that could happen by random chance only once in 10,000 tries. The active ingredients in the therapy operate in a number of ways that evidently slow the progression of Alzheimer’s. And there were no differences in the numbers of patients reporting any adverse effects in either the experimental or control groups. A company spokesperson suggests that they are cautiously optimistic…a bit understated we suggest. But it is true that additional studies need to be conducted across more sites to “clarify and confirm its promising biological and clinical effects.” The Chinese equivalent of the FDA has the company’s data under review now at the same time there are plans for more worldwide drug trials soon. Stay tuned! 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.
There may be as many as 50 million caregivers in the United States today, so the odds are that we all know at least one person who cares for an older adult or someone else with special needs. And we all can help to care for the caregiver with little things that may not take a lot of time or even cost any money. These little random acts of kindness can both help the caregiver and help the person who depends on a balanced and healthy caregiver. What can the rest of us give to the caregiver?

1.    Give the caregiver an excuse. Caregivers can get really caught up in the "have to's" so that they do not even take a coffee break. Be their excuse to get away if only for the hour to share a cup of coffee and conversation with you.

2.    Give the caregiver an ear. We often tend to focus on the older or special needs loved one with questions about "how is your mom?" The caregiver deserves a chance to just vent to someone who can empathize and not judge them as too hard on the "poor mom" who depends on them.

3.    Give the caregiver some familial support. In most families one of the siblings has become the default (or conscious) caregiver, and in my experience it is mostly one of the daughters. Encourage a family conference either in person or on a call to discuss what everyone can do.

4.    Give them something specific. It is really easy to just ask what one can do to help in a general sort of way, and caregivers may simply demure by asking for nothing. But if you are going to the grocery store and call to ask what you can pick up, they can tell you what is running low. Or if you are a neighbor, shovel their walk when it has snowed overnight without being asked. Be creative, but remember to be specific in your offers.

5.    Give the caregiver some time off. Everyone needs a break, so volunteer for specific times or days so that the caregiver actually can make plans for something they need to do - hopefully for themselves.

6.    Give the caregiver a reason to laugh. Most caregiving revolves around helping someone who is in declining health. Change the subject to something they will find more uplifting or something positive in their future. Optimism is a great antidote for the burden of caregiving.

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.
Let me start with the short answer to a question we raised in the email announcement of today’s post. ADRD is a term in common medical use that captures a number of conditions whose hallmark is cognitive decline: Alzheimer’s Disease and Related Dementias. The rest of the story, however, is about what we can and what we cannot control about whether we actually develop one of the ADRDs. The good news is that nearly 40% of cases of ADRD owe to lifestyle choices that we can - well – “unchoose.” If you were told that some basic lifestyle choices that we all make could actually reduce our chances of developing one of the dementias by nearly 40 percent, would you take steps to change your personal habits? Researchers analyzed the histories of nearly 400,000 people in the U.S. who were 65 years old and older to see what made the difference between those who received the diagnosis and those who didn’t. Let’s say that you agree to make some changes, what are the modifiable risk factors that these scientists found:
- Midlife obesity is number one with a risk factor of 17.7%...translated that means obesity in one’s middle years increases the odds of developing one of these dementias by that percentage;
- Physical inactivity is number two with an increased risk of dementia of 11.8%;
- Low education is generally used to identify high school or less and is associated with an 11.7% greater risk of dementia;
- Midlife hypertension (high blood pressure) adds 8.8% to a person’s risk of developing dementia in later years;
- Depression boosts the odds of dementia by 8.8%;
- Diabetes contributes another 7.3% to the dementia risk;
- Smoking contributes another 6.0% to a person’s risk; and
- Hearing loss adds 2.3% to a person’s risk of developing dementia later in life.
Process these a bit and you’ll probably notice that a number of them are really connected to others. Obesity, for instance, can be associated with lack of physical activity and also can lead to either diabetes or high blood pressure. If a person begins to work on the list, the risk improvement can be quite impressive on improving one’s standing on one leads to benefit on other measures. The researchers also reported that three risk factors that we cannot control also impact our likelihood of developing dementia: gender, race and ethnicity. The earlier we start on the factors over which we do have some control, the better. Make a list and start…maybe yesterday? 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.
We are less than a week away from Mother's Day, and preparations are in motion, cards are purchased, reservations are made and flowers will be sent. That is what Mother's Day has come to represent for most of us, but there will be some for whom Mother's Day is more an occasion for dread or sadness. That is because Mom is no longer here to celebrate the date. Especially in my work as a certified geriatric care manager, I've talked with caregivers who have lost a mother. I find that there can be a lot of denial or depression as May comes around. It seems easier to ignore the day, or maybe the sad, slippery slope of depression seems unavoidable. That is where I come back to one of my mantras for all caregivers, and that is that the caregiver needs to care for herself or himself. What does caring for the caregiver look like when one is facing an important, but seemingly hollow, holiday? You can begin by letting the mom who lives in your memory remind you of the good times or the kind words or the special places. Mother's Words. If you have a sibling, perhaps start the conversation about what "mom used to say." If she used words of encouragement like, "It is not about what the other kids do; it is about just doing your best." Or maybe mom liked to talk about finding the "silver lining." Mother's Things. Those of us who have lost a mother also probably saved an item or maybe several of the things that delighted mom or that we particularly associate with her. Maybe your mom kept a collection of your pictures or clippings from the school paper? My mom kept a small spiral notebook of jokes so that she could remember and share them with others. Most of them were admittedly a bit corny, but they make me smile even now when I go through the pages of memories on days like Mother's Day or her birthday. Mother's Actions. It can also be special to do some of the things that your mother used to do as a way of "taking a walk with mom." Maybe mom had a favorite park or garden where she liked to go on "her day." May is such a wonderful month for all the new blossoms of spring, and taking that walk can bring back wonderful memories complete with beautiful buds and their wonderful scents. Or some find it really great to go to mom's favorite restaurant and have their own favorite dish or order the chocolate pie that always was mom's guilty pleasure. It really all comes down to making the day special for yourself just as you used to make it special for your mom by caring for the caregiver. Doing that special something for yourself just as you used to do it for your mom can actually make you both feel better about her day. And if you are a mom with kids of your own, it can also be a wonderful way to let them know how to someday manage their own transition of Mother's Day. Charlotte Bishop is a certified 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 are those who have not seen any changes in their lives in the midst of this pandemic and quarantine. They’re our older family members with Alzheimer’s disease or some other form of dementia that has robbed them of the ability to even comprehend the restrictions of this pandemic. They have been isolated as protection against COVID, but their quarantine experiences are not the same as ours. I bring this up because as more of us are able to be vaccinated and resume some semblance of life before the pandemic we also will likely be able once again to visit Mom or dad who have been under strict quarantine and may have some questions for us. How you answer their questions and engage in conversations in general is necessarily going to be more about them than it will be about you and the rest of the world that has been upended. Honesty is going to be the first casualty of the pandemic when we encounter a loved one who has Alzheimer’s or dementia, but I am not talking about lying. At its core dementia is a progressive decline of the brain’s ability to process what has happened in “their world.” You ought not view your initial reunions with older loved ones with dementia as a “chance to catchup.” We have to be prepared to join their reality using a technique health care professionals call “therapeutic fibbing.” You will need to learn to “go along” with the reality they know by first asking them about themselves, their recent experiences, and what’s going on. This may go against how we all were raised, but telling the truth may be cruel to someone who is not processing reality in the same way we are. An example helps. Picture you’re talking once again with your mother who asks where your Dad is. He had told her, she recounts, that he was going to get the car and come by to pick her up for an outing. The unfortunate truth is that dad died last year, but she keeps coming back to scenarios in which he is just temporarily gone, and understandably is looking for his return. You don’t tell her he died, because she will experience the awful loss all over again, she’ll cry hysterically and become agitated. And since she has short term memory issues she will forget again so she will be primed for experiencing the grief anew the next time you correct her. Instead you might say that Dad suggested he would be delayed a bit and that he had asked you to offer her a snack until he can make it back. She agrees that a snack is a good idea and you get into another conversation. Or, your father with dementia tells you that he is going to go get the car and take mom for a ride. They like their Sunday afternoon drives…it does not have to even be Sunday. So, maybe you can ask how the car is running and suggest it would be nice to have a snack with him for their ride. While you prepare the snack perhaps look out the window and remark on the sunshine or the birds or anything. Then start talking about the view and ask him questions. Share the snack with him and get into a new conversation. My clients with parents or spouses with dementia talk about their “therapeutic fibbing” as really hard at first until they can see their loved one actually brightening with the diversions. And once they both have a brighter conversation, they both have now had a better day. And tomorrow will be another chance to brighten both of their days…and tomorrow…and tomorrow. 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.
My mother used a phrase to put a good face on her moments of leisure. She would say: “Sometimes I sits and thinks, and sometimes I just sits.” I have some bad news for my mother – sitting (thinking or not) too much is not good for your health or your life expectancy. I haven’t missed too many opportunities to talk up the virtues of exercise and diet in not just extending one’s life, but also improving the quality of life. Just when you think that your hearty breakfast this morning and your 60 minutes of cardiovascular exercise will assure your good health, think again. If you took the afternoon off to watch your screen or even read a book and the time spent on that couch over the course of the day totaled 6 or more hours, your chance of dying young just shot up 19 percent over your peers who sat for less than three hours. And the causes of these premature deaths are not limited to just heart issues. There is a whole range of conditions that can get in the way of longevity for couch potatoes. The conditions that can shorten a person’s life can include everything from chronic obstructive pulmonary disease (COPD) to diabetes or lung disease or kidney disease and more. And here’s the part where those of us who are caregivers to older loved ones should pay more attention; it is not just older individuals who run this risk if they sit too much. Researchers have compared transit drivers with transit conductors or prison guards and found that these occupational groups tended to have pretty similar diets and lifestyles. The drivers, they found, were twice as likely to die of a cardiac condition as their counterparts who spent more time on their feet. The scientists cannot claim a cause and effect, but they do point to higher rates of obesity tied to sedentary lifestyles. And the obesity is tied to higher levels of inflammation overall which leads to a host of diseases. But sedentary people also have higher rates of suicide, Parkinson’s disease and Alzheimer’s as well, and this leaves the researchers scratching their heads a bit. The basis for some of these conclusions is a 21 year long prevention study sponsored by the American Cancer Society. Of the 128,000 healthy volunteers who were enrolled in this study, 49,000 died during the succeeding two decades for the causes I have outlined. So, even though they cannot say that sitting kills people, my takeaway is pretty clear. No matter what your age, make it a point to stand up, stretch and walk around every hour and then rinse, repeat. 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.