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

A Caregiver’s Guide to Stroke Survival and Recovery
The best estimates suggest that more than 7 million American have experienced and survived a stroke of some sort. ...
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May 13, 2013
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Forgetfulness-A Caregiver’s Warning Signs
There are an estimated 30+ million cases of dementia worldwide according to the latest statistics. That amounts to a...
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April 11, 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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In the Caregiver's Words

Recent Client Praise

If you are a caregiver, the most important item your older loved one can bring to a doctor's visit is ... YOU! It is really helpful for your older loved one to have an extra set of ears to hear what the doctor asks or says about your loved one’s condition, but it also allows a caregiver to ask questions that may not have occurred to your loved one. And frankly, there are a number of people “of an age” who just don’t feel comfortable questioning their physician – Doctor Knows Best, etc. Well, now physicians are also bringing along a companion to the office appointment. Some hospital systems are adapting their own technologies to uses that are compatible with the Smartphone platform. There are still others that are available for doctors to use with their patients, and many of these are in the App Store. The next time you accompany a loved one to their medical appointment, as your physician about: • Treatment Plan – an App that allows health care professionals to customize a treatment plan to your loved one’s condition. It allows the provider to formulate a specific treatment plan that can be sent to another Smartphone in order to track details once the patient returns home. • Treatment Progress Indicator – Especially for conditions like anxiety, depression or other behavioral issues, it is important that the patient carries home the plan of action as well as a regular update using a diagnostic tool like a short form questionnaire to see that symptoms are resolving or that the patient is adherent with the medication. • Physical Therapy To Go – Anyone who has been to medical visit with physical therapy as part of the at home recovery has seen the paper stick figure drawings of how the therapy is to work. Some of that can easily get lost in translation, and worse yet, are the recommendations that are verbal. They now have an App for video instruction on how the actual therapy is to work. • Prescription Adherence – We have come a long way from the day of the week pill boxes. There are now reminders that can be uploaded to the patient’s phone (of the caregiver’s phone) to persistently remind the patient when it is time to take that pill. In some applications, it also will block taking a pill when it is not the right time. There is a growing host of other Apps that physicians have at their fingertips that can help diagnose skin lesions or other dermatological issues. They also have Apps that can transmit photos of wounds from bed side in a nursing home in order to get informed recommendations from wound specialists to the bid side providers. And there will doubtless be even more as early as … well, tomorrow. 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.
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As a geriatric care manager, I have the chance to work with all manner of caregivers and the elders or others with special needs for whom they care. Sometimes a caregiver becomes significantly more than the person who may help a loved one with shopping, cleaning or other personal needs. There are occasions when that individual becomes sufficiently frail or mentally compromised that they need the support and control of a guardian.

I recently spoke with an attorney, Gordon Gault, who specializes in trusts, wills and probate among other legal areas. We talked about what a guardianship means and when it is appropriate as well as how it comes about. Gordon first explained that a guardian is substantially different from just a caregiver in that a guardian must be appointed by a circuit court judge. That appointed guardian is then able to act on behalf of the individual who is either under the age of 18 or is deemed disabled in some other way.

How can a guardian be useful? I have talked about elder abuse and fraud in another blog posting. A guardian can be appointed when it is concluded that the individual is giving away money or other assets to individuals who may be manipulating to their own ends. This appointment is intended to protect the individual and only happens after a court hearing complete with a physicians’ or other professionals’ opinions being weighed.

I have talked about powers of attorney for health care and for finances in an earlier blog posting, but a guardianship clearly takes this up a notch. But it is important to recognize that not only must a judge be convinced that the individual in question is unable to take care of themselves, but that judge also will oversee the guardian’s activities. As you can see, a guardianship pretty much takes control of an individual’s affairs, but this whole process does not all have to be left to attorneys. Gordon highly recommends that anyone who has a family member growing incompetent, get the powers of attorney signed as a first step. Anyone over age 60, he says, should sign these POA papers so that they can be available should a need arise. And later if you have to get a guardian appointed, you may be able to do it on your own if it is just the individual and their care. If it is an estate worth more than a couple thousand dollars, according to Gordon, you will need an attorney for the paperwork.

If you have questions, please feel free to reach out to Gordon Gault using this link. Gordon is a Chicago-based attorney.

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 throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.,geriatric care manager Chicago,geriatric care Chicago

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In a season with snow already blowing, we may think more about "winter-proofing," but I would like to continue with "fall-proofing." In my last posting, I wrote about how common falls among older adults are and some home improvements that can reduce the risk. I would like to take this conversation a bit further by talking about what are referred to as the intrinsic and extrinsic risk factors for falls. You will see that these offer two more "big picture" ways to both assess an older loved one's fall risk and to safeguard against those risks. Intrinsic Factors: The intrinsic risk factors are those that an older adult carries with them wherever they go, the most common simply is age. With more birthdays will come a decrease in muscle strength and tone, diminished vision and a decline in agility. And with age will come some chronic conditions that may not have been an issue when a person was younger. Increased age also translates into decreased bone density which simply means that the falls that a younger person can incur without complications now can become a hip or long bone fractures for a more mature adult. All of these risks conspire to create challenges to an older person's ability to maintain their balance. Extrinsic Factors: The extrinsic risk factors are those that are introduced to the older person. Many medicines or treatments can cause dizziness by either reducing blood pressure or by interfering with the inner ear's balance. I talked about loss of strength as an intrinsic issue, but a loss of muscle mass in the feet for an older person whose shoes therefore do not fit as snugly can pose its own imbalance and fall hazard. Alcohol consumption can be an extrinsic risk as older individuals' tolerance for alcohol is diminished. And the dehydration that can come from alcohol or any diuretic consumption may cause dizziness. So, if you are a caregiver to an older loved one, what can you do to address what seem to be the human forces of nature and aging? Here are some suggestions from the Centers for Disease Control. Encourage your older loved one to: • Exercise. Regular exercise strengthens muscles and bones for better balance and resilience. • Inventory the meds. Ask a local pharmacist or their primary care provider to review all prescription and over the counter medications for potential interactions or unwanted side effects. • Schedule a regular eye exam. What your older loved cannot see can hurt them, so have their vision checked at least once a year. • Rise slowly. Encourage your loved one to slowly get up from a chair or their bed to avoid the light-headedness that can result in a fall. • Wear shoes. Shoes will give a surer footing both inside and outside. Barefoot or slippers do not give the support or sure footing of properly fitted shoes. • Turn on the lights. Check throughout your loved one's house to upgrade where possible to brighter bulbs and add lighting to any dark or shadowy areas. 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.
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I have shared this statistic before, but in America someone is diagnosed with Alzheimer’s disease every 67 seconds. And Alzheimer’s is just one of the approximately one hundred types of dementia. Scientists do not have a cure for any of the dementias yet, and even the medications that are indicated for Alzheimer’s are only modestly effective in slowing the progression of this condition. But scientists are getting more and more data every year on the conditions or genetics that help to predict a person’s likelihood of manifesting some form of dementia. From physicians in London we learned recently that air pollution and dementia are linked. Among older residents across areas of London, these scientists found that those who lived in parts of the sprawling metropolis whose air was more polluted residents were more likely to be diagnosed with dementia. This adds to what researchers have been finding for years about polluted air contributing to cardiovascular disease, pulmonary disorders and even some kinds of cancer. It’s traffic pollution, manufacturer exhaust and other airborne byproducts of urban living. The researchers admit that preexisting levels of air pollution and subsequent diagnoses of dementia are not sufficient grounds for establishing causation of the latter by the former. They are one more reason, however, to underscore the need to minimize humans’ exposure to air pollution. The researchers calibrated the association between air pollution and dementia diagnoses by tracking individuals and their postal codes. Nitrogen dioxide and ozone levels in these post codes, in turn, were measured starting back in 2004. Patients’ health data confirmed the dementia diagnoses from records forward to 2013, and the statistical association was confirmed. They tracked both Alzheimer’s and vascular dementias (the Alzheimer’s was more common). The relationship between Alzheimer’s and pollution was more consistent that with vascular dementia, but both were statistically significant. The scientists admit that some of the findings may be specific to London, but similar findings have seen corroboration in Canadian research. And it seems unlikely that this is specific to just Commonwealth nations… What can one do? Scientists offer two recommendations, and I offer a third:
1. Where possible avoid heavily trafficked areas during rush hours, and avoid being outside during rush hours.
2. If possible, reside in locales away from traffic and industry to avoid the prolonged exposure to pollutants that location represents.
…and my third:
1. Vote for policy makers who will work to tighten air pollution standards.
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.