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

A Caregiver’s Warning Signs of Stroke
May is National Stroke Awareness month. As a certified geriatric care manager, I maintain that it is a good...
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May 13, 2013
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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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Recovering Heart Health at Any Age
Nearly a million people in America have a heart attack each year, and for two-thirds of these people it...
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February 18, 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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In the Caregiver's Words

Recent Client Praise

Chicago Home Care Service Experts
When looking for Home Care service in Chicago area for an elderly loved one, it’s easy to feel overwhelmed and vulnerable. That is where Creative Care Management comes in. We work with you to completely understand your elder loved one’s needs and then manage the process of selecting and placing your loved one with the right kind of care from a reliable and trustworthy provider.
Finding the Right In-Home Care
Our four step process allows us to guide you from our first meeting to the continued monitoring of your loved one’s in-home care, by developing a thorough Home Care Management plan that is unique to your specific caregiving needs.
Step One: Meeting and Assessment
Everything starts with a meeting. By establishing a personal connection during our initial meeting, we aim to fully understand your concerns. We conduct an assessment of the physical, mental and social health of your loved one to determine the ideal type of elder care service at the moment.
Step Two: Creating a Home Care Plan
Based on our assessment, we work with you to collectively develop a Home Care Management plan that covers everything from the type of care provider required to preparing for changes that may occur in the future.
Step Three: Setting the Plan in Action
When we recommend a care provider, we only offer the best. We hold our providers to the highest standards in regard to responsiveness to a client’s needs, consistent quality of service and level of training and certification required of the provider’s employees. We provide recommendations for a wide range of in-home care options including, but not limited to:

Home companion

LPN (licensed practical nurse)/LVN (licensed vocational nurse)/ CNA (certified nurse’s assistant)

Live-in caregiver

Step Four: Overseeing The Plan
As in-home care is an ongoing process, the Home Care Management plan includes our continued involvement and oversight in the care of your loved one. When conditions and needs change, we will be there to help with any necessary adjustments to the plan. If you are concerned for a loved one, but feel overwhelmed tackling caregiving on your own, our geriatric care services are exactly what you need to lift that weight from your shoulders. Contact us today for a free initial consultation.
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Recent Client Praise

How about a free genetic test to learn more about your ancestors? Free… And finding out about the people who no longer are alive to tell their stories? And your older mom or dad figure why not... Well, identity theft is why not. How many of you have taken the test to find out more about your ancestors? You know, the one where you offer a sample of your saliva in a tube, mail it off and they return a “report” to you that details what they know about where other people with similar genetic profiles call “home.” Most people find they have ancestral roots that go back to a lot of places, not just the family homeland they heard about as children. So, of course, scammers would be finding a way to use this test which is supposed to put us all on the map in order to defraud unsuspecting elders. The U.S. Department of Health and Human Services Office of Inspector General has sent out an alert. Scammers are offering people qualified for Medicare to get the same test that you or I may have paid for on-line. You may have thought your older parents were pretty insulated from this kind of scam, but here is how it works. We’ve all been to the public health or “aging well” events where a roomful of professionals are giving away books on senior residential options, refrigerator magnets, sticky note pads and a cool bag for carrying home the haul of freebies. There are other ways like telemarketing and door to door calls, but scammers are offering the unsuspecting older individuals a free cheek swab by simply providing their Medicare identity, and the target who does not recall that they no longer need to provide their social security number don’t hesitate to offer that in exchange for an ancestral map. Well, it becomes an access point to a different kind of map, your loved one’s financial map. And with the address and social information, scammers can begin the kind of work they do all too well. So, prepare your older loved one to be vigilant about:

If a testing kit arrives at your loved one’s home, tell them to not do a thing if their physician did not request a test. Better yet, take note of the address of return and report it to the authorities.

If a stranger offers a genetic test and…by the way…asks for a Social Security or Medicare number, stop. In fact, anyone other than a physician’s office or lab should not be given any of these pieces of identification.

If anyone asks for Medicare information, and they are not a medical provider to your loved one, beware. So, this is more than saliva in a test tube. If you suspect Medicare fraud, depart the Office of the Inspector General of the Department of Health and Human Services.

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.
Over the years I have devoted a lot of space to talking about what a Geriatric Care Manager (GCM) does. And that is because we as a profession have a long way to go before people know what we do as clearly as they know what a doctor, lawyer or accountant do. In this post, I am going to give two examples of when to call a Geriatric Care Manager, because unfortunately we often get the call later than we could. The call comes after a family crisis instead of before a crisis when we could have been the professionals who help avoid the crisis. Here are two examples of when... The Big Fall. After age 65 approximately one in three older adults will take a fall, not just a stumble or a trip, but a fall where they hit the ground hard. Beyond the age of 80 the chances increase to fifty percent. As geriatric care managers, we certainly can be part of the team who helps your older loved one recover, rehabilitate and get safely back on their feet. Much of that process will be in the hand the medical providers who may repair the broken hip, arm or other bone. And the physical therapists will do a wonderful job of helping to rehabilitate your loved one back to full or nearly full recovery. What a GCM can help with is putting together the lifestyle recovery plan with the family. We assess not just the individual, but also the home in which they live. We help the family to get everything for the recovering loved one that they perhaps used to do for themselves. We also help to make home a safer place for getting about, eliminating further fall hazards and helping everyone to navigate the path to recovery. But, what if the family had called when they first noticed that their loved one's gait had eroded from a stride to a shuffle, and what if the GCM had received the call to come by your loved one's home and help make it safer for getting about and avoid the fall? Dementia. Older adults fear losing their mental capacity more than they fear dying itself. As geriatric care managers we can certainly be called upon to counsel the family in how to manage a crisis once your older loved one has actually wandered away from home and given everyone the big scare. We can give family members by coaching in how to deflect instead of confront a confused older loved one during conversation. And much more. But we can be more effective if we get the call before your loved one has walked aimlessly into the night. We can help the family to make your loved one's home safer against "breaking out" just as you would want security from burglars breaking in. There are also ways to sharpen mental acuity at the first signs of confusion through social engagement and other intellectually challenging therapies. Working toward social engagement in meaningful ways is a high priority. The list is longer than just these two crises to which GCMs respond. How is your older loved one's driving? How safe is home from fires? How safe is your older loved one from scam artists? Is your older loved one getting the best medical care and support for a chronic medical condition? and much more. I would be remiss if I did not also add where you can find a professional Geriatric Care Manager. There are a lot of people who offer services to "help older people," but many lack training or certification. The best place to find a GCM is at the professional association's web site. Click on the button that says: "Find a Care Manager" to locate a professional near you. 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@cr eativecaremanagement.com.
You’ve all probably heard the old joke about why a flamingo stands on one leg…and we have all seen these lanky birds if we’ve ever been to a zoo. The answer is simply, “If they lifted the other leg they’d fall down.” Now, why would a person stand on one leg…and do so for 10+ seconds? According to recent research, it is to test their health and expectation for longevity. You’ve seen or heard it in the news that people in their mid- to late-life who cannot maintain this one-legged posture have more than twice the risk of death in the next seven years over those who can do the pose. That’s a very big differential. To fill in the rest of the research that may not have come across on your evening news or in your online news feed, medical researchers have noted for a long time that agility like this is tied to risk for cognitive decline or other cerebrovascular damage. About 13 years ago, researchers took this a bit farther with a panel of 1,702 patients who would be followed from 2009 forward. Their average age at the outset was 61.7 and 68% of them were men. Over one in five failed the test from the get-go, and as you can imagine, the failure rate was higher among older participants. More than half of the 71 to 75 year-olds could not pass the test. These individuals were followed for a median of just over 7 years and 7.2 percent had died by this next measurement date. But mortality was not equal across the board. Just under 5% of those who could do the one-legged stand in 2009 had died seven years later, but more than 17% of those who could not balance earlier had died. Scratching beneath the surface, there were more factors than simply balancing in play. The researchers found that people who could not balance also:

Were more likely to be obese;

Were more likely to have heart disease, hypertension or dyslipidemia; and

Were three times more likely to have type 2 diabetes.

The study cannot say that there is causation between these factors and death, but these are differences worth paying some attention. So, getting more agile is probably a healthy thing to do, but there likely is more. Getting to a lower weight, managing physical activity to burn calories, taking medications to reduce cholesterol and managing other lifestyle factors to bring one’s long term blood glucose levels down are all pretty sound pieces of advice. Chances are that if a person follows these lifestyle management recommendations that it also may become easier to balance on one leg. The payoff for all of these, then, is pretty obvious. And I think we could add one more. The chance of a fall will be greatly reduced if one gets their nimble back as well, so where will you stand on this issue? 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.
That’s not covered.
The estimate is that about 28 million older Americans have opted out of traditional Medicare and for what are called Medicare Advantage plans. They are not just Medigap which came about soon after Medicare was enacted to help pay for what Medicare did not cover, like prescription drugs and more. They are touted as plans that can offer better services, more services or better value, but these “advantages” have been brought into question lately. There may be value in these plans, but they also go on record with tens of millions of denials for tests or services each year. A report from Medicare administrators (part of the Centers for Medicare and Medicaid Services, or CMS) found that three-quarters of denials for medical services to covered patients were reversed on appeal. An investigation further found that 18 percent of payments for care that had been denied would actually have been covered by Medicare. Insurers use a step in the medical process that requires that approval be sought from an insurer before a procedure can be covered; they’re called prior authorizations. These “prior auths” appear to have been expanding well beyond what they originally were intended to do. The step was initially set up to stave off expensive or unproved procedures and medications. A new medication perhaps has been found to work against a different diagnosis than was originally approved by FDA, but it might not be approved for coverage until it has become a “standard of care.” But it has been used far more commonly to deny a host of services, tests or prescriptions, and patients may not know that they can appeal…or at least give the feedback to the provider who ordered the services, tests or prescriptions. If you are a caregiver to an older loved one who has one of these Medicare Advantage plans, be watchful of services or prescriptions that are denied. Become an advocate for your loved one with their provider and ultimately with the insurer. The real litmus test for the services that may be questioned is whether they would be allowed by Medicare. If Medicare would allow a service, Medicare Advantage plans must also provide for that service. Medicare Advantage plans may have their own criteria for processing services and reimbursement, but they cannot be more restrictive that Medicare. Federal investigators admit that even some of Medicare’s own rules may need to be updated. 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.
It was about two and a half months ago that we posted about the diagnostics telling Chris Hemsworth he had the APOE4 genes that predispose a person to Alzheimer’s disease. Clearly Mr. Hemsworth has embraced, and will continue to embrace, specific habits to deny Alzheimer’s Disease an opportunity to take over. An article recently released in The British Medical Journal has documented six healthy lifestyle habits that you don’t have to be Chris Hemsworth to follow…good thing, because no one can really compete with Thor. Without getting too granular, the researchers recruited nearly 30,000 individuals with a mean age of about 72 years and no evidence of dementia and then followed them from 2009 to 2019 with measurements every two years. They measured participants’ statuses on six “lifestyle factors”…factors that are within the control of participants and therefore modifiable: Exercise, smoking (or not), alcohol consumption (or not), healthy diet, cognitive activity and sociability. Here is a link to the research if you want to drill down into what comprises “exercise,” “healthy diet” etc. Take a moment to rank these from most important to least important before I share the results! The first four are all significant at the p<.001 level…translated, this means that the odds that these factors do not influence cognitive health are less that one in a thousand. Lower levels of significance, like those for the last two lifestyle activities are at a p <.05. In other words, the odds that they do not influence cognition are about one out of twenty were one to replicate the research. From most impact to least – but all statistically significant:

Healthy Diet – a daily measure of consumption of 12 food groups such as products like dairy, fish, vegetables, fruits and such;

Physical activity – measured as the participants’ weekly amount of time devoted to cardiovascular exertion;

Cognitive Activity – consists of reading, playing games like chess or mahjong and writing…I think Wordle and crossword puzzles also apply;

Social engagement – includes participation in meetings, clubs and even parties as well as travel or even online chatting;

Smoking - simply ranked as “never,” “former” and “current” smokers is among those activities that count for something, but appreciably less than the top four;

Alcohol consumption – is measured by categories: “never drank,” “drank occasionally,” “low to excessive drinking,” and “heavy drinking,” and it has the least impact of the six categories.

Okay, we’ve moved beyond New Year’s resolutions, so maybe these are part of what can be our commitments to retaining our cognitive function? Worth the effort? Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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 last week’s post, Steve Steiber, Ph.D. of our Team explained the new Alzheimer’s therapy, aducanumab, and what’s going on in the “Alzheimer’s space” generally, because Dr. Steiber has over 30 years doing market research in the biopharma arena. You can look at the last post for more of his creds in research. … First, if you didn’t yet read last week’s post on the newly approved therapy for Alzheimer’s, wait until you’ve read this week and back track for the news on aducanumab … Aducanumab is a novel biologic that works to interrupt the formation of beta amyloid plaque in the brain. If you’ve read much about Alzheimer’s Disease, you’re familiar with the plaque that diagnosticians see in patients with the disease and how it basically gums up the neural pathways of the brain. FDA approved aducanumab, in part because it seemed to demonstrate an ability to reduce the plaque, but other benefits like improved cognitive ability were mixed in the two phase 3 clinical trials. The approval from FDA was conditional, the condition being a phase 4 clinical trial to settle some of the questions on the therapy’s efficacy. Not every professional agreed with the approval. In the end, three medical professionals on FDA’s Peripheral and Central Nervous System Drugs Advisory Committee resigned their positions over FDA’s ruling. Some speculate that having given the go ahead for an accelerated approval process, the FDA couldn’t find a way to “put the toothpaste back in the tube.” Here is how one source summed it up. That’s it? No, actually the Biogen trials for aducanumab have been just a small part of the Alzheimer’s Clinical Trials still underway under the watchful eyes of FDA. If you go to clinical trials.gov and search “Alzheimer’s Disease”, you’ll find a list of 2,586 trials currently in motion. In fact, it’s enough to be quite overwhelming, so you may want a little help interpreting medical government speak on that site. The Alzheimer’s Association is one of the most aggressive and effective advocacy groups in America. Please check it out at alz.org and while you’re there you can even find local resources to help if you are a caregiver to an older loved one with Alzheimer’s Disease. They have a number of resources available in specific metropolitan areas of Illinois as well as Illinois overall. And there may be a community resource near you. This may come across as complicated, but take heart that the Alzheimer’s Association firmly believes that the first survivor of this disease is now living and breathing in our midst. It is just a matter of time, and the Association is doing all that it can to make that moment happen as soon as possible. If you did not get a chance to read last week’s post that led to this, please “click here.” I encourage you to also send any questions on Alzheimer’s or career support you may have to info@creativecaremanagement.com . 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.

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Who thinks it’s a good idea to just blow off Valentine’s Day? I am guessing not many hands will go up for that idea…some might even say that their spouse will kill them if they don’t bring forth at least a sentimental thought. Never mind the flowers, candy or sparkler. Just forget about the day later this week. Well, that probably is what some of us do every day … with our hearts…we just forget about our hearts. And that is why heart attack and stroke are the top two causes of mortality in the United States. So, what do you do to remember of your hearts? Earlier this decade the American Heart Association came up with seven habits to embrace to help avoid heart attack and stroke. You don’t have to wait until February 14^th to start:
1. Exercise - there is a new exercise program recommended almost every week, it seems, but the simple fact is that getting your body moving regularly and vigorously supports a healthy heart…and the rest of the body with it.
2. Eat right - we all know what the good foods are and what the bad foods are; make a healthy diet your Valentine’s Day resolution.
3. Lower blood pressure - you will need a medical provider to give you your actual numbers (not to exceed 12/80), and if your numbers are high stick to the prescription you will be given and follow #1 and #2 along with losing weight and cutting your salt or sugar intake.
4. Lower your cholesterol - focus your diet on fruits and vegetables along with fish, nuts and soy; your doctor can tell you if a statin is indicated.
5. Manage your blood sugar - sugar is not your friend, so limit its visits to your body in order to keep down your weight and not beat up your pancreas…your heart will thank you.
6. Maintain a healthy weight - losing weight should be an outcome of the first 5 instead of a goal in itself, but keeping your weight down lightens the workload for your heart.
7. Don’t smoke - smokers have double the risk of a heart attack and triple the risk of a stroke over nonsmokers; it is not just your lungs that suffer if you smoke.
So this list is the short version of a lot of material I have covered in other posts. If you have questions, you can use key words to search the blog for a related post or you can go to the American Heart Association web site. Make February your heart-healthy month! 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.
As geriatric care managers, we provide advice, counsel, advocacy and support for older care receivers or other people with special needs of any age. Care managers, however, also provide support to the front line caregivers to these care receivers by adding our CMs eyes and ears when the caregiver cannot be present, our advice based on the experience we have that first time caregivers just cannot have and support for the caregivers themselves. This last is important, because the person most often neglected by the caregiver is they, themselves. They do not sufficiently care for themselves while they are involved in caregiving. That said, there are different kinds of caregivers, and the care they need will be different. We can make a lot of distinctions about kinds of caregivers, but one important dimension that I see a lot very simply is defined by the relationship to the care receiver. By that I mean, the difference between intra-generational caregiving and intergenerational caregiving. Let me explain. Intra-generational Caregiving. According to all the surveys I have seen, one of the most common caregiver relationships is that of one spouse caring for the other. But it also can be siblings who care for one another as one falls ill, or it can be friends, cousins, neighbors and more. These intra-generational caregivers could benefit from the greater knowledge of community resources that GCMs have, the correct questions GCMs can ask at a medical appointment, the help GCMs can bring to the caregiving to avoid harm to the caregivers. This last is especially true when both the caregiver and the care receiver are older and frail. I have seen cases in which the caregiver is injured in a fall while trying to attend to their fallen care receiver. Yet, such accidents can be avoided if a care manager is brought in to "leverage" the good intentions of a caregiver. But a caregiver may feel guilty about asking for help when they perceive they should be taking care of everything. The family needs to talk about helping the caregiver. Intergenerational Caregiving. The other common caregiving relationship is the son or daughter (most often the daughter) who is trying to be the caregiver for mom or dad. This same daughter or son, however, are also responsible for a spouse, or their own children or a job. These are the truly stressed caregivers who would benefit from a trained care manager to attend the medical appointments and to ask the right questions that will get the best care for mom or dad. They also would benefit from a very subtle form of counsel on just how to establish the new ground rules for caregiving. I hear some caregivers say something to the effect that the roles have been reversed, and now mom (or dad) is the child and they are the parent. Wrong! The roles have changed, but they have not reversed. When a child to an older parent steps up to the caregiving role, there need to be some difficult conversations about everyone's expectations and about the older loved one's dignity. A third party like a GCM can be an invaluable arbitrator, not to mention a great resource about all the options in the community that can make caregiving much less stressful and much more rewarding. As I have said in other postings, just as it may take a village to raise a child, it also takes that same village to care for all our older loved ones! 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@cr eativecaremanagement.com.
Of the estimated seven million Americans who have been full-time workers and caregivers, about six percent left the workforce for at least some amount of time to devote themselves full-time to caregiving. If you are one of these caregivers who are now rejoining the workforce, you may be wondering how "caregiving" fits on your resume.

First of all, appreciate that mothers or fathers of newborns or adoptees have been leaving the workforce and returning after raising children for years now. Having raised multiple children from birth to teen years, many of them have had much longer time away from work than a caregiver who takes leave for an older parent. That said, here are some lessons learned for how to dust off a resume:
1. First, don't lie about what we may refer to as your "caregiver gap;" trying to stretch earlier career positions to cover these months or years just will not work when a potential employer can check your story.
2. Make an explanation of this period that is comfortable and to the point; too many details can be a distraction and euphemisms just sound odd.
3. Include volunteer work that you may have been engaged in as well as any coursework you completed, conferences you attended or anything else to keep current.
4. Adapt your experiences for the specific jobs for which you will be applying; one size resume will not fit all applications.
5. There is a month for everything, and yes, September is International Update Your Resume Month, so check out resources on line (http://www.pongoresume.com/blogPosts/588/win-free-pongo-services-during-update-your-resume-month.cfm )
Resume in hand, start with these steps:
1. Restart your business network by tapping appropriate contacts within your social network like Facebook.
2. If you do not have a LinkedIn account, get that started as well with your business contacts from Facebook or your earlier jobs, and reach out to contacts of your contacts.
3. Call your former employer to see if they have freelance work available or new openings; a returning employee can "hit the ground running."
4. Check out college or continuing education courses that will get your skills current for today's job market.
5. Volunteer for a position in a non-profit that will use of the skills you have; such a position becomes a fresh line item for your career story.
6. And just as you may have done in your very first job search, seek out "informational interviews" with employers in your industry.
Throughout all of this, keep reminding yourself that what you did as a caregiver was important and valuable. And it was a full-time job, so you are not really restarting; you are just moving along your career path to your next job.

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 ccbishop@creativecasemanagement.com. Read more about Our Story and Charlotte's mission.
This is one of the most emotionally-charged questions I hear when I am called by a family member who is concerned for the well-being of their older parent/s living alone at home. There is a lot of emotional attachment to "home sweet home," "home as castle" and more that has been learned over time. The question of whether home is still the best or safest place for an aging loved one is not just about the physical space. When invited to evaluate a situation, we look at both the individual's capacity to reside in a space and the environment's capacity to accommodate their needs. In this posting I talk about how we help explore the individual's capacity to get around in their home.

If you as a family are unsure about a loved one's ability to safely live independently, you can start with an assessment of how that person handles the basics of what we call activities of daily living (ADLs). Here is a checklist of the six basic categories of ADLs and how you can make an initial assessment yourself:

Hygiene: Do you see signs that they are not bathing, brushing, grooming as regularly as they once did?

Continence: Are there signs of "accidents" that they or their spouse may be trying to hide?

Toileting: Very simply, can they manage the bathroom on their own?

Dressing: Do they have the balance or strength to change in and out of clothes?

Eating: Do they have the dexterity to bring a utensil from the plate to their mouth, cut their own meat, etc.?

Transferring: Can they get from a chair to the bed, from the bed to another location, in and out of a car, etc.?

Take the example of one of my client's; I'll call Rose. Rose was living alone and independently. The first sign she might be having trouble was when she "forgot" to turn off her gas stove (fortunately it was lit); the kids bought her a microwave. When she consistently burned toast, they took away the toaster. It wasn't until she flooded her basement three times by leaving a kitchen sink running that the family accepted that either moving out or 24/7 in-home care would be their only recourses.

If your loved one is having difficulty with any of these, they may still be able to live independently, but some accommodation may be necessary. A GCM can help with an objective assessment of these functions as well as recommendations for accommodations. We are objective, because we don't represent a retirement home, a home health agency, etc. Also, a GCM can help with assessing the more nuanced or complex activities, what are termed instrumental activities of daily living (IADLs). These are more of the cognitive issues that may either be accommodated by outside assistance or be the red flags that home no longer is a safe or secure environment. Examples of these activities can include looking up phone numbers, cooking meals, doing housework, managing medications, etc. Here again a GCM or social worker can help assess if these are insurmountable shortcomings or if outside accommodations can provide the right level of assistance.

Just because a person does not always remember to take their meds or does "not get around" as they once did are not necessarily reasons to move them from their home. Accommodations, particularly those that can be brought to the home, will be in my next blog.

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.
Medicare has been one of those political footballs where both sides of the aisle have had an entrenched position for decades. One side has been vying for better coverage for our older citizens and the other side claiming a need for more fiscal constraint so as to limit the ever “threat of bigger government.” But regardless of which side of the argument one may have taken, there was never any denying that insuring our most vulnerable population has been an expensive proposition. And it has just kept getting more and more costly. …until recently. True, it continues to grow as an overall price tag, but the cost per Medicare enrollee has been almost flat for more than a decade, something that has not happened ever before for this entitlement program. If the spending per enrollee had continued on its trajectory since 1970, the average spent per individuals should have exceeded $20,000 by now, but instead it has been hovering$12,000 to $14,000 for more than ten years. The overall budget for Medicare has continued to climb, but this plateau translates into $3.9 trillion in federal dollars saved. That’s about 85% of the total federal pandemic expense, 14 times the annual benefits to veterans, 18 times the annual salaries paid to public school teachers, 27 times the annual federal spend on food stamps (referred to as SNAP), 161 times NASA’s annual budget and the list goes on. Recognizing that we’re not out of the proverbial woods yet, Medicare has been most recently granted permission to negotiate directly with Big Pharma on the prices of ten branded drugs. I had talked through this in a recent post. Better drugs are important to our vulnerable older citizens, but higher prices are not as I wrote in that earlier post. There is also the suggestion from the Congressional Budget Office that adding more Boomers to the Medicare rank and file will kick prices up soon enough. If you have an older loved one either on Medicare or soon to be enrolled in Medicare listen closely to what your representatives are saying about Medicare. You may want to make the call to inform them of the facts. Being an active citizen just might turn out to be really good for your older loved one’s health! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, 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.