Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • senior healthChicago's Geriatric Care Manager Center of Excellence

4 Geriatric Care Manager Tips for Preventing Falls in Older Adults
We as certified geriatric care managers all hear about older adults falling. Caregivers often do not expect their own...
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October 9, 2013
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That “Other Caregiver Talk” with an Older Loved One
In my Tuesday posting, I spoke to some of the issues of caregivers about helping their older, single loved...
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September 26, 2013
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A Forgotten Element of Exercise for Seniors – The Voice
In past postings I have talked a good deal about the importance of exercise for seniors who need care...
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September 19, 2013
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Caregivers and Fit Brains
As geriatric care consultants, we always tell our clients that caregivers and the loved ones for whom they care...
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September 17, 2013
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Four Caregiver Health Safety Tips
I have written a number of blog postings on safety in the home, and most of them have focused...
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September 10, 2013
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5 Geriatric Care Manager Tips for Getting Your Elder in Motion
If today’s 60 is yesterday’s 40 and 70 is 50 and so on, then today’s elder needs to be...
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August 22, 2013
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How NOT to Treat Back Pain: Geriatric Care Management Tips
Do you have pain in your back, particularly your lower back – that area around your belt line or...
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August 8, 2013
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Six Geriatric Care Management Tips for a Healthier, Older Brain
Because I work in geriatric care, it almost goes without saying that I talk with a lot of people...
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July 15, 2013
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Six Geriatric Care Management Tips to Beat Summer Heat
It may be just the first week of summer, but if you are a caregiver to an older adult...
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July 1, 2013
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Five Geriatric Care Management Secrets to Living Forever
There is a lot of news about the “older market” or other stories featuring someone who has reached the...
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June 13, 2013
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In the Caregiver's Words

Recent Client Praise

Once every 67 seconds. Every 67 seconds someone in the United States develops Alzheimer's Disease, and among the adults over age 65 in the U.S. about one in nine have the condition. That is about five million older adults, one in ten of whom will die from this disease each year. There are about three caregivers for every one of the older adults with Alzheimer's Disease, and they provide about 17.7 billion uncompensated hours of care each year. But there is help for those with Alzheimer's and their caregivers. As a professional geriatric care manager, I am certified and a member in good standing of the National Association of Professional Geriatric Care Managers. Earlier this month they did what they are calling an "InstaPoll" of those of us who are members. The results from the poll of we care managers, it turns out, offers some very practical advice from those of us who work with clients with this condition every day. The feedback from the nearly 300 NAPGCM members who responded to the poll distill down into six recommendations for caregivers:
1. The most common recommendation revolves around the fact that dementia develops in stages, and that is important that a caregiver be attuned to the capabilities that a person with AD will retain versus lose so that communication is appropriate.
2. Test for a response to such communications as reminiscing. If the care receiver responds positively to talking about the past and long term memories, it can be very positive and affirming to break out the scrap books and memory boxes.
3. To guard against social isolation, try to keep up the old routines and engagements as your care receiver enjoyed before. With less social engagement comes the risk for depression and even further isolation.
4. For those of you who may have raised children, the game of "Mommy and daddy always come back" was important at a young age. It will be that way also with some AD patients for whom an absent caregiver is just gone. Reassurance is key.
5. Don't rush with change, especially the disruption of moving to a new residence. While it is important that an AD patient be secure from wandering, it also is important they be given time to adjust to the concept and an upheaval of house and home.
6. Where there is loss, especially that of a spouse, it is important that a care giver monitor the AD patient for signs that the stress is overwhelming. Their capacity for processing grief will be compromised by the Alzheimer's.
If you would like more information on NAPGCM's InstaPoll or on professional care manager advice as well as a care manager locator, just go to our association's web site: http://www.caremanager.org . 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.
My mom died on March 9th with dementia. During the 4 years as her caregiver, I really valued your emails. I learned so much from reading them and tips made my life better.
A satisfied client
I explained in an earlier post about why we refer to Holidays in the plural, and how we are working to be inclusive of all people’s end of year celebrations of faith. That was the “Holidays” part, but what about the “Happy?” The holidays are also a period of rather widespread unhappiness, if not outright depression, and it’s even more common among our older loved ones. How often have you heard comments like: “Oh, mom is just a bit blue;” or “Her husband died six years ago during the holidays…she should just snap out of it;” or “He just likes his time to himself during the holidays.” They are all ways to discount what is something of an epidemic among older adults in America today: depression…an epidemic that has exploded during the present and ongoing pandemic. If you are a caregiver to an older loved one, the symptoms may be slow to show themselves, but depression is a real medical condition to be addressed every bit as much as dementia or heart disease. Adults 65 years of age and older may only be just 16% of the population, but they account for 18+% of suicide deaths. Inexplicably, suicide rates for most older Americans have trended down during the pandemic, but depression is substantially up. Older adults with depression have healthcare costs 50% higher than non-depressed adults. And depression is common – more than seven million older adults manifest some degree of clinical depression each year. Where should you look for depression? I mentioned widowhood at the beginning. Well, one-third of widows and widowers meet the clinical criteria for depression within the first month after losing a spouse. And half of these are still depressed a year later. Depression also is a classic comorbidity of a number of medical conditions like Parkinson’s, Alzheimer’s and even cancer, arthritis and heart disease. But the prevalence of depression is really just an opportunity to take action. The data show that fully 80% of depression in older adults can be effectively treated with either medication or talk therapy or a combination of both. If you are a caregiver to an older loved one, however, encourage them to see a mental health professional who can offer the best of both medical and talk therapy. About 55% of older adults who do seek help for their depression reportedly go to their primary care physicians. While your loved one’s personal physician may prescribe, they are not schooled in talk therapy. If you suspect an older loved one in your orbit is depressed or maybe just down, consider the holiday gift that actually does keep on giving. Give your older loved one your personal time…and consider the installment plan…the plan that includes a whole calendar schedule of giving into the new year! 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.
I have talked a fair bit about Alzheimer’s disease and you can probably cite from memory that every 67 seconds another new case of Alzheimer’s is diagnosed in the United States. The sum total of all this translates into about one in ten adults over the age of 65 who have been diagnosed with this condition. But we also see a condition that older adults and their families seem to fear almost as much, and it is as rampant, yet not so often acknowledged. One in ten Americans over age 65 live below the poverty level, a rate that has held for most of the past twenty years. It has been higher, but rarely more than a fraction of a percent lower. In fact during that same period the rates of bankruptcy among 65+ year olds has doubled. Experts cite medical costs as a significant driver of this economic trend. It may be long term care, it may be dental implants or hearing aids or it may be the escalating costs of new medications for a chronic condition. Within the medical costs it often is what the insurance was “supposed to cover,” but just did not. According to a recent study from the Kaiser Family Foundation, out of pocket health care costs eat up about 41% of social security income. And this is expected to rise to 50% by the year 2030. I have talked before about the difficult conversations with an older loved one, but this may be at the top of the list, talking about finances. Here are a few tips about what to discuss:
1. Ask about their health insurance options to help find what is most cost-effective – as insurance gets more complicated, it can get wildly costly.
2. Look to local area agencies on aging who can offer Medicare-related advice as well as trusted insurance advisors.
3. There are on-line retirement calculators that can help you run “what if” scenarios with your older loved one in planning for a longer life.
4. Help your older loved one to find the existing cash that can help fund an emergency savings fund for the other “what ifs.”
5. Suggest opportunities to downsize…the home, the car, the vacation, etc.
The added benefit of this conversation with your older loved one is that it will also give you some advance perspective and knowledge about preparing for your own retirement. Please also do a keyword search of my blog to find more suggestions on how to help your older loved one get and stay fit. This one is an example of how to help with a better walking gait as a basic approach to better health http://creativecaremanagement.com/geriatric-care-manager/geriatric-solutions/dont-walk-this-way/ . Then, just add the dog! 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've talked about being on the lookout for signs of early onset dementia as we all begin our holiday gatherings. Dementia may be difficult to detect for a number of reasons. First, early onset can be evidenced in very subtle or small changes in behavior or recall, so it may be the accumulation of a number of tells that begin to tell us there is some slippage. Second, most of us are so fearful of losing our faculties that we tend to deny it or try to hide it from others, and after all who doesn't forget someone's name at some point? Third, loving couples tend to compensate or cover for one another. One partner may see the lapses in the other, but work to help their partner feel as empowered as they were before this decline. For all of these reasons, it underscores how we all should work to be empathetic and sensitive to the special needs of a loved one who may experience some form of dementia, because they can still function very well with some accommodation.

            So, once you do notice something or perhaps any number of things that are just not quite right in your older loved one, be sensitive about how you broach the issue...if you bring it up at all. As dementia sets in, it may cause a great deal of anxiety in the person with the symptoms. The anxiety understandably comes from a feeling of helplessness, and it is important to not provoke the anxiety into full blown defensiveness or angry outbursts. Here are three suggestions for friends, families, and caregivers on how to soothe an older adult with some form of dementia while maintaining a meaningful line of communication.

1.    As you plan the holiday gathering, think about the way these events have always been hosted in the past. Keep the surroundings and the routine familiar, and avoid noisy restaurants, especially places where the older person may be unfamiliar. If there has always been a certain way you prepared the pie, do it that way again, and you may be amazed how the tastes and the smells bring a wonderful memory back even to someone with memory loss.

2.    It may be appropriate to downsize the gathering a bit. In the past you may have invited a whole host of friends and family, but a smaller gathering of familiar faces will prove much easier for a person with dementia to navigate. While not every face will have a name for a person with dementia, familiar faces will put them more at ease.

3.    Appreciate that it is short term memory that is the most common casualty in dementia, but you can still talk about the early memories which everyone can replay and enjoy together. And it does not hurt to hear a wonderful memory repeated more than once at a family gathering.

            Finally, it is really all about family and sharing a positive moment, so be sensitive. If a story is repeated more than once you can indulge that. The most important thing to remember is to just enjoy the family moment. Follow your instincts about what has always been special in the past, and it likely will be pleasant for everyone again this year.

            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.