Chicago's Geriatric Care Manager Center of Excellence – Since 1991 • summer seasonChicago's Geriatric Care Manager Center of Excellence

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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In the Caregiver's Words

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A philosopher/theologian whom I regard quite highly talks about the first half and the second half of life. Life is not exactly divided into two equal halves, but it is divided into two very different task assignments if we look at the first versus the second parts. He says “this first half-of-life task is no more than finding the starting gate”… for the second half. The goals are really pretty straightforward for those who can now reflect on what they experienced once they left home, once they graduated from college or a tech program, once they got married…and all that follows from these and the careers that paid the way. What I’ve seen with my life and what I’ve observed in my own kids, however, is that everyone has a different path and a different success story. At the end of this “first half” everyone works with what they’ve achieved and how to apply it, and there are roughly five categories: Health - Hopefully you’ve kept yourself in good enough shape that you can do what’s on your list. (I refuse to use the word “bucket” along with list, but you can if you like.) So, what needs to be done today and tomorrow and in the future to ensure that you continue to be the best version of you? Wealth – You saved for your “future,” but what is it that you saved for? Perhaps a financial advisor helped you invest from your 401K or your IRA so that you can afford to do what you wish to do now? How do you see your evolving lifestyle, your places to see and things to do accordingly? Social – What lifestyle is important to you? You know the people with whom you had to associate in your work life, and maybe you look forward to leisure time with them or doing what you liked to do before. Or maybe a warmer climate, or maybe travel to see what you have not yet seen? Spiritual – You have values that have informed your daily activities and engagements. What is your commitment now? What is your mission now? Do you have a mountain top and a guru to whom you will seek in order to find a new meaning for you life or a way to give back from the spiritual or financial wealth you’ve accumulated? Housing – As you’ve raised up your family and then seen them leave the “nest” one by one, your home may seem a bit empty at the end of the day when no one is coming home from school. Or it is just more work than you want to invest in keeping up what accommodated the first half of your life? Or, you’d just like to have that place on a lake? Dare to turn your DREAM into a PLAN! Charlotte Bishop is an Aging Life Care Advisor, Retirement Lifestyle Coach and founder of Creative Care Management, LLC, 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.
You’re seated with your frail mother in a jet at about 28,000 feet, row 15. You had volunteered to fly out to meet her and fly her back to your home, and you just took off moments ago. Mom had been unable to use her right side to any good effect for some time, and you are bringing her to your home so you can better care for her. You haven’t made specific plans yet, but you’re certain it will be a good move for her and for your family at home. The plane suddenly lurches downward. The air masks drop from the ceiling. What do you do? If you had paid attention to the in-flight talk as you got settled before taking off you would know that you are to secure your own face mask first, and then help someone with you if they require any assistance. Anyone who has traveled with any regularity has probably heard this so many times that they could probably recite the pitch themselves. But who thinks to apply the same lesson to the rest of their lives? The New York Times carried an opinion piece this past weekend by an author named Lorene Cary. Her book has a title that pretty much tells it all: “Ladysitting: My Year with Nana at the End of Her Century.” She digs deep into the unsavory aspects of caregiving in the 21^st century. It’s often not just transporting a loved one to the doctor or picking up groceries and doing a load of laundry. Caregiving usually starts with no training and then quickly moves into bathing the family member, learning the nuances of adult diapers and all of the other assorted “Activities of Daily Living.” It’s hard, unpleasant and seemingly relentless. One person who came up to me after I had spoken to a gathering some time ago introduced himself as having “recently graduated from four hours of uninterrupted sleep to four hours of interrupted sleep a night caring for his mother.” And did I mention that most caregivers to family members do all of this without pay? Ms. Cary cites a figure that I still find staggering. According to AARP’s Public Policy Institute this cottage industry we call caregiving would total nearly half a trillion dollars in revenue if all the voluntary caregivers were paid just minimum wage. Ms. Cary also raises a point that can easily get missed if we just translate this “caregiver crisis” as some call it into dollars and cents and hours spent. She says, “Too many people have to reconfigure their lives around a loved one’s disability.” She goes on to talk about a different kind of national debt based on what she labels our “Gross National Happiness Index.” If you are a caregiver, try a little exercise. First, in one column list all the activities you have directed to your care receiver this past week….the trips to the store, the in home tasks…everything. Next, make a list of all the activities in which you have participated just for yourself? If that second column looks a bit wane, start today to rebalance your books and begin by caring for the caregiver. It will actually make you a better caregiver as it also makes you a healthier and happier person! 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.
Associate Care Manager Gregory Peebles returns with a series on the Internet and aging. Gregory is both a Certified Senior Advisor (CSA) and Certified Dementia Practitioner (CDP) whose work focuses on helping aging adults and folks with limited independence by providing resources and support to help them discover and lead their best life. Gregory has been a part of CCM, Inc. for over a decade. – Charlotte Back in 2007, when the Internet was still being settled, I was in one of those lines that stretched around the block to ensure that the day it came out, I had a brand new first generation iPhone in my greedy little hand. Once acquired, friends and family were all amused by the machine, but saw little use for it in their own lives. The revolutionary, all-in-one device was an expensive fad that they imagined would calm down. Life had changed though, and I knew it was just a matter of time before what was in my pocket was the norm instead of a curiosity. Five years later, my retired mother, more than a little bored, adopted a smartphone baby, shortly thereafter becoming an excellent texting conversationalist, casually sharing with me links to favorite YouTube finds. She blossomed online and is currently the Facebook page administrator for one of her social groups. My mom is a special case. She’s very curious and took to virtual reality like a duck to water. Not everyone is as interested. It takes all kinds. In 2017, more than 2/3 of adults over 65 have cause to be online, with well over half of that number identified as being active Facebook users. That means that chuckling over technology-challenged grandparents has an expiration date, and it’s now! The cohort we call “oldest old” (85+) still tends towards pencil-and-paper or maybe typewriter modalities (and that doesn’t look likely to change), but aging boomers have rushed online in droves. Some overeducate themselves regarding proper safety, locking their identities down in privacy settings to the point that “social media” loses meaning. Meanwhile, others prefer to bleed important personal information to anyone listening. At CCM, most of our Internet discussion to-date has been dedicated to sharing with you the ever-changing scams Internet predators use to prey on vulnerable users of all ages. (We’ll talk some more about those, too.) But for the next few sessions, we’ll focus instead on the ways aging adults are using the Internet socially to enhance the quality of their lives. From best practices in social sharing to recognizing bots in chat, we’ll be engaging in eye-opening discussion about the real online lives of your older loved one and answering questions like:
- What can seniors expect from online dating?
- Where are seniors online?
- What services or sites have engaged them as a group?
- What does a secure and social Internet experience look and feel like for aging adults?
We hope you’ll join us for this topic each Monday for the next four weeks, commenting and sharing this important, somewhat unusual conversation with your own corner of the Internet.
It seems you can’t talk with anyone about aging these days without the subject of cognitive health or dementia coming up at some point. People fear dementia more than dying itself, and yet most individuals who are “of an age” are probably not doing the one thing they should really be doing and doing it correctly for their brain’s sake. Bring up cognitive decline or dementia and medical professionals may talk about what’s in the biopharma pipeline. The government web site that tracks all of the clinical research on cognition shows more than 60 studies presently in progress and studies on Alzheimer’s Disease number nearly 2,700. While no one has yet tapped into what can truly become the pill or infusion that will change the course of cognitive decline as we age, I’m confident that we will find not just one way, but likely multiple ways to positively influence the memory of the aging brain. In fact, there’s one thing we all can do – and it doesn’t require any work – to improve our cognitive function at almost any age. In fact, it’s almost the opposite of the definition of work; it’s simply sleep. But it’s also the right kind of sleep that will delay cognitive decline and keep our faculties sharper. How much? Any of you who have raised kids know that in their pre-teens kids sleep inordinately long…and seemingly easily. For this age group, 9 to 12 hours is the requisite recharging time required to both function well the next day and to grow their rapidly changing bodies. The teen years reduce this demand a bit to about 8 to 10 hours of solid sleep for healthy functioning. Adults require less overall…usually about 7 hours or so does the trick, and substantially longer can even be a negative indicator of some health or breathing issues. But it’s not just the number of hours one sleeps as an aging adult; it’s how one sleeps. What quality? Waking too often or for too long throughout the sleep cycle interferes with the quality of sleep. Steps to mitigate either sleep apnea or trips to the bathroom need to be taken in order to have a truly restful night. And there are four stages of sleep that are necessary for a night of slumber to be restorative, and each of these stages total about ninety minutes from start to finish. The body relaxes and slows in stages one and two with both breathing and heart rate diminishing their rhythms to prepare for the next two stages. In stage three, referred to as the delta or “slow-wave sleep,” the brain does its after-hours repair work on the toll that a day’s living has taken on the body. The next stage is most important for cognition and brain health as we dream and sort through the day’s information and organize it in the brain. We all have heard about this stage, the rapid eye movement or REM stage, and we all will go through about four cycles of REM before our night is done in order to have an optimal night’s sleep. So, how do you go about getting the best out of your sleep? Everyone will find their own preparation for sleep - maybe a warm bath, meditation, or a relaxing bedtime routine. Laptops and smartphones – blue lights! - are hyper-stimulating, so absolutely no! And spicy or fatty or hot food is also a distraction from quality sleep – no! And what used to be called a night cap (alcoholic beverage) is the farthest thing from what you should consume before sleep – no!. Read a book, yes, but don’t scare yourself with a thriller. Speaking of reading, remember that fairy tale about Goldilocks and the three bears? You should also be looking for a good rest that comes from a happy medium in your sleep habits…one that is “just right.” 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 did not start out as a geriatric care consultant although I have been one for nearly 20 years. I actually started in care management helping injured workers, but it seems that life has come around full circle with an increasingly older work force. Larger percentages of workers are staying on the job beyond what had customarily been the "retirement age" of 65. Yet, today's older worker does not fit some of our historic expectations. The National Council on Compensation Insurance (NCCI) has offered some new research that may surprise a lot of people, especially those who claim that older workers will be more prone to costly injuries. The research showed, for instance, that workers under age 35 had more finger cuts than those over age 35. But workers over age 35 reported more cases of carpal tunnel syndrome or neck injuries than younger workers. This generalized to a lot of what are referred to as repetitive stress injuries like rotator cuff injuries. Even so, the differences were not very great in these latter categories. There also has been a pervasive notion that older workers' injuries will be more expensive than those of younger workers. Well, that depends on what you term "old." It turns out that workers under age 25 do have less expensive injuries with less time lost from work than those older, but it would probably be a stretch to suggest that a 30 year old employee is an "older worker." Moreover, once a worker hits age 35 and up, the costs of their injuries and the time lost from work are very much on par with much older workers. The researchers also found that the best way to reduce injuries and their costs is not to hire 30 year-olds, but to train workers in safety and to report injuries immediately when they happen. And there is one more similarity between the older worker and their younger counterparts, and it has to do with family responsibilities. We all expect younger, married workers to have family responsibilities they juggle with their workplace commitments, but older works are also jugglers. In their case, however, they are trying to manage caregiving responsibilities for older parents along with their maintaining on the job performance. And, of course, some of the "younger, older workers" are sandwich generation workers with kids at home or in college as well as parents who need help. No surprise, then, that an increasing number of our clients are not just the individual caregivers, but also the employers for whom they work who are looking to take some of the stress from their "older workers" by offering our services as a resource and support. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric care consultants, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
How many of you were on the road this past Memorial Day weekend? It is something of an American tradition that families get on the road for a long holiday weekend to visit other family members or just get away for a break. This past weekend had an estimated 36+ million cars travelling 50+ miles on America's roads. How many of these drivers were over the age of 65, and why should that be important to caregivers to older adults? Drivers over the age of 65 have a higher accident rate than any other age cohort except the teens, and by the year 2025 65+ year olds will represent one in every four drivers on the road. Drivers 85 and older have the highest fatal crash statistics of any cohort. This may not be due just to the motor function of older bodies; AAA statistics show that 95% of seniors are on a medication that can impair their driving. And that should be important to caregivers to older loved ones, because it not only puts the loved one at risk but also the other drivers who just happen to be on the road along with them. Yet, research from the National Safety Council shows that caregivers to older adults would much rather talk with an older loved one about funeral plans than about their car keys. So, what can a caregiver do? First, it is important to recognize that older drivers can and do make a lot of safe driving choices. The "do not text while driving laws" were not, after all, written with seniors in mind. Yet, reflexes and visual acuity begin to slip beyond a certain age, and driving is nothing if not a skill set that depends on split second timing of both perceptions and reactions. The American Automobile Association is here to help caregivers and older adults. They have a host of resources that can be valuable to everyone, even the older driver who wishes to do a self-assessment of their skills on the road. The first step is to thoughtfully consider whether your older loved one does, in fact, pose a risk with their current driving habits. You may also wish to speak with their primary care physician for his/her assessment of your older loved one's physical abilities. Then if driving is a risky proposition, take a deep breath, try to put yourself behind your loved one's steering wheel and talk to your older loved one about your concerns. Recommend that they judge for themselves. On the "SeniorDriving.AAA.com" web site they have a self-exam that anyone can take to get a second opinion on their driving capacity. You might consider taking it yourself first so that you can speak to questions your care receiver may have. There also is a host of other options such as helping make the care fit your older loved one, improving their driving skills or learning the driving laws and licensing requirements for older adults in their state of residence. 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.

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Six Geriatric Care Management Tips to Beat Summer Heat

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