Geriatric Care Management Blog

About six percent of Americans suffered from some manifestation of heart disease within the past year according to government sources that keep track of such things.  Over the most recent decades the rate of heart disease has been consistently falling, because we have increasing numbers of ways to lower cholesterol, fewer people are smoking and physical activity is catching on.  Yet, for the few who may suffer from a heart attack, what happens after the attack may not get as much open attention as it deserves. Health care providers can be generally helpful in advising patients on what to make of symptoms they may feel after they have recovered.  Many hospitals and the cardiologists have gotten on board with rehabilitation programs geared to improving a patient’s cardiovascular fitness prior to a full return to normal activity.  And most patients will get good counsel on when it is time to go back to work.  But what about some of the other parts of daily living that don’t get much attention like these? What...

When we think about staying in touch with an older adult in our family or friendship circle, it quite often is about making that long overdue phone call or sending an e-mail or a letter.  But being in touch – especially for older adults – is more importantly about the more literal version of touching.  Especially for the old-old, those who are older than 75 years of age, two sensory stimuli are more unavailable to them than when they were younger.  They don’t hear from people important to them or they simply do not have the opportunity to reach out and touch another individual.  By age 75 a large percentage of seniors will have experienced the loss of a spouse or a loss of their ability to get around as they once did.  And as a consequence, their shrinking world brings them less in communication with or in contact with others, and communication and touching are critical for a well-adjusted and happy life.  Especially touch, we tend to take for granted, because we do not really even think about shaking hands...

Alzheimer’s does not happen overnight.  It can start with small lapses or moments of confusion that inexorably begin to deepen and repeat themselves until recognition of the once familiar goes out like a light.  This condition currently affects an estimated 5.2 million Americans over the age of 65, and by 2050 it is projected to affect 13.2 million.  In its early stages, Alzheimer’s can be mistaken for simple forgetfulness or even as it advances, it may seem like other dementias.  If you are a caregiver to someone even in the early stages of this condition, it is important for both you and the patient to lay a foundation of understanding, caring and thoughtfulness while you are able. Here are some tips for the early stages of Alzheimer’s or any of the dementias that can accompany aging.  The condition can be frightening for both the patient and the caregiver, so some of this early advice is really about establishing mutual trust and caring: Appreciate that there will be good days and bad days, so don’t...

It may come as a surprise to you that the most dangerous mode of transportation – as measured by fatalities per miles traveled - is walking.  Yes, recent data show that pedestrians face the greatest mortal risk with 20.1 fatalities per 100 million miles covered.  Translated into a rate per capita, this is about 1.33 traffic fatalities per every 100,000 population.  Even more alarming is how these statistics disproportionately single out older Americans.  Adults 65 years of age and older are only about 13% of the total population in the United States, but they represent 18% of all pedestrian deaths.  This, according to researchers from Florida State University who tracked such accidents based on state-reported data. Crash rates are highest for young pedestrians age 15 to 19, and then they drop off for older individuals until age 75.  By age 75, however, the rate of fatalities among pedestrians doubles what it is for the rest of the population.  There is a similar trend for parking lot crashes, although the early...

There is a real paradox in Alzheimer’s treatment.  Alzheimer’s patients will have a better quality of life by most standards if they stay at home, but it works best as measured by important metrics if a care management model is applied to the home care environment.  What might be termed just “care as usual” does not do as well for either the patient of the caregiver.  Clinical research has borne this out. Two of the basic tenets of the geriatric care management model are care coordination and care planning.  In a study conducted by Quincy Miles Samus, Ph.D., at the Johns Hopkins School of Medicine 265 patients with early onset Alzheimer’s and at least 70 years of age were randomly divided into two groups.  One group’s patients would receive care as they had been receiving, what the researchers referred to as “care as usual.”  The other half received coordinated care intervention which included counseling of all parties, particularly with caregivers about memory loss.  This second group also was closely monitored...

Identity theft can happen to anyone, but in many respects seniors are easier prey.  First, they are the people who have a savings account or other nest egg that an identity thief may be trying to tap.  Second, they have had a career of earning and saving which has given them very respectable credit scores, and therefore an easy mark for someone looking to use someone else’s identity to run up a credit card bill.  So, whether you are a senior or have an older family member or a senior in your orbit, here are some signs to look out for to protect against senior identity theft. If you or the senior for whom you are a caregiver begin receiving telephone calls from creditors demanding payments for which you have no knowledge, it may be because someone has hijacked the senior’s identity and run up charges of which you are not aware.  Often, a senior eager to maintain their credit standing will simply pay without asking enough questions about the legitimacy of the debt. Be careful in going through credit card or other charge statements – even telephone bills - to be sure all charges are legitimate.  There has been a lot of news lately about “cramming” which is when charges are added to telephone bills by workers at the companies without the owners’ knowledge....

One of the greatest fears people have as they age is not about the ability to maintain their physical bodies, but of losing their faculties.  With that specter looming large with each birthday, it can be easy to get a bit carried away with worries about being forgetful.  Let me just say plainly that if to err is human, then to forget is really human.  We all forget things, regardless of age.  The question is not whether one forgets things as they age; it is what things does one forget and how easy is it to recover? I am going to offer a couple checklists.  The first is for the signs of possible dementia of some sort including Alzheimer’s versus plain forgetfulness.  The second is what the forgetfulness might be if it is not dementia.  Let’s start with the first – what does one take particular note of as a possible (and I say possible, because only an expert can make a diagnosis like dementia or Alzheimer’s) sign of the onset of a dementia: Extreme forgetfulness – Normal forgetfulness is not remembering...

Willie Sutton is alleged to have responded to a reporter’s question of “Why do you rob banks?” saying simply, “Because that’s where the money is.” It seems that the attribution is more urban legend than fact, but there are other crooks who are evidently making use of the same logic.  And those people are not early 20th century gangsters; they are scammers who target seniors according to the Federal Bureau of Investigation (FBI). If you are a caregiver to a senior, the FBI offers some advice on how to protect against fraud which targets these vulnerable individuals.  The top reason why seniors are targeted is precisely because they are where the money is.  Seniors have a lifetime of hard work that typically has resulted in a “nest egg” as well as a home that likely is paid off.  They also have been careful with their money, so they have good credit.  Seniors also were raised in a day when one was polite even to strangers, and they also were raised to be more trusting of others than the current generation who...

Did you know that about one in every ten women who are between the ages of 45 and 56 are caring for both an older parent and their young children.  These sandwich generation adults are a subset of what the U.S. Department of Labor estimates to be about 43 million Americans who are caring for someone who is over age 50.  And as the Baby Boomers age, this population is going to boom just as the birth rate did in the years following World War II. That said, a lot of caregivers are stepping into roles for which they are not fully prepared.  Here are some useful lessons I have learned over the years to help caregivers to better understand and communicate with the elder or other person with special needs in their orbit: You are not reversing roles with an older parent.  A fair number of caregivers make the mistake of thinking that they are now parenting their parents when they really should view it as partnering with their parents.  Your older parent is not asking you to take charge; they are asking for a helping hand....

About one in twenty people over age 60 in the United States and the rest of the western world will develop some sort of dementia if they live long enough.  About two-thirds of these dementias will be of the Alzheimer’s sort.  The prevalence of Alzheimer’s continues to grow - in fact doubling every five years after the age of 65 - to the point that at age 90, the prevalence is about one in four individuals with the condition.  In research reported over the years, Alzheimer’s or other dementias tend to be more frightening to people as they age than just about any other medical condition. Scientists in Iceland have isolated a gene that helps the brain to protect itself against beta-amyloid which is the chemical that seems to open the brain to the degeneration of Alzheimer’s.  The gene does not appear to be related to the actual cause of Alzheimer’s but when this gene is expressed, it lowers the production of beta amyloid in humans.  Only about one in a hundred actually have this protective gene, but the scientists...