By Charlotte Bishop on
10/23/2011 8:51 AM
Alzheimer’s Disease is the most common form of dementia, affecting about 5.3 Americans, and it is expected to grow to 15 million Americans with this disease by the middle of this century. Almost everyone has heard about the condition, and we even see advertisements on television for medicines that may be able to slow the progression of the disease. What we probably do not hear a lot about is that Alzheimer’s commonly is accompanied by other neurological problems that caregivers and Alzheimer’s patients’ providers should be looking for.
While challenging to diagnose in patients with Alzheimer’s or other dementias, depression reportedly affects as many as 20 to 32% of dementia patients. It is particularly common with those who manifest vascular dementia. It is hard for providers to diagnose, because the confusion or lack of focus common to depression also are frequently the hallmark of dementia as well. As a caregiver, be alert to insomnia or hypersomnia as well as agitation or suicidality in patients...
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By Charlotte Bishop on
7/6/2011 9:41 AM
Within the past two weeks the Food and Drug Administration (FDA) has issued a number of warnings that concern me as a geriatric care manager, and they should concern caregivers and the elders in their charge as well. The FDA has announced new warnings for three different classes of medications, those for pain and inflammation, those that lower cholesterol and those that help treat anemia in some patients. In my next three postings, I am going to tackle each, so that you will have a clearer picture of how to safeguard your own health as well as the health of an elder for whom you may be a caregiver.
I am going to start with a group of drugs commonly called non-steroidal anti-inflammatory drugs or NSAIDs. You would recognize the brand names, Aleeve, Motrin, Advil, or Nuprin as well as their generic names, naproxen or ibuprofen, and a lot of people use them to good effect. Many people use these...
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By Charlotte Bishop on
6/24/2011 12:27 PM
According to research reported in the New England Journal of Medicine, approximately one in five Medicare beneficiaries discharged from a hospital will end up back in the hospital within thirty days. It usually is for the same reason they were admitted originally. This means that it not only is bad for the patient who has to go back to the hospital, but it typically represents an expense that could have been avoided. And it is these sorts of statistics that give me a chance to talk about a question I get asked a lot: “What is it that geriatric care managers do?” Let me explain.
The typical picture of an older patient who is readmitted is one without a lot of social support locally, and this older patient:
May not fully understand their discharge instructions.
May not be taking their medications as instructed.
May have complications they cannot handle.
In most of these cases, if the patient had had someone to be the information processor,...
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By Charlotte Bishop on
6/17/2011 3:20 PM
We have come a long way since “help, I have fallen and I can’t get up” and the “panic button” technology. I have written in the past about my work as a geriatric care manager in helping to make home safer from falls and easier to access for adults who choose to “age in place” in their own homes, and technology now takes us to a whole new age of medical safety and security. Some experts already are talking about a day not too far off when medical technology and artificial intelligence will combine to actually predict emergencies in the home before they happen.
The panic button is now being replaced by home monitoring devices that can call when the button is depressed to allow the elder to speak with someone to determine what kind of emergency response will be most appropriate. Such devices now also can be linked with “integrative care platform” software that will take vital signs and transmit to a provider. They also link to interviews tailored to the elder’s chronic condition – COPD, diabetes,...
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By Charlotte Bishop on
4/30/2011 7:52 AM
This is my last posting of our three-part series with John Wank, President of the Illinois Guardianship Association. He concludes our series with these answers to some final questions.
What are the limits, liabilities and responsibilities of guardianship?
Guardianship is a public legal proceeding, with all cases beginning with the filing of a detailed medical report that will be viewed by the judge, a guardian ad litem and others. Personal and financial information of all kinds may then become a subject of the guardianship proceeding and open to public view. Persons with the ability to plan often consider the establishment of health-care proxies (powers of attorney, living wills) and other legal alternatives such as the trusts, joint ownership accounts, estate plans, and the like. Guardianship is always available for those who cannot plan or fail to do so.
Can there be separate guardians for financial, health and other needs?
Yes....
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By Charlotte Bishop on
4/14/2011 8:03 AM
The trees are budding and blooming, the bulbs have forced their way to the surface in beautiful blossoms and the birds are twittering and nesting. Time to put away your winter coats, wool scarves and mittens, right? Well, partly right.
Your winter mittens have another useful purpose that can help you make home an easier place for your older loved ones. As our bodies age, certain of our nerve pathways begin to fail, and the human anatomy uncannily reroutes many of the circuits as they stop firing. But with age, more and more of those pathways may slow or fail for a variety of reasons, and it just makes it harder for older adults to do the simple manual tasks they used to do without even a thought.
Turning a door knob, turning on a lamp or taking the lid off a jar become challenging, maybe even impossible. It is hard for those of you who may be in the prime of your lives to really get this, no matter how empathetic, so I recommend an easy exercise to help you experience what this erosion of...
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By Charlotte Bishop on
3/2/2011 9:08 AM
Older adults with a “rosy” outlook are not just more fun to be around; they will also be around longer than a pessimist, even if they have heart disease. Research reported in the Archives of Internal Medicine this week caught my attention as well as the attention of most of the national news services.
The research authored by Drs. Gramling and Epstein really just repeated what a lot of medical researchers around the world have been reporting for a lot of years. In their specific case, the authors, however, could say with statistical confidence that patients who had had cardiovascular events, but who were also optimistic, tended to outlive their more pessimistic counterparts.
This was a study of older adults who had experienced a cardiovascular event, and the researchers followed nearly 3,000 of these people over 15 years to see how they fared. Even with substantial heart issues still in...
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By Charlotte Bishop on
1/27/2011 11:24 AM
In the past two postings I have been talking about the warning signs of caregiver burnout as well as what caregivers can do to care for themselves. At the center of a lot of what can be done for the caregiver is a very simple philosophy: “Don’t try to do it all alone.” As a Geriatric Care Manager, this is where I often get the call. The caregiver or someone close to the caregiver needs somebody to help make decisions, take over some of the workload, stand up for an elder or other individual with special needs or counsel the caregiver on self-care.
There are other resources that can provide decision-making support, take on some of the caregiving responsibilities, advocate for an elder or caregiver and offer professional counsel on just coping with the responsibilities of caregiving. There are services to help caregivers in most communities, and the cost is often based on ability to pay. Look to programs such as adult day care centers, home health aides, home-delivered meals, respite care, transportation...
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