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Geriatric Care Management Blog

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...
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...
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,...
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,...
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....
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...
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...
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...

Recent Comments

re:
love it! very interesting topics, I hope the incoming comments and suggestion are equally positive. Thanks for sharing information that is actually helpful.

allinfouneed
www.tulleeho.org
Re: A Radio Talk with Aging Info Radio
I have read this post. Really it is so nice.
Re: A Radio Talk with Aging Info Radio
I heard all the answers. I did not know those answers. Thanks for providing answers.
Re: Four Tips for the Accidental Caregiver
Great article Charlotte - I am always heartened at how neighbors and acquaintances will step forward to assist a senior in need. Sometimes it is because the senior has outlived their family members - sometimes there are other reasons. In any event, these situations are really unique, and they require some planning to handle thoughtfully. A geriatric care manager can be a really important piece of that puzzle. You have provided some really good suggestions in this article. Keep up the good work.
I would really love to guest post on your blog.`
This kind of post is very rare.. its so hard to seek a post like this. very informative and the contents are very Obvious and Concise .I will look more of your post
Re: Two More Ways to Make Elders' Homes Safer
Nice article Charlotte - really solid suggestions. I just can't figure out why I'm accumulating so much stuff already!
Re: Caregiving to Older Workers
Nice article Charlotte. This is really becoming an important issue.
Re: Four Steps for "The Talk" About Giving Up the Car Keys
This is the conversation I have been dreading for the longest time. My dream was to have a driver in place before this actually happened, but at this point I don't know. My mom has never been the best of drivers to begin with, but still manages to function well enough and as of this writing is still fully functional. Whether that lasts another week, a year or a few years is out of my control, but when it happens, I will have to deal with it just as you suggested. I expect it to be a huge fight and really would not have it any other way.

My biggest fear really isn't for my mom's safety as it it for everyone else's. My grandfather drove until he was in his 80's and one day drove his car through his next door neighbor's living room. Obviously, that was it. (I have every intention of getting the keys from her before it gets to that point.)

Here is another thing to consider: My mom's car is bought and paid for, so my thinking is that when the time comes, there should be enough sale value left on it to pay for a driver for a certain amount of time. I have no idea what that costs, but this article lit the fire and I intend to find out.

Keep these posts coming, I am sure I am not much different than a lot of your readers in that even though I know I shouldn't, when it comes to my mom, I would like to live in a state of denial as long as possible. It gets harder and harder as she slowly watches her friends die around her and starts to question her own mortality.

Re: Alzheimer's Related Medical Conditions
This is the information that I've been looking for. I'm really glad that you posted it. Thanks for sharing this one!
re:
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Joseph
www.joeydavila.com
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