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Geriatric Care Management Blog

By Charlotte Bishop on 2/19/2012 2:38 PM
You may have heard about the glories of the “only child,” you know….the stories about not having to share with other siblings, about being mom and dad’s favorite.  Well, those of you who have been raised as only children know that it is probably not all that great all the time.  And when it comes to being the only caregiver to older parents, being the only child goes from being special to being on your own.  But it does not have to be. The recession we have experienced over these recent years combined with other social forces makes the one child family the fastest group type of family according to the U.S. Census.  There are currently 20 million families in America today that have only one child, and the percentage of American women having only one child has more than doubled in the past twenty years.  But I am not writing about raising a solo child today; I am looking at the burden of caregiving that falls upon the only child when mom and dad get older and need help. IF you are in the category of...
By Charlotte Bishop on 2/6/2012 5:06 PM
February gives us Valentine’s Day, and February also is American Heart Month, a really good time to talk about cardiovascular wellness. The average human heart beats more than 100,000 times a day and pumps about 1,800 gallons of blood in the process.  Working that hard, it may be little surprise that cardiac-related conditions represent about 27 percent of all deaths in Americans.  That percent increases to 40 percent of all mortality for those ages 65 to 74 and as high as 60 percent of the deaths of people 80 years or older. Aging sets in motion some trends which help explain the increase in mortality:

As arteries age, they become less flexible which can increase blood pressure Mitral valves in the ventricles of older hearts close more slowly which contributes to a slower flow rate The resting heart rate slows and the exercise capacity of the heart decreases with age as well Older hearts do not squeeze as efficiently and the heart actually enlarges as the cells themselves expand...
By Charlotte Bishop on 1/31/2012 1:15 PM
As older parents increase elect to “age in place” caregivers may face challenges on two fronts.  It is partly the aging of the older parent you need to be mindful of, and the other part is about the condition of the aging home as that adult lives there more years.  Since many older adults for whom some of you may be caregivers may be living in multi-level homes, please allow me to offer some pointers on how to avoid falls, particularly on stairs. Lighting.  The easy part is to check that the maximum wattage bulb is in place in the stairway to give an older adults’ eyes a chance to clearly see the steps.  Beware not to exceed the recommend wattage for the fixture, but don’t skimp by placing low wattage in an area that may not get any other ambient light.   When you have installed the optimum wattage check out the stairway from all angles to be sure there is no glare from certain positions that would make it difficult for an older person to see and therefore navigate the steps.  Consider also installing switches at both the top and bottom of ...
By Charlotte Bishop on 1/27/2012 10:15 AM
With this posting, I am introducing a colleague and guest blogger, Pamela Holtzman, who is a therapist I know locally.  Pamela is an R.N and L.C.S.W. who combines her medical background with a combination of cognitive therapy, traumatic release with EMDR and EFT and integrative psychotherapy, to facilitate wholeness and wellness, in her clients. Her perspectives on being well while getting older are worth sharing:  “Have you had that birthday yet which made you suddenly realize that you really are getting older? I don’t mean older in a decrepit, breaking down way. I mean older in a wiser, stronger, and more mature way. I had discovered that I had reached that phase during my recent 60th birthday “initiation by storm” as I came face to face with IRENE, the Class 3 hurricane that wreaked havoc at the doorstep of our home in the Bahamas. What followed was a week-long power outage, and a chance to do a lot of soul searching. As...
By Charlotte Bishop on 1/17/2012 3:26 PM
    There are two fundamental laws regarding the places we call home, and these are no less true for older adults than they are for the rest of us.  One, we accumulate stuff.  Two, we tend to keep home the way it has always been.       The Stuff We Accumulate.  A lot of what makes it great to visit mom or dad is all the things that remind us of when we were younger and all lived together as a family.  But people have a way of hanging on to a lot of things over time, and not all of them are about memories.  The accumulated “stuff” can just become a lot of clutter or even pose a hazard to mom and dad.     Next time you visit mom or dad be aware of clutter.  Are newspapers, magazines and mail being regularly cleared or are they stacking up?  Are there boxes or piles of stuff gathering in the living spaces and walkways?  Even small piles of articles can pose trip hazards, especially if the areas are dimly lit.  Check all the pathways of the house for ready access or easy passage.  Check exits for boxes or...
By Charlotte Bishop on 1/12/2012 10:34 AM
It’s a subject I come back to frequently, because each year almost a million adults over age 65 are treated in hospital emergency rooms for injuries in their own homes.  Many of these injuries could have been prevented.  Just as you never wanted to get F’s in school, you do not want these two F’s in an older adult’s home.  These are preventable:  Falls and Fires.  If you are a caregiver to a senior living independently, please give this a read...and grade appropriately. FIRES:  Regarding fires, some of the places at home that would have been safe when a person was younger can become life-threatening hazards as one becomes older.  Older parents may be living in older homes and feeling some of the draft and cold that were never problems when they were younger, so they do the obvious.  They place space heaters in specific locations in the house where they may feel drafts and cold.  As a rule, that may not be a real problem.  But recall from some of my earlier postings that older adults are not as nimble on their feet and stray cords or the heaters themselves may be obstacles as they move from room to room.  ...
By Charlotte Bishop on 1/3/2012 9:16 AM
For those of you with a loved one who suffers from dementia of any sort, it is hard to see them fade in their ability to remember familiar surroundings, important experiences from the past or even remember you.  And as if that is not enough to manage as a caregiver, your loved one may also at times become inexplicably angry or aggressive.  So what can you do when dementia becomes violent? It is really critical that you always remember that the dementia is not about you, and it is not even really about the parent who once walked you to school, or down the aisle if you are married, or any of the countless other wonderful episodes in your collective life.  It is about the dementia and you cannot reason with it.   The Alzheimer’s Association, an organization founded to provide optimal care and services to individuals confronting dementia, and to their caregivers and families, offers some very helpful advice.  When you are with a person suffering from dementia, and they become aggressive...
By Charlotte Bishop on 12/28/2011 11:38 AM
It may surprise you to learn that as many as one in five caregivers are lending their help to an older adult who is still working a nine-to-five job.  A lot of my writing has been about what we sometimes call the old-old, that is individuals who are advanced significantly above our traditional cut-off of 65 years of age defining someone as old.  But there has been a steady advance over the past two to three decades in the portion of the labor force that is 65 years of age or older.  In 1985, fewer than one in nine workers was over 65, but that figure has increased to almost one in five workers now who is over 65 years of age. So much for the talk about taking care of a frail, elderly parent.  Yet, older workers can benefit every bit as much from a caregiver’s help as someone who fits the more classic picture we have of taking food to an elderly shut-in.  As a caregiver, encourage the following adaptations to the workplace: At least every two hours take a short break to stretch and flex the...
By Charlotte Bishop on 12/23/2011 12:52 PM
    If you will be heading home for any of these seasonal holidays you will find that it can be a wonderful trip back in time as you revisit your own family history in the context of your mom’s or dad’s house.  But when you visit, take a closer look at how safe that house may still be for your older parent living there.  Some parts of the home interior landscape may be just like you remember them, but they may now pose hazards to your older parents.     Start with electrical fixtures.  Check for where the cords to lamps or telephones and other household appliances are.  If they are in the flow of traffic, consider arranging furniture differently.  Also, remember that extension cords are really only meant for temporary use, so it is a good idea to move fixtures to be closer to outlets.  If you must use an extension cord, place it against a wall to reduce the trip hazard. If there are electrical cords under furniture, check for wear on the insulation to avoid fire risks.  Cords under...
By Charlotte Bishop on 12/13/2011 5:28 PM
    We are fortunate to have a new contribution from a good friend and colleague, Julie Northcutt of Caregiverlist.com.  Julie offers a caution in this contribution about the scams that seek to prey on older adults, so please give her warning a read...      “Holidays are a magical time, but unfortunately they are also a time when law enforcement sees a spike in online and telemarketing fraud, especially directed against the elderly. According to the Federal Trade Commission, nearly 25 million Americans are victims of consumer fraud each year. Senior citizens continue to be a rapidly increasing segment of the population. Why are seniors especially vulnerable? Seniors are seen as easy marks with “nest eggs” that make them attractive to con artists. According to the F.B.I., “people who grew up in the 1930s, 1940s, and 1950s were generally raised to be polite and trusting. Con artists exploit these traits, knowing that it is difficult or impossible for these individuals to say "no" or just hang up the telephone.”...

Recent Comments

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: Four Steps for "The Talk" About Giving Up the Car Keys
This article was so informative. I only wish I had read it a year ago. I repeatedly had the conversation with my mother about driving. Unfortunately I live 13 hours from her. She has had both knees and her hip replaced over the last few years and visits with her, and riding with her had made me very anxious about her "reaction time". Each of the steps you gave are so important...thank you for the excellent practical approach to caring for our elderly parents efficiently and sensitively. I look forward to each of your posts.
Re: Four Steps for "The Talk" About Giving Up the Car Keys
Charlotte,

This could be very useful. We will eventually have this conversation with Mindy's parents.

These blogs are wonderful!

Larry
re:
I'm impressed. You're truly well informed and very intelligent. You wrote something that people could understand and made the subject intriguing for everyone. I'm saving this for future use.

Vivian
Marks Web
www.imarksweb.net
Re: What is a Geriatric Care Manager?
Great information Charlotte! Very informative! I can't wait to read you next blog post.