SR Health Guide BODY & INSERT 2018

S EN I OR R ESOURCES ' 2018 Health

CareGuide for Older Adults Counties Served: Milwaukee Ozaukee Washington Waukesha Comprehensive Information On: • Adult Day Services • Care Coordination • Home Care/Non-Medical • Home Health • Home Medical Equipment • Hospice • Hospitals • Skilled Nursing Facilities

Compliments of:

Visit us online: www.seniorresourcesonline.com Senior Resources, Inc. • P.O. Box 285 Germantown, WI 53022-0285

Post Acute Medical Specialty Hospital of Milwaukee

Post Acute Medical brings over 75 years of experience, to the Milwaukee Market. Working together with some of the best professionals and physicians, in the area, we will continue restoring lives and providing excellent clinical outcomes for our patients requiring medically complex care .

... “Coming to Post Acute Medical is a positive and helpful experience for me. All involved in my care are very caring, knowledgeable and friendly. Medical is very lucky to have such employees. “ --Paul Galvan

VISION The Post Acute Medical system continues to build upon its history as a respected provider of quality healthcare services by continuing to develop an environment that fosters meaningful improvement and recovery for people with injuries, illness and disabilities.

MISSION Post Acute Medical is committed to providing

high quality patient care and outstanding customer service, coupled with loyalty and dedication of highly trained source for post-acute services in every community it serves.

NEWLY CERTIFIED - we are the first hospital in the state Wisconsin to have this disease specific certification. RESPIRATORY FAILURE VENT WEANING

“I have been blessed with a compassionate group of individuals who have made my journey their journey. In their own special and unique way, the

Core programs but not limited to: Pulmonologist, Internal Medicine, Critical Care Specialist, Infectious Disease, Wound Care Specialist, Nephrology, Neurology, Cardiology and Surgeons.

me from the vent and help me show continued

people that make great things happen.” --Aurora Garza

r Pulmonary (ventilator management) r Complex wound care management r Medically complex r Transitional Rehabilitation r Cardiopulmonary transitional care r Trauma transitional care r Cardiovascular management r Bariatric program r Palliative Care Program r Pain Management Program

Post Acute Medical Specialty Hospital of Milwaukee

5017 S. 110th Street Main 414.427.8282 Referral # 414.525.2106 Referral Fax 414.425.6573 For more information visit www.postacutemedical.com

The Higher Acuity LTACH... Taking the sicker patient sooner r 4 bed High Observation Unit with ICU level of care. r Ability to manage patients with complex IV medications r lntensivist: Critical Care MD whose specialty is Critical Care r

A N I NTRODUCTION AND O VERVIEW OF THE D IRECTORY Milwaukee County listings show the area of Milwaukee where a facility is located. Please refer to the Milwaukee County map on page 3 for a geo- graphic breakdown. Information was obtained from returned question- naires and phone calls to N EED A DDITIONAL C OPIES ? sionals to give out to the community. If you can’t find a copy or want a copy of any of our other directo- ries, please call or e-mail us. We do ask for a $3 donation if possible to help cover our shipping costs. Individuals –We do provide these directories to profes-

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Professionals – Senior Resources’ Directories are provided free to profession- als. These directories can be given out to older adults and family members to assist them in locating appropriate services. If you are a professional working with older adults and need additional copies, please call or e-mail us and we will be happy to get you additional copies. elcome to the eighteenth edition of Senior Resources’ Health Care Guide for Older Adults . This directory was developed to assist older adults and their families locate appropriate health care options in Milwaukee, Ozaukee, Washington and Waukesha counties. This directory is broken down into eight main sections. Each section begins with a narrative describing the ser- vice offered followed by a comprehensive listing of providers in that section.

facilities listed in this directo- ry. Every effort was made to verify the accuracy of this data. Inclusion in this direc- tory does not constitute a rec- ommendation. Senior Resources is not responsible for inaccuracies in this direc- tory. We hope this information is helpful to you. This directo- ry will be updated and pub- lished annually. We would appreciate any comments or suggestions regarding this directory. Please call 262-253-0901. areas where we do not print a directory, please check out our comprehensive website of Services for Older Adults in the state of Wisconsin at www.seniorresourcesonline.com. Senior Resources, Inc. PO Box 285 Germantown, WI 53022 262-253-0901 info@seniorresourcesonline.com

If you are looking for Wisconsin based services in

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2018

T ABLE OF C ONTENTS

S E N I O R

R E S O U R C E S

A BOUT T HE D IRECTORY

A DULT D AY S ERVICES pg 20 • Early Memory Loss Programs . . . . . . . . . . . . . . . . . . . . . . .22 • Milwaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 • Ozaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 • Washington County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 • Waukesha County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 • Introduction and Overview . . . . . . . . . . . . . . . . . . . . . . . . . . .1 • Obtaining Additional Copies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 • Map of Milwaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . .3 • Informational Phone Numbers . . . . . . . . . . . . . . . . . . . . . . . .4 • Overview of the Medicare Program. . . . . . . . . . . . . . . . . . . .6 • Overview of the Medicaid Program . . . . . . . . . . . . . . . . . . . .7 • Family Care & Family Care Partnership . . . . . . . . . . . . . . . .8 • Emergency In-Home Pendants Do Save Lives . . . . . . . . . .10 • Responsible Planning for Long Term Care Needs . . . . . . .12 • How to Pay for Long Term Care? . . . . . . . . . . . . . . . . . . . .14 • On-Site Medical Care - The Doctor Is In! . . . . . . . . . . . . . .16 • Questions To Ask Before Moving or Downsizing . . . . . . . . .18 • Provider Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 H OME M EDICAL E QUIPMENT pg 36 • Provider Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 H OME C ARE / N ON -M EDICAL pg 40 • Provider Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 C ARE C OORDINATION pg 30

GARY KNIPPEN President

JOE LAUERMAN Production Coordinator seniorresources@wi.rr.com

Senior Resources, Inc. P.O. Box 285 Germantown, WI 53022-0285 (262)-253-0901 info@seniorresources online.com

Find us on the Web: www.seniorresourcesonline.com

Note: Every effort was made to verify the accuracy of the information contained in this directory. This information is provided with the under- standing that the consumer will contact providers to obtain information them- selves prior to making a final decision regarding services. Advertisements do not con- All rights reserved. The con- tents of this publication may not be reproduced without written consent of the publisher. stitute endorsement by Senior Resources, Inc.

H OME H EALTH S ERVICES pg 78

• Provider Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80

H OSPICE pg 90

• Provider Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

H OSPITALS pg 104

S KILLED N URSING F ACILITIES pg 120 • Long Term Acute Care Hospitals . . . . . . . . . . . . . . . . . . . .106 • How to Choose a Rehabilitation Provider . . . . . . . . . . . . .108 • Milwaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110 • Ozaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116 • Washington County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116 • Waukesha County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117 • Short Term Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122 • Changing Nature of Skilled Nursing Care . . . . . . . . . . . . .124 • Milwaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126 • Ozaukee County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145 • Washington County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146 • Waukesha County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150

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NEW WEBSITE COMING 2 0 1 8 !!

M AP O F M ILWAUKEE C OUNTY • broken out by area

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Information and Referral Services Information and referral ser- vices are agencies that provide options for seniors in the com- munity. Multiple listings and referral phone numbers for senior services are available through these agencies.

Alzheimer’s Assistance Alzheimer's Association 800-272-3900 Alzheimer’s Disease Education and Referral Center 800-438-4380 Benefit Specialist Benefit Specialists assist older persons with their private and governmental benefits, such as private insurance or Medicare. Specialists are employed by each county aging unit to pro- vide accurate and current infor- mation regarding available ben- efits. Milwaukee 844-614-5468 Ozaukee 262-284-8120 Washington 262-335-4497 Waukesha 262-548-7848 Title 19 Title 19, or medical assistance, is available to persons who are eligible for Supplemental Security Income (SSI) and to people age 65 or older who are medically needy individuals, who are below established poverty levels after deducting medical expenses. Wisconsin automatically places an individ- ual on Title 19 if they receive SSI.

I NFORMATIONAL P HONE N UMBERS

Aging & Disability Resource Center

National Eldercare Locator 1-800-677-1116

These offices provide informa- tion and services to the elderly. These offices are excellent sources of information.

Milwaukee County Aging Resource Center 414-289-6874 Ozaukee County Aging & Disability Resource Center 262-284-8120 Washington County Aging & Disability Resource Center 262-335-4497 Waukesha County Aging & Disability Resource Center 262-548-7848

Milwaukee County Aging Resource Center

1220 W. Vilet, Ste 300 Milwaukee, WI 53205 414-289-6874

Ozaukee County Aging and Disability Resource Center 121 West Main Street Port Washington, WI 53074 262-284-8120 Washington County Aging and Disability Resource Center 333 East Washington Street Suite 1000 West Bend, WI 53095 262-335-4497

Waukesha County Aging and Disability Resource Center

Milwaukee 800-291-2002

514 Riverview Drive Waukesha, WI 53188 262-548-7848

Ozaukee , Washington & Waukesha Counties 888-446-1239

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CASH In Balance, LLC Daily Money Management For Individuals

Catherine A. Schramka Heidemann Phone: 414.217.4510 catherine@cashinbalance.com Insured & Bonded • Free Initial Consultation Member of American Association of Daily Money Managers www.cashinbalance.com •Maintaining financial files for your CPA/tax accountant, financial advisor, or attorney CASH In Balance, LLC provides assistance with your day-to-day transactions to give you control over your finances. We come to you. Our personal financial services include the following and are tailored to meet your needs: •Opening and organizing mail •Paying bills by preparing checks •Balancing/reconciling checkbooks

SOUTH CENTRAL DIRECTORY

NOW ACCEPTING ADS!

Online: www.seniorresourcesonline.com Email: info@seniorresourcesonline.com Mail: P.O. Box 285 Germantown, WI 53022

Tel: 262-253-0901 Fax: 262-253-0903

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to need "skilled nursing" care to con- tinue on Medicare benefits. Once a person reaches their "maximal poten- tial", Medicare benefits end. This can happen anytime after the first 20 days. • Medicare Part A provides no cover- age beyond 100 days Is Home Health Care covered under Medicare? Yes, Medicare pays 100% for all covered and medically necessary home health services under Part A (or Part B if beneficiary does not have Part A) as long as the beneficiary continues to meet the coverage requirements. Medicare will pay for an unlimited number of visits during an unlimited period, as long as it is med- ically necessary and coverage require- ments are met. It is the intent of home health visits under Part A to deliver skilled medical attention to home- bound patients. Home health care is not available for chronic illness or to help with Activities of Daily Living (ADL's). Requirements include: • Home Health Care Agency must be Medicare certified. • Patient must be under a doctor's care and the doctor must authorize med- ical treatment. • Patient must be in need of skilled care . Hospice care is a service provided to termi- nally ill persons with a life expectancy of six months or less. Medicare defines a hospice as a public agency or a private organization whose primary role is to provide pain relief and symptom management to terminally ill patients. This benefit does not generally cover inpatient room or board charges. Medicare requirements include: • Doctor certification that patient is ter- minally ill and has a life expectancy of less that 6 months • A Medicare-certified hospice pro- gram must provide care Medicare pays 100% of most covered ser- vices. Medicare pays for up to two 90-day periods, one 30-day period, and a fourth unlimited extension period. The beneficiary pays a small co-insurance fee only for outpa- tient drugs and inpatient respite care. For more information on Medicare, please visit www.medicare.gov. Article submitted by Barbara Horstmeyer, Benefit Specialist, Senior Planning Group. 1-866-670-0888

O VERVIEW OF THE M EDICARE P ROGRAM Part A because they or a spouse paid Medicare taxes while they were work- ing. Some seniors, such as those who have not completed the mandatory num- ber of working quarters for Social Security benefits, enroll on a voluntary, premium-paying basis. Medicare Part A begins when someone enters a hospital. Medicare Part A has hospital deductibles. • First 60 days, Medicare pays all but $1,340 • Days 61 to 90, Medicare pays all but $335/day • Days 91 to 150, Medicare pays all but $670/day • Beyond 150 days, Medicare pays nothing Remember, Medicare is a health insur- ance program aimed at covering acute health care costs such as hospitalization (Part A) and periodic doctor visits (Part B). It does not cover most nursing home fees, nor does it offer extensive home health care for the chronic ills often experiences with age. What does Medicare cover for nursing home care? Very little! Medicare Part A helps pay for inpatient skilled nursing care in a Medicare participating skilled nursing facility (SNF) or rehabilitation service facility following a 3 day hospi- tal stay if a person's condition requires skilled nursing services or rehabilitation services such as Physical Therapy (PT), Occupational Therapy (OT), and Speech Pathology (SP). Doesn't everyone get 100 days cover- age in a SNF? No. Medicare will pay up to 100 days. • Days 1-20, Medicare Part A pays 100% • Days 21 - 100, Medicare pays all but the daily co-insurance amount that is the patient's responsibility. The 2018 coinsurance amount is $161.00 per day. After the first 20 days, a person must be making "reasonable, measurable progress" in their rehabilitation, or continue

edicare is a National Health Insurance Program administered by the Health Care Financing Administration (HCFA). Benefits are for: People 65 years of and older. Some people with disabilities under age 65. People with End Stage Renal Disease (permanent kidney failure requiring dial- ysis or a transplant) Medicare has Two Parts: Part A (Hospital Insurance) Part B (Medical Insurance) Medicare Part B covers physician ser- vices, outpatient hospital care, ambu- lance services, prosthetic devices, med- ical equipment, and supplies. You pay the Medicare Part B premium of $134.00 per month for single individuals with an income of $85,000 and a married couple with less than $170,000 (2018 rate). • Single with income greater than $85,001 and less than $107,000 or married with income greater than $170,001 and less than $214,000 - $187.50 monthly Part B Premium • Single with income greater than $107,001 and less than $133,500 or married with income greater than $214,001 and less than $267,000 - $267.90 monthly Part B Premium • Single with income greater than $133,501 and less than $160,000 or married with income greater than $267,001 and less than $320,000 - $348.30 monthly Part B Premium • Single with income greater than $160,000 or married with income over $320,000 - $428.60 monthly Part B Premium Part A (Hospital Insurance) Medicare Part A primarily provides cover- age for inpatient hospital care. It also provides hospice care. Limited coverage is provided for skilled nursing home and home health. No coverage is provided for assisted living. Most seniors become eligible for Part A coverage when they reach age 65 and become entitled to Social Security retire- ment benefits. They do not have to pay a monthly payment called a premium for

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O VERVIEW OF THE M EDICAID P ROGRAM

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his article focuses on the Medicaid program as it applies to elderly and disabled individuals. There are three common names for one program. 1. Medical assistance 2. Medicaid 3. Title 19 Medicaid is a welfare program jointly funded between the Federal and State government. It is designed to assist in paying for skilled nursing facility expenses and many other medical expenses for individuals who have minimal assets and inadequate income to pay for these expenses. The individual is normally responsible to pay for all of his/her own long term care expenses: generally, if the cost of this care exceeds the individual's income and the individual is asset- qualified, Medicaid supplements the individual's own payment. Within the Federal guidelines, each state is able to establish their own eli- gibility standards, determine the type, amount and duration of services, set the rate for payment of services, and administer their own program. This article will outline the eligibility requirements for Wisconsin as of 2018. A single adult qualifies if they meet the following criteria: The applicant can't retain more than $2,000 plus exempt assets 1. Home : Homestead property is exempt regardless of the value if the applicant intends to return home, or if a disabled child is liv- ing in it. 2. Car : One automobile is generally

"Shelter"? The Spousal Impoverishment Act passed by the U.S. Congress in 1988 and the Omnibus Budget Reconciliation Act of 1993 (OBRA'93) provides the legal means for anyone to shelter assets and qualify for financial assistance through an entitlement program. This act protects married individuals from depleting their assets due to an extended nursing home stay. If the couple's combined assets are: $0 - $50,000 the "community spouse" may keep ALL $50,001 - $100,000 "community spouse" may keep .....$50,000 $100,001 - $247,200 "community spouse" may keep .....HALF +$2,000 $247,200 + "community spouse" may keep ....$123,600 plus $2,000 for a total of $125,600 These figures are adjusted annually for inflation. Note: This article provides a limited space for information regarding Medicaid Eligibility. There are oppor- tunities for married couples to protect more that the above figures. Attorney Ryan Zenk offers free consults or call for your free booklet on "What is Spousal Impoverishment?" please call 262-670-8888 or 1 (866) 670-0888. For more information, please visit the Wisconsin Medicaid webpage. Article submitted by Barbara Horstmeyer, Benefit Specialist, Senior Planning Group . 1-866-670-0888

excluded if the current market value is less than $4,500. 3. Life Insurance : Life insur- ance is exempt if the face value of all policies is less than $1,500. If the face value exceeds $1,500, full cash value counts towards resource limit. Term insurance has no cash value and is excluded from countable assets. 4. Household goods and per- sonal effects : generally no inquiry unless reason to sus- pect unusual value. 5. Pre-paid funeral arrange- ments : money paid for burial spaces, urns, vaults, caskets, lot can be of unlimited value. Irrevocable burial trust exempt up to $3,000. Sometimes indi- viduals contract for an all- expense package of services and burial spaces, and the pur- chase of "burial insurance" that they irrevocably assign to the funeral home in full pay- ment for the service contract. Married couples can own exempt assets listed above plus: 1. A car of any value in addition to the car of the "institutional- ized" spouse with a value of $4,500 or less. 2. IRA of the community spouse How much money may a couple

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F AMILY C ARE AND P ARTNERSHIP Individuals must also meet these requirements: • Income • Functional • Residency – Family Care is offered in certain counties in Wisconsin. Individuals must live in one of these counties Partnership helps you coordi- nate your health, medical and long-term care needs. All Partnership members are part of a care team. • Together you will discuss your goals, assess your abili- ties and needs, and name your outcomes. • The team creates a plan just for you to support your health, medical, and long- term care needs. • The plan includes items in the Partnership benefit plan plus other natural supports that will help you achieve your outcomes. • The care team works with you to coordinate all covered health services. This means they will check with your providers to see how care is going and help manage spe- cial services such as X-rays, tests, and any follow-up care. Who can be a Member of Partnership? Partnership is for people who Partnership

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amily Care and Partnership are programs that help frail seniors and adults with disabilities manage health and long-term care needs. Partnership also provides assistance with medical needs. Here’s more information about these programs. Family Care Family Care helps you coordinate your long-term care needs. All Family Care members are part of a care team. Your care team includes you, a care manager and a registered nurse. • Together you will discuss what your goals are, assess your abilities and needs, and name your outcomes. • The team creates a plan just for you to support your long-term care needs. • The plan includes items in the Family Care benefit plan plus other natural supports that will help you achieve your out- comes. • The care manager and regis- tered nurse stay in contact with you to ensure all parts of the care plan are working well, and make changes if necessary. Who can be a Member of Family Care? Family Care is for people who need help with long-term care and who are: • Frail adults, age 65 or older • 18 or older with physical dis- abilities • 18 or older with intellectual dis- abilities

need help with their health, med- ical and long-term care needs and who are: • Frail adults, age 65 or older • 18 or older with a physical or intellectual/developmental dis- ability Individuals must also meet these requirements: • Income • Functional • Residency – Partnership is offered in certain counties in Wisconsin. Individuals must live in one of these counties How do I Become a Member of These Programs? The Aging and Disability Resource Center (ADRC) in your county will help you understand your options along with income and other requirements, and deter- mine if you qualify for Family Care, Partnership or another pro- gram. To learn more about ADRCs and locate one in your county, visit: www.dhs.wiscon- sin.gov/adrc/

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Choosing Self-Direction in Long-Term Care ?

A TTORNEY J OANNE L EIFHEIT • Medicaid Analysis and Veterans Benefits • Special Needs Trusts and Asset Protection

• Powers of Attorney • Disability Planning • Probate

• Estate Planning • Elder Law Issues • Wills & Trusts • Guardianships

CHOOSE

(262) 347-2820

N27 W23953 Paul Road, Suite 107 Pewaukee, WI 53072 Located one mile north of the Machine Shed Restaurant Check our website for upcoming dates to our complimentary monthly educational estate planning & Medicaid workshop! www.LawOfficeofJL.com

tmgwisconsin.com

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E MERGENCY I N -H OME P ENDANTS D O S AVE L IVES neck or on a wrist band. That sends a radio signal to the console at the telephone, which then automatically dials the phone. The remote dialer can be programmed to call any number the user specifies. Most people choose to have the unit dial a remote moni- toring center, which will then determine the nature of the emergency and contact the appropriate responder (family or neighbor or emer- gency responders). If the PERS wearer does not respond to the monitoring center, or if the monitoring center can't determine the exact nature of the emer- gency, they will most typi- cally contact emergency responders and stay on the line until help arrives. Before you commit to using a particular emergency response system, you will want answers to the follow- ing questions: 1. Is monitoring available

around the clock, 365 days a year? 2. What training do response center employees receive? 3. How does the monitoring center test that the unit is working properly? 4. Can you keep and use the same system if your elder moves? 5. How easy is the unit to set up? What are the most common reasons for "mal- functions?" 6. Can you test the unit in your elder's home to be sure it works from every point in the home before you commit to renting, leasing or purchasing? What is the return policy? Help keep yourself or your loved one safe in their home. Don’t wait for a crisis to hap- pen—be proactive to help pre- vent such a situation. PERS units can cost as little as just over $1 per day so take some time and help protect the ones you love. This article was submitted by William Horstmeyer, founding owner of Secure At Home, a local company based in Brookfield. Call for a free, no cost, no obligation demonstration of how Secure At Home can provide you with peace- of-mind. Toll Free at (866) 670- 0888 or www.secureathomellc.com

ave you always said that a Personal Emergency Response Unit (PERS) isn’t for you? Do you tell your children that you won’t fall or do you try explaining that wearing that necklace just isn’t for you? Think again! Each year, one in every three adults age 65 and older falls. Among those, falls are the leading cause of injury death. And for every hour a senior lies on the floor they will mostly likely have to remain in rehabilitation for one week. By having a PERS unit in your home you are greatly decreas- ing your odds of injury death. These emergency systems are not for everyone. A senior who will benefit from a PERS unit must be able to understand what the unit is for, what con- stitutes an emergency, and be able to remember what to do with the "HELP" button in an emergency. There are three components to a personal emergency response system: A small transmitter (the "HELP" button), a commu- nications console connected to the user's telephone, and a remote monitoring center. When the person using the system needs help, he or she presses the "HELP" button, typically worn around the

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R ESPONSIBLE P LANNING FOR L ONG T ERM C ARE N EEDS Medicaid and Medicare for benefits if and when they require expensive care, no amount of government-sponsored education or tax breaks will change the underlying behavior. My message to you is to pre-plan, save, invest or insure for long-term care. Do not get caught up in denial which holds one back from pre-planning for long- term care needs. Remember, by pre- planning for your long-term care needs, you are actually giving your self more options when care is needed. Planning ahead gives you a voice after you are incapacitated and allows a choice in the type of care that you receive. By failing to pre-plan, you are putting a burden on your family, limiting the type of care you receive, and potentially putting your “nest egg” at risk in the process. By pre-planning, we also fulfill our responsibilities as citizens. The best way not to become poor is to take the risk of long-term care seriously and make sure you have adequate protection for you and your family. How can we pre-plan? If you are between the ages of 55-70, seriously evaluate the possibility of long-term care insurance. Long-term care insur- ance is not appropriate for everyone. Never buy from someone who tries to rush you into a decision after only one meeting. Always work with a Long-term care specialist who represents several

ost Americans want to be good providers for their families and good citi- zens. Both responsibilities require fore- thought, vigilance and planning. Today, the least expected and most daunting chal- lenge for our country and ourselves is to provide competent, humane and loving long-term care for our elders . . . and ulti- mately, for ourselves. Yet, we are unpre- pared--as individuals and as a country--for this responsibility. Few older Americans, and fewer-still baby boomers, have private long-term care insurance to help with the catastrophic cost of long-term care for chronic illness. Consequently, most people end up in nursing homes on public welfare when they need professional care instead of pay- ing privately for help in their own homes or assisted living. Why does this remain true even as the age wave begins to crest and threatens to crash upon us? For 38 years, our government has tried to provide long-term care services through Medicaid and Medicare. This effort, while well intentioned, has never provided ade- quate care to enough people in the most desirable settings. But it has, unintention- ally, de-sensitized us to the risk and cost of long-term care. Today, the government- financed, welfare-based, nursing-home- oriented system is falling apart, character- ized by limited access, poor care, and widespread bankruptcies. The government needs to act quickly to educate the public about the necessity to plan early and save, invest or insure fully for long-term care. Will it? We will prob- ably see measures of this kind passed by Congress and signed by the President sometime in the near future. This will help, but will not alone solve the problem. As long as most people continue to ignore the risk of long-term care, avoid the pre- miums for private insurance, and rely on

companies rated in one of the top two cat- egories by at least two rating services. This way you can compare prices and fea- tures to determine which is best for you. Remember, long-term care insurance is necessary to insure that any transfer of money can take place outside of the 60- month lookback. The law’s have changed on divestments and gifting as of 2/8/06. I recommend that every senior take a per- sonal inventory. This should include a health history, legal inventory, income inventory, asset inventory and insurance inventory. For example, your legal inven- tory should have advanced directives. You need to have a Health Care Power of Attorney, Durable Power of Attorney and a Will in place. You should be investigating the use of a quitclaim deed to protect your “cottage up north” or your homestead. You also need to take an inventory of your investments. I often find that older seniors loose track of “all their holdings”. My emotional inventory usually encour- ages clients to “pre-plan” for their funeral arrangements using irrevocable burial trusts. Insurance inventory forces us to re-evaluate our life insurance policies, disability policies, long term care insur- ance and Medicare supplements. Income inventory allows us to evaluate total income, and income after the death of a spouse. An inventory of assets is of great importance when evaluating asset preser- vation, asset transfer, and gifting. Remember, the decisions you make today are the decisions that you and your fami- lies will have to live with tomorrow. Please call 1-(866) 670-0888 for a free consultation. Article submitted by Barbara Horstmeyer, President, Senior Planning Group, www.seniorplanninginc.com

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an insured to undergo under- writing to qualify. Any agent you work with should be able to explain the differences or choose another agent. Lastly, one may qualify for gov- ernment benefits if a qualifying Veteran (or spouse of a Veteran) or if he/she meets the income/asset test of Family Care (assisted living facilities) or Medicaid (skilled nursing facilities). To qualify for Family Care or Medicaid one generally must have $2,000.00 or less in countable assets and income less than the cost of care. Many facilities do not accept Family Care or Medicaid. Furthermore, many accepting Family Care require a private pay period prior to allowing one to go on Family Care. It is very important that any plan implemented, to qualify one for Family Care or Medicaid, take into considera- tion the care plan, all options available to pay for the care and a strategic plan to minimize taxes, legal, administrative expenses, and opportunities to prevent impoverishment in any or all of these goals. The finan- cial, tax, legal, and care plans must all work together to maxi- mize the results. W. Ryan Zenk, JD, CFP ® Elder Law Center of Wi, LLC 125 N. Executive Dr., Ste 210 Brookfield, WI 53005 262-812-6262 www.eldercarecenterofwisconsin.com

he cost of long term care is very expensive. It can range from hundreds to tens of thou- sands of dollars per month. Many studies indicate the odds of a 65 years old needing long term care, at some point, is over 50%. So how can one pay for it? The answer is there are 3 ways to pay for long term care. First, one can pay with one’s own assets until either broke or deceased. Second, one can use long term care insurance if one was smart enough or fortunate enough to obtain such insur- ance while he/she was insur- able. Third, one may qualify for governmental assistance through the Veteran’s Administration, Family Care or Medicaid. Let’s look at each option further. Private pay will require assets be liquidated (or already liquid i.e. cash) and a check written to caregivers typically on a month- ly basis. The liquidation of assets such as IRAs or appreci- ated assets may be a taxable event though typically the tax liability is completely or mostly offset by the medical deduction generated by spending on care costs. Paying privately will reduce and may eliminate any inheritance for family or chari- ties. Worse yet, this may cause an individual to go broke while alive or a healthy spouse to become impoverished. Are there ways to prevent spousal impoverishment – Yes with proper planning this can be pre- vented.

HOW TO PAY FOR LONG TERM CARE? The second option, long term care insurance, has changed drastically over the past sev- eral years. Many carriers no longer offer long term care insurance because the product was underpriced and carriers lost large sums of monies. It is still available from some carriers including newer options. One such option is a type of life insurance policy that pays a benefit if needed for care and pays a death ben- efit if never or only partially used for care. One good thing about these policies is the insurance company does not keep the money, either the client receives monies for care expense or it goes to his/her beneficiaries as a death bene- fit. These types of policies typically require prepayment of the premium over one to seven years. After this, no additional premiums are ever paid. Other policies (partner- ship policies) allow an indi- vidual to protect assets equal to the benefit of the policy. For example, a policy with $200,000.00 benefit allows the family to protect $200,000.00 of assets. Still others are the traditional annual pay policies with a set benefit. These are the traditional use it or lose it policies. All of these require

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O N - SITE M EDICAL C ARE – T HE D OCTOR IS IN ! side effects and interactions, which may be difficult for the patient to manage alone. On-site primary care allows for a complete review of the patient’s ongoing plan of care thereby reducing risks from medications, and improving understanding of On-site primary care visits from a medical provider help establish a more per- sonal doctor-patient relation- ship. Seeing patients at their place of residence allows the provider to work with the on-site care team to monitor medications more closely, evaluate living space for possible safety issues, and get a better sense of how the patient is doing in general. Care team collaboration with other on-site service partners such as home care and hos- pice staff also allows for bet- ter communication and effi- ciencies in care for these patients. the full picture of the patient’s health status.

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n-site medical care is designed to meet the unique and growing needs of patients living in residential care com- munities. Residents of care communities more often than not, have complex chronic conditions, memory issues, and multiple medications requiring close oversight by a physician care team. By using a collabora- tive, team-based, on-site, med- ical care program, it is possible to reduce the need for emer- gency room visits and trips to the hospital which leads to sig- nificant improvement in the overall care of the patient and peace of mind for their fami- lies. For those with loved ones in residential care communities, it can be a daunting challenge to transport them to a clinic setting for regular office visits. If there are complex care needs, multiple specialty visits can add to this burden. It is not unusual for patients in res- idential care communities to experience fragmented care with lack of overall care plan oversight. If multiple doctors are involved trying to manage a variety of chronic issues, this can result in a number of pre- scriptions, all with different

Those who reside in residen- tial communities deserve com- passionate medical care, social and psychological support, and awareness of their wishes. On-site providers have found that getting to know the patient at home, on a regular basis, helps accomplish this goal, and has an enormous positive impact on the well- being of the patient.

Article Submitted By: Bluestone Physician Services

Online: www.seniorresourcesonline.com Email: info@seniorresourcesonline.com Mail: P.O. Box 285 Germantown, WI 53022

Tel: 262-253-0901 Fax: 262-253-0903

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A TTORNEY J OANNE L EIFHEIT • Medicaid Analysis and Veterans Benefits • Special Needs Trusts and Asset Protection

• Powers of Attorney • Disability Planning • Probate

• Estate Planning • Elder Law Issues • Wills & Trusts • Guardianships

(262) 347-2820

N27 W23953 Paul Road, Suite 107 Pewaukee, WI 53072 Located one mile north of the Machine Shed Restaurant Check our website for upcoming dates to our complimentary monthly educational estate planning & Medicaid workshop! www.LawOfficeofJL.com

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Q UESTIONS T O A SK B EFORE M OVING O R D OWNSIZING · Are you afraid when the doorbell rings unex- pectedly? · Are you afraid of being alone or getting sick with no one to help? · Do you refuse to go out in inclement weather? · Is the neighborhood getting too noisy? · Is the neighborhood getting too busy? · Do you need more interesting activities to fill your time? · Do you feel the need to be around people your own age? · Have you been ill and are having difficulty getting back into your former routines? Being ill can zap our energies and make it difficult to get back to the way things were. · Are you ill and finding it difficult to cope with everything else? · Would you like to be in a more secure environ- ment? · Have you recently lost a spouse and are finding it difficult to function

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without the extra sup- port?

oving or downsizing can be emotional and stress- ful. If you are unsure of whether or not you should move, read the following questions and ponder your answers. The thoughts they provoke should help point you in the right direction. IN WHICH OF THE FOL- LOWING AREAS ARE YOU HAVING DIFFICULTY? · Do you hesitate about going out to do necessary errands? · Do you refuse to leave the house for social activities? · Is it difficult to take a shower or bath? · Are you getting everyday tasks done to your satis- faction? · Is it painful to go up and down stairs? · Do you dread the thought of extra tasks; yard work, shoveling, mowing the lawn? · Are weekly tasks becom- ing overwhelming; changing beds, washing floors, vacuuming…? · Do you remember to take your medication? Do you find yourself wondering whether or not you have taken your medica- tion? · Are you preparing healthy and appetizing meals?

If you answered yes to most of the above questions, then you probably need to be thinking about a more secure environment. Everyone has the right to feel comfortable where they live. If you answered no to most of the questions, then you should be able to stay where you are. Of course, that choice is up to you. There might be other reasons com- pelling you to move, or you might find that a different lifestyle would suit you bet- ter. If you decide to stay, getting extra assistance may be the solution to minor problems. Remember that it’s easier to move when you’re healthy and able to make your own choices about your new home. We wish you the best with the decisions you are about to undertake, whether it be staying put or moving.

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ServingWaukesha and Milwaukee Counties for over 25 years

2 6 2 -6 4 9 -7 8 0 2 www.elmbrook.firstlighthomecare.com

dtreis@firstlighthomecare.com ServingWaukeshaCounty & the Greater Milwaukee Area

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A DULT D AY S ERVICES

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dult Day Services are a practical and appealing part of the solution to long-term care needs of older adults, as well as younger disabled persons. For many, Adult Day Services are an option to nursing home or other residential or institutional forms of care. Adult Day Centers are designed to serve adults who are experiencing a decrease in physical, mental and social functioning and who need the protective environ- ment that Adult Day Services can provide. Adult Day Centers are able to care for persons with Alzheimer's Disease or related disorders, mental retardation and developmental disabilities, chronic mental illness, and physical problems related to aging and disability. Not all centers are able to provide care for all of these various popula- tions. If you are looking for care for yourself or a loved one, it will be important to find out what kinds of people the center you are checking into is able to care for. Has the staff been trained to care for the special needs of persons with the kinds of needs you or your loved one has? Are there other people in the center with similar kinds of needs? Is the program integrat- ed, that is do all persons regardless of disability, or spe- cial needs participate in one

to meet those needs. Adult Day Centers have a variety of professional staff based on the range of services that they pro- vide and may include nurses, social workers, therapists and other staff specially trained to work in the day care setting. Day Center activities may include everything from partic- ipating in a variety of programs such as current event discus- sion groups, arts and craft activities, health education, and passive exercise groups. Music and art activities give partici- pants an opportunity to express themselves in a variety of ways, as well as opportunities to learn and develop new skills. Adult Day Services are less expensive than institutional care. Fees for Adult Day Services vary from center to center based on what services are included in the fee. Some centers may be able to offer low income persons a reduced fee based on ability to pay. Milwaukee........................24 Ozaukee ..........................27 Washington ......................28 Waukesha ........................28 COUNTY INDEX For frail older adults, Adult

program or are there special- ized programs and services available? These are just some of the questions you should ask. Adults who can benefit most from the special care provided in an Adult Day Center are those who need supervision, social interaction and assistance with more than one activity of daily liv- ing such as eating, walking, toileting, bathing or dressing. Centers provide a wide vari- ety of services such as Recreational Therapy, Meals, Social Services, Transportation, Personal Care including bathing, hair and nail care, Nursing Services, Rehabilitation Therapy including physical, occupa- tional and speech therapy, and Medical Services. Not every center will pro- vide all of these services. Many programs, especially in urban areas, may provide the should receive the services that they need based on an assessment by the center's professional staff and the development of a plan of care full range of services. Individual participants

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2018

Now accepting new clients.

Our Curative Care Senior Center offers a warm, friendly environment for older adults with mild/moderate memory loss, dementia, and/or health concerns who want a community-based program to help them remain active. Our proven program offers peace of mind and daytime respite for caregivers.

A place where seniors thrive

Curative Care Senior Center | 149 Wisconsin Avenue, Waukesha | 414-479-9653 | curative.org/seniors

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E ARLY M EMORY L OSS P ROGRAMS facilitator might invite par- ticipants to name a word starting with each letter of the alphabet that has to do with springtime. Participants would then brainstorm together to come up with appropriate words. For example: A = Apple Blossoms; B = Baseball; C = Crocus … and so on. Opportunities for independent memory exer- cises – such as crossword puzzles and math puzzles – also are offered. In addition to mentally challenging activities, Early Memory Loss Programs stress the benefits of physi- cal activity and proper nutrition. Physical activity stimulates blood circula- tion, which can help supply more oxygen to the brain. Exercise also is a stress reliever. Research has shown that stress can have a negative impact on mem- ory. Research also indicates that foods rich in antioxi- dants, whole grains and omega-3 fats can be espe- cially beneficial for memo- ry.

ost health profession- als encourage mentally chal- lenging activities for aging adults in an effort to stimu- late and strengthen brain activity. The ultimate goal is to maintain or improve mem- ory, language skills, thought and other mental activities. During the last several years, a number of Early Memory Loss Programs have been introduced in the community for older adults who want to take a proactive approach to a diagnosis of early memory loss not typically associated with the normal aging process. For example, per- sons who: • Are in the early stages of Alzheimer’s disease or other forms of dementia. • Have been diagnosed with Parkinson’s disease or Mild Cognitive Impairment. • Have suffered a stroke. Research indicates that mem- ory enhancement programs may help participants main- tain memory function for a longer time and even regain lost ground. A trained facilitator engages Early Memory Loss Program participants in a variety of planned activities during each session, including brain- teaser exercises that draw on memory and encourage con- versation. For example, the

Early Memory Loss Programs offered in the com- munity typically include the following components. • Education on memory and brain function. • Information about memo- ry techniques. • Mental exercises, includ- ing written and verbal exercises, sensory stimu- lation and creative activi- ties. • Opportunities for partici- pant input. • Camaraderie and peer support. • Social interaction. • Laughter and humor. • Family support. • Physical exercise and/or education on the benefits of exercise. • Engagement with the environment. • Activities that foster independence. • Information about avail- able support services in the community. While Early Memory Loss Programs may slow the pro- gression of memory loss, it is beneficial for families to develop a transition plan for participants who will ulti- mately require more support- ive services. As memory loss progresses, individuals may benefit from enrollment in an Adult Day Services Program and/or Supportive Home Care Services.

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