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August 2014

plus! The magazine for active, mature lifestyles

6 ADRC director concluding long career


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ADRC director concluding long career Judy Rank, director of the Manitowoc County Aging Resource Center, poses with durable medical equipment that the agency loans out to Lakeshore area residents. Rank is retiring after many years with the ADRC. Sue Pischke/50 Plus

reveal their secrets to a long, happy life

50 Plus! is published monthly by the Herald Times Reporter Media. It also is distributed to select businesses in Manitowoc County.

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Medication management

vital to overall health health By Ryan Rathke Medication watchdog. Herbal medicine, supplement and vitamin advisor. Teacher. Record keeper. Physician liaison. These are some of the roles today’s pharmacists play in helping older adults maintain their overall health. Pharmacists can be a valuable resource for seniors, by helping them select appropriate over-the-counter drugs and providing useful tips on drug safety, possible drug interactions, correct usage, proper storage of drugs and much more. The field of pharmacy has evolved over time to better meet the needs of patients of all ages. Decades ago, pharmacists

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could not offer any health care advice to patients and they were not allowed to talk with patients about their medications. Today pharmacists can look forward to discussing important information, such as why the drug is being prescribed, how it works, dosage instructions, any precautions, possible side effects, or any known food and drug interactions. Prescriptions come with written instructions called monographs, but these can be confusing to many people. They are much easier to understand if a pharmacist counsels the customer first. A verbal message helps reinforce the patient’s memory.


Age comes in on little crow’s feet Sue came in complaining about her aching back and about being tired after spending a hot day weeding the garden. I said, “Well, stop acting like you’re 50.” I’m pretty sure we Jim Mullen had something I don’t like for dinner that night, or at least I did. I didn’t mean it as an insult; it’s just that getting older sneaks up on you. Some days you wonder, why can’t I read more than a few pages of a book at night without falling asleep? I used to be able to read for hours at a time. “I’m old” wasn’t my first thought. When you ask someone to twist off the cap on a jar of salsa for you, “I’m old”

isn’t your first thought. When people start talking about spending the winter in Florida, “I’ll never do that, it’s for old people” won’t be your first thought. It’s not as if Sue and I are old-old, but we both wish we were only 50 again — back when we could get out of a chair after watching an hour of TV without feeling like someone had rabbitpunched us in the kidneys. Back when people passing us on the freeway didn’t flash us rude hand gestures for going so slow. Back when we only had one doctor, and we knew his name and what we were paying him for. Now we get bills from doctors we’ve never heard of for tests we don’t remember taking. “Was that the one where they stuck that thing down my throat, or the one where they stuck that thing up the other end?”

“No,” Sue says, “that was last month. This is the bill for the MRI on your knee.” “That doesn’t seem as expensive as we thought.” “This is just the bill for the guy who took the results from the technician, walked them down the hall and handed them to the doctor. We haven’t gotten the real bills yet.” And we’re some of the lucky ones. Neither of us are on chemo; we can still walk, we have our own teeth and the kids aren’t asking us who’s going to get Grandma’s dishes when we croak. Yet. The surprise is how getting old sneaks up on you. The first time you get a free copy of the AARP magazine in the mail, your first reaction is to hide it from your friends and family. “I’m not old,” you think. “I’m only 50! Why are they sending this to me? There must be some mistake.” It takes about seven years before you stop tossing it automatically into the garbage. At some point, you start reading every issue word for word. You look at the famous people on the cover and

realize that they are your age. And they don’t look so bad. Of course they don’t look bad — they have personal trainers and personal chefs and they’re wearing makeup and a $500-an-hour stylist has just fluffed their hair. Remember, when anybody on TV says that 50 is the new 30, or that 60 is the new 40, or that 70 is the new 50, they aren’t talking about you. They’re talking about Cher. She’s 68 and looks great — but that’s her job! Think how fantastic you would look if you got paid to spend eight hours a day exercising, stretching, tweezing, dieting and shopping. That’s not even mentioning nips and tucks, capped teeth and hair weaves. Madonna’s 55. Harrison Ford is 71. Sean Connery is 83. So that’s four people — out of 6 billion — who don’t look their age. And for all we know, they all need help opening a new jar of mayonnaise when they’re at home. I’m not relishing the prospect of becoming feebler and feebler, but the trick is not to pretend to be young. The trick is learning how to be old. Contact Jim Mullen at

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Program teaches various aspects of dementia By Judy Rank The Aging & Disability Resource Center of the Lakeshore (ADRC) is in its second year of a state pilot project offering services to people with a dementia through its Dementia Care Specialist program. Next Thursday, July 31, the ADRC will be teaming with staff from Azura Memory Care to offer a program at its office called “Brain Basics and Dementia Specific.” It will be held in Room 300 from 2 to 4 p.m. in the Office Complex, 4319 Expo Drive. Those attending will learn the basics of dementia, how to best communicate with someone with memory loss, and how to boost your own brain power.

Care, in addition to nursing home Medicaid and the Wisconsin Chronic Disease Program. Payments for premiums, copays, and deductibles for Medicare Part B are not recoverable through the estate recovery program.

There is no cost to attend. Please RSVP by calling the ADRC at (920) 683-4180. Statutory changes have been made to the Wisconsin Medicaid Estate Recovery Program (ERP) as a result of 2013 Wis. Act 20 and 2013 Wis. Act 92. ERP seeks repayment for the cost of certain long-term care services paid for by Medicaid on behalf of recipients and from liens placed on their homes. The money recovered is returned to the Medicaid Program and used to fund Medicaid benefits for others.

Medicaid recipients should have received a publication from the state explaining some of the changes to the ERP. The changes will affect life estates, revocable trusts and life insurance policies of the member created on or after Aug. 1. It will also affect joint tenancy properties created on Aug. 1 or later. A portion of marital property owned by a legally married couple may be recoverable as well as other non-probate property such as those held in trusts of property payable upon death, or transfer upon death may be subjected to recovery for recipients who die after Aug. 1.

The changes affecting property recovery and the recovered services will be effective for services received on or after Aug. 1. Recoverable services include all services that are received while participating in a long-term care program, which may include waiver programs through Community Options, IRIS and Family

Marketplace credits

County fair

Individuals who have insurance through the federal government’s Marketplace may now have found that they have premium tax credits and cost sharing subsidies. Tax credits are based on a person’s income and is the amount the federal government covers on the in-

The Manitowoc County Fair will begin with gates opening on Tuesday, Aug. 19, at 4 p.m. and running through Sunday, Aug. 24. General admission for seniors age 60 is just $5 every day of the fair. This fee does not include rides or the grandstand, but does include park-

Estate recovery changes

When you are looking for more than just an apartment... Let us welcome you home! We take pride in our apartments and it shows! You will be captivated by the beauty you will find in the apartments, common areas, and grounds. For those low income 50 years & up or adults with disabilities we offer rent that is 30% of adjusted gross income & includes utilities. We also offer a low-cost DirecTV package, are located on the bus line, and have a county nutrition site. • Tenant and staff-led activities • Pet-friendly • Large rec room with Wi-Fi, • pool table, games and puzzles

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surance premium. Individuals whose income is less than 133 percent of the poverty level pay only 2 percent of their income toward the cost of the premium and this increases to 9.5 percent for individuals between 300 and 400 percent of the poverty level. This tax credit can be taken monthly or at the end of the year when taxes are paid. Consumers must report any changes in income during the year to the Marketplace.

You will learn how to make a difference in your own life as well as making a difference in someone’s life who has a dementia. The afternoon will be topped off with parfaits sporting brain healthy toppings.


Cost-sharing subsidies apply when the consumer selects a silver plan and, based on monthly income, the consumer may have a monthly reduction in outof-pocket costs and an annual cap on maximum out of pocket expenditures. This is available to consumers with incomes up to 400 percent of the federal poverty level. Consumers should contact the Marketplace with questions.

ing. Wheelchairs may be borrowed from the ADRC for use at the fair.

Medicare seminars Individuals turning 65 soon or those new to Medicare should mark their calendars to attend one of the upcoming seminars, Medicare A-D. On Monday, Sept. 22, ADRC staff will be presenting the facts about Medicare, supplemental insurance, drug plans, Advantage plans, and SeniorCare from 1 to 3 p.m. at the Two Rivers Senior Center. On Wednesday, Sept. 24, this same program will be presented at the ADRC office in Manitowoc from 5 to 7 p.m. There is no cost to attend either program, but please RSVP to (920) 683-4180 or 1-877-416-7083.

Prevention programs The ADRC is taking reservations for several upcoming prevention programs. A new program added this year is Living Well with Diabetes. It is a six-week program for the person with a diabetic diagnosis. It is set to

begin Sept. 23 from 1:30 to 4 p.m. at Aurora Medical Center. Individuals with a diabetic diagnosis are among the largest percentage of elderly who find themselves hospitalized. This program can help a person understand the disease as well as how to regulate it, and can help avoid hospitalization. The cost of the program is $10. This same six-week program is available for individuals who have other chronic conditions. The Living Well program is set to start Sept. 17 at Harbor Town. Both of these programs help the person with the chronic condition realize that conditions do bring about stress, teaches them how to deal with the stress, and allows them to adjust their lifestyle to be able to live more comfortably with their condition. There is a $10 fee to attend these programs, and any adult is welcome to attend. Please RSVP to the ADRC at (920) 683-4180 or 1-877-416-7093. Judy Rank is executive director of the Aging and Disability Resource Center of the Lakeshore.

MEDICATION MANAGEMENT CONTINUED FROM PAGE 2 By taking the time to talk to a customer faceto-face, the pharmacist can get a better feel of whether or not the person understands the prescription’s directions and they can answer any questions the patient may have.

than brand-name drugs. But are they as effective? In short, the answer is “yes.” Ongoing supervision by the FDA assures that generics sold in this country are as safe and effective as their brand-name counterparts.

The pharmacy also serves as a centralized record-keeping resource of all the prescription medications a person is taking. A pharmacist can track all the different medications prescribed for the patient and will alert him or her to any potential drug interactions and alert the physician about any known drug allergies.

The FDA requires that all generic drugs be “bioequivalent” to their brand name counterparts — that is, they must deliver the same amount of the active drug ingredient(s) to the body in a similar time frame. In recent years more than 70 percent of all retail prescription drug sales were for generic drugs.

To eligible patients, many pharmacists offer a comprehensive medication review service. This is an in-depth meeting with the pharmacist. The entire medication regimen is reviewed including samples, medications filled at other pharmacies, mail order or the Internet, over-the-counter medications, herbal supplements and vitamins. Here the pharmacist addresses patient concerns and preventable medication related problems are identified.

However, seniors should discuss with their own health care provider or pharmacist whether or not generic drugs are right for them. There are subtle variations between some generic and brand name drugs that may make one type preferable in their particular medical situation.

Today pharmacists field many questions about generic drugs. Generic drugs have become increasingly popular since the 1980s, when the generic drug approval process was expanded and the Food and Drug Administration (FDA) issued safety guidelines.

Today’s pharmacists are a vital part of the health care team. They are a valuable resource to help older adults become more informed about the medications they are taking. Working closely with physicians and other health care professionals, pharmacists help people live well by helping maximize both their medical care and their health care dollars.

New generic drugs are approved by the FDA each year and they are typically less expensive

Ryan Rathke is a pharmacist at the Aurora Pharmacy in Manitowoc.



. August 2014 . 5

Americans how to best care for their loved ones without burning themselves out, or their pocketbook, according to Rank. The home-delivered meals not only provide nutrition, but a person regularly knocking on your door, “checking on you” so to speak. Many rely on the congregate meals at the senior center and other locations as not just a meal, but a social outlet, said Rank. It was in 1998 seeing the pilot ADRC programs that Rank knew that the U.S. Government was leaning toward the ARC’s becoming ADRC’s. By 2004, Rank wrote the grant that changed the services that many Manitowoc and Kewaunee county residents are relying on daily. Now both facilities not only help those older than age 60, they are able to help those finishing in the school system age 17½ and older that are physically or developmentally disabled. In 2004, grants were made available to upgrade these centers, Rank said. Gov. Scott Walker wanted all counties to have an ADRC by 2012, according to Rank, but some counties were too small to support that operation, so Manitowoc partnered with Kewaunee. There are 26 employees between the two facilities and some 500 volunteers. “We do not charge for services. Due to the lack of reauthorization of the Older Americans Act and increase in number of the people we are serving means that we have to rely on volunteer help and consumer donations,” said Rank.

ADRC director

concluding long career Judy Rank, left, director of the Manitowoc County Aging and Disability Resource Center, visits with Elaine Karstaedt inside her apartment at the Regency House in Manitowoc. Elaine just finished her lunch provided by the Nutrition Program, which is one of the many programs that Rank oversees at the center. Sue Pischke/50 plus

Rank recalls helping individuals By Joni Shavlik | HTR Media Correspondent Judy Rank, director of the Manitowoc County Aging and Disability Resource Center, will be retiring in early September after a long career of helping people.

6 . August 2014 . 50


The ADRC began as the Aging Resource Center and served people ages 60 and older and includes their spouses if they are younger than 60. It was funded through the Older Americans Act. Staff will help individuals weed through the confusion of Medicare and Medicaid by a specialist in the field and help people find out if they are eligible for benefits, assist in finding a long-term care facility that meets their physical needs as well as financial, help with transportation, and even teach caregivers of older

Seventeen years ago the ARC of Manitowoc County offered home-delivered meals, congregate meals, an elder benefit specialist, care giver support through a program called “Powerful Tools for Caregiving,” transportation funding (also aided by the Department of Transportation) and used Assist to Transport, and plenty of information on how to locate in home assistance from cleaning to yard work to care giving and nursing. These services are all still offered, according to Rank, but baby boomers are more than 65 years old. Helping individuals early on with exercise and finances will help them to stay in their own home longer, stated Rank. Now the ADRC is offering prevention programs like “Stepping On” to help reduce the risk of falling, “Living with a chronic condition” as well as “Living with diabetes,” both of which are offered on a regular basis and works with medical providers to get the people into these programs that really need them. One diabetes class participant stated: “I always thought I would die first” and didn’t pay attention to caring for her own diabetic condition, and now realizes the importance of caring for herself. The ADRC has just added a dementia care specialist as well as the “Leaps” program. It matches a volunteer with a person diagnosed with dementia. They meet two hours per week — one hour for physical work and one hour for mental stimulation.

Judy Rank, director of the Manitowoc County Aging Resource Center, poses with durable medical equipment that the agency loans out to Lakeshore area residents in need.

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As a “gateway for long-term care for the a financial assessment by Human Serindigent,” (indigent is described as hav- vices is done to determine whether ining less than $2,000 in financial assets) home support to keep the individual in and passing through a the home will need to functional screen it is be paid by medical asthen determined if they sistance. If the individHelping are eligible for long ual is not found eligible term care in their home, for services, staff will individuals early according to Rank. work with the power of on with exercise attorney to understand Rank recently received and finances budgeting and timely a call from a financial will help them payment of bills. The institution about the excommunication from to stay in their ploitation of the senior the lending institution own home longer, population. She said a made it easier for staff younger family memstated Rank. to sift through the fiber was handling the nances. Knowing that finances for someone the institution cares unable do this. The perabout its consumers and has that partson handling the accounts wasn’t transnership with us will alert us that a conferring funds appropriately thus costing sumer of theirs may need help to stay in the elder in overdraft fees that could the community.” have been used on services needed for “In most situations like this,” Rank said, “we engage Adult Protective Services staff from the Human Service Department to work with the individual and lending institution to determine whether money is being misused by the financial power of attorney. In this case, we were already doing a functional screen to determine whether the individual was no longer able to provide all of their daily activities of living by themselves. Then

We will help analyze: • How to optimize your benefits • What strategies a married couple can use to coordinate benefits and receive maximum cash flow • Whether you should take benefits at the earliest age possible or wait • What happens if a spouse passes away

Nail trimming and foot care was also a needed service that Rank saw almost immediately, and was able to establish guidelines for this service with medical providers

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Rank explains one good reason for loving her job. “I had a home visit this week with someone who called and asked me to come. I didn’t call prior to my arrival. I am not sure I helped the individual and not sure ADRC DIRECTOR CONTINUED ON PAGE 9

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sudoku there, I remember it all too ____” 47. *”____ the nights are better” 48. Small stream 50. Scorch 52. Bard’s “before” 53. Oration station 55. Hawaiian Mauna 57. *”Good times never seemed __ ____” 60. *”Where ______ is heard a discouraging word...” 63. Vessel pointed at both ends 64. *”You ain’t seen nothing ___” 66. Musical duo Hall & _____ 68. Makes eyes at 69. Caustic chemical 70. Anti-elderly 71. *”Father Christmas... Don’t mess around with those silly ____” 72. *”___ it be” 73. Tooth trouble



1. Raccoon’s cousin 6. Western tribesman 9. Rigatoni relative 13. Deposit the ashes 14. Computer simulation 15. Courted 16. In-place, legally speaking 17. Common Market initials 18. Repetitions 19. *”Should old ac-

quaintance be forgot and never brought __ ____...” 21. Swellings 23. *”The day my Mama socked it to the Harper Valley ___” 24. Confined 25. Financing acronym 28. *”Back in the U.S., back in the U.S., back in the ____” 30. Tree of Life to an-

cient Egyptians 35. They will inherit the earth? 37. *The O’Jays, “Ship ____” 39. You can be fined for hitting these in NYC 40. Vigor 41. Specific site 43. Warsaw Pact opponent 44. “The Raven” author 46. *”It was rare, I was

1. Belarus+ Russia+Ukraine, originally 2. *”Get down __ __” 3. Camera setting 4. Donald or Ivanka 5. Unmoved 6. Hand-me-down 7. *”I keep the ends out for the ___ that binds. Because you’re mine...” 8. Mike holder 9. Camera feature 10. Bit 11. Found in a caddie’s pocket 12. Dog tags, e.g. 15. *”How sweet the sound that saved a ______ like me...” 20. Like Fran Drescher’s

Fill in the blank squares in the grid, making sure that every row, column and 3-by-3 box includes all digits 1 through 9. Crossword and Sudoku solutions on page 11. voice 22. Chain letters 24. A particular course of action 25. *”Oh beautiful for spacious skies, for _____ waves of grain...” 26. Hidden or placed on watch 27. Monarch’s duration 29. *”One for the money, two for the ____...” 31. Top notch 32. Hunger for 33. Lay to rest 34. *”I hope some day you’ll join us, and the world will be __ ___” 36. Riddle without solution

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38. Christmas season 42. Satisfy, as in thirst 45. Does over again 49. ___ Tsu 51. Load again 54. Tennyson poem, e.g. 56. “Haste makes waste,” e.g. 57. Kind of palm 58. *”____ the good die young” 59. *”There ____ my baby” 60. Editor’s mark 61. Auricular 62. Tableland 63. Soldier’s bed 65. *”It’s the ___ of the tiger. It’s the thrill of the fight.” 67. Chester White’s home

ADRC DIRECTOR CONTINUED FROM PAGE 7 I had given him the hope or expectation he wanted, but I was there and listened to him, was empathic, and shared some suggestions on things he could do,” she said. “When I left he said to me – ‘I am going to thank the Lord tonight for sending you to me today. You have made me so happy with your visit. I will have a good evening tonight because of this. “A lot of our consumers are like this. We often hear the words “you have helped me so much. Your staff are just great. Usually we have simply listened to our consumers, shared some resources with them, or helped them understand paperwork they may have received. We remind people often that our job is to assist them in identifying resources that can help them maintain their independence as long as possible. And often this is just reassuring them that they are doing OK. It’s the happiness and joy

consumers express that makes it easy to become attached to them and easy to come to work each day.” Rank’s replacement is Cathy Ley. “She has worked in every position in the facility,” said Rank. “While we have grown from helping just aging Americans to including those with physical and intellectual developmental disability, we always feel the need to do more and expand the resources in our community. Our partnerships with the community always have room for more involvement. We hope to embark on a ‘dementia friendly community’ project within the year and be a community that looks after and cares for one another regardless of any physical or mental condition.”

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reveal their secrets to a long, happy life


One hundred years ago, the average American’s life expectancy was between 50 and 60 years, and so the estimated 53,000 centenarians in the United States today have lived much longer than most of their contemporaries. Perhaps that is why a new survey shows that these 100-year-olds feel “blessed” (36 percent), “happy” (31 percent) and “surprised” (12 percent) to have lived so long. Not one reports feeling sad or burdened; only 3 percent say they feel lonely.

care Retiree Solutions. UnitedHealthcare serves more than a quarter of America’s centenarians through its Medicare plans. “By looking at how they are living their daily lives, we can glean important insights about the keys to staying healthy and feeling vibrant as we age.”

For the past nine years, UnitedHealthcare has conducted a survey of one-hundred 100-yearolds to gain insight into their lives. For its most recent 100@100 survey, the company also polled 65-year-old baby boomers to examine how the attitudes and lifestyles of people entering their retirement years compare to those who hit that same age 35 years ago.

Despite their age, centenarians stay active: more than half walk or hike and nearly a third do strength-training exercises. Some even run outdoors or play team sports every week (4 percent). Exercise is an important part of boomers’ lifestyle as well. Nearly 3 in 4 walk or hike each week, 37 percent do strength-training exercises and 13 percent run outdoors or play team sports.

According to the study, one thing both groups agreed on is that they feel younger than their years. On average, the centenarians surveyed said they feel just 83 years old, while 65-year-old baby boomers said they feel 55 years old.

Secret 2: Get preventive care to stay healthy.

“It’s encouraging that older Americans feel more youthful than the number of candles on their birthday cake might suggest,” said Rhonda Randall, D.O., chief medical officer of UnitedHealth-

The following are some of the secrets to healthy aging, as revealed by the 100@100 survey.

Secret 1: Keep up with exercise.

Older Americans are taking the saying “an ounce of prevention equals a pound of cure” to heart by keeping up with preventive health care services to stay well. Nearly 9 in 10 get an annual exam (87 percent of centenarians and 89 percent of baby boomers) with their primary care physician, and the majority also report getting eye exams regu-

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larly (71 percent of centenarians and 76 percent of baby boomers).

Secret 3: Maintain a positive attitude. Both centenarians and baby boomers say maintaining their physical health and a positive attitude are equally important to successful aging (66 percent and 81 percent, respectively). In fact, 82 percent of centenarians say laughing/ having a sense of humor is important to healthy aging.

that living a long, healthy life is about more than just genetics. Daily habits and lifestyle choices can make a difference not only in how long people live but also in how they feel as they age. For more information on how to stay healthy beyond 65, visit nihseniorhealth. gov. For complete 100@100 survey results, visit the news room on BrandPoint

Perhaps the most important lesson revealed in the 100@100 survey findings is

River’s Bend Health and Rehabilitation Center Achieves Five-Star Quality Rating from CMS Providing high quality care and services to our residents is a responsibility we take very seriously and we are pleased to share that we have achieved a Five-Star quality rating from the U.S. Centers for Medicare & Medicaid Services (CMS). Designed to help patients, families, and caregivers compare nursing centers more easily, the Five-Star Quality Rating System promotes transparency and accountability across the post-acute care industry by providing a ranking of one to five stars, with five being the best.

Sonnenburg Builders Plumbing Center Are you thinking about staying in your home longer? Do you want to convert to a walk-in-shower?

... helping people live better

For a tour of our center or to learn more about the Five-Star Quality Rating System, please contact:

Visit our updated showroom with fully functioning showers. See our new Safety First walk-inshowers and in home safety solutions.


2125 N. Rapids Rd, Manitowoc 684-3399 • 684-6733

960 S. Rapids Road • Manitowoc, WI 54220 920.684.1144 WI-5001813867



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CommunityDedication -

For over six decades, Shady Lane, Inc., its local leaders who sit on our board of directors, and its staff have served our residents and our community through a philosophy of servant leadership and a commitment to providing quality affordable care.


Find out why people...

Think of Us First for comfort of skilled care

Designed for living with beautifully decorated and lovely gardens, Shady Lane offers skilled nursing care for short or long-term care, therapy services, social services and hospice care. Medicare and Medicaid Certified.

for planning to get better . . . Therapies provided by: Holy Family Memorial

All Private Rooms!

Recovering after an illness, joint replacement or surgery is a team effort. In fact, it could be called "Team You"! We offer physical, occupational and speech therapy, respiratory services, pain management and neurological, orthopedic and cardiac rehabilitation. Medicare and Medicaid Certified and some private insurances. In-patient or Out-patient Services.

for the joys of home without the work From two bedroom apartments to single bedrooms with private bathrooms, Laurel Grove offers a variety of assisted living options to meet your needs. Enjoy the gardens, optional activities and care-free living. Prices start at $1,450.

Now Open! HFM Clinic at Shady Lane Manitowoc’s only not-for-profit citizen directed care facility. 1235 South 24th Street • Manitowoc, WI • • 920-682-8254 WI-5001813860

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50 Plus August 2014