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editor’s pick!

SARTORI CHEESE | | 800 558 5888

ABOUT SARTORI Sartori is a fourth-generation family owned and operated company in the great American tradition. But we’re prouder still of the family feeling that runs throughout the entire company every day. From our leadership and artisan cheese expertise, to our cheesemakers, to our network of patron farmers, we share a deep sense of connection to one another and the land. Even the cows are in on it. And now, you are too.

Sartori Our Cheese

Featured Recipe Antipasto Salad with Sartori Basil and Olive Oil Asiago Ingredients

Reserve Cheese


Beginning with our original BellaVitano®, the Sartori Reserve® portfolio has grown to include a mesmerizing array of supremely tempting flavors. Each distinctive variety is an award winner unto itself, enhanced by the magic ingredient known as imagination.

When I was walking through the grocery store and tasted several of the brands many highly flavored cheeses...I grabbed 7 different kinds and had a panini party. Our whole crew could not get enough of the cheese by iteself pairing it with our favorite red wine, but when making the paninis with this fantastic cheese, we were hooked.

SarVecchio® Parmesan BellaVitano® Gold Balsamic BellaVitano® Black Pepper BellaVitano® Merlot BellaVitano® Raspberry BellaVitano® Chai BellaVitano® Espresso BellaVitano® Dolcina® Gorgonzola Extra-Aged Asiago Basil & Olive Oil Asiago Rosemary & Olive Oil Asiago Salsa Asiago Extra-Aged Fontina Mediterranean Fontina Tuscan Blend Sicilian Blend

The flavors melt in your mouth providing spice, cream, texture, etc. The word quality comes to mind. I have made serveral dishes... Breakfast, lunch and dinner and the cheese adds the richness and flavor to each dish. This is a must get. You won’t be sorry!!!


Espresso BellaVitano is one of the award-winning cheeses in the Sartori Reserve product line. This gourmet cheese is a delicious treat for your breakfast or dessert. Freshly roasted espresso is hand-rubbed into sweet, sugary BellaVitano wheels aged to creamy perfection. The cheese received a Silver Medal in the 2010 World Cheese Awards and a 3rd place in the 2011 American Cheese Society Competition. It pairs well with Pinot Noir, Shiraz, Merlot and Chardonnay or with your fruit beers, stout, Porter beer, Trappist style ale or Barley wine. Food pairings are also multiple, how about chocolate, dried fruit, sweet pastries, honey.

1lb Bowtie pasta, cooked, ½ bottle Balsamic Vinaigrette 6 oz provolone cheese, cubed 6 oz Sartori Basil Asiago , cubed ½ red bell pepper, diced ½ yellow bell pepper, diced ½ orange bell pepper, diced 1 bunch green onions, chopped 1 pint grape tomatoes 8 oz summer sausage, cubed 2 tbl minced garlic Directions Add all ingredients together and mix thoroughly. Add more dressing if necessary

Every year, we offer limited quantities of artisan cheese inspired by the creative spirit of our founder, Paolo Sartori. These special releases are meticulously crafted in the European tradition and presented with the joy of an authentic Sartori family event. Extra Aged Goat Cheese Cognac BellaVitano® Pastorale Blend® Cannella BellaVitano® Peppermint BellaVitano®



MORE CHEESE Absolute essentials for tasting the good life every day, these flavors are crafted to grace our own tables and be shared with knowing friends. Each one springs from the unique Wisconsin terroir of climate, water and soil that produces the world’s best cheese. Classic Parmesan Classic Fontina Classic Asiago MontAmoré Classic Romano


Valentines Day for the Kids...

Blue Harbor Resort

Valentines Day for the Adults...

HOTEL RED Madison’s first true stylish boutique hotel & restaurant. Stay, play and dine in style at Madison’s first true stylish boutique hotel and restaurant. Steps away from the University of Wisconsin’s legendary Camp Randall Stadium and the eclectic shopping, sights and sounds of Monroe Street, come experience Madison as you never have before.

Experience a truly unforgettable lakeside retreat at the newly renovated Blue Harbor Resort & Spa. Escape for a romantic getaway. Discover pampered serenity at Reflections Spa. Enjoy a day of outdoor adventure or indoor waterpark fun. Delight in delicious dining and sip the perfect cocktail on our lakeside patio. Endless lakeside views are waiting for you. Find it all at Blue Harbor Resort & Spa - Nestled on the Wisconsin shore of Lake Michigan. Step inside the world of Blue Harbor Resort and find a truly unique vacation experience. Relax in our grand resort, or set sail on your adventure – Blue Harbor resort has something for everyone. Take a look! ACCOMODATIONS From couples, to families or a weekend with friends, our 182 spacious guest suites and 64 beautiful condominiums offer a wide variety of configurations, including lavish, fully-appointed two and four bedroom villas with kitchens. Relax in a lakeside suite with amazing balcony views, take advantage of your own in-room Jacuzzi tub, or stay casual and comfortable in a kidfriendly bunk-bed suite. Blue Harbor accommodations include admission to our indoor waterpark and feature all the comforts of home including high-speed wireless internet! REFLECTIONS SPA Reflections Spa was voted one of the best boutique spas in the state by Milwaukee Magazine! From manicures and pedicures to body wraps, facials and massage, we will pamper you from head to toe. Experience new treatments, retreat into peaceful tranquility, and dissolve your stress away under the hands of our licensed professionals. Our caring staff is trained in the latest spa therapies to enhance and customize your spa treatments for an exclusive experience created just for you. The Spa, designed with earth-tone colors, offers a quiet retreat with soft music, aromatherapy candles, and a Feng Shui balanced atmosphere. With five luxurious treatment rooms, and a manicure/pedicure room, and featuring four relaxing body treatments to choose from, our caring spa team has created a retreat to restore your sense of balance and well being. THE WATERPARK Giving new meaning to the term “year-round family resort,” Blue Harbor defies the weather outside with an indoor waterpark experience that has young and old soaking in the fun! Whether it’s 10 degrees below or raining cats and dogs, it’s always a balmy 84 degrees inside Blue Harbor Resort’s 54,000 square-foot entertainment area and indoor waterpark. Blue Harbor’s indoor waterpark is an ideal escape for both parents and kids, offering an environment that allows for both bonding together-time and safe, supervised yet independent kidfriendly fun that gives parents time to relax with children in sight.

Bright and well-appointed, our 48 suites are each outfitted with modern furnishings, original art, high speed WiFi and HD LCD TVs, a full kitchenette and a host of room-specific amenities such as soaking tubs and private patios.

RED HOT ROMANCE PACKAGE Split of sparkling wine and chocolate covered strawberries delivered to your room upon check-in Turndown service with a romantic quote written on a card tucked in the pillow Breakfast in bed (to include one breakfast entrée and choice of coffee, tea, milk or juice per person; must be ordered by 10:00pm the night prior) Late and lazy 1pm checkout

THE WISE A hip urban bistro stretching the length of the lobby, The Wise is open for breakfast, lunch and dinner. Offering a small plates menu with a fresh, cosmopolitan twist, The Wise also features a bar with an extensive mix of classic cocktails and craft beers. The Food More than two dozen local food suppliers, some from the immediate neighborhood More than 45 local farms represented Serving Wisconsin classics with a fresh twist Banquet and catering services available The Drinks Local artisan brewers Classic cocktails and specialty concoctions Bartenders trained in the fine art of drink preparation




Insomnia in Older Adults



About Sleep We all look forward to a good night’s sleep. Sleep allows our body to rest and to restore its energy levels. Without enough restful sleep, not only can we become grumpy and irritable, but also inattentive and more prone to accidents. Like food and water, adequate sleep is essential to good health and quality of life. Two Types of Sleep There are two types of sleep: non-rapid eye movement -- or NREM sleep -- and rapid eye movement -- or REM sleep. NREM sleep includes four stages, ranging from light to deep sleep. Then we go into REM sleep, the most active stage of sleep when dreaming often occurs. During REM sleep, the eyes move back and forth beneath the eyelids and muscles become immobile. We cycle through the NREM-REM stages of sleep approximately every 90 minutes. How Sleep is Regulated Researchers believe that two body systems -- the sleep-wake process and our circadian biologic clock -- regulate our sleep. They program our bodies to feel sleepy at night and awake during the day. The sleep-wake process works by balancing the amount of sleep a person needs based on the time spent awake. Our circadian biologic clock is a 24-hour body rhythm affected by sunlight. It regulates hormones such as melatonin, which is secreted during the night and promotes sleep, and other processes like body temperature. Sleeping at a time that is in sync with this rhythm is important for healthy sleep. Diagram of changes in sleep patterns as we age. - Click to enlarge in new window. Sleep Needs, Patterns Change With Age Sleep needs change over a person’s lifetime. Children and adolescents need more sleep than adults. Interestingly, older adults need about the same amount of sleep as younger adults -- seven to nine hours of sleep per night. Unfortunately, many older adults often get less sleep than they need. One reason is that they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep. Also, older people often sleep less deeply and wake up more often throughout the night, which may be why they may nap more often during the daytime. Nighttime sleep schedules may change with age too. Many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning. Why These Changes There are many possible explanations for these changes. Older adults may produce and secrete less melatonin, the hormone that promotes sleep. They may also be more sensitive to -- and may awaken because of -- changes in their environment, such as noise. Older adults may also have other medical and psychiatric problems that can affect their nighttime sleep. Researchers have noted that people without major medical or psychiatric illnesses report better sleep. Poor Sleep Can Lead to Problems Not sleeping well can lead to a number of problems. Older adults who have poor nighttime sleep are more likely to have depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls, and use more over-thecounter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life. If You Have Trouble Sleeping

Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report few or no sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging. If you are having trouble sleeping, see your doctor or a sleep specialist. There are treatments that can help. Treating Sleep Disorders Once You’ve Been Evaluated Based on your sleep evaluation, your doctor or sleep specialist may recommend individual treatment options. It is important to remember that there are effective treatments for most sleep disorders. If you are diagnosed with a sleep disorder, your doctor may suggest specific treatments. You should ask for information to find out more about your condition and ways to improve your sleep. Therapies You may want to try limiting excessive noise and/or light in your sleep environment. Or, you could limit the time spent in bed while not sleeping, and use bright lights to help with circadian rhythm problems. Circadian rhythm is our 24-hour internal body clock that is affected by sunlight. Relaxation techniques also may be helpful in reducing physical and emotional tensions that can interfere with sleep. There are also cognitive therapies aimed at changing attitudes and concerns people may have about insomnia and not being able to sleep well. Some specialists believe medications also can be useful early in your treatment, and if necessary, you can use them from time to time if you have trouble falling asleep. Treating Sleep Apnea People who are diagnosed with sleep apnea should try to lose weight if possible, but often they may need other treatments as well. Adjusting your body position during the night may benefit you if you experience sleep apnea more often when you lie on your back. The CPAP. The most effective and popular treatment for sleep apnea is nasal continuous positive airway pressure, or CPAP. This device keeps your air passages open by supplying a steady stream of air pressure through your nose while you sleep. To use the CPAP, the patient puts on a small mask that fits around the nose. Air pressure is delivered to the mask from a small, quiet air pump that sits at the bedside. The patient not only wears the mask at night but also during naps, since obstructions can occur during these times as well.

Dental Devices. If you have a mild case of sleep apnea, sometimes a dental device or appliance can be helpful. Surgery. If your condition is more severe and you don’t tolerate other treatments, your doctor may suggest surgery to increase the airway size in the mouth and throat. One common surgical method removes excess tissue from the back of the throat. Treating Movement Disorders Very often, people who suffer from movement disorders during sleep such as restless legs syndrome or periodic limb movement disorder are successfully treated with the same medications used for Parkinson’s disease. People with restless legs syndrome often have low levels of iron in their blood. In such cases doctors often prescribe supplements.Treating REM Behavior Disorder Medications can also treat people with REM behavior disorder. If there are reports of dangerous activities such as hitting or running during these episodes, it may be necessary to make changes to the person’s sleeping area to protect sufferers and their bed partners from injury. Getting a Good Night’s Sleep SLEEP>>page 46

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Participating in Activities You Enjoy MORE THAN JUST FUN AND GAMES A number of early studies found that people who are involved in hobbies and other social and leisure pursuits may be at lower risk for (and less likely to develop) some health problems, including dementia.

June feels great. She enjoys gardening, playing cards with friends on Tuesdays and Fridays at the senior center, and taking a water aerobics class at the county indoor pool. She turns 78 this year, but she feels like she’s still in her thirties. Does June’s active lifestyle have anything to do with her good health and good function? Researchers would likely say “yes.” There are many things you can do to help yourself age well. Physical activity, exercise, and making healthy food choices are the cornerstones for most suggestions about healthy aging. But emerging research also indicates the possibility that engaging in social and productive activities you enjoy, like taking an art class or volunteering in your community or with your place of worship, may also help maintain your wellbeing. A number of early studies found that people who are involved in hobbies and other social and leisure pursuits may be at lower risk for (and less likely to develop) some health problems, including dementia. They might even live longer. In one study, older adults


who reported participating in social activities (e.g., played games, belonged to social groups, traveled) or meaningful, productive activities (e.g., had paid or unpaid jobs, gardened) lived longer than people who did not. Researchers are exploring if participation in these kinds of activities can be the direct cause of positive health outcomes. Melvin has not quite felt like himself since he retired. He worked at the same job for over 50 years and enjoyed his daily routine. Now, Melvin misses catching up with his customers and hearing about their families. He misses teaching new employees the ins and outs of the trade. He misses waking up feeling like he has a purpose. Melvin heard about a program at a library where retired people volunteer to help children with homework. He thinks that might be a good idea for him. Research shows that people who are sociable, generous, and goal-oriented may be happier and less depressed than other people. Sitting at home alone could help explain why Melvin is not feeling like himself.

Volunteering might help Melvin feel better. According to researchers, older adults who participate in what they believe are meaningful activities, like volunteering in their communities, say they feel healthier and happier. For example, older adult volunteers from an urban community worked approximately 15 hours a week in their neighborhood public elementary schools, in a special program designed to improve children’s school success. Researchers learned that the older volunteers increased their cognitive, social, and physical activity levels. Participants also reported feeling personal satisfaction from the experience. Although more research is needed, researchers think that over the long term the participants may have decreased their risk for disability, dependency, and dementia in later life. When Maria was younger, she took part in rallies for local issues and even went to Washington, DC, to hear Martin Luther King, Jr.’s “I have a dream” speech. Maria is proud she participated in these events. She cur rently serves lunch at a homeless shelter twice a week

but is looking for a second activity. Maria has been learning about the problems with the environment and wants to get involved in finding a solution. She thinks it would be a good way to volunteer her time and give back. Many causes need help from volunteers. For example, groups that help homeless people need volunteers to serve meals or organize clothing donations. The USO needs people to send care packages to soldiers stationed overseas. Animal shelters need help caring for dogs and cats. Senior groups need aides to help people with disabilities run their errands. The list goes on. Researchers have found that older adults, like Maria, who take part in these types of activities often do so to make a difference in their communities and feel good about what they are doing. Linn was used to helping care for her grandchildren while her daughter was at work. But now the younger grandchildren are in high school. They just don’t need as much help. As a result, Linn finds that she has a lot of extra time on her hands. She is thinking about joining her church’s young-at-heart social group. She hears that they do many different volunteer activities, play bingo Sunday evenings, go to the movies together, have a knitting club, and even organize a power walk in the mall two mornings a week. Linn’s church has an active program. But, there are plenty of other options for places to volunteer or be socially active. Where you look to find these opportunities might depend on what you are interested in doing. The following are some examples of social and productive activities you might like: Volunteering at a library, hospital, or other community health facility Joining a senior center Playing cards and other games with your friends Going to the theater, a movie, or a sporting event Traveling with a group of older adults, perhaps a retiree group Visiting friends and family Trying different restaurant Gardening in your backyard or at a community park Organizing a park clean-up through your local recreation center Taking a cooking class Singing in a choral group Joining a local theater troupe Forming or joining a book club Going dancing

Participating in activities you enjoy should be fun, not stressful. Taking a group exercise class Playing a musical instrument, learning a new instrument Joining a group interested in a hobby like knitting or wood carving Getting a part-time job Two years ago, Ted started doing volunteer work at his senior center. Later he started some clubs at the center. Now he volunteers 3 days a week, is part of the center’s theater group, and plays in a weekly poker game. He recently joined the planning committee for his apartment building. It meets twice a month. Ted is rushing all the time and starting to feel that he is doing too much. Everyone has different limits to the amount of time he or she can spend on social or other activities. What is perfect for one person might be too much for another. Ted may cut back his volunteer hours and find that doing a little less is just right for him. His friend Rasheed may feel that doing two activities—a monthly book club and tutoring once a week in the high school—is enough.

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How To... TALK WITH YOUR DOCTOR “Most people know that communicating with their doctor is important to their health care, especially as they age and are more likely to have health conditions and treatments to discuss

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How do you talk about a sensitive subject with your doctor? What if you forget to ask an important question? What if you feel rushed during your visit? How can you get the most out of your visit with your health care provider? Being able to communicate openly, comfortably and assertively with your doctor can help you make good health decisions and stay well. But some older people shy away from this approach and hesitate to ask questions or take the doctor’s time. The best patient-doctor relationships are more of a partnership, with both sides taking responsibility for good communication. To guide older patients in speaking with their doctors, the National Institutes of Health (NIH) offers Talking with Your Doctor, a newly released topic on, a Web site developed by NIH with the needs of older people in mind. The Web site is a joint effort of the National Institute on Aging (NIA) and the National Library of Medicine (NLM), which are components of the NIH. “Most people know that communicating with their doctor is important to their health care, especially as they age and are more likely to have health conditions and treatments to discuss,” says Judith A. Salerno, M.D., NIA deputy director. “The key is to know how to have that conversation.” Older adults can turn to this newest feature on the NIHSeniorHealth Web site for information on managing conversations with their doctor. How to prepare for a doctor visit, what to ask, what information to provide, and how to understand what the doctor says are among the many helpful tips older adults can find on the site. One of the fastest growing age groups using the Internet, older Americans increasingly turn to the World Wide Web for health information. In fact, 68 percent of wired seniors surf for health and medical information when they go online. is based on the latest research on cognition and aging. It features short, easy-to-read segments of information that can be accessed in a variety of formats, including various large-print type sizes, open-captioned videos and an audio version. The site also links to MedlinePlus ( medlineplus/), the National Library of Medicine’s premier, more detailed site for consumer health information.

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Have you ever felt dizzy, lightheaded, or as if the room were spinning around you? These can be very troublesome sensations. If the feeling happens often, it could be a sign of a balance problem. Balance problems are among the most common reasons that older adults seek help from a doctor. Why Good Balance is Important Having good balance means being able to control and maintain your body’s position, whether you are moving or remaining still. An intact sense of balance helps you walk without staggering get up from a chair without falling climb stairs without tripping bend over without falling The part of the inner ear responsible for balance is the labyrinth. To maintain your body’s position, the labyrinth interacts with other systems in the body, such as the eyes, bones and joints. Woman walking and carrying groceries. - Click to enlarge in new window. Good balance is important to help you get around, stay independent, and carry out daily activities. When People Have Problems with Balance As they get older, many people experience problems with their sense of balance. They feel dizzy or unsteady, or as if they or their surroundings were in motion. Disturbances of the inner ear are a common cause. Vertigo, the feeling that you or the things around you are spinning, is also a common symptom. Photo of woman in a wheel chair. - Click to enlarge in new window. Falls and fall-related injuries, such as hip fracture, can have a serious impact on an older person’s life. If you fall, it could limit your activities or make it impossible to live independently. Many people often become more isolated after a fall. According to the Centers for Disease Control and Prevention, roughly more than one-third of adults ages 65 years and older fall each year. Among older adults, falls are the leading cause of injury-related deaths BPPV (Benign Paroxysmal Positional Vertigo) There are many types of balance disorders. One of the most common is benign paroxysmal positional vertigo, or BPPV. In BPPV, you experience a brief, intense feeling of vertigo when you change the position of your head, such as when rolling over to the left or right, upon getting out of bed, or when looking for an object on a high or low shelf. BPPV is more likely to occur in adults aged 60 and older, but can also occur in younger people. Drawing of displaced calcium stones in the inner ear. - Click to enlarge in new window. In BPPV, small calcium particles in the inner ear become displaced and hit the inner ear balance sensors, causing dizziness. The reason they become displaced is not known; the cause may be an inner ear infection, head injury, or aging. Labyrinthitis Large-scale model of the labyrinth. - Click to enlarge in new window. The part of the inner ear responsible for balance is the labyrinth. To maintain your body’s position, the labyrinth interacts with other systems in the body, such as the eyes, bones and joints. Ménière’s Disease Ménière’s disease is a balance disorder that causes a person to experience vertigo hearing loss that comes and goes tinnitus, which is a ringing or roaring in the ears a feeling of fullness in the ear. It affects adults of any age. The cause is unknown. There are many ways to treat balance disorders. Treatments vary depending on the cause. See your doctor if you are experiencing dizziness, vertigo, or other problems with your balance.


The Johns Hopkins Medical Letter While it’s less publicized than knee or hip arthritis, shoulder arthritis is a crippling condition, causing extreme pain and limited motion. Arthroplasty, or joint replacement surgery, can relieve pain and restore motion in people with severe shoulder arthritis. And according to a recent study done at Johns Hopkins, shoulder arthroplasty is just as safe as much more common hip and knee replacements. Yet people with shoulder arthritis are more likely to stick with conservative treatments. Why don’t more people choose shoulder arthroplasty? “Many people don’t know that shoulder replacements

are available or think that shoulder arthroplasty is extremely traumatic or that replacement joints just don’t work,” says Edward McFarland, M.D., Wayne H. Lewis Professor of Orthopaedics and Shoulder Surgery at Johns Hopkins. “One of the reasons that we performed the recent study was to dispel these shoulder arthroplasty myths.” The Data During the study, researchers reviewed the medical records of over 50,000 men and women who had undergone shoulder, hip, or knee replacement in the state of Maryland. People who underwent shoulder arthroplasty were less likely to have been treated for in-hospital

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complications. Shoulder arthroplasty patients also left the hospital earlier, staying a bit less than 2.5 days compared with more than 4 days for hip or knee surgery patients. A New Joint The shoulder (glenohumural) joint consists of the “ball”, or head, of your upper arm bone (humerus) and the “socket” of your shoulder blade (scapula). Both are covered by a layer of cartilage that smoothes the movement of the ball inside the socket, allowing your arm its remarkable range of motion. Arthritis or trauma can wear away cartilage and force bones to rub against each other, causing pain and loss of movement. “Many cases of shoulder arthritis are idiopathic. We can’t tell the exact cause, but suspect a genetic predisposition,” explains Dr. McFarland. “The second most common cause is trauma, such as fracture or shoulder dislocation. Immunologic problems, like rheumatoid arthritis, also can affect the shoulder joint.” During total shoulder replacement,

surgeons remove the damaged humeral head and replace it with a prosthetic ball that is usually made of metal. The ball is attached to a stem that is inserted into the humerus. A plastic insert is place in the scapula. The surgery can be performed using regional or general anesthesia, but general anesthesia is most commonly used. The procedure takes about 3 hours and requires 1-3 days in the hospital. Shoulder arthritis can also damage the rotator cuff, which is the group of muscles and tendons that connects the humerus to the scapula and stabilizes the glenohumeral joint. If the rotator cuff is too heavily damaged, a traditional shoulder arthroplasty may not work. In these instances, patients can undergo reverse shoulder arthroplasty, during which the head of the humerus is replaced with a cup (rather than a ball) and a ball is placed in the scapula socket. This reverse design allows the patient to lift the arm using the deltoid muscle, which lies above the shoulder, instead of the rotator cuff. Dr. McFarland says, “Reverse SHOULDER>>page 47

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hether your stay at a hospital is planned or unplanned, we can be your bridge between hospital and home. Our goal is to get you well so you can get back to life! � Short-term comprehensive, customized care � Nationally recognized for providing quality service � Expanded insurance contracts � Private rooms available Sponsored by the School Sisters of St. Francis

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How does your home bring you to life?

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Assisted Living Mom and dad are finding it harder to live by themselves at home. I think they need a place where they can have at least some assistance day-to-day. Quite often, adults reach a point when they should no longer live on their own but don’t need round-the-clock nursing care. Assisted living facilities provide an alternative. Assisted living is for adults who need help with everyday tasks of dressing, bathing, eating, or using the bathroom. But they don’t need full-time nursing care. Often they are part of retirement communities or are near nursing homes, so a person can move easily if their needs change. Although assisted living costs less than nursing home care, according to the U.S. Administration on Aging, it is still fairly expensive. Older people or their families usually foot the bill. Health and long-term care insurance policies may cover some of the costs. Medicare does not cover the costs of assisted living. Licensing requirements for assisted living facilities vary by state. There are as many as 26 different names for assisted living, among them: residential care, board and care, congregate care, and personal care.

With friendly neighbors, caring staff and plenty of choices. Seminars and activities with dedicated activity staff. Fresh meals made by an expert chef. Comfortable living spaces and spacious apartments with all the features you expect in a place to call home—and helping hands to provide support when needed. Call (414) 292-0400 or visit to learn more about assisted living and specialized memory care services at Oak Park® Place. Welcome home.

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WHAT SERVICES ARE PROVIDED? Residents of assisted living facilities usually have their own units or apartments. In addition to having a support staff and providing meals, most assisted living facilities offer at least some of the following services: Health care management and monitoring Help with bathing, dressing, and eating Meals (some or all) Housekeeping and laundry Medication reminders and/or help with medications Recreational activities Security Transportation

HOW TO CHOOSE A FACILITY A good match between a facility and a resident’s needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you get started in your search for a safe, comfortable, and appropriate assisted living facility: Think ahead. What will the resident’s future needs be and how will the facility meet those needs? Is the facility close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)? Does the facility have limits on admitting or allowing residents to remain if they have mental impairments or severe physical disabilities? Does the facility provide a written statement of its philosophy of care? Visit each facility more than once, sometimes unannounced. Visit at meal times, sample the food, and observe the quality of mealtime and the service. Observe interactions among residents and staff. Check to see if the facility offers social, recreational, and spiritual activities. Talk to residents. Learn what types of training staff receive and how frequently. Review state licensing reports. FEBRUARY 2013 MHL 37

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9047 W. Greenfield Ave. West Allis, Wisconsin 53214 Phone: (414) 453-9290 Fax: (414) 777-7356


Respite Stays Skilled Nursing Services Alzheimer’s/Dementia Care Physical, Occupational, and Speech Therapy Services

Staying Sharp How To Avoid Brain Drain As You Age An estimated one out of five people aged 75 to 84 has Alzheimer’s disease. Among those aged 85 or older, it’s two out of five. By Bonnie Liebman Can’t remember that new neighbor’s name? Not sure why you came into a room or what you planned to say? Can’t find your keys? Odds are, those are normal signs of aging. But when you leave your wristwatch in the refrigerator, can’t remember common words like “toothbrush,” can’t find your way home, or can’t remember how to use a key—those are more likely to signal Alzheimer’s or other kinds of dementia. An estimated one out of five people aged 75 to 84 has Alzheimer’s disease. Among those aged 85 or older, it’s two out of five. While some risk factors, like Alzheimer’s-prone genes, can’t be changed, dementia may not be inevitable. Whether you eat a healthy diet, keep moving, and use your brain may make a difference. “For so long, Alzheimer’s disease was considered an inevitable consequence of aging,” says researcher Martha Clare Morris of the Rush Institute for Healthy Aging in Chicago. “In the last 10 to 15 years, it’s started to look more like heart disease,” she explains. “Heart disease research has given us many tools to lower risk—diet, exercise, weight, cholesterol, blood pressure. Alzheimer’s may also have multiple risk factors.” In fact, Alzheimer’s may have some of the same risk factors as heart disease. Researchers now believe that only a blurry line separates Alzheimer’s and vascular dementia—which occurs when blood vessels that feed the brain become narrowed or clogged, either slowly or after a stroke. One difference between heart disease and dementia: “Heart disease research is 30 years ahead,” says Morris. Why do some brains stay sharp while others get fuzzy as they age? To find out, researchers are looking not just at who ends up with a diagnosis of dementia. They’re also looking at people who don’t have dementia, but whose scores on memory tests decline after a few years. For example, in the Chicago Health and Aging Project (CHAP), which has been tracking roughly 3,700 older people since the mid-1990s, the participants take cognitive tests every three years. Among them, “subjects are read a story and asked to repeat the main theses to test their immediate memory, and again 15 minutes later to test delayed memory,” says researcher Martha Clare Morris. Another example: In the timed digit-recall test, “we pair symbols with numbers,” she explains. “Then we present a series of symbols to see how fast participants can name the corresponding numbers.” When a person’s scores on those kinds of tests drop significantly over time, it’s called “cognitive decline.” Here’s a sampling of steps you can take to keep your brain in shaped over the next five or ten years. Since much of the brain research is in its infancy, we include only advice that—even if it doesn’t help your mind—should lower your risk of heart disease, stroke, diabetes, cancer, or other illness. Shoot for two or three servings of fatty fish each week. The polyunsaturated omega-3 fish oil—DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid)—seem to protect the heart. And there’s growing evidence that they may also protect the brain. “EPA is anti-inflammatory, and inflammation is part the Alzheimer’s disease syndrome,” says William Connor, a heart disease expert at the Oregon Health & Science University in Portland. But the evidence for DHA is even more compelling. It’s the most prominent fat in the brain, especially in the nerve cells in the cerebral cortex. “People with Alzheimer’s have less DHA in their cerebral phospholipid cell membranes than normal people,” explains Connor. “Taking DHA could replace the missing DHA.” When researchers feed DHA to adult monkeys who have been on DHA-deficient


diets, the DHA gets into their brain phospholipids. “The DHA crosses the blood-brain barrier and enters the brain,” explains Connor. “We think there’s wear and tear on polyunsaturated fats in the brain all the time, and that they’re constantly getting replaced.” So far, only a handful of studies have tried to see if fish or omega-3 fats are linked to cognitive decline. But they’re promising: In the Framingham Heart Study, which tracked nearly 900 healthy older men and women living in the Boston suburb for roughly nine years, people with the highest blood levels of DHA—they ate about three servings of fish per week—had about half the risk of dementia compared to those with lower levels. In the Zutphen Elderly Study in the Netherlands, which followed 210 older men for an average of five years, those who ate no fish had more cognitive decline than fish eaters. In the Atherosclerosis Risk in Communities (ARIC) Study of more than 2,200 older residents of the Minneapolis suburbs, scores on a verbal fluency test (“write as many words as you can in one minute that start with F, A, or S”) were less likely to decline in those who had higher blood levels of omega-3 fats. Omega-3s only appeared to protect people who had high blood pressure or a combination of low HDL (“good”) cholesterol and high triglycerides. In the Chicago Health and Aging Project, cognitive decline was 10% slower among people who ate fish at least once a week than among those who ate fish less often. “The preponderance of studies shows an association between fish consumption or DHA and cognitive decline,” says Connor. “But it’s only an association, so it may be time for a more definitive clinical trial.” Until then, he recommends omega-3s, but not necessarily for the brain. “My advice is to consume fish to prevent heart disease,” says Connor. “There’s no harm, and it might also prevent Alzheimer’s.” Shoot for two or three servings of fish per week. To get the amount of omega-3s that seemed to protect the Dutch men, you’d have to eat five ounces a week of fatty fish (like salmon) or 30 ounces a week of leaner fish (like cod, haddock, or tuna). If you don’t eat fish, taking fish oil capsules or vegetarian omega-3s from phytoplankton is second best, says Connor. Limit bad fats. It’s clear that saturated and trans fats are bad for your arteries. Could they also harm your brain? The Chicago Health and Aging Project study tracked 815 healthy people for nearly four years, and then searched for clues about the 131 who were diagnosed with Alzheimer’s. “We saw a doubling of the risk of Alzheimer’s disease among those who ate the most saturated fat versus those who ate the least,” says CHAP researcher Martha Assisted Living and Memory Care Communities Clare Morris. (Those who ate the most sat fat averaged 25 grams a day, while those who ate the least averaged half that much.) The risk was also roughly double among those who ate more than about 1.8 grams of trans fat a day (the amount eaten by the group with the lowest trans intake). In a second study, which tracked more than 2,500 people for six years, “we found a faster rate of cognitive decline in people who consumed the most saturated and trans fat,” adds Morris. And in April, the ARIC study reported significantly more RCAC... CBRF...ADLS... cognitive decline in people with higher blood levels of palmitic What does all thisRCAC... mean? Stop and learn about Assisted Living. CBRF... ADLS... acid, which is found in saturated It’sdoes never early to know are available you. What alltoo this mean? Stopwhat and options learn about AssistedtoLiving. fats. Private Studio, One and Two Bedroom Apartments. It’s never too early to know what options are available to you. It’s not clear how bad fats might affect Alzheimer’s risk, but Private Studio, One and Two Bedroom Apartments. Heritage West Allis there’s reason to suspect a link. “The only gene that’s been Heritage at Deer Creek-New Berlin, e For mor linked to late-life Alzheimer’s e l foatriomnor alrm Cfo call Lexington Heritage - Greenfield. in is apoEe4, which encodes a n io at rm fo in cholesterol-transport gene,” Donna at Heritage Court-Menomonee Falls 00 97 2notes Morris. “And cholesterol30 04 441 70 183 ) 08 (6 lowering statin drugs seem to protect against Alzheimer’s in some studies.”

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Whether you are moving to an independent, assisted or any other senior community, changing your lifestyle can be stressful and emotionally draining on yours The decision about where you should move is often tricky and emotional. Each individual will have its own reasons for wanting to take such a step. You may decide a move is right because you no longer need so much space or cannot manage the home. Others may need for hands-on care in a long-term care facility motivates a change. In some cases, a move frees up cash so that the parent can afford a more suitable situation. Keep in mind that leaving a home, community, and familiar medical care can be very disruptive and difficult.


Older adults and their families have some choices when it comes to deciding where to live, but these choices can be limited by factors such as illness, financial resources, and personal preferences. Making a decision that is best for youcan be difficult. Try to learn as much as you can about possible housing options. Older adults, or those with serious illness, can: stay in their own home, or move to a smaller one, move to an assisted living facility or retirement community, move to a long-term care facility, or move in with another family member. Experts advise families to think carefully before moving an aging adult into an adult child’s home. In its fact sheet

Home Away From Home, the Family Caregiver Alliance suggests considering the following issues before deciding whether or not to move your parent to your home: Evaluate whether you needsconstant supervision or assistance throughout the day, and consider how this will be provided. Identify which activities of daily living (eating, bathing, toileting) you can perform independently. Take an honest look at your health and physical abilities, and decide if you are able to provide care for yourself. Consider the type of medical care you need and find out if appropriate doctors and services are available in your community.Once you’ve decided on a place to live you must get your things in order.

Taking inventory on your possesions is the first step to a easier move. Start with the basement and work your way up. You will have gathered quite a few belonging and will probably need to sort through your keepsakes and your throw aways. To help keep the clutter to a minimum, it is wise to have your family hold on to important items you are not ready to let go of. Moving can be physically demanding. Getting your friends and family involved is always a good idea whether you decide to hire movers. With extra help you can concentrate on other important matters. When planning out a time table, make sure to give yourself at least a week break that will help you not become so overwhelmed.


John P. Bonavia, MD As people age, their risk of contracting certain diseases increases. That’s why many health-related organizations (e.g., the American Cancer Society and the United States Preventive Services Task Force) recommend certain medical tests (screenings) and certain vaccinations for people age 50 and older. Men and Women  Colon cancer—All normal risk individuals should be screened for colon cancer starting at age 50. Colonoscopy is becoming an increasingly popular screening option because it discovers the vast majority of precancerous polyps and finds early colon cancers when they are most treatable. Annual tests for blood in the stools, combined every 5 years with a sigmoidoscopy test, are also popular screening options.  Flu—Influenza vaccine saves lives every year. When vaccine supplies are adequate, all persons age 50 or older should receive a yearly flu shot (if they do not have a condition which makes a flu shot inadvisable). People over 65 are at particularly high risk of becoming very ill, or even dying from the flu. They should be immunized each year. Over 90 percent of influenza-related deaths occur in individuals older than 60. Many other people with medical conditions also should be immunized. Ask your doctor to determine if you are in a high-risk group.  Pneumonia—The pneumococcal vaccine helps prevent pneumonia and is recommended for people age 65 or older. Younger individuals with certain chronic conditions should also be immunized. Most people who receive the vaccine at age 65 or older require this vaccine only once. Ask your doctor if you should get this valuable immunization. Women  Breast cancer—Screening for breast cancer saves lives. Mammograms and clinical breast exams are recommended. Discuss this with your doctor. Most physicians recommend yearly clinical breast exams and regular mammograms. A typical recommendation might be mammograms every one to two years between 40 and 50 and yearly after that. Many clinicians continue breast cancer screenings in all women with a life expectancy of 10 years or greater. Again, discuss your situation with your physician.  Cervical cancer—A Pap smear is a screening test for cervical cancer. After 3 or more yearly normal Pap smears, normal risk women can decrease the frequency of Pap smears to every two to three years. Women who have had regular, normal Pap smears throughout their lives can usually stop getting Pap smears at age 70. However, women who have not gotten regular Pap smears should start getting them whatever their age. 25 percent of all cervical cancers occur in women over 65 and 40 percent of all cervical cancer deaths occur in this age group. Men  Prostate Cancer—Routine screening for prostate cancer is somewhat controversial. Talk to your doctor about the approach you should take. Many experts recommend yearly digital rectal exams and the blood test called the PSA test starting at age 50. However, screening is often recommended to start at age 40 for African American men and those with a family history of prostate cancer.


WHY CAN’T I REMEMBER HER NAME? MEMORY LOSS AND AGING Everyone forgets a name or misplaces keys occasionally. Many healthy people are less able to remember certain kinds of information as they get older. Memory loss that disrupts everyday life is not a normal part of aging, however. It is a symptom of dementia, a gradual and progressive decline in memory, thinking and reasoning skills. The most common cause of dementia is Alzheimer’s disease, a disorder that results in the loss of brain cells. Alzheimer symptoms progress, affecting communication, learning, thinking and reasoning. Eventually they have an impact on a person’s work and social life. 10 Warning Signs of Alzheimer’s Disease The Alzheimer’s Association, the world leader in Alzheimer research and support, has developed the following checklist of common symptoms to help recognize the warning signs of Alzheimer’s disease. 1. Memory loss – Forgetting recently learned information is one of the most common early signs of dementia. 2. Difficulty performing familiar tasks – People with dementia often find it hard to plan or complete everyday tasks, such as preparing a meal or placing a telephone call. 3. Problems with language – People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. 4. Disorientation to time and place – People with Alzheimer’s disease can become lost in their own neighborhoods, forget where they are and how they got there, and not know how to get back home.

5. Poor or decreased judgment – Those with Alzheimer’s may dress inappropriately, or they may show poor judgment about money, like giving away large sums to telemarketers. 6. Problems with abstract thinking – Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are and how they should be used. 7. Misplacing things – A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl. 8. Changes in mood or behavior – Someone with Alzheimer’s disease may show rapid mood swings – from calm to tears to anger – for no apparent reason. 9. Changes in personality – The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member. 10. Loss of initiative – A person with Alzheimer’s disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities. If you or someone you know is experiencing these symptoms, consult a physician today. Early and accurate diagnosis of Alzheimer’s disease or other dementia is an important step to getting the right treatment, care and support. Evidence suggests that early diagnosis and subsequent treatment can help slow the progression of symptoms. Where to Turn for Help MEMORY<<page 42

Memory Care at Tudor Oaks For Alzheimer’s, dementia and associated concerns

Call Tudor Oaks to learn more about... • Recognizing Changes What signs could indicate memory issues • How to Start the Conversation Suggestions for addressing this sensitive subject • Benefits of Dedicated Memory Care Support 24/7 in an engaging environment • Customized Care Plans Based on the “whole person” concept • Help for Making a Smooth Transition Call to tour our newly redeveloped commu-

nity where your loved one will thrive. Our senior living counselors can help you through this process.

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S77 W12929 McShane Drive, Muskego, WI 53150

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Tudor Oaks Retirement Community is owned and operated by American Baptist Homes of the Midwest, a not-for-profit provider of senior housing and healthcare since 1930.





By Gina Botshtein. The question “are you ready?” is commonly heard when people embark on a new journey in their lives-- going off to school, making a career move, starting a family or retiring. It is not usually a phrase associated with getting older. Ask an individual at 60, 70, 90 or 100 and each stage of life brings new perspective. Moreover, the numerical value associated with age is not necessarily an indicator as to what needs to be done to prepare for the aging process. JFS works with over 1,200 older adults each year. Each year we realize that the question “are you ready?” is more relevant than ever. People need to prepare for the aging process and get things in place so that when the time comes, the decisions have already been made. People get ready for trips, special events and retirement. These events are considered positive stepping stones, and while there can be stress associated, they are still a pleasure to prepare for. Aging and the need for assistance is not always perceived in the same light. If an individual and their family properly plan for the future, the experience of aging can be both pleasant and organized with

limited stress and chaos. But, how does one prepare for getting older? The most important aspect of preplanning is making your wishes known. Having powers of attorney for healthcare and finances is critical. This step can be both a cost saving to your family, as well as a guide to your wishes. Another important aspect of pre-planning includes a family meeting to discuss key issues that may arise such as driving, receiving care and placement options. These discussions can take place with the individual as an active participant, which ensures that their wishes are being heard. Many older adults have fears that they do not share with anyone, and a family meeting may give them the opportunity to alleviate such fears and reassure them that their requests will be met. A few years ago at a family meeting, a client expressed when it was no longer safe for him to drive, that his car would go to a grandchild who would also commit to taking him on errands twice per week. Years later, when his macular degeneration made it unsafe for him to be on the road any longer, a grandson stepped forward to make this commitment. Since the grandfather’s wishes had been clearly expressed, it alleviated any family tension or discussions as how to proceed when the time came. Many older adults and their families seek help in a time of crisis because there is no plan in place. Crisis is a situation in which things are very uncertain, difficult, or painful, and a time when action must be taken quickly. Older adults and their families may not have time to review all the options available to them and make thoughtful decisions. This stress can be avoided through pre-planning. While prepaying for a funeral or cemetery plot are important steps in pre-planning, end of life is only one small component of what needs to be arranged. You must not forget to consider all the decisions regarding your care, safety and well-being that need to be made first. The staff of JFS has worked with individuals and families who are still active in assisting them with planning for the future, whether it is facilitating family meetings, developing individualized care plans or just learning about an individual and their wishes so that at a time of crisis, we are able to help navigate the social service system in the most appropriate way for the older adult and their family. Gina Botshtein is the Vice President of Older Adult Services at Jewish Family Services, a non-profit agency which services the entire community, regardless of religion, race or financial circumstance. For more information about Jewish Family Services, Inc., call 414-390-5800 or visit

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It’s all about Choices


Many people delay the decision to move to a retirement community due to misconceptions or fear. They often regret not making the decision to move sooner; when they were healthier, more involved, or did not realize how lonely they were and the reasons go on and on. Regret is undesirable in all times of life; retirement decisions are no different. The many activities and daily interactions with friends and neighbors offer a dynamic and stimulating environment. Residents freely share their thoughts about retirement living in general and the choices available to them. As you read through this article, look for the comfort, freedom and peace of mind that come from making informed choices. “Statistics show that retirement community residents live healthier and longer lives than those living alone.” That doesn’t sound like rocket science; we need people. A resident commented, “If I knew how many of my friends lived here, I would have moved in years ago.” As one resident says, “I have to admit, it was lonely sometimes at home, now there is always something enjoyable to do.” Whether you want to participate in all of the social activities and outings or read a good book in the quiet of your apartment, the choice is yours. “I love telling stories and reminiscing but it’s not always easy when they’re thirty years younger than me,” remarks a resident. A retirement community, by its very nature, allows people to interact with people their own age affording greater empathy and identification. Memories and recollections are complimented when two people can truly share the depth and breathe of events. Somewhat tongue-incheek yet true, is the adage that retirement communities provide a “constant reservoir of friends.” “I never have to worry about home upkeep or shoveling again,” said a smiling resident. Now you can choose what you would like to spend time

doing: cooking in your apartment, patio gardening, traveling, learning to paint or play the piano; all of the things you never felt you had time to do before. The choice is yours. Keeping the mind, body and spirit healthy is the goal of many retirement communities. “When I moved here, it was very impressive to see how many care about my wellbeing,” a resident reported. Your choice of personal wellness goals are supported by a retirement community’s team who are all rooting for you. “Wellness programs” are growing initiatives in retirement communities to ensure balance, increased strength and awareness of changes. Many retirement communities provide a spiritual component through pastoral visits or Sunday services that keep your hope and faith strong through all times of life. Retirement communities offer various forms of financial protections like “life care” or “endowments” that protect your financial future regardless of your health. A “life care” type contract also provides the potential for tax deductions for prepaid medical expenses. If you don’t feel the need for long term health care coverage, many communities offer rental programs, so again the choice is yours as to which option works best for you. “When my wife had her stroke, it was so convenient to visit her several times a day. I couldn’t do that if I had to drive each way,” commented a resident. Should a care need arise, retirement communities can provide professional and caring services, all in the comfort of your “community.” The choice is yours regarding your lifestyle and many elements need to be considered in making your decision. Should you decide that a retirement community is right for you, there are many elements, such as the ones listed here, that need to be considered and weighed, so that you can feel confident about your choice.

February 2013

Enriching Lives through Connections MONDAY


WEDNESDAY Alexian Village of Milwaukee THURSDAY



The RSVP HOTLINE is (414) 371-7811 11

Visit Us Online! 44 MHL FEBRURARY 2013

5 Body Language II Lyn Evans, 11-Noon, Clubhouse Computer Basics 1-2 pm, Clubhouse

6 Lunch & Bingo, 12- 2 pm, Clubhouse

7 Tai Chi, 10:30-11:30 am, Clubhouse Computer Basics 1-2 pm, Clubhouse Alzheimer’s Support Group, Pavilion 2 -3:30 pm

8 Marcus Theater Noon “Young at Heart Movie

12 “Debunking the Cons,” Lyn Evans, 11-Noon, Clubhouse Computer Basics 1-2 pm, Clubhouse Sandwich Generation Support Group 6:30 -7:30 pm, Clubhouse

13 Lunch & Nicolet Play 10:45-4:00 pm. “Joseph and The Amazing Technicolor Dreamcoat”

14 Tai Chi, 10:30-11:30 am, Clubhouse Computer Basics 1-2 pm, Clubhouse

15 Games, Games & More Games! 2-4 pm, Clubhouse

19 Elder Exploitation I Lyn Evans, 11-Noon, Clubhouse Email Basics 1-2 pm, Clubhouse

20 Healthy Cooking & Bingo, 12-2 pm, Clubhouse

21 Tai Chi, 10:30-11:30 am, Clubhouse Email Basics, 1-2 pm, Clubhouse Book Club, 2:30 – 4:00 pm, Clubhouse


26 Potawatomi Day Trip, 8:00 am, Clubhouse “Elder Exploitation II” Lyn Evans, 11-Noon, Clubhouse Email Basics 1-2 pm, Clubhouse

27 Lunch & Movie, Noon - 3:00 pm

28 Tai Chi, 10:30-11:30 am, Clubhouse Email Basics, 1-2pm, Clubhouse

Unless noted, all events are held in the Clubhouse located on the ground floor of Alexian’s Health & Rehabilitation Center, 9225 N. 76 Street. Some Club Alexian events may have a cost associated with them.



By Karyl Richson Social Security Public Affairs Specialist in Milwaukee, WI You may already know that Medicare is a medical insurance program for people who are 65 or older and for people who are disabled at any age. Some people are covered only by one type of Medicare; others opt to pay extra for more coverage. Understanding Medicare can save you money. If you’re eligible for and want to be covered by Medicare Part B medical insurance, now is the time to sign up. The general enrollment period for Medicare Part B runs from January 1 through March 31. Before you make a decision about general enrollment, here is some useful information. There are four parts to Medicare: Parts A, B, C and D. Part A helps pay for inpatient hospital care, skilled nursing care, hospice care, and other services. Part B helps pay for doctors’ fees, outpatient hospital visits, and other medical services and supplies not covered by Part A. Part C allows you to choose to receive all of your health care services through a managed health care organization. These plans, known as Medicare Advantage Plans, may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C. And Part D is the Medicare Prescription Drug Program. There is a monthly premium for Medicare Part B. In 2013, the standard premium is $104.90. Some high-income individuals pay more than the standard premium. Your Part B premium also can be higher if you do not enroll during your initial enrollment period, or when you first become eligible. There are exceptions to this rule. For example, you can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. If this situation applies to you, you have a “special enrollment period” in which to sign up for Medicare Part B, without paying the premium surcharge for late enrollment. This rule allows you to: • Enroll in Medicare Part B at any time while you are covered under a group health plan based on your own current employment or the current employment of any family member; or • Enroll in Medicare Part B during the eight month period that begins following the last month your group health coverage ends, or following the month employment ends, whichever comes first. If you receive disability benefits and have coverage from a working family member, the same rules apply. If you live in one of the 50 states or Washington D.C. and you’re already receiving Social Security retirement or disability benefits or railroad retirement payments, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you don’t enroll in Medicare Part B when you first become eligible to apply and you don’t fall under the special enrollment period, you’ll have to wait until the general enrollment period, which is January 1 through March 31 of each year. At that time, you may have to pay a higher Medicare Part B premium. For more information about Medicare, visit the Centers for Medicare & Medicaid Services (CMS) website at Or read our publication on Medicare at


SLEEP<<page 29

A good night’s sleep can make a big difference in how you feel. Here are some suggestions to help you. Follow a regular schedule. Go to sleep and wake up at the same time, even on weekends. Sticking to a regular bedtime and wake time schedule helps keep you in sync with your body’s circadian clock, a 24-hour internal rhythm affected by sunlight. Try not to nap too much during the day. You might be less sleepy at night. Try to exercise at regular times each day. Exercising regularly improves the quality of your nighttime sleep and helps you sleep more soundly. Try to finish your workout at least three hours before bedtime. Try to get some natural light in the afternoon each day. Be careful about what you eat. Don’t drink beverages with caffeine late in the day. Caffeine is a stimulant and can keep you awake. Also, if you like a snack before bed, a warm beverage and a few crackers may help. Don’t drink alcohol or smoke cigarettes to help you sleep. Even small amounts of alcohol can make it harder to stay asleep. Smoking is dangerous for many reasons, including the hazard of falling asleep with a lit cigarette. Also, the nicotine in cigarettes is a stimulant. Create a safe and comfortable place to sleep. Make sure there are locks on all doors and smoke alarms on each floor. A lamp that’s easy to turn on and a phone by your bed may be helpful. The room should be dark, well ventilated, and as quiet as possible. Develop a bedtime routine. Do the same things each night to tell your body that it’s time to wind down. Some people watch the evening news, read a book, or soak in a warm bath. Use your bedroom only for sleeping. After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed. Try not to worry about your sleep. Some people find that playing mental games is helpful. For example, think black -- a black cat on a black velvet pillow on a black corduroy sofa, etc. Or, tell yourself it’s five minutes before you have to get up and you’re just trying to get a few extra winks. If you are so tired during the day that you cannot function normally and if this lasts for more than 2 to 3 weeks, you should see your family doctor or a sleep disorders specialist. MEMORY>>page 46

There are numerous clinics in Wisconsin that specialize in the assessment of memory loss. Many of them are affiliated with the Wisconsin Alzheimer’s Institute (WAI), a center within the University of Wisconsin-Madison School of Medicine and Public Health. These clinics follow a diagnostic protocol based on best practice models suggested by the WAI, and utilize an inter-disciplinary team of professionals, which guides the patient and their family through each phase of the assessment process. The team can include a physician, a psychologist, a nurse, and a social worker or another specialist in dementia care. The physician (usually a neurologist or gerontologist) completes a medical history and physical exam possibly including xrays and/or lab testing. The psychologist or nurse works with the patient to evaluate memory, thinking, and mood. A social worker meets with the patient’s family to complete a social history and provides additional one-on-one support. Sources: “Ten Warning Signs” brochure (©Alzheimer’s Association 2005), and Southeastern Wisconsin Chapter newsletter (Winter 2006).

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SHOULDER<<page 36

shoulder arthroplasty is performed on a small minority of patients. Usually they’re over 70 with shoulder arthritis, since the rotator cuff gradually wears down over time. Unfortunately, rotator cuff wear is one of the consequences of aging, but fortunately heavy damage is relatively rare.” Recovery and Relief According to Dr. McFarland, “Most patients can move their arm right away after undergoing shoulder arthroplasty and they can feed themselves and write after a day.” Rehabilitation begins as soon as possible, with finger, wrist, and elbow movements, and it can last for months. For4 the first 3 months after surgery, patients attend physical therapy sessions twice a week. After that, rehab exercises continue at home. But Dr. McFarland says, “Improvements in range of motion can continue for up to 2 years after surgery.” Perhaps the greatest difference that patients can expect after surgery is in their level of pain. Dr. McFarland says, “I have found that 99% of shoulder arthroplasty patients find pain relief. Patients can do daily tasks that were too painful to perform before, like washing their hair or reaching into a cabinet. Improvement in range of motion may not be as impressive as the improvement in pain relief, but most patients do have better function.” Complications of shoulder arthroplasty include loosening of the artificial socket and, in rare cases, infection. “Most total shoulder joint replacements last for a long time,” says Dr. McFarland. “At one follow-up done 15 years after shoulder arthroplasty, it was found that only 5% of patients had undergone revision surgery for their joint replacement.” Since reverse shoulder arthroplasty is a relatively new form of surgery (it’s only been available in the United States for 3 years), there are few long-term studies of its results. “One study of reverse shoulder arthroplasty patients 7-8 years after their procedures found that 95% of patients still had their original replacements,” says Dr. McFarland. “Patients who had previous shoulder operations were more likely to need revision surgery.” If You’re Considering Surgery To avoid complications, it’s best to find a center or surgeon who performs shoulder arthroplasty often—a minimum of 15-20 procedures a year, according to Dr. McFarland. “It’s especially important to find an experienced surgeon if you’re gong to have a reverse shoulder arthroplasty.” When is it the right time to have shoulder arthroplasty? “There’s no real ‘right time’ or age limit,” states Dr. McFarland. Most people try rest, heat or ice, and pain relievers for as long as possible. Physical therapy can also help. But Dr. McFarland cautions, “Many patients wait too long to consider arthroplasty. Over time, the bone in the scapula wears away, making it impossible to place an artificial socket. While it is possible to replace only the head of the humerus (hemiarthroplasty), total joint replacement provides better pain relief for a longer time. Thus we urge that people with shoulder arthritis be evaluated by an orthopedic surgeon sooner rather than later.” Reprinted permission of the Johns Hopkins Medical Letter Health After 50, copyright MedLetter Associates, 2007. To order a one-year subscription, call 386447-6313.

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