Edel Caregiver Institute

from Coastal Georgia Seniors Resource Directory

by jbasilesrd

Healthy Savannah

38 If you’ve ever been a caregiver you know what an impossible and frightening situation it is. You need help, but you don’t know exactly what help you need. You don’t know where to get it or how to pay for it. You just don’t know. Sometimes the need creeps up – chronic aging, progressive disease, or worsening dementia. Sometimes it’s sudden – an accident, a heart attack, a stroke, or an unexpected cancer diagnosis. It is devastating to get the news that a loved one is facing a debilitating illness, one that has no cure, and a quality of life that is headed downhill. The Edel Caregiver Institute can help. It’s the first of its kind in the United States, and while started under the umbrella of not-for-profit Hospice Savannah it is not designed for those in the final stages of life. Rather, it is for any unpaid family member or volunteer caregiver who needs advice, comfort or support in the struggle of caring for a loved one with a disability, serious illness or dementia. Sooner or later, everybody becomes either a caregiver or in need of care themselves. Often both. Central to the program are family caregiving classes that address and individualize everything from long-term care/financial planning, to handson practical patient skills and wellness services (which may include respite volunteer assistance so caregivers can take a few hours off). “Caregivers often don’t know how to accept or ask for help. This program shows them,” says Tonya Hillis, program coordinator “We’re here to put out the fire. We meet and address every situation individually.” The most difficult and frightening diagnosis to deal with, she has found, is dementia. She helps caregivers explore its probable progression, treatment and prognosis and offers practical coaching and volunteer help. Another of the Institute’s unique programs is Project Sherpa, supported by volunteers who are retired medical professionals. They help interpret medical information and advocate for patients as they climb the often daunting “medical mountain.” A Sherpa physician can even accompany the patient and caregiver to the next medical appointment. The Institute also provides caregiver support groups and deep breathing relaxation and yoga classes. “It’s like the classic airplane instructions... As a caregiver, you’ve first got to put the oxygen mask on yourself before you can help others,” says Tonya, “So let us help. We’re here for anyone. There are no costs. But, of course, contributions are always welcome.” Savannah’s Edel Caregiver Institute offers advice, comfort, and support to family caregivers.

912-629-1331 If you’ve ever been a caregiver you know what an impossible and frightening situation it is. You need help, but you don’t know exactly what help you need. You don’t know where to get it or how to pay for it. You just don’t know. Sometimes the need creeps up – chronic aging, progressive disease, or worsening dementia. Sometimes it’s sudden – an accident, a heart attack, a stroke, or an unexpected cancer diagnosis. It is devastating to get the news that a loved one is facing a debilitating illness, one that has no cure, and a quality of life that is headed downhill. The Edel Caregiver Institute can help. It’s the first of its kind in the United States, and while started under the umbrella of not-for-profit Hospice Savannah it is not designed for those in the final stages of life. Rather, it is for any unpaid family member or volunteer caregiver who needs advice, comfort or support in the struggle of caring for a loved one with a disability, serious illness or dementia. Sooner or later, everybody becomes either a caregiver or in need of care themselves. Often both. Central to the program are family caregiving classes that address and individualize everything from long-term care/financial planning, to handson practical patient skills and wellness services (which may include respite volunteer assistance so caregivers can take a few hours off). “Caregivers often don’t know how to accept or ask for help. This program shows them,” says Tonya Hillis, program coordinator “We’re here to put out the fire. We meet and address every situation individually.” The most difficult and frightening diagnosis to deal with, she has found, is dementia. She helps caregivers explore its probable progression, treatment and prognosis and offers practical coaching and volunteer help. Another of the Institute’s unique programs is Project Sherpa, supported by volunteers who are retired medical professionals. They help interpret medical information and advocate for patients as they climb the often daunting “medical mountain.” A Sherpa physician can even accompany the patient and caregiver to the next medical appointment. The Institute also provides caregiver support groups and deep breathing relaxation and yoga classes. “It’s like the classic airplane instructions... As a caregiver, you’ve first got to put the oxygen mask on yourself before you can help others,” says Tonya, “So let us help. We’re here for anyone. There are no costs. But, of course, contributions are always welcome.” Savannah’s Edel Caregiver Institute offers advice, comfort, and support to family caregivers.

912-629-1331 32 38 If you’ve ever been a caregiver you know what an impossible and frightening situation it is. You need help, but you don’t know exactly what help you need. You don’t know where to get it or how to pay for it. You just don’t know. Sometimes the need creeps up – chronic aging, progressive disease, or worsening dementia. Sometimes it’s sudden – an accident, a heart attack, a stroke, or an unexpected cancer diagnosis. It is devastating to get the news that a loved one is facing a debilitating illness, one that has no cure, and a quality of life that is headed downhill. The Edel Caregiver Institute can help. It’s the first of its kind in the United States, and while started under the umbrella of not-for-profit Hospice Savannah it is not designed for those in the final stages of life. Rather, it is for any unpaid family member or volunteer caregiver who needs advice, comfort or support in the struggle of caring for a loved one with a disability, serious illness or dementia. Sooner or later, everybody becomes either a caregiver or in need of care themselves. Often both. Central to the program are family caregiving classes that address and individualize everything from long-term care/financial planning, to handson practical patient skills and wellness services (which may include respite volunteer assistance so caregivers can take a few hours off). “Caregivers often don’t know how to accept or ask for help. This program shows them,” says Tonya Hillis, program coordinator “We’re here to put out the fire. We meet and address every situation individually.” The most difficult and frightening diagnosis to deal with, she has found, is dementia. She helps caregivers explore its probable progression, treatment and prognosis and offers practical coaching and volunteer help. Another of the Institute’s unique programs is Project Sherpa, supported by volunteers who are retired medical professionals. They help interpret medical information and advocate for patients as they climb the often daunting “medical mountain.” A Sherpa physician can even accompany the patient and caregiver to the next medical appointment. The Institute also provides caregiver support groups and deep breathing relaxation and yoga classes. “It’s like the classic airplane instructions... As a caregiver, you’ve first got to put the oxygen mask on yourself before you can help others,” says Tonya, “So let us help. We’re here for anyone. There are no costs. But, of course, contributions are always welcome.” Savannah’s Edel Caregiver Institute offers advice, comfort, and support to family caregivers.

912-629-1331 32

ADULT DAY CARE GEORGIA INFIRMARY ADULT DAY HEALTH Open M-F, Medicaid and Private Pay Options 1900 Abercorn Street, Savannah 912-819-1500

SCI SENIOR CITIZENS INC. See ad on pages 12, 42 3025 Bull Street, Savannah 912-236-0363

CARE MANAGEMENT AND PERSONAL ADVOCACY CARE PATROL See ad on page 18 Better Senior Living Sources 912-438-1036

SCI SENIOR CITIZENS INC. See ad on pages 12, 42 3025 Bull Street, Savannah 912-236-0363

Don’t let pain or injury hold you back.

Talk to the licensed physical therapists at your local BenchMark about how we can help you move better and feel better, faster! CATARACT AND REFRACTIVE SURGERY

SCHULZE EYE & SURGERY CENTER See ad on page 34 728 East 67th St, Savannah 912-352-3120

DIALYSIS FRESENIUS KIDNEY CARE AREA CHATHAM DIALYSIS CENTER See ad on page 40 113 Minis Avenue, Savannah 1-800-881-5101

HEALTHCARE RESOURCES/ PHYSICIAN REFERRAL

SOUTHEAST GEORGIA HEALTH SYSTEM BRUNSWICK CAMPUS See ad on inside back cover 2415 Parkwood Drive, Brunswick 912-466-7000

Brunswick (912) 262-2151 • Hinesville (912) 368-0534 • Pooler (912) 330-8444 Port Wentworth (912) 965-0601 • Richmond Hill (912) 459-0072 Savannah – Southside (912) 356-3559 • Savannah – Victory (912) 236-7020 St. Simons Island (912) 634-5885 • Wilmington Island (912) 231-3619

YOU CHOOSE YOUR… DOCTOR… PHARMACY…

WHY NOT CHOOSE YOUR PHYSICAL THERAPY?

BRUNSWICK (912) 280-9205 KINGSLAND / ST. MARY’S (912) 729-1333 ST. SIMONS ISLAND (912) 638-1444 ASK FOR ADVANCE REHAB! When it comes to healthcare decisions, YOU MAKE THE CALL ON YOUR CARE. Just like selecting who you want as your physician or where to get your prescriptions lled, choosing your PHYSICAL THERAPY provider is always YOUR DECISION. www.advancerehab.com

RESTORING HEALTH TO WOUNDS THAT WILL NOT HEAL

SOUTHEAST GEORGIA HEALTH SYSTEM CAMDEN CAMPUS 2000 Dan Proctor Drive, St Marys 912-576-6200 HEALTHCARE RESOURCES/ PHYSICIAN REFERRAL

NEPHROLOGY & HYPERTENSION MEDICAL ASSOCIATES See ad on pages 44 - 46 1115 Lexington Ave, Savannah 912-354-4913

FRESENIUS KIDNEY CARE GOLDEN ISLES See ad on page 40 475 Gateway Center Boulevard, Brunswick 1-912-265-0533 or 1-912-265-0581 Ext 220 FRESENIUS KIDNEY CARE KINGSLAND See ad on page 40 234 Kings Bay Road, Kingsland 1-912-510-4350 Ext 217 or 215 310 EISENHOWER DRIVE BLDG 12 SAVANNAH, GA 31406 912-417-3050 WWW.SPINECENTERSAV.COM

HEALTH AND WELLNESS OPTIM HEALTHCARE See ad on page 1 210 East DeRenne Avenue, Savannah 912-644-5300

HOSPICE OF THE GOLDEN ISLES See ad on page 30 1692 Glynco Parkway, Brunswick 912-265-4735

HOSPITALS AND MEDICAL CENTERS ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SAVANNAH See ad on back cover and pages 36-37 6510 Seawright Drive, Savannah 912-235-6000

SOUTHEAST GEORGIA HEALTH SYSTEM BRUNSWICK CAMPUS 2415 Parkwood Drive, Brunswick 912-466-7000

SOUTHEAST GEORGIA HEALTH SYSTEM CAMDEN CAMPUS 2000 Dan Proctor Drive, St Marys 912-576-6200

FRESENIUS KIDNEY CARE GOLDEN ISLES See ad on page 40 475 Gateway Center Boulevard, Brunswick 1-912-265-0533 or 1-912-265-0581 Ext 220

FRESENIUS KIDNEY CARE KINGSLAND See ad on page 40 234 Kings Bay Road, Kingsland 1-912-510-4350 Ext 217 or 215

MEMORIAL HEALTH 4700 Waters Avenue, Savannah 912-350-8000

ST JOSEPH’S HOSPITAL 11705 Mercy Boulevard, Savannah 912-819-4100

CANDLER HOSPITAL 5353 Reynolds Street, Savannah 912-819-6000

• Affordable Rates at $499 for Non-Contrast Studies and $749 for Contrast Studies • Multi-Study Discounts Offered • Walk-in Appointments and Same Day Scheduling with Physician Order • CD Given at Time of Service • Exams Interpreted by Board Certified, Fellowship Trained Neuro and MSK Radiologists • Professional and Courteous Employees • 24/7 Telephone Access to Imaging Manager for Questions and Comments • Wide and Ultrashort Bore with Patient Comfort Features such as Noise Reduction Technology, Audio System, Ventilation and More.

310 EISENHOWER DRIVE BLDG 12 SAVANNAH, GA 31406 912-417-3050 WWW.SPINECENTERSAV.COM

Where You Go For Rehabilitation Does Make A Difference

After a stroke, brain injury or other traumatic event such as a hip fracture, where you go for rehabilitation can make a difference in your ability to return home and back to your prior level of function. With so many different kinds of healthcare facilities, the below tips can help you compare availability of services, personnel, approach to delivery of patient care and patient outcomes, and find rehabilitative care that best meets the needs for you or your loved one. Do your research: Selecting a rehabilitation provider is like choosing your doctors; you want the best care possible for you or your loved one. Many facilities offer rehabilitation services but the quality, experience and comprehensive nature of these services can vary significantly. Don’t assume all therapists are the same: Therapists may be required to study the same information and abide by the same rules and guidelines, but a good therapist offers more than just textbook solutions. At Encompass Health, therapists are experienced in providing rehabilitation for many conditions including stroke, spinal cord, amputee, neurological and more. Our therapists are also skilled to help patients relearn the skills needed to return to the community.

Rehabilitation facilities and nursing homes are different: Research shows that outcomes are better and recovery is faster in the acute-care setting, compared to skilled nursing and nursing home care. But, there are various types of rehabilitation providers, each offering different levels of care. Determining the best option is dependent upon the patient’s condition. Ultimately, the provider chosen should strive to help you or your loved one achieve the highest level of independence possible. Don’t be afraid to ask questions: When the doctor or insurance company makes a recommendation, ask questions to ensure the provider and staff will meet the rehabilitation needs of you or your loved one. To ensure you’re making the ‘right’ decision, you can ask the following questions: • How often does the doctor visit with patients and what type of access will family members have to the doctor or staff? In a true rehabilitation hospital, a doctor visits with patients five to six times per week, opposed to a skilled nursing facility where doctors are only required to visit once every 30 days. • How long do most people stay and who decides

when it’s time to go home? Every situation requires a different amount of rehabilitation time and a patient shouldn’t leave until their progress has been fully evaluated by their entire rehabilitation team. • How many patients (who have the same/ similar condition) have been successfully treated? This is an important question because not all facilities can handle every situation. It is acceptable to ask for the phone number of the specialists and ask questions about their methods of treatments and daily routines. Ask them how many hours of therapy patients typically go through a day. • How many patients return home after discharge, opposed to going to a nursing home? This varies by condition. • What type of educational and weekend programs are available? Many Encompass Health rehabilitation hospitals offer support groups and other resources. Take a tour: Before you make a decision, make an appointment to take a tour of the hospital.

Look for cleanliness, smell for odors and ask to see therapy areas and equipment. Do the comparison: Make sure to compare the years of service, specialty programs, patient satisfaction, national clinical ratings and patient clinical outcomes among facilities. Taking these steps in choosing the right rehabilitation can make a huge difference in a patient’s recovery. When it comes to finding the best rehabilitation services, be sure that you understand the differences in your rehabilitation options.

For more information, contact: Encompass Health Rehabilitation Hospital of Savannah, at 912-235-6001 or visit the web site at: encompasshealth.com/savannahrehab

LANDMARK HOSPITAL 800 East 68th Street, Savannah 912-298-1000 HOSPITALS AND MEDICAL CENTERS

SOUTHEAST GEORGIA HEALTH SYSTEM SENIOR CARE CENTER See ad on inside back cover 2611 Wildwood Drive, Brunswick 912-466-5651 805 Dilworth Street, St. Marys 912-882-4281

SPINE CENTER SAVANNAH See ad on page 35 310 Eisenhower Drive Building 12, Savannah 912-417-3050 IMAGING SERVICES

NEPHROLOGY & HYPERTENSION MEDICAL ASSOCIATES See ad on pages 44 - 46 1115 Lexington Ave, Savannah 912-354-4913 NEPHROLOGY

ADVANCE REHABILITATION See ad on page 34 100 A, Lindsey Lane, St Marys 912-729-1333

ADVANCE REHABILITATION See ad on page 34 212 Retreat Village, Saint Simons Island 912-638-1444

LO COST PHARMACY See ad on this page Immunization-Delivery-Bubble Packing 612 E. 69th Street, Savannah 912-352-0375 PHARMACIES

VILLAGE WALK PHARMACY See ad on this page Compounding-Delivery-Compliance Packaging 1 Skidaway Village Walk, Savannah 912-598-8669

OPHTHALMOLGY SCHULZE EYE & SURGERY CENTER See ad on page 34 728 East 67th St, Savannah 912-352-3120

ORTHOPEDICS AND PAIN MANAGEMENT

OPTIM HEALTHCARE See ad on page 1 210 East DeRenne Avenue, Savannah 912-644-5300

38 PAIN MANAGEMENT ADVANCE REHABILITATION See ad on page 34 4204 Coral Park Drive, Brunswick 912-280-9205 IMMUNIZATION . DELIVERY . BUBBLE PACKAGING MEDICAL EQUIPMENT MIDTOWN: 612 East 69th Street, Savannah 912-352-0375

COMPOUNDING . COMPLIANCE PACKAGING MEDICAL EQUIPMENT SKIDAWAY ISLAND: 1 Skidaway Village Walk, Savannah 912-598-8669

When faced with a serious illness or disease, getting the appropriate treatment is critical. However, there are often other support and comfort needs to be met, from assistance with navigating the diagnosis and care options, to help with easing and managing pain. That’s where palliative care can fill the gap—and that’s the goal of the Southeast Georgia Health System Palliative Care Center. Established in partnership with Golden Isles Palliative Care, the Center enables the Health System to expand its palliative care services to include inpatient and outpatient consultations. Located on the Brunswick Campus, the Palliative Care Center team helps to improve quality of life for patients with serious illnesses by providing support for the stress an illness can cause as well as relief from the symptoms and pain.

ADDRESSING A GROWING NEED Palliative medicine has become the fastest-growing medical specialty in the United States, with 67 percent of U.S. hospitals with 50 or more beds staffing palliative care teams. During the 26 years in his primary internal medicine practice, John E. Shaner, M.D., board-certified physician and medical director of the Health System’s Palliative Care Center, witnessed the increasing pressures to provide health care while having less direct face-time with patients, and fewer opportunities to help them understand their illness and treatment options. “Many physicians with a previous primary practice have moved into palliative medicine to help make sure patients and families have the information they need to make very difficult decisions,” he says. “The palliative care team coordinates with the patient’s attending physician to provide patients and families with extra support and the opportunity to discuss and establish the goals of care.”

PROVIDING THE RIGHT CARE AT THE RIGHT TIME Palliative care can be provided at any time in a patient’s illness and may be offered along with curative and lifeprolonging treatments. Studies have demonstrated that palliative care produces significant improvements in clinical outcomes. These include relief from pain and symptoms, less anxiety and depression, and improved quality of life for patients and their families. Patients feel supported by ongoing discussions of their greatest concerns and hopes; they are relieved to have help with difficult decision

making and with knowing what to expect and how to handle it. Family care-givers feel supported with the care they are able to provide. In small studies among cancer and chronic obstructive pulmonary disease (COPD) patients, palliative care has been shown to contribute to significantly better survival rates. “Palliative care providers help families understand recommendations from different specialists,” Dr. Shaner explains. “We bring everything together. Then we help patients and families set goals and guide the care to achieve those goals.”

LENDING A WEALTH OF EXPERIENCE The Southeast Georgia Health System Palliative Care Center is staffed by a team of expert, caring professionals. Board-certified in internal medicine, hospice and palliative medicine, Dr. Shaner is a passionate advocate of palliative care and its benefits. Prior to moving to Brunswick in 2010, he pioneered an inpatient palliative care consulting service at Genesis HealthCare System in Zanesville, Ohio. Dr. Shaner is a member of the American Academy of Hospice and Palliative Medicine and a certified trainer in Education in Palliative and End-of-Life Care, a program of the Northwestern University Feinberg School of Medicine. He’s given more than 40 presentations for doctors, nurses, pharmacists, clergy, social service professionals and other ancillary staff.

“At-home dialysis gave me my freedom and my life.” — Laura, on dialysis since 2013

More freedom. Better results. Treatment in the comfort of your home. Learn how you can thrive with home dialysis. Visit or call:

FRESENIUS KIDNEY CARE COASTAL DIALYSIS 1460 E. Victory Dr. Savannah, GA 31404 1-912-232-2691 Ext 42

FRESENIUS KIDNEY CARE GOLDEN ISLES 475 Gateway Center Blvd. Brunswick, Georgia 31525 1-912-265-0533 or 1-912-265-0581 Ext 220

FRESENIUS KIDNEY CARE KINGSLAND 234 Kings Bay Road Kingsland, Georgia 31548 1-912-510-4350 Ext 217 or 215

How we save lives, celebrate lives, and lead the fight for a world without cancer in Georgia.

Here are just a few examples of how the American Cancer Society worked toward achieving our mission in 2016.

Supporting Cancer Survivors • Helped more than 900 women manage appearance-related side effects of treatment • Provided nearly 2,600 special kits of tailored information and resources for newly diagnosed patients • Provided more than 800 wigs to cancer patients

Offering Information and Education • Our website, cancer.org, had more than 2,469,800 visits from residents in our state and provided the latest, most accurate information on virtually all topics related to cancer. • Our 24/7 helpline handled 10,000 calls and live chats from residents in our state seeking support, information, and resources.

Providing Leadership and Education for the Health Care Community • Worked with more than 200 health care systems to help more people prevent cancer or find it early, provide patient and provider education, and improve care

Helping Cancer Patients Access Care • Provided more than 8,200 rides to treatment and other cancer-related appointments through our Road To Recovery® program • Provided 21,780 free nights at our Hope Lodge® communities, and more than 2,250 free or reduced nights with our hotel partners, saving more than $3,600,000 • Our patient navigators helped guide more than 2,100 newly diagnosed, underserved cancer patients to overcome barriers to care.

Finding Cancer’s Causes and Cures • As of March 2017, we are currently

funding cancer research grants totaling $4,812,000.

Fighting Cancer through Public Policy

• Our advocacy affiliate, the American Cancer Society Cancer Action Network SM , helped pass model palliative care legislation to improve public education on and access to palliative care services

This yellow dot could save your life

When minutes count Yellow Dot is a free program that gives rst responders immediate access to important medical information so they can provide care quickly in a medical emergency. It’s simple Just place the Yellow Dot decal on the front window or entry door of your home and keep the Yellow Dot packet on the refrigerator. You can also keep one in the glove compartment of your car and place the Yellow Dot on your back window. Contact SCI To learn more and nd the nearest enrollment site, call SCI at (912) 236-0363, toll-free at (866) 579-2116, or go to seniorcitizensinc.org. Don’t wait! Register for the life-saving Yellow Dot program today.

ABOUT US

NEPHROLOGY Nephrology is the study of kidney function, kidney problems, the treatment of kidney problems, and renal replacement therapy (dialysis and kidney transplantation). Patients are seen by a physician specializing in nephrology for various reasons such as: acute renal failure, chronic kidney disease, hematuria, proteinuria, kidney stones, hypertension, and disorders of acid/base or electrolytes.

HYPERTENSION Hypertension (high blood pressure) is a chronic medical condition in which blood pressure in the arteries is elevated. Blood pressure is made up of two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole). Hypertension puts strain on the heart, leading to hypertensive heart disease and coronary artery disease. Hypertension is a major risk factor for stroke, aneurysms of the arteries, peripheral arterial disease, and chronic kidney disease.

Nephrology & Hypertension Medical Associates, P.C. is a full service, privately owned and operated practice based in historic Savannah, Georgia. Since 1969, our focus and specialty has been diagnosing and treating patients with kidney related diseases and hypertension. We also provide hemodialysis services, peritoneal dialysis, renal transplant referrals, and care following transplantation.

44 OFFICE LOCATIONS SAVANNAH: 1115 Lexington Avenue . Savannah, Georgia 31404 . (912) 354-4813 BLUFFTON: 16 Okatie Center Blvd, Suite 100 . Okatie, South Carolina 29909 . (843) 706-9955 BEAUFORT: 16 Kemmerlin Lane . Beaufort, South Carolina 29907 . (843) 524-2002 BRUNSWICK: 3025 Shrine Road, Suite 450 . Brunswick, Georgia 31520 . (912) 264-6133 RINCON: 604 Towne Park Drive, West . Rincon, Georgia 31326 . (912) 354-4813 www.TheKidneyDocs.com

MEET OUR PHYSICIANS Our lives are dedicated to providing our patients and their families with the finest of care as we seek to enhance health and improve the quality of life for those we serve.

DANA A. KUMJIAN, MD

REBECCA L. SENTMAN, MD

JAMES K. BAZEMORE, MD

College - University of Florida,Gainesville, FL Medical School - University of Florida, Gainesville, FL Fellowship - Vanderbilt University, Nashville, TN

JESSICA COLEMAN, MD

College - Yale University, New Haven, CT; Northwestern University, Evanston, IL; Finch University of Health Sciences Chicago Medical School, North Chicago, IL Medical School - Medical College of Virginia, Richmond, VA Fellowship - Medical College of Virginia, Richmond, VA

ERIK D. BERNSTEIN, MD

College - Georgia Institute of Technology, Atlanta, GA Medical School - Mercer University of Medicine, Macon, GA Fellowship - University of Kentucky, Lexington, KY

Medical School - MCP Hahnemann University School of Medicine, Philadelphia, PA Fellowship - Oregon Health and Science University, Portland, OR

BRYAN J. KRULL, DO

College - Armstrong State University, Savannah, GA Medical School - American University of the Caribbean School of Medicine, Plymouth, Monsterrat, British West Indies Fellowship - Medical University of South Carolina, Charleston, SC

MIKHAIL NOVIKOV, MD

College - Kiev State University, Ukraine Medical School - University of Kentucky, Medical College Fellowship - Indiana University, Indianapolis

WILLIAM G. GRUBB, MD

College - Washington and Jefferson College, Washington, PA Medical School - Philadelphia College of Osteopathic Medicine, Philadelphia, PA Fellowship - University of Pittsburgh Medical Center, Pittsburgh, PA

College - Auburn University, Auburn, AL Medical School - University of AlabamaBirmingham, Birmingham, AL Fellowship - Nephrology University of Florida, Gainesville, FL

OFFICE LOCATIONS SAVANNAH: 1115 Lexington Avenue . Savannah, Georgia 31404 . (912) 354-4813 BLUFFTON: 16 Okatie Center Blvd, Suite 100 . Okatie, South Carolina 29909 . (843) 706-9955 BEAUFORT: 16 Kemmerlin Lane . Beaufort, South Carolina 29907 . (843) 524-2002 BRUNSWICK: 3025 Shrine Road, Suite 450 . Brunswick, Georgia 31520 . (912) 264-6133 RINCON: 604 Towne Park Drive, West . Rincon, Georgia 31326 . (912) 354-4813 www.TheKidneyDocs.com

Ways To Avoid Kidney Disease

Get a Primary Care Physician: Everyone needs a primary care physician,” says Dr. Coleman. “They are the captain of the ship of your body.” She recommends patients see them at minimum once per year, or as often as the physician recommends. Make sure the PCP performs a physical exam, runs a metabolic blood profile and a urinalysis showing creatinine levels once per year. Creatinine is the number doctors use to see how well the kidneys are working. When your kidneys aren’t functioning properly, creatinine can accumulate in your body. A urinalysis will also help see if damage is being done to your kidneys. Exercise: Keep active and exercise. Movement stimulates the body and helps all organs do what they were made to do. Dr. Coleman recommends 30 minutes of exercise a minimum of three times per week under the supervision of a PCP. Exercise will also help improve muscle function and sleep, which will in turn benefit kidney function. Even moderate exercise such as walking will improve one’s overall quality of health.

Water, Water, Water: “Drink lots of water,” says Dr. Coleman. Water flushes the toxins from the kidneys and keeps your entire body hydrated. “You want to keep flushing toxins out of your body. The best way to do that is with lots of water,” she says. Those living in the Lowcountry should be extra careful to drink enough water, as they can lose hydration easily through daily activity. Control Blood Pressure: Uncontrolled high blood pressure is the leading cause of kidney disease. Monitor your blood pressure. Try to keep your top number (systolic) below 130; your diastolic number (bottom) below 80. Salt is an enemy. It raises blood pressure and puts unneeded stress on your kidneys. Avoid Preserved Meats: Preserved meats such as lunch meat, bacon, pepperoni and red meat are high in uric acid and salt, which are hard on kidney function and also causes painful gout. Control Bad Cholesterol: Total cholesterol should be less than 200 mg. Good cholesterol should be above 50. Limit dining out, especially fast foods. It is suggested one eat more high antioxidant foods such as colorful fruits and vegetables, legumes, nuts and low or non-fat dairy products. Avoid Cigarettes: Smoking affects your entire body, including your kidneys. Smoking can also interfere with medications used to treat high blood pressure. Control Your Blood Sugar: Try to keep blood sugar levels (A1C) less than 7 percent. Uncontrolled diabetes accelerates loss of kidney function. It is suggested people try to consume high-fiber/low-sugar foods.

What Services Does Medicaid Cover in GA?

It’s always a good idea to ask your doctor or pharmacist whether Medicaid covers the specific service or item you need. There are some limits to these services, and some may require you or your doctor to get permission first. (This is called prior approval.) Following are basic Medicaid services. Additional services are offered by each of the waiver programs. Your caseworker can provide more information about other available services. In general, Medicaid covers these services: a Doctors’ and nurses’ office visits (when you visit a doctor or nurse for check-ups, lab tests, exams or treatment)

a Prescription drugs a Inpatient hospital services (room and board, drugs, lab tests and other services when you have to stay in the hospital) a Outpatient hospital services (services you receive in a hospital, even though you do not stay in the hospital overnight) a Nursing facilities (nursing homes) ν Emergency ambulance services Medicaid Waiver Programs in Georgia a Non-emergency transportation (to get to and from medical appointments if you don’t have any other means of transportation) a Medical equipment and supplies prescribed by a doctor for use in your home (such as wheel chairs, crutches or walkers) a Home health services ordered by a doctor and received in your home (such as part-time nursing, physical therapy or home health aides) a Hospice care services provided by a Medicaid hospice provider Some other services covered by Medicaid include: a Case management ν Diagnostic, screening and preventive services a Laboratory services V Behavioral or community mental health services a Orthotics and prosthetics (artificial limbs and replacement devices) a Podiatry services a Therapy services (physical, occupational and speech) ν County Public Health Departments a Dialysis and services for end-stage renal (kidney) disease

HOME AND COMMUNITY SERVICES: WHAT’S NOT COVERED? Some services are not usually covered by Medicaid. These include: private duty nursing, services given by a relative or member of your household, cosmetic surgery, disposables (such as adult diapers or bandages), experimental items and chiropractic services among others. If you’re not sure what Medicaid covers, ask your provider or call CSRA Area Agency on Aging (866) 552-4467 or (706) 210-2018 47

The New Focus of Modern Estate Planning

While estate tax planning is still of primary concern to some, the new catalyst for estate planning is long-term care costs. And for those in the middle class, failure to plan for the inevitable and exorbitant costs of long-term care can result in much more devastating consequences than even the most draconian estate tax regime.

Many people are under the false assumption that Medicare will pay their long-term care expenses. That is false! If you or your parents require assisted living or nursing home care, you have only three options: privately pay for these services; hope the long-term care insurance you’ve purchased, if any, will pay for these services; or try to qualify for Medicaid.

Depending upon your age, purchasing long-term care insurance may not be a viable option — though it is still something to strongly consider if you can afford it. If long-term care insurance is not an option, that leaves only two other options: paying from personal funds or qualifying for Medicaid. Currently, the average cost of a nursing home in Georgia is approximately $6,500 per month. At that rate, it won’t take long for the wealth you’ve accumulated over your lifetime to be consumed.

Is there a way to protect your assets from being devoured? Some of you reading this article may own assets that have been in

your family for generations. Will you have to sell those assets to pay for your nursing home costs? Maybe not, if you properly structure your estate plan to account for impending long-term care needs.

A properly structured irrevocable trust will help protect what you have worked so hard to build and keep. These types of trusts differ, in several important respects, from standard revocable trusts that you may have incorporated into your estate planning strategy. First, these trusts must be irrevocable — meaning that, outside of certain special circumstances, the terms of these trusts cannot be changed. Second, the persons creating these trusts (the grantors) should not serve as trustees of these trusts.

Although Grantors must relinquish some control of the assets inside these trusts, they can reserve income rights to the property inside these trusts. For example, if you have a piece of property, such as farmland, that you want to protect but rely on lease payments or timber sales from

the land to pay your living expenses, it is possible to put the farmland inside one of these special trusts but require that all income from the land be paid back to you. Additionally, many of these trusts contain the power, exercised in the grantors’ wills, to change the ultimate beneficiaries of the trust. This is known as a special power of appointment. By retaining this power, you can ensure that the assets inside the trust will receive a basis adjusted to fair market value when those assets are distributed after the death of the grantors. This is important if any capital assets such as stocks, bonds, or real estate are inside the trust because it can greatly reduce the amount of capital gains taxes the beneficiaries will have to pay when those assets are later sold. Such tax savings are not available with outright gifts, and that is a significant reason why this type of planning is far superior to gifting assets outright to children. Many of these trusts that we draft contain “trust protector” provisions. These provisions provide for the appointment of someone who can amend the trust, even though it is irrevocable, to comply with unforeseen changes in the tax law, the trust code, or the Medicaid rules. Having a trust protector provides for maximum flexibility in trust administration and can also be used to resolve disputes among beneficiaries, thereby avoiding a potentially costly and lengthy court battle.

A carefully drafted irrevocable trust can add significant tax and nontax benefits to your overall estate plan, yet these types of trusts are, in the author’s humble opinion, underutilized. As with any estate planning technique, it is important to carefully review your particular circumstances with an expert estate-planning attorney before deciding whether one of these types of trusts is appropriate for you or your parents’ situation.

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