Montana 55 October 2013

fall 2013

the magazine for montanans in their prime

cancer in seniors upgraded facilities holiday treats cookies grandeur senior learning new opportunities

You are making the right choice.

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At some point, we all need help for ourselves or someone we love and we have to make the choice.

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Getting the right care is the right choice.

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The Village

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2651 South Avenue West Missoula, Montana 59804 (406) 728-9162 www.villagehealthcare.com

Health Care Center

225 North 8th Street Hamilton, Montana 59840 (406) 363-1144 www.valleyviewestates.org

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Health Care Center 1301 East Broadway Missoula, Montana 59802 (406) 721-0680 www.riversidesenior.com

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2815 Old Fort Road Missoula, Montana 59804 (406) 549-1300 www.villagesenior.com

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(406)656-5010 www.innorehab.com

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illings Health & Rehabilitation Community 2115 Central Avenue Billings, MT 59102 (406)656-6500 www.billingshealth.com

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The services offered through Generations Health Network: Home Care Retirement Living Long-term Care Respite Care

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Fall 2013

3

Fall 2013

inside senior health strength training

holiday gifts

what to get someone who has it all

holiday treats

cookies granduer

by greg patent

www.montana55.com

Cookies that keep well are high on my list, and the recipes here get an A+ for doing so. Oatmeal cookies can be crunchy or soft and chewy. I like both kinds, but with dried fruits I prefer the softer version. They're thicker and quite substantial. You can use raisins instead of cranberries or a combination of both or even dried huckleberries or blueberries. Cut-up dates are also good in these cookies.

The apricot coconut walnut bar cookies take me back to my teen years when I created the recipe for the 10th Pillsbury Bake-Off. I submitted my recipe as a bar cookie, but the company published it as a dessert bar topped with whipped cream and served on plates with forks. I've returned the recipe to its roots. The bars are easy to hold and to eat out of hand.

Meringue cookies have always fascinated me. As a kid I bought meringue kisses at a neighborhood bakery every week when I received my allowance. The crunchy outside and the soft inside gave me shivers of delight. They were one of my first attempts at baking. The transformation of gloppy, unpromising egg whites into a pure white and stiff substance simply by beating in sugar correctly is a miracle. Over time I've made additions to the basic meringue, and here I've included powdered espresso coffee. I also like mini semi-sweet chocolate morsels folded in just before shaping the cookies.

Have fun baking and eating this holiday trio.

Oatmeal Cranberry Cookies This recipe makes large semi-soft cookies packed with fruit, oats and nuts. You can refrigerate the dough for several days and bake cookies as you need them.

1 cup unbleached all-purpose flour (dip dry measure into flour container, fill to overflowing, and sweep off excess) 1 cup whole wheat flour (measured the same way as above) 1/2 teaspoon salt 1/2 teaspoon baking soda 1/2 teaspoon ground cinnamon 1 cup (2 sticks) cold unsalted butter 1 cup firmly packed brown sugar, light or dark 1/2 cup granulated sugar 1 large egg 1 large egg yolk 3 tablespoons agave syrup or light corn syrup 2 teaspoons vanilla extract 1 1/2 cups dried sweetened cranberries 1 1/2 cups old-fashioned rolled oats 1 cup chopped pecans or walnuts Adjust an oven rack to the center position and preheat the oven to 325 degrees. Line a large cookie sheet (14 by 17 inches) with cooking parchment, silicon baking pan liner, or aluminum foil. Have 2 or 3 additional liners handy.

In a medium bowl, whisk together both flours, salt, baking soda and cinnamon.

Slice the butter and put the pieces into a large mixing bowl. Let stand about 10 minutes

I

I've always liked things big, and when it comes to cookies, the bigger the better. Nothing dainty for me, thank you very much, though there's nothing wrong with that. I find that with small cookies I just keep popping them mindlessly into my mouth, but with a big cookie I nibble and savor and they last a lot longer.

until slightly softened. Beat the butter with an electric mixer until smooth. Add both sugars and beat on medium high speed until fluffy, 2 to 3 minutes. Add the egg and egg yolk and beat in well. Then add the agave or corn syrup and vanilla and beat until smooth.

By hand, stir in the dry ingredients with a wooden spoon, then mix in the cranberries, oats, and nuts.

Shape cookies by heaping soupspoons onto prepared cookie sheet, spacing them 2 to 3 inches apart. I put 9 cookies on one sheet. After cookies are on the sheet, moisten your hands and roll each mound of cookie dough into a ball; flatten slightly and replace on the sheet.

Shape remaining cookies the same way on two additional cookie sheet liners, about 9 cookies for each. Let stand until ready to bake. I usually get 26 to 28 cookies in all.

Bake for 12 to 16 minutes, until lightly browned and centers feel almost firm. Slide pan liner off the cookie sheet onto countertop and cool the cookies right on the liner. Remove cooled cookies with a wide metal spatula. Bake remaining cookies (slide pan liner with shaped cookies onto cookie sheet) and cool the same way.

Store airtight at room temperature for up to 1 week. Cookies may be frozen for up to 2 months. Place cooled baked cookies on cookie sheets and freeze solid. Transfer to heavy-duty zip-top freezer bags. Date and label. Thaw completely, then remove from freezer bags.

• Makes 26 to 28 large cookies.

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Fall 2013

26

estate planning

28

investment

30

estate planning

34

retirement

“last best” advice

not all stock brokers are your friend

“last best” advice

questions and answers

11

holiday treats

senior learning

new opportunities

upgraded facilities

by dillon kato

www.montana55.com

Benefis SCI provides the only CyberKnife services in a 5 state region

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alf of the people in the United States diagnosed with colon cancer will die of the disease. “Many of those deaths could have been prevented if they had a colonoscopy when they were 50,” he said. He also recommended that people, especially smokers, have a CT scan for lung cancer.

The Billings Clinic currently has six medical oncologists, three radiation oncologists and two gynecologic oncologists, all who practice what Nieva terms “multidisciplinary care,” where there is good teamwork between cancer specialists, primary care physicians and other specialists. In addition to physicians, Billings Clinic also has dieticians, social workers, genetic counselors and physical therapists based in the cancer center.

This collaboration means patients receive care that is more targeted to their specific needs. “Let’s say a patient completes chemotherapy and needs to engage in physical rehabilitation.

We don’t just write a prescription and send them across town,” Nieva said. Instead, the therapist can come in, interact with oncologists and see cardiology history to make sure they aren’t pushing a patient too hard.

Nieva also recognizes the importance of care that is close to home. Billings Clinic specialists spend 17 days each month traveling to smaller rural communities in Montana Wyoming and North Dakota to give them access to top quality care.

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n Missoula, the most recent cancer treatment news is the opening of a new, $15 million cancer center at Community Medical Center. The Community Cancer Care Center, which opened at the end of September, gives the hospital room to grow and meet the rising demand for cancer care, said Community Medical Center CEO Steve Carlson.

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Fall 2013

cancer in seniors

20

affordable care act

22

affordable care act

24

new fraud law

upgraded facilities

what you need to know

glossary of terms

increased protections for seniors

events students bring up.

“It can be free reign, it can often go in different directions. We don’t have to follow a marked syllabus, you can just bounce ideas back and forth,” he said.

Stearns earned his master’s in history and doctoral degree in education from UM, and spent many years as a history teacher at Missoula’s Sentinel High School, then in the graduate school at UM. He said the biggest difference between teaching MOLLI classes and graduate students is the more relaxed atmosphere that comes from people being there just for the sake of learning.

“Graduate students sit on the edge of their seats, writing notes on everything you say so they can give it back to you on the test. Or they are detached because the class is something they have to take because it’s required for a degree,” he said.

With MOLLI students, every student

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Yes! Please send me your free brochure.

Yes! I am interested in the following illustration: One-life Two-life $25,000 $10,000 $5,000

Yes, it’s true! Depending on your age, the American Heart Association Charitable Gift Annuity will pay you from 5.6% to 11.5%.

U

Montanans who never quite grew out of the desire to keep learning and expanding their horizons have major programs at both the University of Montana and Montana State University to rekindle a passion for education.

The Osher Lifelong Learning Institute at UM, also known as MOLLI, is a program for adults age 50 and older who want to experience classes and participate and be involved at the University of Montana without being enrolled as a traditional student.

Amount:

(Other) $ If funded with appreciated securities, the approximate cost basis is: $

Here’s how it works. Mr. Jones, age 79, gives the American Heart Association $10,000 to fund a Charitable Gift Annuity. In return, the American Heart Association agrees to pay him $800 per year (8.0%) for his lifetime.

photos courtesy of School of Extended & Lifelong Learning at UM

University programs help quench the thirst for knowledge well into the adult years

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Stearns’ MOLLI course is always about Montana history, and he finds it interesting to bring people together to reaffirm their keen love of the state.

“I talk about the famous, about the infamous. About the things that if you live in Montana, you just should be aware of,” he said.

While Indian education is now a requirement in schools, Stearns said some adults might not understand the importance Native Americans played in our history. Or the importance of homesteaders, miners, ranchers and farmers.

Why did Marcus Daly, the copper king, have his horse farm in Hamilton?

Why is the Battle of the Little Bighorn the most written about in American history? What changed from the original state constitution in 1889 to the rewrite approved in 1972? All of those are questions Stearns likes to answer for his MOLLI students.

Because of the less formal setting, the class is free to discuss people, places or

Imagine: 8.0% income for life.

Montana cancer treatment facilities are expanding to better serve their patients

As a person enters their senior years, the best thing they can do to for themselves to stay on top of the risk of cancer is regular screenings and tests, said Dr. Jorge Nieva, the chairman of hematology and oncology at Billings Clinic.

This means annual mammograms for women and having a colonoscopy every 10 years.

“It’s proven to save lives. There is no debate after the age of 50. There is a survival benefit,” Nieva said.

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www.montana55.com

The MOLLI program, which began in 2006, offers classes during three different semesters: fall, winter and spring. This fall, the program featured 23 different courses, primarily taught by members of UM’s faculty. Unlike traditional classes, MOLLI courses are noncredit, and as such, don’t have tests or homework.

MOLLI is a member organization that only allows people aged 50 and older, and people interested in taking a class must pay an annual $20 fee. After that, each class costs $60, with a slight discount for taking multiple courses in a semester.

Each course lasts for six weeks, and meets once a week for an hour and half each time. Most of the classes take place on the UM campus, although alternate venues are used for courses that require specific facilities.

Hal Stearns is one of the instructors who has been teaching MOLLI courses almost since the start of the program.

cookies grandeur

cancer in seniors

by dillon kato

1st Person Name

More good news. Because of his gift, approximately 60% of his yearly income ($560) is considered tax-free income.

Also, he receives an immediate charitable tax deduction for $4,400 (approximately 45% of the gift). The best part, however is knowing that this gift helps those with heart disease through lifesaving research.

Birthdate or age

Birthdate or age

Note: We urge you to consult with a qualified advisor before making a final decision regarding any planned gift for the American Heart Association.

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Address City

For a brochure about gift annuities and a confidential, non-obligatory illustration on how this gift can benefit you, fill out and mail this form to the American Heart Association shown in the bottom right corner or by calling toll-free at 1-886-762-0441.

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CLIP OUT & MAIL IN

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This is not an insurance product. Illustrations are based upon the January 2003 IRS Discount Rate of 4.2%. Returns are based on rates suggested by the American Council on Gift Annuities. Payments are backed 100% by the American Heart Association’s own assets. Fill out and mail this form to: Mel Feeley, American Heart Association 3578 Hartsel Dr., Unit E, #319, Colorado Springs, CO 80920

Fall 2013

38

senior learning

42

getaways

46

looking back

new opportunities

storming the castle

big sky honor flight

37

www.montana55.com

the magazine for montanans in their prime

publisher jim mcgowan

editor sherry devlin

marketing manager stephanie bull sales coordinator jacque walawander sales assistant holly kuehlwein

graphic designers adam potts jesse brockmeyer

Montana 55 is a special publication of Lee Enterprises and the Missoulian. Copyright 2013.

For advertising information contact Jacque Walawander 406-523-5271, 800-366-7193, ext. 271, or email jacque.walawander@lee.net www.montana55.com

Fall 2013

5

senior health

W

strength training

When it comes to exercising for health, longevity and greater quality of life, what comes to mind? Walking or perhaps jogging? Maybe swimming or biking?

While these aerobic forms of exercise bring many benefits, strength training is becoming increasingly recognized as a means to stay healthy as we get older. Strength training, also known as weight lifting or resistance training, reduces the risk of nearly every age-related disease.

First, let’s look at the most obvious. Strength training is essential for controlling weight and reducing our risk of weight-related diseases such as diabetes and heart disease. But how does strength training control weight? Doesn’t cardiovascular exercise burn more calories?

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by jessica stonefield You have probably heard of (or even experienced) the inevitable slowdown in metabolism as we age. This decline is due to the breakdown of muscle mass in our bodies. Muscle, just by its existence in our bodies, increases metabolism slightly. More muscle on your body also means your body is “leaner,” lowering your risk of heart disease and diabetes.

What’s even more significant is the increase in one’s ability to perform nearly all other types of exercise, because of the increased strength. Simply, you can do more at a higher intensity. For example, you will be able to walk faster and farther by including a strength training component to your routine. This is why the American Heart Association now recommends strength training as part of a program to prevent and treat heart disease.

Strength training, more so than cardiovascular training, also decreases one’s risk of injury. A welldesigned program will improve your muscle synergy (the way your muscles work together) and develop strength to support your joints. In turn, you improve your balance and coordination, reducing the your injury risk.

If you have had physical therapy for a past injury, regular strength training is the perfect way to prevent the same injury from happening in the future. And if you are still in the process of physical therapy, make sure your therapist approves your strength training program before you begin. Your therapist may even have a good recommendation for a personal trainer to design your program, and help you work through it.

Like muscle loss, bone loss is natural after a certain age (around 20 to 30). Low estrogen levels in pre- and post-menopausal women may add to the weakening.

Only weight-bearing exercises, including strength training, help prevent bone loss. Just twice per week can slow or sometimes even stop the weakening of bones.

Pumping iron has positive effects on mental health , too, particularly with regard to depression.

Interestingly, intensity may be directly related to benefit. A study posted in the Jounals of Gerontology in 2005 states that, “High-intensity progressive resistance training is more effective than is low-intensity PRT or general practitioner care for the treatment of older depressed patients.” In other words, the harder you pump, the better it works. Just remember to start slow and build from there.

Some other conditions benefiting from regular strength training are arthritis, back pain, dementia and sleep difficulties. Let’s not underestimate the aesthetic value, as well. Most of us would love to “firm up” a little (or a lot). Building even a small layer of muscle helps give a firmer appearance to skin, and adds shape and definition to the body.

www.montana55.com

So what kind of strength training should you do?

The traditional lifting weights and counting repetitions is not your only option. Body weight exercises, in which you don’t use any extra weight, are also very effective. Yoga and pilates can greatly improve strength, especially in the core. Resistance bands are inexpensive, take up very little space, and can be very effective. They also travel well.

Whatever you choose, remember to start easy, and increase your intensity slowly over time. To increase intensity, lift more weight, do more repetitions or make reps last longer. Do this over the course of three to six weeks. Then change your routine, and start building again.

As you begin your strength training program, it is best to seek expert advice. If possible, hire a personal trainer for a few sessions or attend a beginner class.

When hiring a personal trainer, look for someone with experience working with seniors or with any health issues you may have. Ask friends, co-workers, or even gyms to recommend someone who would be right for you. Don’t feel nervous or intimidated to ask any questions. Contrary to the stereotypical “gym rats,” most personal trainers are used to coaching beginners as part of their jobs.

If weight loss is your goal, you might consider a reputable program, such as the Be Your Best Diabetes Prevention Program at Missoula City-County Health Department, which includes exercise instruction and resources. Keep in mind that the best exercise programs include both cardiovascular exercise and strength training.

As with anything, the hardest part is starting. I dare you to try a new form of strength training this week.

Go on, what do have to lose? You have strength to gain.

Jessica Stonefield, pubic health nutritionist, provides nutrition services through the Be Your Best Diabetes Prevention Program and can be reached at 258-4935 or at jstonefield@co.missoula.mt.us.

October is Volunteer Appreciation Month.

Contact MTBL to find out about the new BARD Mobile apps available soon.

To learn more, visit MTBL at 1515 East 6th Avenue in Helena or call 800.332.3400.

MTBL is a Regional Library of the National Library Service.

Fall 2013

7

holiday gifts

G

buying for someone who has everything

Gift buying for adults of a certain age can be an exercise in frustration.

When someone has been in the world more than five or six or even seven decades, it’s fair to say they have accumulated most everything they need to function and have fun.

Most often, they are downsizing, which adds a unique twist to the gift-buying challenge.

Here are a few ideas to help make the gift-buying and gift-giving season less stressful when you are shopping for people who don’t need a lot or want a lot.

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by betsy cohen

www.montana55.com

1 2 3 4 5 6

Make a donation in the person’s name to his or her favorite cause or charity, such as the local food bank or animal shelter.

Wrap up gift passes to the local movie theater

or tickets to an upcoming concert, theater, dance or symphony production.

For readers, newspaper and magazine subscriptions are a welcome treat.

The gift of housecleaning or yard cleanup or

garden weeding – either offer to do it yourself, or let a professional do the job – is sure to please.

For those who can never find their keys, a bluetooth or GPS tracking device is essential.

For a family member or friend interested in preserving their life story for future generations, the Lifebio memory journal is a book that prompts the writer to tell his or her story with more than 250 carefully crafted biography questions.

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Brighten up a house – and loved one’s mood –

every month with the gift of a year’s worth of fresh flowers delivered every month from a local floral shop.

Give someone the adventure of learning with a gift of lessons – tango, ceramics, cooking, golf, Spanish – whatever the interest.

Don’t worry about your loved ones when they are on the road or traveling. Give them an On-Call International Membership. This service provides medical and travel assistance for both domestic and international travel. It includes everything from transportation home in a medical emergency to assistance for family members (including grandchildren).

For more information, go online to oncallinternational. com or call toll-free 1-800-575-5014.

Betsy Cohen is a Missoulian reporter. She can be reached at (406) 523-5253 or by email at bcohen@ missoulian.com.

7

Help them stay fit, feel good, have fun with a

membership or a punch card to local yoga studio or fitness club.

New West is Here for You. 888-873-8044 · TTY 711

newwestmedicare.com

New West simplifies the Medicare process so you can focus on what’s important to you. Our knowledgeable local representatives offer straightforward information with personalized service. Contact us and we will help you understand your options.

New West Makes Medicare Simple.

New West Health Services is a health plan with a Medicare contract. Phone hours of operation 8 a.m. to 8 p.m. daily. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact New West Medicare.

Benefits may change on January 1 of each year.

H2701_NW#469A-11-12 CMS Accepted Fall 2013

9

holiday treats

I

cookies grandeur

I've always liked things big, and when it comes to cookies, the bigger the better. Nothing dainty for me, thank you very much, though there's nothing wrong with that. I find that with small cookies I just keep popping them mindlessly into my mouth, but with a big cookie I nibble and savor and they last a lot longer.

10

by greg patent

www.montana55.com

Cookies that keep well are high on my list, and the recipes here get an A+ for doing so. Oatmeal cookies can be crunchy or soft and chewy. I like both kinds, but with dried fruits I prefer the softer version. They're thicker and quite substantial. You can use raisins instead of cranberries or a combination of both or even dried huckleberries or blueberries. Cut-up dates are also good in these cookies.

The apricot coconut walnut bar cookies take me back to my teen years when I created the recipe for the 10th Pillsbury Bake-Off. I submitted my recipe as a bar cookie, but the company published it as a dessert bar topped with whipped cream and served on plates with forks. I've returned the recipe to its roots. The bars are easy to hold and to eat out of hand.

Meringue cookies have always fascinated me. As a kid I bought meringue kisses at a neighborhood bakery every week when I received my allowance. The crunchy outside and the soft inside gave me shivers of delight. They were one of my first attempts at baking. The transformation of gloppy, unpromising egg whites into a pure white and stiff substance simply by beating in sugar correctly is a miracle. Over time I've made additions to the basic meringue, and here I've included powdered espresso coffee. I also like mini semi-sweet chocolate morsels folded in just before shaping the cookies.

Have fun baking and eating this holiday trio.

Oatmeal Cranberry Cookies This recipe makes large semi-soft cookies packed with fruit, oats and nuts. You can refrigerate the dough for several days and bake cookies as you need them.

1 cup unbleached all-purpose flour (dip dry measure into flour container, fill to overflowing, and sweep off excess) 1 cup whole wheat flour (measured the same way as above) 1/2 teaspoon salt 1/2 teaspoon baking soda 1/2 teaspoon ground cinnamon 1 cup (2 sticks) cold unsalted butter 1 cup firmly packed brown sugar, light or dark 1/2 cup granulated sugar 1 large egg 1 large egg yolk 3 tablespoons agave syrup or light corn syrup 2 teaspoons vanilla extract 1 1/2 cups dried sweetened cranberries 1 1/2 cups old-fashioned rolled oats 1 cup chopped pecans or walnuts Adjust an oven rack to the center position and preheat the oven to 325 degrees. Line a large cookie sheet (14 by 17 inches) with cooking parchment, silicon baking pan liner, or aluminum foil. Have 2 or 3 additional liners handy.

In a medium bowl, whisk together both flours, salt, baking soda and cinnamon.

Slice the butter and put the pieces into a large mixing bowl. Let stand about 10 minutes

until slightly softened. Beat the butter with an electric mixer until smooth. Add both sugars and beat on medium high speed until fluffy, 2 to 3 minutes. Add the egg and egg yolk and beat in well. Then add the agave or corn syrup and vanilla and beat until smooth.

By hand, stir in the dry ingredients with a wooden spoon, then mix in the cranberries, oats, and nuts.

Shape cookies by heaping soupspoons onto prepared cookie sheet, spacing them 2 to 3 inches apart. I put 9 cookies on one sheet. After cookies are on the sheet, moisten your hands and roll each mound of cookie dough into a ball; flatten slightly and replace on the sheet.

Shape remaining cookies the same way on two additional cookie sheet liners, about 9 cookies for each. Let stand until ready to bake. I usually get 26 to 28 cookies in all.

Bake for 12 to 16 minutes, until lightly browned and centers feel almost firm. Slide pan liner off the cookie sheet onto countertop and cool the cookies right on the liner. Remove cooled cookies with a wide metal spatula. Bake remaining cookies (slide pan liner with shaped cookies onto cookie sheet) and cool the same way.

Store airtight at room temperature for up to 1 week. Cookies may be frozen for up to 2 months. Place cooled baked cookies on cookie sheets and freeze solid. Transfer to heavy-duty zip-top freezer bags. Date and label. Thaw completely, then remove from freezer bags. • Makes 26 to 28 large cookies.

Fall 2013

11

Apricot Coconut Walnut Bars I won second prize in the Junior Division of the Pillsbury Bake-Off with this recipe as a 19-year-old. I've been making these bar cookies ever since and never tire of them. You can substitute dried sour cherries for half the apricots if you wish.

Apricot filling 1 pound dried apricots 3 cups water 1 cup sugar Cookie base 1 2/3 cups unbleached all-purpose flour (dip dry measure into flour container, fill to overflowing, and sweep off excess) 1/4 teaspoon salt 1/2 teaspoon baking soda 3/4 cup (1 1/2 sticks) unsalted butter, slightly softened 1 cup sugar 1 cup shredded sweetened coconut, chopped (3 1/2 ounces) 1 cup chopped walnuts (4 ounces) For the filling, put the apricots and water in a heavy medium saucepan and bring liquid to the boil over medium-high heat. Reduce heat to low, cover the pan, and cook at a slow boil, stirring occasionally, until fruit is completely tender, about 40 minutes. Turn into a large strainer set over a bowl to drain and cool slightly. Reserve

1/4 cup of apricot juice.

Return apricots to saucepan and add the sugar and apricot juice. Mash well with potato masher to make a thick puree. Cook, stirring almost constantly, over medium-high heat for 5 minutes. Cool to room temperature.

Adjust oven rack to center position and preheat oven to 400 degrees. Butter or coat with cooking spray a 13-by-9by-2-inch baking pan.

For the cookie base, in a medium bowl, whisk together the flour, salt, and baking soda. Beat the butter with an electric mixer until smooth. Add the sugar and beat on medium speed until smooth and fluffy, 2 to 3 minutes. With a wooden spoon, stir in the dry ingredients, coconut and walnuts. Dough will be crumbly.

Press 3 cups of the crumb mixture on the bottom and halfway up the sides of the pan. It will be a thin layer. Do not be concerned about making neat edges, but be sure there are no bare spots on the bottom crust.

Bake crust for 10 minutes; it will appear uneven and be lightly colored. Remove from the oven but do not turn the oven off. Spread apricot puree into hot crust. Sprinkle remaining crumb mixture evenly on top and pat gently into place. If some filling shows through, it's OK. Return pan to oven and bake another 20 to 25 minutes, until golden brown. Cool completely on a wire rack. Cut into 24 bars with a sharp knife. Store airtight for up to 1 week.

• Makes 24 cookies.

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Call (406) 651-8111 for more details and come see why we say, ®

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OPPORTUNITY

12

Big Espresso Meringue Cookies These large meringues, crunchy when freshly baked, become soft and chewy a day or two later. They're delicious both ways.

3 large egg whites 1/8 teaspoon salt 1/4 teaspoon cream of tartar 3/4 cup sugar 1 tablespoon instant espresso powder (I use Medaglia d'Oro) 1 teaspoon vanilla extract 12 chocolate-coated coffee beans Unsweetened cocoa for dusting Adjust an oven rack to the center position and preheat oven to 225 degrees. Line a large baking sheet (11 by 17 inches) with aluminum foil or cooking parchment.

In a large bowl, beat the egg whites and salt with an electric mixer on medium speed until foamy. Add the cream of tartar and continue beating until the whites form softly curling peaks when the beaters are raised.

Beat in the sugar 2 tablespoons at a time, beating about 30 seconds after each addition. Beat in the espresso and vanilla, then increase speed to high and beat until the meringue forms stiff, shiny, unwavering peaks when the beaters are raised.

Make 12 large mounds of meringue on the lined baking sheet, spacing them 2 inches apart. Top each mound with a chocolate-covered coffee bean and dust lightly with the cocoa.

Bake about 1 1/2 hours. To test for doneness, carefully try to lift a meringue off the baking sheet. It may feel soft, but if it comes off easily, it's done. Continue baking, if necessary.

When meringues are cooked, turn the oven off and prop the oven door open slightly. Let meringues cool completely in the turned-off oven, about 2 hours. Store airtight. The meringues keep fresh for about 1 week.

• Makes 12 meringues.

Greg Patent is a food writer and columnist. Visit Greg's website at www.gregpatent.com. You can write him at chefguymt@gregpatent.com.

Let us help heat your home This winter, we’re helping keep families safe and healthy by assisting with home heating costs. NorthWestern Energy customers who qualify for the Low Income Energy Assistance Program (LIEAP) may receive a discount on their electric and natural gas bills. Customers who rent or own their homes may also be eligible for free weatherization measures.

To apply, contact one of our state’s Human Resource Development Councils today.

Call National Energy Assistance Referral (NEAR) toll-free at 1-866-674-6327 or TTY 1-866-367-6228 for local agency information.

Fall 2013

13

cancer in seniors

14

upgraded facilities

by dillon kato

www.montana55.com

Benefis SCI provides the only CyberKnife services in a 5 state region

M

Montana cancer treatment facilities are expanding to better serve their patients

As a person enters their senior years, the best thing they can do to for themselves to stay on top of the risk of cancer is regular screenings and tests, said Dr. Jorge Nieva, the chairman of hematology and oncology at Billings Clinic.

This means annual mammograms for women and having a colonoscopy every 10 years.

“It’s proven to save lives. There is no debate after the age of 50. There is a survival benefit,” Nieva said.

H

alf of the people in the United States diagnosed with colon cancer will die of the disease. “Many of those deaths could have been prevented if they had a colonoscopy when they were 50,” he said. He also recommended that people, especially smokers, have a CT scan for lung cancer.

The Billings Clinic currently has six medical oncologists, three radiation oncologists and two gynecologic oncologists, all who practice what Nieva terms “multidisciplinary care,” where there is good teamwork between cancer specialists, primary care physicians and other specialists. In addition to physicians, Billings Clinic also has dieticians, social workers, genetic counselors and physical therapists based in the cancer center.

This collaboration means patients receive care that is more targeted to their specific needs. “Let’s say a patient completes chemotherapy and needs to engage in physical rehabilitation.

We don’t just write a prescription and send them across town,” Nieva said. Instead, the therapist can come in, interact with oncologists and see cardiology history to make sure they aren’t pushing a patient too hard.

Nieva also recognizes the importance of care that is close to home. Billings Clinic specialists spend 17 days each month traveling to smaller rural communities in Montana Wyoming and North Dakota to give them access to top quality care.

I

n Missoula, the most recent cancer treatment news is the opening of a new, $15 million cancer center at Community Medical Center. The Community Cancer Care Center, which opened at the end of September, gives the hospital room to grow and meet the rising demand for cancer care, said Community Medical Center CEO Steve Carlson.

Fall 2013

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Construction crews work on the lobby of the new Community Cancer Care Center in Missoula in September. The center will have more than 18,000 square feet dedicated to all cancer services.

TOM BAUER/Missoulian

Carlson cited a recent study by the National Academy of Sciences that identified what he called the “Crisis in cancer care today.” The study concluded that the growth in demand for cancer services is set to grow by 40 percent by the year 2030, and that too often, the care that is available is very fragmented.

“To make sure that we can handle that demand, we designed the new center to be able to double, and in some cases triple our previous spaces for specific treatments,” Carlson said. The former 4,000 square foot cancer center that opened five years ago was almost immediately at capacity, but once the full space of the new center is opened, it will total more than 28,000 square feet.

In addition, the new center is designed to be added on to in the future. The support and office space was made so that if demand requires it, that staff can be moved elsewhere, and those offices can be converted into more clinical space.

Along with the new center, Community partnered with Billings Clinic to bring a board certified gynecologic oncologist to the center twice a month. “This partnership means we bring decades of experience together from day one,” Carlson said.

Dr. Patrick Beatty, a medical oncologist working at the new Community cancer center, said that while they have always done state of the art treatment, the increase in space 16

means patients will experience a lower stress atmosphere.

It also means that there will be more space to ramp up clinical trials, he said, and service patients at a radiation therapy wing, scheduled to open in the new center next spring.

Beatty is a part of Montana Cancer Specialists, a separate organization of radiologists that splits its physicians’ time between Community Medical Center and Providence St. Patrick Hospital.

Providence St. Patrick medical oncologist Dr. Michael Snyder, who works in its Montana Cancer Center, said healthy lifestyles contribute to a reduced risk of cancers and other diseases. A diet containing fresh fruits, vegetables and lean protein, as well as maintaining an exercise regime or having an active lifestyle are important for all seniors.

Snyder stressed the importance of having a primary care physician that a person visits regularly, who can make sure a patient is receiving preventive care and proper screening tests. “Early detection is important, and gives you the best opportunity for a cure,” Snyder said.

The Montana Cancer Center makes sure its physicians and support staff work together to be what Snyder calls a patient’s “healthcare team,” that is integrated from primary care to diagnosis and through treatment and recovery. This is a move that many specialist care clinics across the country

Fall 2013

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have been moving toward, as it more closely tailors a patient’s care to their specific needs.

T

Dr. Jorge Nieva, chairman of hematology oncology at the Billings Clinic.

LARRY MAYER/Billings Gazette

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he Benefis Sletten Cancer Institute in Great Falls uses a cutting edge technology, called the CyberKnife system, for pinpoint accurate cancer treatment. CyberKnife is a non invasive radiosurgery that allows for outpatient treatment of malignant and benign tumors that might otherwise be inoperable, said Betsy Smith, who works at Benefis as a genetic counselor in its cancer center.

Smith said patients come from across the region and Canada, as Great Falls is the only place in the state with the CyberKnife technology.

CyberKnife uses a higher dose of radiation therapy than what would normally administered through more traditional beam radiation treatment. It can also be positioned at a wider variety of angles, to better isolate tumors. Because it is computer assisted, it can accomplish highly advanced procedures, such as tracking a tumor in the lungs and even taking into account its movement when a patient breathes.

Smith’s own work in genetic counseling means she works with families where there seems to be a high risk of cancers or unusual cancers with a hereditary pattern of risk.

“Ten percent of cancers are part of a hereditary cancer syndrome, where the family has a high risk gene that is related to specific cancers. I look at an individual’s personal history or family history to see if they have this type of risk,” she said.

For example, some families might have a history of Lynch syndrome. This raises the risk of colon cancer from around six percent to 80 percent. If this link can be established, colonoscopies and other tests could start in a person’s 20s or 30s, and treatment could begin while the disease is still in its precancer form, Smith said.

Even people who may have already diagnosed with cancer can benefit from genetic counseling and testing. Information from genetic testing could be able to see patterns for their children or relatives or spots links to other types of cancer. Genetic counseling and testing can also establish certain types of heart disease and dementia (including Alzheimer’s).

Smith, who also oversees Benefis Sletten Cancer Institute’s national accreditation, said the center has been recognized as a premier cancer program since the 1980s.

Fall 2013

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affordable care act

know this

Basics of the Affordable Care Act — if you know nothing else, know this.

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HELENA — The Affordable Care Act’s health insurance marketplace and individual insurance mandate are getting all the publicity now, but there’s a lot more to the lengthy, complex health care law passed by Congress in 2010.

Here’s a look at some of the ACA’s other key elements: Pre-existing health conditions: As of next year, health insurers cannot deny or delay coverage for anyone because of a pre-existing health condition. Insurers also can’t use that condition to adjust rates.

Limits on insurance company profits: The law requires health insurers to pay at least 80 percent of premium revenue on medical claims, and pay customer rebates if they don’t.

In 2012, more than 13,000 Montana insurance customers received an average rebate of $170, totaling $1.5 million.

Narrowing the “doughnut hole” for prescription drug coverage: Senior citizens on the Medicare drug plan have lower out-of-pocket costs. In 2012, nearly 10,000 Montanans got a 50 percent discount on drugs when they hit the doughnut hole, a tier of usage that’s not covered. They saved $6.5 million, an average of $656 a person.

Young adult coverage: The law allows young adults to stay on their parents’ policy until age 26. Through 2011, some 12,000 Montanans took advantage of this provision.

Preventive services fully covered: Those on Medicare and regular health insurance generally don’t have co-payments for some preventive services, such as cancer screenings.

Community health center funding: These federally funded clinics, which serve lowerincome customers across the state, have received more than $15 million in grants under the ACA to expand their services.

Reinsurance fee: Next year, everyone with health coverage will pay $63 each to fund a reinsurance pool that will help pay for high-cost claims from those who buy policies on the marketplace.

Medicare taxes on the wealthy: This year, those earning more than $200,000 ($250,000 for a married couple) saw their Medicare payroll taxes increase from 1.45 percent to 2.35 percent. They also must pay a 3.8 percent Medicare tax on investment income.

Other taxes: The pharmaceutical manufacturing industry ($3 billion next year), health insurers ($8 billion next year) and medical device sales (2.3 percent this year) also are paying new taxes to help finance the health care overhaul.

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Resources to find out more about ACA HELENA — For consumers who have questions about Montana’s new health insurance marketplace and Affordable Care Act regulations and programs, several websites and phone numbers offer answers: www.healthcare.gov: The main website for the marketplace, operated by the federal government.

It explains the marketplace and can guide you through the process to purchase health insurance and determine whether you can get a government subsidy to help pay for it.

1-800-318-2596: The federal call-in center for questions about the marketplace. www.montanahealthanswer.com: State Auditor Monica Lindeen’s website where consumers can ask and get answered questions about the marketplace and ACA. Lindeen is Montana’s top insurance regulator.

1-800-332-6148: The toll-free telephone line to Lindeen’s office, for questions about the ACA. www.kff.org/health-reform: The Kaiser Family Foundation, a nonprofit that’s probably the leading independent source on health care reform and the Affordable Care Act. The site has a wealth of information and news about the law, its effects and how it works. www.familiesusa.org/resources/tools-foradvocates/guides/federal-poverty-guidelines.html: A site where you can see how your household income compares to federal poverty levels, which are used to determine if you’ll get a subsidy on the marketplace to offset the cost of health insurance policies.

Subsidies are available for most families earning from 100 percent to 400 percent of the poverty level.

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affordable care act Major new laws come with their own jargon, and President Barack Obama's health care overhaul is no exception.

With the first open enrollment season kicking off for the uninsured, here are some terms consumers might want to get familiar with:

Affordable Care Act — The most common formal name for the health care law. Its full title is the Patient Protection and Affordable Care Act. Opponents still deride the law as "Obamacare," but Obama himself has embraced that term, saying it shows he cares.

Employer mandate — A federal requirement that companies with 50 or more workers pay a penalty to the government if one of their workers obtains taxpayer subsidized coverage through the law. Delayed one year to Jan. 1, 2015. Intended to keep companies from "dumping" employees into public coverage.

glossary of terms

Individual mandate — A federal requirement that virtually everyone in the United States has health insurance, either through an employer, a government program or by buying his own plan. Effective Jan. 1, 2014. Exemptions for financial hardship and religious objections. Does not apply to immigrants living in the U.S. illegally. People who ignore the mandate will face fines from Internal Revenue Service.

Essential health benefits — Basic health benefits that most health insurance plans will have to cover starting in 2014. They include office visits, emergency services, hospitalization, rehab care, mental health and substance abuse treatment, prescriptions, lab tests, prevention, maternal and newborn care, and pediatric care.

Marketplaces — Online health insurance markets in each state where consumers can get private health insurance, subsidized by the government. They used to be called "exchanges," but the feds decided that was too confusing and started calling them "marketplaces." Still, some states stuck with the original name. Open enrollment starts Oct. 1, and the coverage takes effect Jan. 1, 2014.

Fifteen states and Washington, D.C., are running their own marketplaces, according to a tally by The Associated

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Press. The Obama administration is taking the lead in 35 states, in some cases partnering with the state government.

All the marketplaces can be accessed online through healthcare.gov. Small businesses will have their own marketplaces.

Medicaid expansion — The health care law also expands the federal-state safety-net program to cover more low-income people. Medicaid is expected to account for about half the 25 million uninsured people who, the Congressional Budget Office estimates, eventually will gain coverage through the law. The federal government will pay the full cost of the new coverage from 2014-2016, then phase down to 90 percent. Twenty-four states plus Washington, D.C., have accepted the expansion, according to AP's count.

Eight states are still considering it. And 18 have rejected it, including Texas and Florida, which have many uninsured residents. Many adults below the poverty level will remain uninsured in the refusing states. A state can change its decision at any time, but the full federal payment for the expansion is only available through 2016.

Metal levels —The four levels of coverage available through exchange plans, called bronze, silver, gold, and platinum.

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cover only 60 percent of average costs. Platinum plans have higher premiums and cover 90 percent of expected costs.

Pre-existing condition — An ongoing or past health problem. Currently insurers can use pre-existing conditions to deny or restrict coverage, or charge more. Those practices will be barred by federal law starting Jan. 1, 2014, and insurers will have to accept all applicants.

Tax credits — Government health insurance subsidies for individuals will come in the form of tax credits. The money will be paid directly to the consumer's health plan, to help cover premiums. The subsidies are on a sliding scale based on income. Each year, people will have to "true up" with the IRS to make sure they got the right amount. People who receive too generous a tax credit may owe money back to the government.

Tax penalty — The fine levied on individuals who disregard the individual insurance mandate. It starts small and gets bigger in subsequent years. In 2014 it's $95 or 1 percent of taxable income. By 2016, it's $695 or 2.5 percent of taxable income, whichever is greater. Thereafter it's adjusted for inflation.

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new law

increased fraud protections

A

A new Montana law that went into effect on Oct. 1 puts stricter penalties in place for people convicted of fraud and scam crimes that target the elderly or mentally ill.

The law, which started as HB 287 during the 2013 session of the Montana Legislature, allows a judge to impose up to an additional $10,000 in fines on a person convicted of violations of Montana's Consumer Protection Act, if the victim of their crime is older than 60 or is a person with developmental disabilities.

This penalty would be on top of the $10,000 in potential fines those crimes already carry. The new law means that Montana joins 17 other states that currently have similar enhanced penalties for fraud-related crimes.

Daniel Salomon, the Republican legislator from House District 12 who introduced the bill in the 2013 legislative session, said it was the end result of a team effort spearheaded by Attorney General Tim Fox's office.

Salomon said he felt the law was very important to help deter people who might target these groups.

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"These are people that might be more trusting and maybe not quite as diligent. That can make them easier to prey on," Salomon said. “The new law does not create any new crimes, but simply amps up the punishments for existing fraud crimes against these groups.”

Salomon said the attorney general's office worked to draft a proposal, and when he was approached to carry it, he was happy to do so.

Fox's office then worked to make sure that lawmakers questions or concerns were answered or addressed as the bill went through the legislature with strong bipartisan support.

"Nobody was really against it. At most, there were just questions about is this constitutional, do we have the authority to do this, as there is with every bill," Salomon said.

Statistics from the attorney general’s office show that of the 1,423 complaints its Office of Consumer Protection received last year, 1,204 people gave demographic information. Of those, 429, or 35 percent, were above the age of 60.

Matthew Dale, the director of Montana's Office of Consumer Protection, said the types of fraud schemes his office saw ran the gamut from door-todoor and mail to telemarketing and email-based scams. His office worked closely with the attorney general to draft HB 287.

One of the office's compliance specialists, Ryan Sullivan, said one type of fraud he's seen recently is what he called the "grandparent scam."

"People will call up pretending to be a grandchild. They might say that they are very sick, or maybe in jail in another country. They need their 'grandparent' to wire them money immediately to pay for medical bills or legal fees," Sullivan said. "They are trying to instill that instant feeling of fear or panic that might make them do something impulsively."

Dale said the real impact of the new law will be

felt when scammers who are caught experience the new teeth added to their penalties. While he said he thinks the new law will deter would-be criminals, he also warned people to always be careful and vigilant, especially with financial or private information.

"Use your gut instinct. If you are questioning yourself about if this is a good idea, it's probably a scam," he said. One of the easiest tipoffs, he said, is anytime you are asked to wire money, especially out of the country.

Anyone with questions about something they have received can call the Office of Consumer Protection, who can help them to verify. It also has a warning service on its website called Scam Alerts, where a person can sign up to be notified with details of new frauds that have been detected in Montana.

Deputy Attorney General Jon Bennion said when Attorney General Fox’s office began to see that a greater proportion of consumer protection complaints were coming from older people, they felt that there was a growing need for a tough deterrent. He also serves as Fox’s legislative liaison when the Legislature is in session.

"Once it passed the Legislature, it went to the governor's desk, who was the attorney general only months before, so he clearly saw the importance of this type of legislation and signed it," Bennion said.

From talking with other states which have enacted similar laws, Bennion said they have seen criminals take notice. "People have taken all of that state's area code phone numbers out of their telephone scam database. Pretty soon, they might be doing the same with 406," he said.

Dillon Kato is a Missoula free-lance writer and regular contributor to Montana 55.

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estate planning

Hard Choices or Not? All the Reasons to See a Real Attorney for Estate Planning I read last month’s estate planning article, recommending you visit with your family about your plan. I disagree. Depending upon your age, wealth, health and circumstances, they may need to be involved. But probably not. Money, power, control, sibling rivalry don’t go away because we’re now over 65 or our children are. Most elder abuse is from family. Some is emotional, but much of it’s financial. I advise many seniors or I probate their estates after death, where a substantial portion has already been given to or taken by children unwisely or unfairly. Talk to your professional first. Then decide the extent to which to involve your children.

26

“last best” advice

Here are some thoughts we should all consider: 1.You avoid seeing an attorney because of

a. Fear of cost (unjustified, it’s one of the least expensive legal services around)

b. You not certain of your estate, or you fear

you’ll have to have organized records, titles and account numbers. (Wrong, you don’t need this information, especially not for a first meeting) c. You haven’t made decisions (surprise, most seniors visiting lawyers aren’t certain what they should do. Many of them outright ask me how to leave their estate) d. You’re conflicted over tough decisions, because of “that child” with the ____problem, or whom you have no contact with. Or you don’t trust their spouse. Or you’ve already given them ______. Or a special needs child or grandchild. Or because of your own or your spouse’s health or money issues. (Wrong again.

This is the perfect time to see an attorney) e. You’ve been to legal zoom and it looks

by randall a. snyder

pretty simple and pretty inexpensive. (Just say “no.”

They can’t answer questions, give advice or help you with alternatives or goals. Anyone can type documents. What you need is a sounding board and objective, experienced advice.) f. I don’t know who to call; the internet gives a million hits, banner ads and tell me nothing. (Like finding a contractor or auto-repair, referrals work best. Call someone you know. Ask your pastor or doctor, call the local bar association or State Bar of Montana. Ask ANYONE and make the call. If it’s not the right lawyer, have that attorney give you several more names. I frequently find attorneys for folks when I’m not the right guy. Trust me, I know my colleagues much better than the internet or yellow pages. I can also likely make the appointment for you. Most attorneys will.

2. Like planting a tree, there are two best times to see an attorney for estate planning: 30 years ago and today.

3. What will the attorney ask you:

a. A general inventory and value of your estate; your present income and needs; Again, you don’t need titles, deeds or bank statements. b. Yours and your spouse’s health, the health of any who

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may still be dependent upon you. (Some have disabled children). Your attorney can present better options if they know your health status. Be honest, none of us are as smart, as fast or remember like we used to. It’s pretty normal to eventually need help with the checkbook, medication and care. Remember, your planning for your future, not just the present. You need to be honest and realistic. c. Your marriage and family. Don’t worry; few of us bring a simple husband-wife, home, 3 kids and two cars to the interview. Many homes are blended. We can still help you; and advance planning in your case is even more important. d. Your goals. Both current, in the next five years and ultimately upon demise. This is the single, biggest fear of my clients. They don’t know what to do. Many ask me outright, “What should I do” or “Is that fair?” I can’t decide your plan for you. But I can ask you questions, help you to talk and think out loud and help you with options you may not have considered. Trust me, when you talk about it privately, outside your family, you’ll come to the right decision. And remember, you’ll have more time to think it over between an interview and signing. After you sign, you can go back and change it very easily.

Fall 2013

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4. What will you need to decide as part of your estate plan?

a. Who will you trust to give a power of attorney to? That should be your spouse first, then perhaps a child, relative or trusted friend. Ask your attorney about how these work and about how to change them.

Never hesitate to change your power of attorney if you have any reason to mistrust the agent who will have your signature authority in your absence or disability. If your durable power of attorney is more than five years old, get a new one with the current, statutory form. It’s different and title companies now insist on current powers of attorney. b. Same with a health care power of attorney. That’s different than a durable power of attorney over your money and property. Health care is only for health care. Your spouse can admit you to care and get records, but no one else can. You’ll need a current health care power of attorney. Ask and make certain your attorney is using the most current forms. They were updated in 2011. c. Who will be in charge of your estate? That’s your executor or Personal Representative. Probably your spouse, but who next? Try to avoid naming ALL

of your children – it makes for excessive work and signatures on even the smallest of tasks. The executor only needs to (1) have the time and interest and (2) be trustworthy. They don’t have to live in Montana, though that helps. The probate attorney will counsel your PR on what to do. d. How do distribute your estate. i. It’s helpful to write a list to dispose of personal property – those items: the guns, jewelry, art, tools, all the household items. They don’t need to be listed in your will. Make a list, change it, sell it, give it away or whatever. You don’t need to call your lawyer after your will is written and signed. ii. Specific amounts and percentages work best.

“Equally to children” works very well. $10,000 to my church. iii. Decide what to do if a beneficiary predeceases you. Montana law says such gifts “pass by representation”, meaning a gift to a child goes to that child’s children – your grandchildren. Ask you lawyer about this. iv. Contrary to popular myth, Montana does not take your estate if you have no will. You might think they want your home, but they really don’t.

State law provides that your estate still goes to

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your heirs. Perhaps not as you would distribute it – so get your will done. v. Most of us can forget about death taxes – they’re all but gone. No more state inheritance tax; and for most of us, no more federal estate tax.

5. Be cautious about living trusts.

At least once per month I’m updating a trust -- a 30 – 60 page document the client can’t read or understand, to update distributions or the successor trustee.

These plans – extraordinarily expensive to set up and frequently not maintained, are seldom advisable. Most families need a simple will and estate plan for $300.00 or less. Trusts run into the thousands and usually don’t do much more than a simple will. Ok, they can be helpful if you own property in multiple states or have federal estate tax exposure. Few of us do. And yes, they can avoid probate. Probate in Montana is very clean, very straightforward and (if you shop for a lawyer), not a lot more money than some living trusts. Trusts don’t shield property from Medicaid or the expenses of long term care.

6. Ask your lawyer about costs. We want you to.

We don’t want misunderstandings about fees either.

The lawyer should send you a confirming “engagement letter” outline what he or she will do, when and for what cost.

7. Keep your own documents. If you have six months to live and your attorney will shortly be probating your estate, then leave your will at the law office. Otherwise, take the original, keep it in a sealed envelope (the attorney should do this for you) and keep it in a lock box, preferably a safety deposit box. It’s your will and your property. Your heirs can decide whom to hire if a probate is required.

8. Consider filling out an Advanced Care Directive. You can find that on line at http://www. caringinfo.org/files/public/ad/Montana.pdf This will help you make decisions about end of life care.

Randall A. Snyder has practiced real estate, estate planning and probate in Bigfork for 30 years. He is a frequent instructor in ethics and elder law issues and is president of the State Bar of Montana for 2013-2014.

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investment

Not all stockbrokers are your friend

T

This question came to Montana’s AARP office from Jack in Billings.

Q: I recently found out that my stock broker put all of my investments into variable annuities. As it turns out, variable annuities are considered “inappropriate investments” for someone my age (I just turned 60) but he put me into that type of investment because he makes a lot more in commission. How can I protect myself from an unscrupulous stock broker in the future?

A: Jack, if you knew that your stock broker earned substantially more commissions from certain investment choices, would you be less likely to trust his advice?

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That’s a sobering thought, isn’t it? The vast majority of stock brokers – even the ones you pay fees to – don’t owe you, the individual investor, much loyalty at all. As a result, they are free to recommend risky, high-fee investments that might cost you more money and earn themselves higher commissions.

In May, AARP conducted a survey asking people who invest in an employee retirement plan whether this conflict of interest mattered to them.

The numbers were overwhelming. Nearly eight out of 10 said they were at least “somewhat concerned” about this potential conflict. A staggering 93 percent of those surveyed said they think any advice given by a stock broker should be required to be in their best interest.

Yet, as the rules stand today, most stock brokers are free to put their interests first, without even letting you know they’re actually looking out for “Number One.”

by stacia dahl Part of the problem for consumers is that there is no fundamental “duty of care” standard that applies to all stock brokers and all clients. It varies. People advising workplace investors – for example, 401(k) and 403(b) investors – may owe one type of duty, while people advising individual investors (IRA and mutual fund investors) owe another duty, depending on what type of credentials they carry and what kind of investments they sell.

There are, however, some advisors who owe a clear duty of loyalty – a “fiduciary duty” – to their clients. They are called “registered investment advisors” (because they are either registered with the U.S. Securities & Exchange Commission or a state securities regulator), and they operate on a fee-for-service basis. In other words, you pay them some percentage of your managed assets and, in return, these advisors are obligated to put your interests ahead of their own.

Stock brokers sell products for commissions and the law requires them to make recommendations that are suitable for you based on your investment objectives, your level of risk tolerance, your financial situation, among other factors.

Stock brokers are not required to act in your best interest.

So, while a broker may recommend to you a suitable fund, stock, or other financial product, they are not prohibited from recommending an investment that will result in a bigger commission for them and a higher cost for you.

Investment advisers manage your money for a fee, usually about 1% annually based on the size of your investment portfolio. They do not sell products for a commission.

Investment advisers have a fiduciary duty (a legal requirement) to act in your best interest and are, therefore, prohibited from taking unfair advantage of your trust.

When you enter an arrangement with an investment firm, the agreement you sign should tell you the capacity your financial adviser is acting in and whether the advisor is held to a suitability standard or a fiduciary standard.

Federal regulators, such as the U.S. Department of Labor and the SEC, are trying to clear the muddy waters by imposing that gold standard – the “fiduciary duty” – on all advisors, with no loopholes.

Naturally, the mutual fund industry – which manages and invests nearly $20 trillion of Americans’ retirement assets – is pushing back -- with some success.

So now what? If the government can’t protect you from unscrupulous brokers, what can you do to protect yourself?

Jean Setzfand, vice president of the Financial Security team in the Education and Outreach group at AARP offers these tips: • First, ask your broker whether he or she is a fiduciary.

• If they are not a fiduciary, ask your broker about the fees associated with the investment he’s recommending, and how those fees compare to other investments. Ask whether he or she will earn a commission if you choose the investment.

• If they are a fiduciary, you may be paying a

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management fee in addition to fees charged by the investment funds you select. Over the course of time, those fees will eat up some of your account balance.

Unless your broker is consistently beating the market by at least as much as you are paying in fees, you are wasting money – perhaps lots of it.

• If you don’t want to choose between conflicted brokers or high fees, consider investing in index funds through an online brokerage. Index funds automatically invest in broad swaths of the market – for instance, the Dow Jones Industrial Average. They make money when the market is up, and lose money when the market is down.

But, because they don’t have to pay a superstar fund manager to pick stocks for the fund, their fees tend to be much, much lower than actively managed funds.

In Montana, you may call the Commissioner of Securities and Insurance at 1-800-332-6148 to make sure your investment advisor is properly licensed and the product is properly registered.

Do you have a question for AARP Montana? Send your question to “Ask AARP Montana” at MTAARP@aarp. org or 30 W 14th St., Helena, MT 59601 or call our toll-free hotline at 866-295-7278. As we receive questions, we will consult with both internal and external experts to provide timely and valuable advice.

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Fall 2013

31

real estate

H

is it time?

How do you know when it’s time to throw something away? How do you know when something has passed its point of usefulness? When does a household item that was once so important become another thing to store or pile up or give away someday but not today?

When it comes time to sell your home or right size or just lighten up your lifestyle, will your material surroundings stop you from moving forward? It does for some people and even for those who don’t have a problem giving away obsolete things, it can still be a difficult job.

I just returned from an estate sale recently. The family was lovely and the people assisting with the sale were working tirelessly. I was exhausted watching people bustling in and out of the home looking for treasures. But I freely admit that I found one myself. I bought a wonderful dining set that I love.

32

by joy earls

www.montana55.com

If at all possible, families should have discussions about family treasures. Everyone should be honest about what could be useful to them someday and what can be given to someone who will use it today. Antiques Roadshow has become a very popular television program. One reason is that viewers may picture themselves discovering something of worth in their home or loft. But how often does it truly happen that someone doesn’t know the approximate value of an item or at least that it is rare or unusual?

Most of our treasurers are not worth small fortunes. Instead, for some people, these collections are like anchors keeping their lives from moving forward. They also pile up unnecessary storage costs. Think first about collecting those cherished items. Keep what is important and enjoy what surrounds you. But at the same time don’t allow your material belongings to take on a life of their own and keep you from moving, selling your home, rightsizing or just simplifying.

Sometimes the best way to decide what you need and what is ready to go out the door is to ask for help. Your family may be the best gauge, but you may also want to engage a professional organizer, move manager or sometimes a “take charge friend”.

Next time you see a garage sale sign, take a moment and look at what is for sale. Then think about your own home and if those items look very familiar. Perhaps that may be enough motivation to start unloading some treasures. When you decide to move, it will be a much easier task.

Joy Earls is a Real Estate Broker/Owner of Joy Earls Real Estate. She truly enjoys your stories, calls and emails. You can find her at: joyearls@joyearls.com or 406-531-9811

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My husband wasn’t there, but I know our household rule. When one new thing comes into the house, at least one must leave. In this case, it was going to be easy, as I definitely don’t need two tables and chairs in my kitchen.

The next day I cleared off our old round oak dining table. Carter, our son came down and when I told him what was happening, he asked what was wrong with this set. He had eaten meals around this old table for as long as he could remember. We drove it home in our van from Canada on a family vacation.

While I thought he seemed sentimental, which I loved, I think he also thought all this work wasn’t necessary, as we had a perfectly good kitchen set. And there were so many memories of Thanksgivings and dinners and friends and family sharing time together. Why do things need to change?

I absorbed that feeling and went right up to our loft where we store things not used every day. I asked Carter to help me rearrange. We moved an antique desk needing repair to the right and some framed pictures to the left to make room for the old kitchen table and chairs. Then I went back to the house and found all the round table cloths collected over the years, which I neatly folded and put in a plastic cover. Surely one day, one of our boys will love the round oak table with chairs and use it in their home with this great assortment of covers.

When I put the cloths with the table up in the loft, my thoughts returned to that estate sale. There were so many cherished items in their home. I remembered the family sitting on a couch in the living room tired beyond words. Losing a family member is heart wrenching enough. Observing them deal with all these belongings looked overwhelming.

I have helped couples, widows, families and out of town estates prepare homes for sale. I remember looking at neat piles of linens perhaps from beds long gone. And I remember seeing rooms of furniture long passed their usefulness. Some of these people must have had the same thoughts I did about my table. They think their children will enjoy them or someday they will be useful. But often families are all over the country or not interested in their parents things. What was once a cherished item can become another burden.

kathy G. Earle REvERsE MoRTGaGE ConsulTanT nMls# 402121

Fall 2013

33

retirement

questions and answers

A secure retirement requires advance planning “running out of money� is not a good option

T

This question came to us from Rick who visited our booth at the Fountain of YOUth fest in Helena this spring.

Q: My father, now approaching 90, literally ran out of money in his retirement years.

It was quite a scary realization for our entire family. I am still working, but hoping to retire in the next ten or so years. How can I plan now for my financial needs 25 years from now so I am not in the same situation as my father?

34

Dr. Brian Rah

by stacia dahl

A: Good question, Rick. Hopefully your family has been able to help your father.

If you saved, say, 10 percent of your salary for the rest of your working life, do you think that would be enough to get by? The so-called “experts” have long pegged that as the target savings rate, but how would you know whether it would meet your individual needs?

There are plenty of calculators out there to tell you how much money you might have saved by the time you retire; some will even tell you how long that money might last. But here’s the thing: Running out of money isn’t exactly a viable option – as you and your family found out.

That’s why AARP recently redesigned its retirement calculator to focus on calculating and budgeting your total retirement income instead of your guesstimated retirement savings.

In our new calculator, you can’t ever run out of money.

After you enter information about your current savings and savings rate, we show you how much annual income that might give you for the rest of your life – and then we show you ways to boost that income. Log onto www.aarp.org/ RetirementCalculator to find the calculator.

The calculator also shows you a red line that is the target income you would need to keep your current lifestyle after inflation is built in. If it doesn’t look like you’ll hit that target, the calculator gives you options. Lots of them.

If you can’t access the new calculator from a desktop or laptop computer, here are a few ways to solve an income shortfall problem: Delay your Social Security claim. Too many Americans race to claim Social Security the day they are first eligible.

That can cost them – and their families – big-time in the long run. If you claim at 62, your benefits will be significantly reduced for the rest of your life. If you wait a little longer to claim, your benefits check will grow as much as 8 percent annually (until you hit age 70) for each year you delay. The difference between claiming early at 62 and claiming late at 70 is staggering: Your check will be more than 70 percent larger if you wait until 70 to claim.

However, there may be some people who can’t wait, such as those unable to work, or who would eventually get a much larger benefit on their spouse’s account when he or she retires. The AARP Social Security Benefits Calculator will walk you through various strategies for maximizing your benefits. Log onto www.aarp.org/SocialSecurity to find the calculator.

Work a little longer. The longer you work, the more time you will have to save money (and build pension or delayed Social Security credits), and the later you will be forced to start drawing on your savings. Even part-time work can help tremendously. Bear in mind, though, that some of

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your Social Security benefits will be withheld if you claim early but then continue to work. If you wait until your “full retirement age” (usually 66 or 67) to claim Social Security, you can collect your full benefit check even if you continue to work.

Adjust your lifestyle. Of course this seems like a nobrainer, but the new AARP Retirement Calculator shows you the projected national averages for various living expenses in your retirement. You can choose which ones to cut back on – say, downsizing or paying off your mortgage – and see the impact on your retirement income.

In addition to the two tools mentioned above, AARP offers a comprehensive set of retirement decision-making tools at www.aarp.org/readyforretirement. Working forever is rarely an option, but running out of money should never be an option.

Do you have a question for AARP Montana? Send your question to “Ask AARP Montana” at MTAARP@aarp. org or 30 W 14th St., Helena, MT 59601 or call our toll-free hotline at 866-295-7278. As we receive questions, we will consult with both internal and external experts to provide timely and valuable advice.

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Fall 2013

35

senior learning

new opportunities

MOLLI Members Enjoying Marilyn Bruya’s “Practice of Drawing” Class

U

photos courtesy of School of Extended & Lifelong Learning at UM

University programs help quench the thirst for knowledge well into the adult years

Montanans who never quite grew out of the desire to keep learning and expanding their horizons have major programs at both the University of Montana and Montana State University to rekindle a passion for education.

The Osher Lifelong Learning Institute at UM, also known as MOLLI, is a program for adults age 50 and older who want to experience classes and participate and be involved at the University of Montana without being enrolled as a traditional student.

36

by dillon kato

www.montana55.com

The MOLLI program, which began in 2006, offers classes during three different semesters: fall, winter and spring. This fall, the program featured 23 different courses, primarily taught by members of UM’s faculty. Unlike traditional classes, MOLLI courses are noncredit, and as such, don’t have tests or homework.

MOLLI is a member organization that only allows people aged 50 and older, and people interested in taking a class must pay an annual $20 fee. After that, each class costs $60, with a slight discount for taking multiple courses in a semester.

Each course lasts for six weeks, and meets once a week for an hour and half each time. Most of the classes take place on the UM campus, although alternate venues are used for courses that require specific facilities.

Hal Stearns is one of the instructors who has been teaching MOLLI courses almost since the start of the program.

events students bring up.

“It can be free reign, it can often go in different directions. We don’t have to follow a marked syllabus, you can just bounce ideas back and forth,” he said.

Stearns earned his master’s in history and doctoral degree in education from UM, and spent many years as a history teacher at Missoula’s Sentinel High School, then in the graduate school at UM. He said the biggest difference between teaching MOLLI classes and graduate students is the more relaxed atmosphere that comes from people being there just for the sake of learning.

“Graduate students sit on the edge of their seats, writing notes on everything you say so they can give it back to you on the test. Or they are detached because the class is something they have to take because it’s required for a degree,” he said.

With MOLLI students, every student

Stearns’ MOLLI course is always about Montana history, and he finds it interesting to bring people together to reaffirm their keen love of the state.

“I talk about the famous, about the infamous. About the things that if you live in Montana, you just should be aware of,” he said.

While Indian education is now a requirement in schools, Stearns said some adults might not understand the importance Native Americans played in our history. Or the importance of homesteaders, miners, ranchers and farmers.

Why did Marcus Daly, the copper king, have his horse farm in Hamilton?

Why is the Battle of the Little Bighorn the most written about in American history? What changed from the original state constitution in 1889 to the rewrite approved in 1972? All of those are questions Stearns likes to answer for his MOLLI students.

Because of the less formal setting, the class is free to discuss people, places or

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“MOLLI members enjoy a lively lecture”

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is interested and attentive, because they chose that specific subject.

“A number of people who take my course are, for example, doctors or engineers, who maybe felt like they were shortchanged the first time in school because they had so many requirements they couldn’t take classes they wanted to enjoy,” Stearns said.

MOLLI classes are also a great way to become more involved with UM in other ways. A friend of Stearns’ had only come to campus for sporting events before taking a MOLLI course. “Now he’s here for presidential lectures or seminars or just to have coffee and talk to people,” Stearns said. “There’s a phrase MOLLI uses a lot. Curiosity never retires. I think it’s a perfect way to describe it.”

R

oger Maclean, the dean of the School of Extended & Lifelong Learning, which facilitates the MOLLI program, said: “I see MOLLI as being about celebrating the pure love of learning, of taking classes without worrying about things like exams or assignments.”

MOLLI has seen record enrollment year after year, from around 200 its first semester to more than 700 this fall.

MOLLI is not the only program offered through the School of Extended & Lifelong Learning. For example, this fall, they also began offering a series of non-credit Professional Development programs. These courses, Maclean said, are aimed at post-baccalaureate professionals in the workforce who want to acquire new skills. They cover Fall 2013

39

“MOLLI members enjoy Steven Hesla and Barbara Blegen’s “Celebrate Piano!” course

subjects like marketing and project management, or offer certifications in fields such as digital design.

These classes provide no academic credit, and range from seminars lasting only a few days to up to six weeks, primarily taking place in the evening or online.

“The reality is that you have people who have to work longer for a variety of reasons. People that may have lost jobs and when they came back have to do so at a lower skilled job, and might need to retrain to move back up to a job like what they were doing,” Maclean said.

More information on these courses can be found online at umt.edu/profdev. Information about MOLLI courses can be found online at umt.edu/ce/ plus50.

40

S

ally Maison is the founder of a similar continued education project in Bozeman at Montana State University, called Wonderlust. When Maison, a former psychologist with a Ph.D, moved to Bozeman in 2001, she brought with her a love of learning.

“I wanted to take classes, but I sure as hell didn’t want to write any more papers. I just wanted to learn things,” Maison said.

She quickly found a group of similar-minded people who were frustrated that there were no lifelong learning opportunities in the town. “I just decided, let’s get it started. We had a reception at the Museum of the Rockies. Two hundred people showed up. Obviously, this was a niche to be filled,” Maison said.

Enter Wonderlust. The main component of Wonderlust, like MOLLI, is a series of short, four- to eight-week courses taught primarily by MSU faculty. Originally, Wonderlust had three classes in the fall and spring semesters, This year, there will be six in each semester, with the plan to possibly expand to seven next year.

Maison, who previously served as the president of Wonderlust, is now the curriculum chair, charged with organizing classes and instructors for each of the semesters. As Wonderlust doesn’t repeat classes, that means a new slate each semester. She is still putting together the finishing details for the spring, which will do away with the fall courses on American presidents, Renaissance art or the mountains of the world in favor of Baroque music, World War I, and Chinese culture.

Unlike MOLLI, Wonderlust classes take place off campus, and in the afternoons between 2:30 and 4:30.

“While it’s not a hard rule, and anyone can take the classes, it is generally targeted toward retiree-aged people,” Maison said. “They told us parking on campus and night classes are two things that they don’t want to have to deal with, and we understand and respect that.”

Wonderlust also organizes book and opera clubs, and holds public monthly forums on topics of local interest. It also puts together short, one-hour classes called side trips, focused on specific topics.

The annual fee to join Wonderlust is $35, said Marilyn Jarvis, the assistant director of continuing education with MSU’s Extended University. Wonderlust is a sister program cosponsored in part by MSU, which manages the logistics and registration for the project. That fee provides a discount on the courses, as well as access to the side trips.

Information about Wonderlust can be found online at eu.montana.edu/wonderlust.

Jarvis said the program has proved to be very popular, starting fairly small and growing to as many as 350 students last year.

“People take part because they are interested in the topics, or just interested in learning something new. Some people take several of the courses each semester,” Jarvis said.

If someone does take a class from Wonderlust, they might even find Maison sitting at the desk next to them.

“I take one or two of these classes every semester. I’ll tell you what, this whole thing is an entirely selfish enterprise for me to keep learning,” Maison joked.

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Fall 2013

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getaways

storming the castle

Samantha French enjoys the view from the edge of one of the cliffs at Castle Butte last week. The 184-acre Bureau of Land Management parcel is protected as an Area of Critical Environmental Concern because of its pictographs.

Hike at BLM site offers sweeping views, link to history 42

C

CASTLE BUTTE -- With such an expansive view, it was almost as if I could see the curvature of the Earth to the north. Certainly from this high place on the plains of Eastern Montana, I could see a long distance -- the Pryor Mountains to the southwest, Steamboat Butte to the west, the Bull Mountains northward and brown undulating plains to the east.

by brett french

www.montana55.com The rock outcrop does resemble a walled fortress. Other buttes in Montana and across the West carry the “Castle” name.

The view came with a price, though -- a steady pounding by a frigid southeastern wind. Dropping off the top onto the western side of the vantage point, it was as if I had hopped from April in Montana to April in Miami. The temperature was warm and the wind was only a hiss in the boughs and needles of the pine trees above. Fragrant tart sage scented this leeward side.

Castle Butte -- located about 50 miles northeast of Billings and roughly 15 miles north of Pompeys Pillar -- was an area I had never heard of before the Bureau of Land Management released its Resource Management Plan last month. That may be because the butte’s sandstone walls are home to several early historic pictographs, a couple of them quite detailed. Fear that such rock etchings may be vandalized prompts many folks to keep these precious sites quiet. But anyone scanning the Internet can easily find the location, photographs of the rock art as well as interpretations of some of the inscriptions.

Castle Butte is mentioned in the BLM’s plan because the agency manages the 184-acre site as an Area of Critical Environmental Concern. ACEC designation is meant to protect the unique cultural values of the property.

Unique quality The BLM’s Resource Management Plan goes into some detail about Castle Butte. It says in part, “Although there are numerous known rock art sties in the Northwestern Plains region, many of which are considered eligible to the National Register of Historic Places, site 24YL0418, the complex of rock art at Castle Butte is almost unique in the quality and concentration of artwork, particularly for the early historic time period. Panels at the site are believed to be biographical in character and to actually document events in the lives of 18th and 19th century Northwestern Plains horse nomads.

“Castle Butte is one of a handful of sites in the Northwestern Plains which show a range of rock art styles

dating over a long period of time. Examples of Native American art styles dating from around AD 1100 to the fur trade period have been identified on the site, as well as historic EuroAmerican graffiti dating from 1874 to the present. The rich concentration of pecked, incised, and more rarely, painted motifs of a variety of styles in a relatively small area has resulted in some panels which show superimposing of elements. This is an important key to the relative dating of the various styles.

“Some of the panels at Castle Butte can also be directly associated with adjacent buried archaeological deposits which can be dated through the use of radiocarbon dating techniques. This situation increases the scientific value of the site immensely. Site 24YL0760, an adjacent multiple component camp site, is closely associated with the rock art panels and probably was used by the persons who created the rock art at Castle Butte. Projectile points recovered from the surface of the site show that occupation occurred throughout the period during which the rock art was created.”

Rock search Hoping to see some of the images -- which the Internet shows depicting an elk, a native woman and a battle scene -- I set out last week with a BLM map of the Hysham area and a warm coat. Spring is the best time to explore Eastern Montana, before the sun raises the temperature to the “Bake” setting, while snakes and ticks are still hibernating and mud and snow block the high country. This early in the season, though, visitors do miss the greening of the prairie, as well as the blossoms. It’s a tradeoff because once the flowers bloom, the snakes, ticks and flies are certain to be out.

The butte is easy to find. Take the Bundy Bridge Road past Pompeys Pillar and turn right on Castle Butte Road.

Follow that past the radio towers, staying to the left, and through a few more right-angled jogs in the road and you Fall 2013

43

A small rifle is etched into one of the cliff faces. There are other, more detailed pictographs at Castle Butte for those willing to spend some time exploring.

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arrive at the base of the butte. A parking area on the south end is the jumping off point.

From the parking area, you’re on your own to choose which route to ascend the rock fortress. An outer wall about 12-feet tall provides the first impediment to the top.

Find a way past that -- maybe by scaling a narrow kneescraping notch -- and you can walk around or up and over the fortress’s inner walls. At its highest point the butte is only 3,584 feet in elevation. Still, that’s more than 200 feet above the prairie below.

The butte terminates at its south end, arcing back to the north and west with saddles between the rock uplifts.

Along its sweep, modern graffiti is a lot easier to find than any historic pictographs. It seems every other person who visits the site is inspired to carve their name into the soft sandstone – an illegal act. One person even scaled 20 feet up a vertical side of the rock to etch their name.

Seeing the beauty Luckily, the natural beauty of Castle Butte far outweighs the distraction of the carved names. The rocks vary in shape and texture. Some look like large dollops of smooth ice cream. One flat tabletop slab was brightened by splashes of orange lichen. Another rock slab showed ripples frozen in its surface, the petrified remains of what may have been the edge of an ancient sea or stream.

On the cliff sides, the layers of rock are revealed providing a window into the area’s geologic past. The thick bands of sandstone were likely laid by large rivers and deltas carrying silt from mountains to the west to an inland sea to the east roughly 65 million years ago.

Atop one of the castle’s towers, a hole had been weathered into the rock large enough to hold half a huddled human. Along the edge of one cliff, a large nest – probably a golden eagle’s – clung to the rock. No eagle couple was around, though, just the occasional flushing rock pigeons.

While looking across the surrounding landscape, it was fun to think back 200 years to when the grasslands were dotted with large herds of migrating buffalo. The Yellowstone River at Pompeys Pillar was well known as a crossing point for animals and humans, a gap in the high riverside cliffs. Castle Butte would have undoubtedly offered a great vantage point for a historic hunter to plan a stalk, as well as to locate friends or enemies on the move north to the Musselshell River, or south to the Yellowstone River valley.

Despite walking over, around and up many of the cliffs, I saw only one pictograph left by those long-ago travelers, and then only after walking past it the first time.

It appeared to be a lone rifle, not more than 6 inches tall.

Other scratches nearby were indecipherable.

Although seeing more pictographs would have added to the adventure, climbing around on the rocks, investigating the site and taking in the vast views were reward enough.

Plus, not finding the relics gives me a reason to return to this remote region of the Eastern Montana plains for another exploration.

Fall 2013

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looking back photo by Arthur Mouratidis

L

Left to right, Kenneth McAfee, 91, from Bozeman, and Phillip Lee, 86, from Great Falls, pose for a photograph inside the Franklin Delano Roosevelt Memorial during the sixth Big Sky Honor Flight. McAfee entered the Army in 1942 and served in intelligence with the 84th Infantry Division in Europe. Lee was in the Navy and worked as a ward corpsman on a hospital ship.

In mid-October, the Honor Flight ferried its seventh cadre of Montana World War II veterans to Washington, D.C., in a program that continues to inspire and honor all Montanans.

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AVAIlABlE noW!

www.montana55.com

the weway were a collection of photographs from life in western montana submitted by readers of the missoulian

only $16 available by ordering online at missoulian.com/books

Fall 2013

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Cancer Center

Working Together Welcome to Advance Cancer Care We welcome our newest medical specialists.

Venu Thirukonda, MD Oncologist/ Hematologist

Erin Stevens, MD Gynecologic Oncologist

Pamela Smith, MD Oncologist/ Hematologist

Michelle Proper, MD Radiation Oncologist

Our state-of-the-art Cancer Center services include: • Multidisciplinary care • Disease-specific cancer teams and patient care navigators • Medical Oncology, Radiation Oncology and • Region’s only Stem Cell Gynecologic Oncology Transplant Program • Advanced treatments, • Naturopathic/integrative medicine including stereotactic • Genetic counseling and testing radiosurgery and da Vinci® • Dedicated Inpatient Cancer Care Unit robotic surgery

Next-day appointments available for new cancer patients.

If you need a cancer specialist, call Billings Clinic HealthLine at 255-8400 or 1-800-252-1246 or go to www.billingsclinic.com/cancer

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These new doctors join this team of Billings Clinic Cancer Center providers who work together to care for and support each patient:

Front row (L-R): Christopher Goulet, MD; Brock Whittenberger, MD; Doreen Kenfield, PA; Roberta Bourgon, ND; Kathryn Waitman, DNP, FNP; Ala’a Muslimani, MD Back row (L-R): Roger Santala, MD; Travis Allen, PA; Mary Caroline Deigert, PA; Jorge Nieva, MD; John Schallenkamp, MD; Randall Gibb, MD