According to the U.S. Centers for Disease Control and the Wisconsin Department of Health Services, Wisconsin has the highest rate of deaths from falls in the country. The number of falls that emergency medical services respond to is rapidly growing each year, resulting in 55,000 emergency department visits in 2024 alone. This is bad for older adults who get hurt, first responders and health care providers who are stretched thin and taxpayers who shoulder the burden of hospitalizations and lengthy recoveries.
Unfortunately, many older adults are not getting the preventative care they need to maintain their balance and health. That needs to change.
The Stopping Addiction and Falls for the Elderly (SAFE) Act, sponsored by U.S. Rep. Carol Miller and U.S. Sen. Jim Justice, both West Virginia Republicans, would address this crisis by allowing Medicare beneficiaries to receive a no-cost falls risk assessment from a physical or occupational therapist as part of their annual wellness visit.
A growing number of bipartisan co-sponsors — including Democratic Rep. Mark Pocan of Wisconsin — supports this legislation. I urge all of Wisconsin’s congressional delegation to do the same.
Kevin Svoboda is a physical therapist in Greendale and a member of the Alliance for Physical Therapy Quality and Innovation.
Guest commentaries reflect the views of their authors and are independent of the nonpartisan, in-depth reporting produced by Wisconsin Watch’s newsroom staff. Want to join the Wisconversion? See our guidelines for submissions.
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Wisconsin leads the nation in reported fall deaths among older adults, with more than 1,800 in 2024.
The reasons aren’t fully clear but may include how local officials report deaths, graying demographics and Wisconsin’s culture of alcohol use.
Many falls can be prevented — and Wisconsin is a leader in that work.
Programs from ballroom dancing to parkour help older adults build strength, balance and confidence.
About a dozen gray-haired adults line the playground fence at Madison’s Warner Park. Standing on narrow wood planks, they balance on the balls of their feet.
“Calves are burning, woo!” someone yells. The class stops to shake out their legs. Participants, most in their 60s or 70s, step back onto the boards and lift their heels off the ground — one of several movements in the class to help build muscle to prevent falls and practice parkour.
Alice Morehouse, 70, hits the playground’s blue, rubber surface. She shifts her weight to her left side and pushes herself up onto her toes. An instructor reminds everyone to flatten their hands — a tip Morehouse already picked up during two years in Parkour for Seniors classes.
She drops to the ground and confidently springs back up twice more.
“When I first started, I went home, drank a cup of coffee and took a nap,” Morehouse tells a classmate. “Now I only need the coffee.”
Sitting on a swing, holding two Jenga blocks in the form of a “T,” Morehouse says she has tried other workout classes. But parkour is “way, way more fun,” she adds while pushing off the ground.
Anne Cook, left, practices a balancing exercise with Kathy Reinhard during a parkour class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
Wisconsin has the nation’s highest reported death rate from falls among older adults, according to the U.S. Centers for Disease Control. More than 1,800 older Wisconsinites died from falls in 2024.
It’s not clear why Wisconsin stands out. Without firm evidence, experts point to several possible factors, including how local officials report deaths, graying demographics and Wisconsin’s culture of alcohol use.
But one thing is certain: Many falls can be prevented.
Wisconsinites are national leaders in fall prevention work. A local nonprofit trains people across the country to provide an evidence-based course, Stepping On, recommended by the CDC. Oshkosh health care providers started a “Mugs-for-Rugs” event to get older adults to trade hazardous throw rugs for free local coffee. Madison area advocates and experts developed a network of balance-enhancing classes, including ballroom dancing and parkour.
Still, the number of fall-related EMS calls in Wisconsin increased between 2023 and 2024, according to the Wisconsin Department of Health Services. Falls made up more than 20% of 911-related ambulance runs in 2024.
Stepping On is offered in 43 Wisconsin counties, including Dane. Madison residents can also access a wide range of additional classes. Still, falls remain a leading cause of injury deaths in the county.
To change those numbers, advocates say they need to reach more older adults. But that costs money. Attempts to dedicate state dollars toward fall prevention failed in the Legislature.
Parkour for Seniors grew popular enough this year to add a Thursday morning class. Morehouse has gained confidence since joining.
“I’m no longer afraid to fall because I know I’m going to do it, and I know how,” she says. “And I’m much, much stronger.”
Her favorite part of the class is watching participants have fun.
Kathy Reinhard, right, lifts her leg while participating in a parkour class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
She stands in a circle with the others, stretching.
“Have we talked about grapefruit in our armpits yet?” asks Shelby Copeland, a parkour instructor and former “American Ninja Warrior” contestant.
The group looks confused before Copeland explains the warmup. She tells everyone in the circle to pretend they placed two grapefruits inside their armpits. “See if you can juice them using just your shoulders,” she instructs the group.
“What do we do with the juice?” someone asks.
“Citrus deodorant!” another attendee jokes.
‘Every senior should take this class’
“How’s everybody doing with their exercises?” facilitator Marcy DeGreef asks the Stepping On participants.
“I’m thinking about it,” 89-year-old Gary Geller responds after a brief pause.
“We work together on that,” adds Jim Jenkins, 79.
The small group of older adults laugh before reviewing exercises that reduce fall risk. Heel-toe walks help with balance. Knee lifts build strength. They can easily do these at home. TV commercial breaks are long enough to finish several sit-to-stands, someone says. Another attendee says she practices side steps while waiting for hot cocoa to heat in the microwave.
It’s the last of seven weekly classes. They’ll return to the Jewish Social Services building in three months to check in. Before they leave, DeGreef runs through some of what they learned: Vitamin D supplements can help with bone health; trained professionals should install grab bars in the bathroom; they should clean shower mats regularly so they don’t lose their stick; proper footwear is a must. The attendees should talk with their doctors and pharmacists about how their medications affect balance. They should also consider regular bone density screenings and get their vision checked.
A participant in a Parkour for Seniors class at Warner Park, April 23, 2026, in Madison, Wis. The class aims to build balance and coordination to prevent falls. (Joe Timmerman / Wisconsin Watch)
Older adults stand on wooden planks to build strength and improve balance, April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
“We just had our eye exam,” Geller says. “They went from 20/20 in my right eye to 20/40 to 20/25.”
“He’s getting better instead of worser,” his wife Denny quipped.
As the review wraps up, Geller offers an endorsement: “Every senior should take this class.”
Stepping On reduces falls by more than 30%, says Jill Renken, executive director of the nonprofit Wisconsin Institute for Healthy Aging, which licenses the program and helps distribute its curriculum nationwide.
But expanding the class and other prevention efforts in Wisconsin requires more funding to train instructors and run awareness campaigns that reach more participants, Renken says.
Earlier this year, Rep. Patrick Snyder, R-Weston, and Sen. Jesse James, R-Thorp, introduced bills to set aside money for the Wisconsin Institute for Healthy Aging and community emergency medical initiatives.
The Assembly unanimously approved Snyder’s proposals in February, but they stalled in the Senate — failing to reach Gov. Tony Evers’ desk before lawmakers wrapped up work for the year.
Snyder says the proposals died due to Senate Republicans’ concerns about funding, including $600,000 for community EMS and $400,000 for fall prevention across the 2025-26 and 2026-27 fiscal years. Neither James nor Senate Majority Leader Devin LeMahieu, R-Oostburg, responded to questions from Wisconsin Watch about the failure of the bills.
Snyder plans to bring the proposal back next session, which starts in 2027. That’s if he’s reelected later this year.
“I’m hoping that next session we can actually get a substantial amount of money for fall prevention,” he says.
Barb Brown, second from left, and Shelby Copeland, second from right, instruct a group of participants during a Parkour for Seniors class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
An antidote to loneliness
For Jim Jenkins, the class has already prevented a fall.
The day before the final class, he noticed a raised edge in the floor while leaving a restaurant. Paying close attention to his surroundings, he climbed over it.
“Six weeks ago, I probably would have just blundered through there and on down,” he says.
The classes have helped him avoid injury and loneliness, Jenkins says. His wife died more than a year ago, and he now lives alone. Stepping On gave him a social outlet, he says. He plans to take as many classes as he can.
“I wish I was going to be seeing everybody every week,” Jenkins says as the class wrapped up its final spring meeting.
He and others exchanged emails to plan extra outings.
Where to find fall resources
The nonprofit Safe Communities works to reduce injury-related deaths, like falls, in Dane County and keeps a list of fall prevention resources on its website and hosts community events focused on fall prevention.
The Madison School and Community Recreation program guide lists classes — like Parkour for Seniors —- that help people build fall resiliency. People can register online or get assistance by calling 608-204-3000.
AgeBetter provides free home safety assessments for older adults in Dane County. Elsewhere in Wisconsin, residents can ask their Aging and Disability Resource Center about local home safety resources.
Fallsfreewi.org lists schedules and locations for Stepping On across the state.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Falls are the leading cause of injury death for people over 65 years old across the country, and more than 1,800 older Wisconsinites died from them in 2024, according to the U.S. Centers for Disease Control.
But fall injuries don’t have to be so common.
Wisconsin Watch talked with local experts and attended three Madison-area classes designed to improve balance and prevent fall injuries: Stepping On, Parkour for Seniors and Ballroom Basics for Balance.
Here’s what we learned.
Practicing balance can be fun
Children walk on curbs and twirl on purpose. But as people get taller, heavier and older they often stop practicing movements that help with balance, said Susan Frikken, a physical therapist and co-creator of Ballroom Basics for Balance.
The class uses music and different dance genres to teach people to improve balance. Students often waltz on their tip toes, turn during tangos and switch from lead to follower to challenge their minds during salsa.
The nonprofit Safe Communities outlines its “Keys to Better Balance” on its website, including the balance exercises used during ballroom dancing and movements people can do at home.
Throw away the throw rug
Loose rugs and cluttered walkways increase fall risk. Small home improvements like taping down rugs, installing grab bars and adding bright tape to stairs can significantly improve safety, according to the AARP.
AgeBetter Today provides free home safety assessments for older adults in Dane County. Elsewhere in Wisconsin, residents can ask their Aging and Disability Resource Center about local home safety resources.
Talk about falls
Stepping On is a multi-week fall prevention course that has been shown to reduce falls by more than 30%. Wisconsin residents can find a statewide list of classes through the Wisconsin Institute for Healthy Aging.
Attendees at a recent class in Madison reviewed the importance of regular eye exams.
Marcy DeGreef, who facilitated the class, suggested discussing fall risk with health care providers. It’s important for people to understand how the medication they are taking might impact balance, she explained.
The Madison School and Community Recreation program guide lists classes — like Parkour for Seniors —- that help people build fall resiliency. People can register online or get assistance by calling 608-204-3000.
For many families across the Midwest, discussing end-of-life planning is about as comfortable as a January blizzard on Highway 175. However, proactive planning is a final act of care that prevents legal headaches and ensures a legacy stays within the family. In Wisconsin, specific statutes — ranging from marital property laws to unique transfer-on-death rules — make it essential to use the right tools. Whether you are a young parent or assisting aging parents, these are the legal and financial cornerstones for a solid plan.
Write a will and consider a living trust
A last will and testament is the traditional bedrock of any plan. In Wisconsin, a will allows you to name an executor (the person who will manage your estate) and a guardian for minor children. Without a will, a state judge — not your family — decides who raises your kids and how your assets are split.
For many Wisconsin families, a revocable living trust is a powerful alternative or supplement.
Benefit: Unlike a will, which must go through the public, often costly probate court process, a trust allows assets to pass privately and immediately to heirs.
Midwest reality: If you own property in multiple states (like a cabin in Michigan’s Upper Peninsula or a farm in Iowa), a trust can prevent your family from having to open probate cases in every state where you own land.
Assign power of attorney: health care and finances
Control is often lost not at death, but during a period of incapacity. Wisconsin law recognizes two distinct roles:
Financial power of attorney: This grants a “trusted agent” the authority to pay your mortgage, manage your taxes and handle your bank accounts. Under Wisconsin Chapter 244, these are “durable” by default, meaning they remain valid even if you lose mental capacity.
Health care power of attorney: This allows someone to make medical decisions if you cannot. In Wisconsin, your spouse is not automatically authorized to make all medical decisions for you without this document. It requires two witnesses who are not related to you or responsible for your health care costs.
Create an advance directive (living will)
While a health care power of attorney names who makes decisions, an advance directive (often called a “declaration to physicians” in Wisconsin) tells them what those decisions should be. This document outlines your wishes regarding life-sustaining treatments, such as ventilators or feeding tubes, specifically if you are in a terminal condition or a persistent vegetative state.
For Wisconsin residents, the Department of Health Services provides standard forms that are legally recognized across all state health systems.
Name beneficiaries for accounts and insurance
One of the most common mistakes is assuming a will covers everything. In reality, beneficiary designations on life insurance policies, 401(k)s and IRAs “trump” what is written in a will. If your will says your estate goes to your children, but your 20-year-old life insurance policy still lists an ex-spouse, that money will likely go to the ex-spouse.
To keep things simple, many Wisconsin banks offer payable-on-death (POD) options for checking and savings accounts, which keeps that cash out of the probate court’s hands.
Transfer-on-death deeds
Wisconsin is one of the states that allow a transfer-on-death (TOD) deed for real estate. This is a game changer for the “family home.”
How it works: You file a TOD deed with your local register of deeds (such as the one in Juneau for Dodge County). It names who inherits your home, but it has no effect while you are alive. You can still sell the house or change your mind at any time.
The catch: Because Wisconsin is a marital property state, if you are married, your spouse generally must sign the TOD deed even if the spouse’s name isn’t on the original title.
Note: For small estates, Wisconsin offers a “transfer by affidavit” process for estates valued under $50,000. This allows heirs to collect assets without a full court proceeding, provided they follow strict notification rules for the state’s Medicaid Estate Recovery Program.
This story is published in collaboration with Multi-Media Channels. It originally appeared in Multi-Media Channels’ print “Dignity in Care” publication.
Hi, Wisconsin! Health reporter Addie Costello here.
I spent last Saturday with around 80 attendees of a senior breakfast in Merrill, and it was one of my best-spent weekends so far in 2026.
Northwoods residents packed a banquet hall to eat, talk with neighbors and list the biggest issues they face as older adults.
The Senior Empowerment Project, an organizing group focused on issues impacting older people in rural areas and small towns, organized the event and asked me to give a short presentation about my reporting on long-term care issues. The most exciting part? Once I finished talking, a microphone was passed from table to table as older adults shared the questions and issues they think about the most.
Where can they get transportation on the weekends? How can older adults afford to stay in their homes as property taxes increase? Where can they get nutritious food?
Wall decor is shown at the Northwoods Senior Breakfast at the Eagles Club in Merrill, Wis., March 28, 2026. (Addie Costello / Wisconsin Watch)
I left the event with a long list of questions I plan to answer in a new project. We’re calling it Q&Aging, a series of short stories where I interview experts to answer your questions about getting older in Wisconsin — whether about health care, housing or what comes next.
I reported this as part of our collaboration with several Multi-Media Channels, which cover swaths of northeast and central Wisconsin. Find the full Dignity in Care project here.
Choosing a long-term care provider is an important, expensive decision. Like test-driving a car, unannounced visits can provide helpful insight.
So what should someone do before a “walk-in” visit?
Wisconsin Watch asked two experts to weigh in:
Devon Christianson, director of the Aging and Disability Resource Center of Brown County.
Mike Pochowski, president and CEO of the Wisconsin Assisted Living Association.
Here’s what they recommend:
Start with a scheduled tour. The person giving tours likely has important information about a facility’s care and costs. The state health department provides a guide for comparing assisted living providers, and the federal government has a similar guide for nursing homes. ADRCs can also help people prepare for tours.
Ask about “walk-in” visits. Facility staff might list certain times that are not ideal or explain security concerns, especially in a facility that offers memory care. But if the answer is an absolute no, that is something to consider when comparing providers.
Be transparent. The goal of drop-in visits is not to catch a provider doing something bad. Prospective residents or their family members should tell staff who they are and go through the normal guest registration process.
Be respectful. Nursing and assisted living facilities are people’s homes. Visit at a reasonable time and stay in common areas.
Ask residents and their families if they would be open to talking, Christianson said. Don’t base your decision around one resident’s experience. Use these conversations as a tool to help inform your decision.
This article was inspired by a reader sharing an experience touring facilities for a loved one. Do you have something to share? Please reach out.
Q&Aging
Aging comes with big questions — whether it’s about health care, housing or what comes next.
Wisconsin Watch is working to answer questions and share practical tips about aging in Wisconsin. To ask a question or offer a suggestion, fill out this form or contact reporter Addie Costello via email (acostello@wisconsinwatch.org) or phone (608-616-5239).
People cannot avoid death, but they often avoid talking about it. That’s why many people don’t receive as much — or any — hospice care they qualify for, experts say.
“There’s a real taboo in society that hospice equals death,” said Alisa Gerke, the board chair of Wisconsin Hospice and Palliative Care Collaborative and executive director at Unity Hospice and Palliative Care, a nonprofit provider that serves 14 northeast Wisconsin counties.
The goal of hospice isn’t to speed up the dying process; it’s to make people more comfortable — treating the symptoms of an illness instead of trying to cure it.
Once families enroll in hospice, Gerke said, they often ask: “How come nobody told us about this sooner?”
When to talk about hospice
Don’t wait for your provider to bring up hospice.
Patients and providers often wait for the other person to bring hospice up, said Angela Novas, an advanced certified hospice and palliative care nurse and consultant at the nonprofit Hospice Foundation of America. Let providers know that’s something you might be interested in.
Patients or their loved ones can also reach out to hospice providers directly and ask for an eligibility assessment, Novas said.
The basic requirements for adults to receive hospice care under Medicare include:
Verification from two physicians that a patient has a life expectancy of six months or less.
A patient’s willingness to pursue treatments to provide comfort instead of treatments aimed at extending life expectancy.
Clearing up misunderstandings about hospice
Some people may have misperceptions about hospice. Here is what it is not:
A place. Instead, it’s a model of care, Gerke said. While some providers may run facilities, hospice care can be provided at home and in nursing homes, assisted living facilities, hospitals and other settings.
Constant nursing care. Hospice is meant to supplement care from family or facility caregivers, Novas said. But providers should be readily accessible for questions and concerns.
Stopped if someone lives longer than six months. Instead, providers work to re-certify that someone is still likely to die within the next six months, Gerke said. Patients are no longer eligible for hospice if their life expectancy unexpectedly improves.
Permanent. Patients can decide to stop hospice and try curative treatment. If their outlook doesn’t improve, they can return to hospice, Gerke said. They can also freely switch providers.
So what’s palliative care?
Palliative care is a philosophy and medical speciality focused on alleviating suffering, according to Dr. Sara Johnson, a palliative care physician and University of Wisconsin School of Medicine and Public Health professor.
Hospice is a form of palliative care for people at the end of life. But people with a serious illness can access palliative care earlier in their diagnosis and while receiving curative treatments.
Palliative care services are becoming more accessible, Johnson said.
Palliative care specialists add a layer of support for patients and their families, Johnson said.
There is no harm in asking a provider about palliative care options, Johnson said. “If you’re thinking about it, just ask.”
How to find the right provider
Ask local providers for hospice care recommendations, Novas said. But don’t be afraid to shop around. Experts recommend asking these questions before choosing a provider:
How long have you served this area, and where are your staff located?
“Having staff that know that community, live in that community, are a part of that community is huge,” Gerke said.
What is your response time?
A patient’s condition can quickly change, making it important to know how quickly staff will answer calls or arrive in those cases.
What is your relationship with nearby providers?
If you know you want to use a particular nursing home, hospital or physician, it helps to know whether hospice providers have relationships and contracts with them.
What grief support do you offer?
Medicare requires hospice companies to provide families with bereavement services. But the level of those services can range widely.
What is your Medicare rating?
Medicare.gov offers a hospice look-up tool with quality care ratings. The federal agency provides comparative ratings based on family surveys and metrics like nursing visits in patients’ last days before death.
Are you for-profit or nonprofit?
Private equity and publicly traded companies are increasingly taking hold of the hospice industry. Those providers have been associated with lower quality of care, according to a Cornell University study.
For-profits face expectations around financial performance and typically have obligations to shareholders, Gerke said.
But a nonprofit status does not guarantee better care, Novas said. People should prioritize whether a provider fits their specific needs.
What services do your volunteers provide?
Medicare requires hospice providers to have a volunteer program. Do volunteers play games with patients? Provide pet therapy? Read to people? Some volunteer programs are more robust than others, Novas said.
What medications do you not cover?
Not all medications and supplies are covered under the Medicare hospice benefit, Novas said. It’s important to know what you might have to pay for out-of-pocket or with other health coverage.
Aging comes with big questions — whether it’s about health care, housing or what comes next.
Wisconsin Watch is working to answer questions and share practical tips about aging in Wisconsin. To ask a question or offer a suggestion, fill out this form or contact reporter Addie Costello via email (acostello@wisconsinwatch.org) or phone (608-616-5239).
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Wisconsin has thousands of assisted living providers. Some are small houses; others are more like apartment complexes. Some take Medicaid, while others require residents to pay out of pocket. It’s a lot to sort through, especially when someone needs care fast.
Searching “assisted living” on Google pulls up several pages of facilities, many listed under a prominent “sponsored results” section.
Mixed in with actual providers are referral companies that promise a way to compare options. Long-term care referral companies don’t typically charge families for their services. Instead, they often receive money from facilities they recommend.
Wisconsin lawmakers in May proposed legislation to make any financial relationships between a referral agency and an assisted living facility clearer.
Supporters of the bill said disclosure requirements could help families make more informed decisions. Opposing the bill, referral companies argue that they are already transparent and that proposed guardrails would prevent them from helping more families.
The bill failed to pass before the Assembly adjourned last month. But the debate left me wondering: Where should someone start the search for care?
Aging and disability resource centers
Aging and disability resource centers (ADRCs) can provide objective provider lists for free, alongside information about services and payment options, said Janet Zander, the advocacy and public policy coordinator with the Greater Wisconsin Agency on Aging Resources, Inc.
ADRCs cannot recommend one facility over another, Zander said. But they can suggest what to look for during a tour. Zander also recommends looking at a facility’s Wisconsin Division of Quality Assurance surveys.
They can also help people identify what kind of care makes the most sense and explore aging at home, said Sara Tribe Clark, the director of the Eldercare Locator, which offers local resources for older adults, people with disabilities and caregivers.
If you work with a referral agency, ask questions
Tribe Clark recommends asking:
Do you receive compensation from the providers you recommend?
Are your referrals limited to certain facilities?
How do you determine which providers to suggest? What is the criteria for inclusion/exclusion?
Are there providers in my area that you do not represent?
We want to answer your questions
Getting answers to my own questions is a perk of being a reporter. But I haven’t yet navigated Wisconsin’s aging and disability resources for myself or a loved one. I know I’m missing important questions, so please send me yours, alongside your perspectives.
What has been confusing or frustrating about finding care?
What do you wish you’d known sooner?
What made the process easier?
Even after more than two years reporting on long-term care in Wisconsin, I won’t have all the answers. But I will find experts who do. Email me at acostello@wisconsinwatch.org or call 608-616-5239.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Wisconsin’s average age is slightly higher than the national average age.
According to data from the Wisconsin Department of Health, which shows the average of ages between 2019 and 2023, the most recent data available, the national average is 38.7.
In Wisconsin, the average age is 40.1 for the same time period.
Those numbers reflect the rapidly aging baby boomer generation, which is skewing Wisconsin’s population to individuals over 65, according to Wisconsin Public Radio.
Between 2010 and 2020, this demographic grew from 777,000 people to more than 1 million and is projected to expand to 1.3 million by 2030. Meanwhile, the working-age demographic in the state is holding steady, meaning that the population of those over 65 is growing as a percentage of the total.
This fact brief is responsive to conversations such as this one.
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Dementia Innovations, a nonprofit started in Sheboygan County, is developing what it describes as the first U.S. village where people diagnosed with dementia will live and own homes.
Unlike a traditional risk-averse memory care facility with locked doors, homeowners at Livasu, short for “living as usual,” will be free to navigate the village with support from staff.
It’s similar to a European model. Experts say the village care model is difficult to replicate in the litigious U.S., but Livasu’s founders hope the village will show it can work in Wisconsin and other states.
To limit costs, the village is using manufactured homes, a more affordable alternative to site-built options.
A row of footprints followed John and Terri Cooper, both 70, as they carefully navigated an icy road near Sheboygan, Wisconsin. They stopped at a row of concrete slabs.
“This is our house,” John said, waving at the first snow-covered block.
“It’s pretty big,” Terri added while standing on the foundation.
As they do every Sunday, the Coopers had driven around 20 miles from their independent living community to the construction site of their soon-to-be home. John flies a drone over the neighborhood taking shape around it, which will include a grocery store, a spa and a gym. He photographs progress on the 45-acre development designed specifically for people like Terri, who has Alzheimer’s disease.
John and Terri Cooper stand in the construction zone where their home will be placed in Livasu, a Sheboygan County, Wis. village built to allow people with dementia to live freely, Dec. 7, 2025. (Addie Costello / WPR and Wisconsin Watch)
The couple has moved a lot during their 50-year marriage. But this summer’s move will be different from all the others.
Dementia Innovations, a nonprofit started in Sheboygan County, is developing what it describes as the first U.S. village where people diagnosed with dementia will live and own homes. It’s similar to a European model that encourages people with memory loss to remain more independent. The Sheboygan County village, Livasu, short for “living as usual,” will allow people with dementia to live alone or with loved ones and continue typical routines from their homes as their disease progresses.
Applauded for years in other countries, experts say the village care model is difficult to replicate in the U.S. Livasu’s founders hope the estimated $14 million village will show it can work in Wisconsin and other states.
A drone’s view of the construction of Livasu, a Sheboygan County village emphasizing dignity in dementia care. (Courtesy of John Cooper)
To limit costs, the village is using manufactured homes, a more affordable alternative to site-built options. People will buy their home and set hours of caregiving, depending on their level of need.
Unlike a traditional risk-averse memory care facility with locked doors, homeowners will be free to travel throughout the village with support from staff.
“We all take risks every day, but as we age, and especially as we age with dementia, there’s a safety-at-all-cost approach,” said Livasu’s project lead, Mary Pitsch. “That cost is actually a loss of personhood.”
Rather than a fence surrounding the village or automatically locking doors, landscaping will direct people from their home toward the community’s “downtown.” People living in the village’s 124 houses will have access to a lodge with support staff and a place to eat meals with neighbors and to watch the Packers, Pitsch said.
The village will eventually feature a public grocery store and a restaurant.
“We are changing the way we are thinking about care and support,” Pitsch said.
Aging at home — together
The Coopers met in college.
“I picked Terri out almost immediately. It took me some months to convince her that I was the right guy,” John joked.
“Thankfully,” Terri chimed in with a laugh.
As the couple raised two daughters, John worked different technology jobs and photographed sporting events like triathlons on the weekends. Terri was a structural steel detailer.
After watching her mother battle Alzheimer’s, Terri made sure to eat healthy and exercise to prevent herself from getting the same disease. But in 2019, John started noticing changes. Two years later, Terri was officially diagnosed.
“I mean right now,” she asked John outside of the Livasu construction site, “I think I’m OK, right?”
“Yeah, you’re great!” he responded emphatically, prompting another round of laughs.
Terri shook her head.
“This is what I live with,” she said.
The couple moved into an independent living center over a year ago after John was diagnosed with two forms of cancer that are now in remission.
“We wanted to be someplace where, if I was gone, Terri could live and have people take care of her,” John said. “That’s still the goal.”
Unlike institutional settings, Livasu will allow them to age in their home together.
An illustrated map of the future Livasu village is on display, Dec. 3, 2025, in the Town of Wilson, Wis. (Angela Major / WPR)
Manufactured housing brings savings
The Coopers are excited to again own a home, even if it’s smaller than they’re used to.
First they left their 2,400 square foot home in Neenah for a 1,500 square foot duplex. Their future manufactured home in Livasu measures just 1,140 square feet, John said. But unlike the independent living duplex they rented, they are purchasing this home.
Home prices in Livasu currently range between $95,000 and $175,000 — less than traditional site-built houses.
Like with any manufactured homes, savings come from finding scale in mass production, with factories buying materials in bulk and cutting down material waste through computer design.
A model home showcases what a residence at Livasu could look like, Dec. 3, 2025, in the town of Wilson, Wis. When installed, the homes will be flush with the ground to be accessible to people with dementia and their families. (Angela Major / WPR)
The Livasu homes are built off-site, limiting construction time and noise as people move in at different times, Pitsch said. The homes have a title, similar to a car, instead of a traditional deed. That will make transferring the homes between owners easier.
Terri Cooper lived in a mobile home during one year at college, John recalled. But today’s manufactured homes are higher quality, he said.
“They’re actually built pretty nice,” he said.
Every detail is designed for someone aging with dementia, Pitsch explained while walking through a model home placed outside the Livasu construction zone.
More lights in each house help aging eyes. Dark door handles contrast to lightly painted doors. The homes feature safer electric stoves instead of gas.
A model home showcases what a residence at Livasu could look like, Dec. 3, 2025, in the town of Wilson, Wis. (Angela Major / WPR)
While homes in most manufactured housing communities — traditionally called “mobile home parks” — have stairs, Livasus will place homes at ground level.
Bedrooms will have a direct line of sight to the toilet, which can help prevent incontinence.
“The shower was a big discussion. Do you have glass doors? Do you have a shower curtain?” Pitsch remembered debating with the other designers.
“Lots of conversations about some things that would seem really simple, were long conversations,” she said, “and we made the best decisions we could.”
Dignity in dementia care
Pitsch, a social worker, developed her passion for this work while working with older adults. She has run an at-home care company with her husband for close to 20 years. She learned Sheboygan-area law enforcement often responded to emergencies involving people with dementia.
She and other community members started a task force to evaluate the county’s response to residents with dementia. That prompted changes in the county’s emergency protocols and the creation of Dementia Innovations.
“I’m kind of one of those people that if it’s not me, then who’s going to do it?” Pitsch said.
Livasu project lead Mary Pitsch stands inside a model home, Dec. 3, 2025, in the town of Wilson, Wis. (Angela Major / WPR)
Pitsch and others started planning a way to better care for people with dementia and to prevent emergency situations in the first place. They learned about Hogeweyk, the world’s first dementia village in the Netherlands.
“We are far behind other countries in a better, humanistic way of providing care for those with dementia,” Pitsch said.
Dementia care in the U.S. tends to prioritize safety above all else, said Emily Roberts, an associate professor at Oklahoma State University who researches the connection between older adults and their physical environment.
Creating environments where people can make choices and take risks can be expensive, especially in a litigious country like the U.S., she said.
Support staff in Livasu will regularly monitor the grounds. Cameras can alert them if someone walks in or out of the village through an unexpected area.
Construction of the Livasu village is underway, Dec. 3, 2025, in the town of Wilson, Wis. (Angela Major / WPR)
Creating a home-like environment also prevents people from wanting to leave, Roberts said. As the number of people with dementia continues to grow, the country will need more environments that support people with dementia, she said. That’s especially true in aging Wisconsin.
A private room in a nursing home cost $127,750 on average in the U.S., according to the Alzheimer’s Association — more than a smaller home at Livasu. Village residents will pay for care as they need it, similar to at-home care, and potential homeowners discuss their finances with Livasu volunteers, Pitsch said.
Livasu raised more than $8 million for the first phase of construction. It still needs to raise around $6 million more to complete the entire village, but the first houses are already waiting to get placed on foundations.
Pitsch recently watched as a construction crew drove excavators and bulldozers over the giant field where a restaurant, post office and ice cream shop will eventually go.
“I pinch myself,” Pisch said. “It gets pretty emotional actually, to see that it’s actually happening,”
A sign labels the future site of Livasu as construction work is ongoing Wednesday, Dec. 3, 2025, in the Town of Wilson, Wis. Angela Major/WPR
‘Wherever she goes, I go’
When the Coopers move in, they don’t expect to need any caretaking. They still make weekly visits to see their grandkids and take weeks-long hiking, camping and cycling excursions.
“Wherever I go, she goes, wherever she goes, I go. Except in the women’s bathroom,” John said, eliciting more laughs from Terri.
“We kind of like each other, so that’s OK.”
As the couple finished checking in on construction of their future community, they carefully walked back to their car — holding hands the entire way.
John and Terri Cooper hold hands as they walk together on the road next to their future home in Livasu, a Sheboygan County village built specifically to accommodate people living with dementia. Photo taken Dec. 7, 2025. (Addie Costello / WPR and Wisconsin Watch)
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