• July 4, 2017 /  Special Needs

    I know Lori Cochrane from our association at the local Professional Fiduciaries Association chapter where she is chair of the education committee. She is also a local, licensed professional fiduciary specializing in all matters of the person and practices a person-first-and-centered philosophy as a special needs and health care advocate. She earned her B.A. in Behavioral Psychology and her Master’s Degree in Special Education from CSU, Sacramento. She is a professional member of the National Guardianship Association, Professional Fiduciary Association of California, The Arc of California, and the Placer County BAR Association. She has been helping families during times of difficulty and transitions since 2000. Lori can be reached at 916-705-7309 or Lori@CochraneCSS.com.

    This is posted with permission and may also be found at:  https://www.cochranecss.com/single-post/2017/06/06/SPECIAL-NEEDS-PLANNING-Who-will-watch-over-my-child-with-special-needs-as-they-age-when-I-am-not-able

    Special Needs Planning: Who will watch over my child with special needs as they age when I am not able?

    For parents of a child with special needs many questions arise as the child becomes an adult;

    Will they be able to live independently? Will they have an adequate and dignified place to live? Will they be able to pay their own bills? Who will watch-over my child to ensure their needs are met?

    If you have come to the realization of life-long dependence for your child, planning for their transition into adulthood will go a long way to ease your mind. Before your child turns 18-years-old, becoming an adult, it is important to plan for who will make decisions on their behalf if they are not able. Consult with an attorney to discuss whether assigning an agent with power of attorney or establishing a court conservatorship is appropriate.

    Who can be assigned as a decision maker?

    Parents are the likeliest chosen decision makers. The usual recommendation is to select one parent primarily and the other parent as an alternate. Both parents may be assigned as co-conservators if your adult child does not have capacity.

    The usual recommendation when planning is to include a succession plan in the event you become unavailable, incapacitated, or die. You may consider including a close responsible adult as an alternate. Whoever is selected they must be over 18 years of age, and be willing to serve in this role.

    The qualities of a person best suited to act as a decision maker for a person with special needs is someone who will act in the best interest of the person, separate from their own interests. They must be trustworthy and capable as a strong advocate navigating and adapting the plan of care as the person ages. They must have the knowledge necessary to preserve the person’s public benefits and prudently manage their finances. Direct service providers or their employees may not serve in this role.

    There are professionals who specialize in this area who can help you plan, manage services, and advocate for your adult child’s best interest.

    How will I know when it’s time to seek help?

    Planning for your inability to serve as your child’s decision maker is wise. The loss of your ability or willingness to manage important things isn’t likely to be black and white or happen overnight. As time progresses and the realities of aging become known, you as a parent may find yourself less-willing or less-able to manage everything for your adult child. Maybe you are feeling it is best to be busy in your own lives or you want to help your adult child become less dependent on you.

    The need for less dependency or a less restrictive arrangement may become apparent. You may choose to step-back somewhat to provide your adult child the tools or resources which will be available to them as you become less available. Arranging for your adult child to live outside of your home with the necessary supports will be important to do before long. Finding an appropriate living arrangement along with navigating the maze of resources and public benefits, can be managed by a professional.  You might consider involving a licensed professional fiduciary to help with the transition between your adult child being your dependent, to your adult child living independent of you.

    What can a licensed professional fiduciary do to help the transition?

    Licensed professional fiduciaries provide critical services to help protect and maintain quality of life for vulnerable people. When it comes to people with special needs, some professional fiduciaries who specialize can identify critical needs, manage a person’s publicly provided services, protect their public benefits, and consult with doctors and attorneys as necessary.

    A Licensed professional fiduciary can open an *ABLE Act account on behalf of a person, and serve as the legal representative managing the account.

    A licensed professional fiduciary can also serve as a consultant, or as agent for power of attorney for health care and/or for finances. They can also serve as a court appointed conservator for a person with special needs under a limited conservatorship. Some fiduciaries specialize in serving as either health care agent or finance agent as trustee.

    In California, fiduciaries are licensed and regulated by the state of California’s Professional Fiduciary Bureau under the Department of Consumer Affairs.  You can learn about the high standards and stringent requirements licensed professional fiduciaries are held to by visiting their website at www.fiduciary.ca.gov.

    *You can learn more about the ABLE Act by visiting www.ablenrc.org.

    guardian visit

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  • February 28, 2017 /  Special Needs

    It’s an unfortunate truth that elder abuse is more common than some assume. It affects four percent of the elder population every year. But, according to experts, less than one in 14 cases of elder abuse are reported to law enforcement authorities. This post will go over how to recognize and cope with abuse. Whether you’re a senior citizen who wants to keep yourself safe, or a family member who is trying to prevent any issues, this will help you stay alert.

    Why and Where It Happens

    Elder abuse commonly occurs where the elder lives. In the home, abusers can be adult children or caretakers. It also happens in long-term care facilities, where nurses and caretakers take advantage of the elderly in some form. So, why does this happen? As they age, they become more vulnerable. They lose much of their physical strength, making it hard for them to fight back. Their mental state, as well, can affect their ability to protect themselves.

    The Five Common Types of Elder Abuse

    • Physical – This may include pushing, shoving, slapping, pinching, hitting, and the like.
    • Sexual – Some people are surprised by this, but it does happen to older adults. More often, it’s caregivers who take advantage of weaker senior citizens who can’t stand up for themselves.
    • Psychological – Obviously, the other forms of abuse are going to have an effect on someone’s psychological health. However, this can stand on its own as well. The perpetrator may threaten, speak abusively, become rude and sarcastic, and otherwise belittle the senior.
    • Financial – This involves the improper – even illegal – use of an elder’s assets. They might take money or property, cash social security or pension checks for themselves, or coerce the elder in some other financial way.
    • Neglect – This is a passive, rather than aggressive, form of abuse, but is just as powerful. It constitutes more than half of all reported cases of elder abuse. The caregiver might fail to provide medication or food on time. They might neglect to help the elder with their hygiene. Even if the neglect is unintentional, it’s still wrong and has a serious effect on the abused.

    How to Recognize Abuse

    Oftentimes signs of abuse are passed off as symptoms of dementia, mental deterioration, or side effects of the elderly person’s frailty. So, it’s important to know how to spot it. Warning signs would include frequent arguments between the elderly person and their caregiver, or sudden changes in personality or behavior. Let’s look at some warning signs for each kind of abuse.

    • Physical abuse is easier to spot. Look for unexplained signs of injury, such as bruises or welts. Broken bones and sprains would be an obvious clue. Don’t simply assume it was an accident. You don’t need to be overly suspicious, but you should investigate the causes of any injuries to be on the safe side.
    • Sexual abuse warning signs would include bruises around private areas, unexplained bleeding, and a sudden change in the elder’s behavior. They could become more defensive, angry, or jittery. This kind of abuse has an especially profound effect on their psychological state.
    • Psychological abuse could be happening if the elder shows a sudden and marked change in personality, such as defensiveness, overreacting to small things, or crying easily. Gently approach your loved one to see if they’ll open up about it.
    • Financial abuse warning signs include significant withdrawals from their accounts, items or cash missing from the household, and unpaid bills even when they have enough income for it. Look for any indication that their spending habits have changed, and find out whether they’re handling their own finances, or if a caretaker has assumed responsibility without asking.
    • Dehydration, malnutrition, and bed sores are just a few signs of possible neglect. Keep an eye out if the home is unsanitary, or the elderly person is left dirty or unbathed.

    If you’re a senior citizen, you can also take action to protect yourself. Make sure your financial and legal affairs are in order. If they aren’t, you can enlist professional help. It’s also important to keep in touch with your family and friends, in order to avoid becoming isolated. And if you’re unhappy with the care you’re receiving in-home, or in a facility, don’t be afraid to speak up. You can turn to a trusted friend or family member. There are also elder abuse helplines. The National Council on Child Abuse and Family Violence has compiled a list, which you can find here: https://www.nccafv.org/adult-protective-services-numbers.

    By staying aware of the warning signs, you can stop abuse or prevent it from escalating any further. Find more information and resources from the CDC here, and from The NCPEA (National Committee for the Prevention of Elder Abuse) here.

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  • October 3, 2013 /  Special Needs

    Here is an article from Ken Covinsky on Kevinmd.com.

    smiling nurse I too, have found that not only are the nurses and doctors in an assisted living and skilled nursing have a lack of concise or correct information to the recent care of their patient in a hospital but also the patient’s primary care doctor (PCD) lacks the same information! Each time I have had my client come back to their respective communities, I have had to readdress the medications given them with their PCD as well.

    In advocating on my client’s behalf, I request the attending physician in the skilled nursing community work with my client’s PCD. The PCD usually does not want to “interfere” with the skilled nursing doctor but, as far as I am concerned, the PCD are the ones who know my client’s medical history the best and are most likely to better understand their needs.

    Serving Auburn, Lincoln, Roseville, Rocklin, Sacramento, and the counties of Placer, Sacramento, Sutter, Yolo, Yuba, El Dorado, Nevada and even Humboldt.

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  • August 29, 2013 /  Special Needs

    I had a blind guitar instructor in college. He knew his way around campus (Sac State) and was more than proficient playing the guitar. He didn’t need help, taught me the right way to “guide” him (he held on to my arm) when he needed help in negotiating or was lazy in using his stick, and amazed me with his independence.

    One day he was teaching me a fancy lick on the guitar and all of a sudden he “disappeared”. I mean, not physically but mentally…personality left. He was quite for a few moments and then asked, “Where am I, who are you?” I asked him if he was okay and he started getting agitated so I told him my name and that we were in his house. He asked what was going on and why he couldn’t see anything. At that moment I remembered that sometimes when someone “blanks” out that it could be a form of epilepsy.

    the arc logoI don’t know why I should think of that right then but I decided to “play along” with him. I told him that the lights went out, we were waiting for them to come back on and that, in the meantime, I was playing guitar for him. So I asked if I could continue and he was okay with that.

    When he “came back” he again, asked what happened. This time I used his name and asked him, “Is that you?” Answering in the affirmative he asked if I understood what just happened. I told him that I guessed that he had an epileptic episode and he confirmed it. He was pleasantly surprised that I would know that and apologetic that he hadn’t told me that he had seizures in the past but hadn’t had any for a couple of years. He was the best guitar instructor I ever had and miss him and his corny jokes.

    The point is that I was prepared and that is one of the messages of The Arc organization. They want the public to understand and be prepared for including those with intellectual and developmental disabilities into their world. They also advocate on their behalf and provide resources.

    Please visit the national website http://www.thearc.org/who-we-are and then go to the state site http://www.thearcca.org/ and finally our local site in Roseville http://www.thearc.org/.

    Serving Auburn, Lincoln, Roseville, Rocklin, Sacramento, and the counties of Placer, Sacramento, Sutter, Yolo, Yuba, El Dorado, Nevada and even Humboldt.

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