• Reducing Hospitalizations: Insights from a Care Manager

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    August 1, 2024 /  Basics, Special Needs

    This is an article from Felicia Juntunen, Director of Eldercare Management. I have used them in a variety of situations over the last 12 years and have been pleased with how the relate to and care for my clients. They are also involved with community education such as the Dementia Caregiver series (next one is August 28, 2024 (2:00pm – 3:30pm), in collaboration with the Del Oro CRC at the Senior Center of Elk Grove: 8230 Civic Center Drive, Ste. 140, Elk Grove 95757. Please contact maureen@eldercm.com for reservations and other educational opportunities.

    Reducing Hospitalizations: Insights from a Care Manager

    Imagine finally being discharged from the hospital, feeling a sense of relief, only to find yourself back in the emergency room just weeks later. This frustrating cycle happens all too often for many patients, especially those dealing with complex or fragile health issues. Not only does it disrupt recovery, but it also puts a strain on the healthcare system and drives up costs. An Aging Life Care Professional can help break this cycle and ensure a smoother recovery, significantly reducing the chances of readmission.

    Aging Life Care Professionals, or care managers, play a crucial role in today’s healthcare environment. They act as a bridge between medical providers and community resources, leading to better outcomes for their clients. Their job involves comprehensive care coordination, with a focus on communication and advocacy. By ensuring these aspects are covered, they help prevent unnecessary rehospitalizations and improve overall patient outcomes.

    Avoiding rehospitalization begins with careful planning and coordination. Care managers start by thoroughly assessing a client’s needs and creating personalized care plans, which they continuously refine as needed. They also educate clients and their families about available community resources and guide them on how to access these services. Managing medication is another critical area they handle, ensuring accurate communication between the patient’s old and new care settings. They keep the lines of communication open with medical providers to relay important information about symptoms and medical history, ensuring continuity of care. Additionally, they facilitate communication among the various healthcare professionals involved in the patient’s care.

    Care transitions or the movement between different healthcare settings—such as from a hospital to a skilled nursing facility, or from these settings back home—are crucial moments in a patient’s rehabilitation. Effective management of these transitions is essential to avoid complications and ensure a smooth recovery. Aging Life Care professionals excel in this area, guiding patients through each stage of their care journey. They address common challenges like medication errors, communication breakdowns among healthcare providers, inadequate follow-up care, and insufficient support from family or caregivers.

    For patients recovering from illness or surgery, these challenges can disrupt their progress and potentially lead to relapse. For example, a patient might return home and struggle with preparing meals or accessing medications due to transportation issues. Care managers work proactively to identify and resolve these obstacles, aiming to prevent setbacks and rehospitalization.

    Care managers use several effective strategies to support their clients and reduce the risk of rehospitalization. They keep everyone informed about the client’s status during hospitalization and help facilitate communication between hospital staff and family members. They also provide essential information for developing safe and effective discharge plans and assist in finding suitable alternative care settings when home care isn’t feasible. Helping clients understand their discharge plans and supporting follow-up care, including home health services and medical appointments, is another crucial aspect of their role. They manage medications post-discharge, address polypharmacy issues, and adjust care plans as necessary.

    Through these efforts, Aging Life Care professionals make a significant impact on improving patient outcomes, reducing rehospitalization rates, and ensuring a smoother transition between care settings. Their expertise in coordination and communication is invaluable in helping clients achieve the best possible results.

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  • Hoarding and Older Adults

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    May 6, 2024 /  Basics, Special Needs

    I have worked with Elder Care Management since 2015 and support their advocacy for
    my clients as well as other fiduciaries’ clients. For questions regarding trainings,
    community events, and supporting May as National Aging Life Care Month, contact
    Maureen Lawrence at maureen@eldercm.com

    Hoarding and Older Adults

    By Felecia Juntunen, Director of Elder Care Management – Posted May 2024

    Among the challenges that confront Aging Life Care professionals, working with a client
    who has hoarding behaviors is one of the most perplexing. Families may engage a care
    manager when they’ve discovered an aging parent or loved one’s safety and well-being
    are jeopardized by excessive clutter in their home. In our practice, we have encountered
    situations with varying degrees of hoarding: from a client who collected shopping bags
    full of drugstore items that were never unpacked or used, to those whose homes were
    impassable because of many saved items including garbage and old food. A care
    manager’s task in these circumstances is multifold as they work to address the needs of
    their client while also helping families or other concerned individuals understand how the
    issue can be addressed. Care managers collaborate with other service providers to
    discern how and when to intervene in a hoarding situation, how to overcome an
    individual’s resistance to help, and how to evaluate whether the hoarding behavior is a
    choice or the result of diminished capacity.

    In her article, “Hoarding and Elders: Current Trends, Dilemmas, & Solutions,” Emily Saltz
    explains the basic tenets of hoarding behavior. Hoarding behavior typically begins early
    in life – usually by the time a person is adolescent, and it can take years or decades to
    develop until it becomes an obstacle to functional living. A central characteristic of
    hoarding is continuously bringing items into one’s home – whether with excessive
    purchases or collecting random items. Those with hoarding tendencies cannot categorize
    or organize their belongings and are disabled by the thought of discarding or parting with
    an item. They typically have little or no insight into the problem and experience significant
    denial about their situation. People who hoard may be prone to experience depression,
    social phobia, isolation, anxiety, or substance abuse. Hoarding is further complicated by
    aging. The effects of chronic illness, physical and mental decline, and increased isolation
    compound the problem. When dementia is present, hoarding can present a significant
    obstacle to health and safety as those with dementia are even less able to differentiate
    the importance of items or deal with the effects of their hoarding.

    While the cause of hoarding behavior can vary from individual to individual, it is
    understood that previous trauma and unresolved grief are common driving factors. Those
    who hoard receive emotional comfort from acquiring items and have a compulsive need
    to control and manage their belongings. It’s important to understand that denial is a
    prime characteristic of those who hoard and presents a formidable obstacle to treatment.
    Hoarders would prefer to live in a cluttered and unsafe space than forfeit their
    possessions. There is no easy solution for hoarding and current forms of treatment have
    limited success. It is now recognized that the forced removal of possessions without an
    individual’s permission can cause feelings of violation and additional trauma. Care
    managers tend to concentrate their efforts on what is referred to as a harm reduction
    approach – focusing on helping the individual with hoarding tendencies to live more safely
    rather than eliminating the hoarding.

    Providing compassionate support begins with the hallmark of quality care management:
    a good assessment. Aging Life Care professionals will screen for capacity and consult with
    other professionals for an objective and clinical perspective. Determining if the person is
    legally competent to choose their lifestyle is critical in determining how to mitigate any
    issues created by their hoarding. The goal is to protect the autonomy of the individual
    (their fundamental right to their own decision-making) and balance that with their
    safety. Developing a trusting relationship with the person who hoards is essential to any
    success in working with them toward some resolution. As trust develops, care managers
    can encourage treatment for underlying conditions like depression and anxiety. When
    empathy is conveyed that respects the individual and the meaning of their possessions,
    goals can be developed that enable them to maintain a sense of personal control as they
    collaborate with the care manager to improve their safety and wellbeing.

    Saltz, Emily B., “Hoarding and Elders: Current Trends, Dilemmas, and Solutions.”
    Journal of Geriatric Care Management, Fall 2010, pp. 4-9.

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  • Caregiving: It’s a Balancing Act

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    August 3, 2023 /  Basics, Special Needs

    Elder Care Management is still my go to care managers because they can respond to a broader range of needs for my clients. They have ongoing seminars that help give guidance for you, the family caregiver, as you care for your loved ones.

    August 7th, 1:00pm Successful Aging: It Takes a Plan, Felicia Juntunen, Director of Care Management for ECM. This will take place at Eskaton Village Placerville

    There is a second presentation of this topic on August 15th, 2:00pm at Revere Court 7707 Rush River Dr. Sacramento 95831 (RSVP by 8/11/2023).

    Please contact Maureen Lawrence at maureen@eldercm.com for questions about these events.

    Caregiving: It's a Balancing Act

    Caregiving: It’s a Balancing Act

    by Felicia Juntunen, MA, CMC, ECM Director of Care Management

    Just a sampling of the statistics on caregiving provides a sobering perspective on why the topic of caregiving and support for caregivers is so important.

    According to The Family Caregiver Alliance, in 2015:

    ·    34.2 million Americans provided unpaid care to an adult over 50 years old.

    ·    16.1 million provided unpaid care for someone with Alzheimer’s Disease or dementia.

    ·    34% of caregivers were over the age of 65 and two-thirds were women.

    ·    25% of caregivers are “sandwich generation” providing care for an older adult and a child under age 18.

    ·    Americans provided 18.5 billion hours of care valued at $234 billion.

    Figures like these make it clear that we all have an interest in understanding the impact of caregiving, knowing the signs of stress and caregiver burnout, and knowing how to promote caregiver well-being.

    Whether care is provided by a family member or paid caregiver, the financial impact can be significant. Many family caregivers use after-hours, weekends, and vacations to meet the needs of their loved ones. To fulfill caregiving responsibilities, family caregivers often sacrifice time spent in other relationships and commitments. For those who utilize or plan to use paid caregivers, it’s important to understand the cost of care. In the last two years, due to labor shortages and new regulations, the hourly rate for in-home care has increased to approximately $38 an hour. An Aging Life Care Professional can assist a family in examining their options for care at home, and how to supplement and locate support resources. Care managers regularly help family caregivers by suggesting services, evaluating in-home care needs, attending medical appointments, and providing emotional support.

    The physical and emotional impact of caregiving is significant. Caregivers tend to put their own needs after that of their loved one, sometimes neglecting their own health and well-being. Studies show that the stress associated with caregiving increases the occurrence of chronic illness. Signs of caregiver stress include isolation, sleep deprivation, poor eating habits, failure to care for personal health needs, and frequent illness. Some signs of caregiver burnout may include becoming easily angered with the person being cared for, ongoing feelings of despair, and chronic insomnia. Understanding the signs of caregiver stress can help prevent the onset of caregiver burnout. A caregiver may not recognize these signs in themselves. A care manager can encourage family caregivers to recognize the importance of pursuing some balance between their own needs and the needs of their loved one.

    Aging Life Care Professionals provide support and education to family caregivers, recognizing their value and encouraging them to practice self-care so they can ‘go the distance’ in their role. It’s vital to help caregivers understand that considering and meeting their own needs does not mean they are selfish. Rather, it means they are dedicated to their role and understand they must remain healthy. Taking regular breaks and attending to their own health care is a good place to start. Attending a caregiver support group can ease isolation, offer information, and the value of a shared experience. Asking for and accepting help is also part of self-care. Help may mean asking someone to provide the caregiver with a few hours of respite by staying with their loved one. Help may mean hiring some paid caregiving assistance to supplement care. Even small increments of time a caregiver spends on themselves can have big dividends for their well-being and the well-being of their loved one. Chances are you know someone who is a caregiver. Offer them a helping hand and the encouragement they need to balance their caregiving responsibilities with their own self-care.

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  • Benefits of Hospice and Palliative Care by Felicia Juntunen, CMC, ECM Director of Care Management

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    November 2, 2022 /  Basics, End of Life Issues, Miscelleaneous, Special Needs

    I continue to work with Elder Care Management and have found them responsive, attentive, and knowledgeable. They have ongoing seminars related to care of our seniors. There is a seminar, Thursday, November 17, 2022, 3:00pm titled: The Final Chapter: A Discussion on Death and Dying. This requires advance registration ( www.tinyurl.com/ElderCMNov ) You can also view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Among the many privileges of care management work is the opportunity to journey with clients to the end of their lives. Because we spend time developing familiarity with our clients, regularly provide advocacy for their care, and understand what their priorities are for their well-being and quality of life, they trust us to contribute to the conversation about end-of-life care. We provide insight and guidance to help families determine when it’s time to consider palliative care or hospice as an option for their loved one.

    The primary difference between palliative and hospice care is their curative intent. Both levels of care emphasize relief from pain and other symptoms of a serious illness, but with hospice, attempts to cure a person’s illness are no longer pursued; the comfort of the patient is the sole focus.

    To qualify for hospice, a patient must have a diagnosis that their physician believes is terminal, with a life expectancy of six months or less, or the patient is in the end stages of Alzheimer’s Disease or another dementia. Hospice care provides a team of professionals trained to address the physical, psychosocial, and spiritual needs of the person and provide support to family members. Services are delivered to the patient where they reside and include weekly nursing visits, a home health aide who helps with bathing, and chaplaincy and social worker visits, if desired. Importantly, hospice providers are available to respond 24 hours a day, 7 days a week if concerns arise. Hospice agencies provide bereavement care to patient families. Hospice is a fully covered benefit under Medicare and is covered under most insurance.

    Palliative care is specialized medical care with a focus on providing relief from symptoms of an illness while improving the quality of life for the patient and those caring for them. Palliative care, unlike hospice, is based on the needs of the patient and not their prognosis, and services can be provided along with curative treatment options. Like hospice, palliative care teams include physicians, nurses, social workers, and chaplains, and may also include nutritionists and other professionals who offer support to patients. Unlike hospice, palliative services may be limited, according to the patient’s needs. Most palliative care programs are run by hospice agencies. Palliative care is often covered by Medicare, other insurance, or non-profit hospice agencies.

    Care managers can assist families in recognizing changes in their loved one that may indicate a need for the kind of support offered by either palliative or hospice care. Because a care manager develops familiarity with and regularly monitors a client’s situation, we often recognize when
    there is a significant decline in their physical or cognitive status. We can help a client and families understand they don’t have to be in the final days of life to receive hospice care but can receive care early and take advantage of the many benefits hospice and palliative care can offer. For a patient whose family may be unavailable, a care manager can provide the hospice agency with important information about the client. Elder Care Management care managers collaborate with hospice agencies as they deliver care to their patients, and we are grateful to the hospice community for the enhanced quality of life and comfort they provide our clients.

    Palliative Care is a relatively new offering and can certainly benefit individuals suffering from a debilitating disease with the additional support they need. However, some worry that the emergence of Palliative Care ultimately dissuades physician’s from referring to Hospice, when it is actually more appropriate. “The Future of Hospice in the age of Palliative Care“, an article by the CSU Shiley Haynes Institute for Palliative Care touches on this concern.

    When discussing the topic of death and dying, it would be remiss to not also touch on the importance of finding support for those individuals left behind. Whether a death is sudden and unexpected or part of a long journey that has come to an end, loved ones will face their own unique experience of grief and loss. “Salt Water: Find Your Safe Harbor” is a website created by Margo Fowkes to share and offer support to individuals during the difficult period after a loss. Another helpful website, “Cake“, provides education on “navigating mortality” and support for loved ones.

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

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    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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  • How to Recognize Elder Abuse

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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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  • The Difficult Transition Between the Hospital and Nursing Home

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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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  • Special Needs – People with Disabilities

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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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