Lisa is now 55 years old. She has been living with Marsha and Cindy for the past several years. Lisa enjoys her part-time job at a local grocery store, and she has been working there for 12 years. Lisa is content. She has an understanding that there is something wrong with Cindy, and she knows that her Marsha is sad a lot of the time. She vaguely remembers attending her father's funeral many years ago, but she does remember that she hasn't seen him in so long - she's almost forgotten what he looked like.
Marsha tells Lisa that Cindy has cancer, and she is preparing for the two to deal with Cindy's death. Cindy's cancer is non-Hodgkin's lymphoma, a form of the disease that has a low rate of cure. The doctors detected the cancer at a fairly late stage. For Cindy, she knows that Marsha and Lisa will be OK in the house, and that is at least some comfort for her. Marsha is getting up in years as well, and she worries about Lisa if something should happen to her.
Lisa started to notice that she cannot see things as clearly as she used to, and she recently got a pair of eyeglasses to aid her reading.
Lisa doesn't know how she will live without Cindy, a woman she has known for most of her life as a caregiver and parent. She is scared and has no idea what will happen.
* If Marsha were to die, what options are there for Lisa? Is it legally possible for Marsha to determine what she would like to happen if Lisa is unable to live on her own (which is unlikely)?
* Describe the developmental milestones of middle adulthood. What kinds of changes is Lisa likely to have experienced? How are these typical developmental changes mediated by her disability?
* When is Lisa eligible for Medicare? What is the difference between Medicare and Medicaid?
Questions from group 7:
ReplyDelete1. What information is out there that could help Marsha and Lisa make the decisions dealing with the next steps in both Marsha and Lisa’s lives? For instance, what are the possible housing options are there for adults who are on the autism spectrum, what accommodations are offered?
2. We know from Lisa’s past that she had a difficult time understanding her brother’s death. If Cindy is to pass, where can Lisa seek assistance in coping and understanding the situation?
Marsha can determine some things she would like to happen to Lisa if she is unable to live on her own. If Marsha becomes Lisa’s court-appointed guardian then she can have more say in the issues. When Marsha would die, the court would “appoint a successor guardian” and would place great “weight in the choice of the deceased parent and guardian.” 1 Thus, Martha should make her “wishes known to the court” through “language” in her “recommending the appointment of the parent's first choice (and at least one alternate) as successor guardian for the child.” 1 Martha may also arrange for finances to be provided for Lisa through money she leaves to Lisa, a POA, or a “court-appointed conservator” upon death. If Marsha has money she wants to leave with Lisa she should set up either a “discretionary support trust” or a “special needs trust.” 1 In the Discretionary Support Trust, Marsha could include the “testamentary trust” in her will and appoint a “trustee who will have the discretion to make (or refuse to make) payments for the benefit of the disabled child” for “support, care, education, and assistance.” 1 If Lisa is receiving either Medicare or Medicaid she would need a Special Needs Trust which would “provide financial management and to ensure that the person will continue to be eligible for government programs.” 1
ReplyDeleteIf Marsha were to die, Lisa would most likely need to find a new place to live, with someone else, or ask someone to move in with her. Perhaps Marsha or Cindy has siblings, an aunt or uncle of Lisa's, or a cousin that she could move in with or have move in with her. Lisa may even have made a close friend at work she would feel comfortable living with. Alternatively, Lisa could look into a group home in the area. She would be with others that have disabilities and might feel like she fits in with them.
Links for reference:
1 Estate Planning - Trusts for Disabled Persons. (2003-2010). Fitzwater Meyer LLP. Retrieved November 28, 2011, from http://www.fitzwaterlaw.com/practice/estateplanning/trustsfordisabled.cfm
In the stage of middle adulthood, people generally start to create different behavioral and lifestyle choices. Lisa will eventually have to make choices or help her mother make choices about her future. She is likely experiencing physical changes like the loss of vision, osteoporosis, or menopause which can also trigger emotional changes that are enhanced by the feelings at home of Cindy's imminent death. The idea of death is something hard to understand for Lisa, illustrated by the death of her father. She may not understand that death has a finality to it. Because Lisa is starting to get older, she might start to have some memory loss, also illustrated by her father's death, since she can't remember him very well. Autism may even progress her memory loss faster than that of someone without Autism, however studies have shown that symptoms tend to improve with age. For instance, Lisa is more aware of her surroundings, knows Marsha is sad, and is aware that Cindy is sick. She also understands that change is in her future, without Cindy and possibly Marsha, even though she doesn't know what she will do.
ReplyDeleteReferences:
Autism Improves in Adulthood. (n.d.). WebMD - Better information. Better health.. Retrieved November 30, 2011, from http://www.webmd.com/brain/autism/news/20070927/autism-improves-in-adulthood
Psychology, Biology, etc...: Adolescence and Adulthood Developmental Stages. (n.d.). Psychology, Biology, etc.... Retrieved November 30, 2011, from http://stokercg2913.blogspot.com/2009/10/adolescence-and-adulthood-developmental.html
Lisa is eligible for Medicare when she reaches the age of 65. Medicaid is different than Medicare. Medicaid is a "state governed program" for low income individuals, including: "pregnant women, children under the age of 19, people 65 and over, people who are blind, people who are disabled, and people who need nursing home care." 1 People may apply for Medicaid at their "State's Medicaid agency." 1 Whereas, Medicare is "a federal governed program" which serves "people 65 and over, people of any age who have kidney failure or long term kidney disease, and people who are permanently disabled and cannot work." 1 People may apply for Medicare at their "local Social Security office." 1 People may qualify for both programs, and are considered "dual eligible.” 1
ReplyDeleteLink for reference:
1 What is the difference between Medicare and Medicaid?. (2008, August 26). Medicare.gov - The Official U.S. Government Site for Medicare. Retrieved November 28, 2011, from https://questions.medicare.gov/app/answers/detail/a_id/2038/~/what-is-the-difference-between-medicare-and-medicaid%3F