Trisha Stefano: Well I'm Trisha Stefano and in our group we had Christine, Amber and Esther. Esther who speaks multiple languages in one conversation.

[Laughter]

Trisha Stefano: So Leroy is a 74 year old person who is a wonderful father of five children. He was divorced and he raised his kids. He was very independent is our assessment of him. He was in control when he was the head of the household.

Now at the point of his life, he has now multiple medical conditions. He has issues with coronary artery disease, congestive heart failure. He also has some evidence of dementia that must be progressing to a point that's impacting him but there hasn't been a diagnosis made yet. He's already on multiple medications which apparently they have played around with some of the medicines and have finally got him in some whatever control on what his on right now.

But it requires a lot of his resources. And basically apparently it's leaving him with very little financially to meet his basic needs whatever those are. He doesn't qualify for every single type of federal funding that he could possibly be getting. And I assume that the questions were the same with the scenario changed?

Moderator: Yes.

Trisha Stefano: Right. Okay so I'll just sort of look in front as long as I'm talking now. What are the critical needs that as a family we need to work on with him. We felt that the first thing would be physical assessment of his environment and his own physical and mental situation. We needed to find out how independent he was or wasn't. What he was really getting from his own environment.

We also felt that a critical issue was trying to determine a diagnosis of what was causing his dementia so that he could get on really appropriate medication. And be in an appropriate setting whether he is going to be able to remain independent or moving on to his family members or going into a facility of some place. So we really wanted to do assessment of all of his basic needs, nutritional, whether he was subject to falls because of the physical setting. And what was going on with his common housing.

What is the key information that we were trying to make decisions upon? We really felt that the big things that was in the scenario was the medications. So we want to be sure that we really worked on. Was he getting all the resources that he could for his pharmacy support. As far as the community, was he getting what he needed?

And we were talking about if you went to the web sites and try to see what was available, the public wouldn't necessarily have the ability to go in and see. It's almost like everybody needs a case manager to figure out what they need for doing individual case. Was he really able to access the system? We don't know how much of an opinion he has. He was a very independent person and very much in-charge so we want to include whatever his wishes and thoughts were into whatever was happening with him.

We wanted to find out how much resource are really available from the children. Did they have the availability of bringing him into their homes instead of being there and being more supportive. How would we really weigh out what was going on with this information depending upon what was available from the family and then going into the public resource availability. We would try to see what we could do to access what else was in the community for him.

We really felt that if he'd been in a hospital setting like a case manager for instance would have been able to really help him work with what would be available in the community. But when you're at home alone there isn't that much access.

So if you went into some kind of a wonderful clearing system and imaginary clearing system where you could put in his situation. What his current availability of resources is and come out with a plan for him. That would just be a wonderful world. And everything would link up either to real person which a lot of older people need to talk to a real person or have a real person involved.

Maybe the younger children could go into different links and find out what community services would be available. And we really felt that it was important that there was a legal help here because we don't know about advance directors, power of attorney, surrogate and all those decisions that a person in his state might need assistance with. But if the children could link up to that, that would really be a big help.

We wanted about a telemonitoring for this individual that he could remain independent and have some kind of monitoring in the home setting. We felt that the pharmacy in case management would be a real big help to him because maybe he could access MyFlorida Rx or some other information. And that would assist with his medications when get a little bit extra money on the other end and he could help with the pharmacy issues

We felt that he needed more, if we were going to looking to help him and we were his family members, what could we do to help with the finances and help with the financial. What the government could do to assist him as far as medicare, medicate, social security, VA support, food stamps, meals on wheels and that kind of information.

Also this individual dependent in his prior life a lot on his church, in his neighbors, in his community and we felt that that would be an important thing to tap into what he needs and in a holistic approach. And whether that could be tied into some kind of website information is a thought, like tie-in somehow what's in your own community into that web information. So I don't know what track we're on, but that's all we came up with. Any questions?

[Applause]

Moderator: Alright. Next let's hear about Joshua Deadford.