>> HELLO. I AM DR. MICHAEL CREEDON, NEWLY RETIRED CHAIRMAN OF THE AGING STUDIES PROJECT AT A.T. STILL UNIVERSITY. FOR MANY YEARS NOW, I HAVE FOCUSED MY EDUCATIONAL AND PROFESSIONAL CAREER ON WORKPLACE ISSUES AS IT RELATES TO THE AGING POPULATION, RETIREMENT AND ELDERCARE ISSUES. SINCE 1978, I HAVE LED AGING STUDIES PROGRAMS AT SEVERAL UNIVERSITIES, INCLUDING THE UNIVERSITY OF BRIDGEPORT AND JOHNS HOPKINS UNIVERSITY. OVERALL, I HAVE A PASSION FOR ENSURING THAT THE NEEDS OF SENIORS AND VULNERABLE ADULTS ARE MET. RUSH IS PLEASED TO PARTNER WITH THE SOCIAL SECURITY ADMINISTRATION, THE NATIONAL ADULT PROTECTIVE SERVICES ASSOCIATION AND WELLS FARGO'S FINANCIAL EDUCATIONAL PROGRAM, HANDS-ON BANKING, TO BRING THIS TRAINING TO YOU TODAY. THERE ARE APPROXIMATELY 44.7 MILLION AMERICANS WHO ARE AGE 65 OR ARE OLDER. OF THOSE, AN ESTIMATED 5 MILLION HAVE DEMENTIA. MOREOVER, PEOPLE WITH INTELLECTUAL DISABILITIES ARE LIVING LONGER DUE TO NEW FORMS OF TREATMENT. AND A SIGNIFICANT NUMBER OF INDIVIDUALS EACH YEAR SUFFER A TRAUMATIC BRAIN INJURY THAT AFFECTS CAPACITY. AS A RESULT, THERE ARE INCREASING NUMBERS OF ADULTS WHO MAY BECOME UNABLE TO MAKE DECISIONS FOR THEMSELVES. WE WANT THIS TRAINING TO SERVE AS A RESOURCE FOR YOU IN ASSISTING INDIVIDUALS WHO ARE UNABLE TO MAKE DECISIONS FOR THEMSELVES. ALTHOUGH YOU ARE NOT RESPONSIBLE FOR DETERMINING WHETHER A PERSON CAN MAKE FINANCIAL OR OTHER DECISIONS, WITH THE INFORMATION YOU LEARN DURING THIS TRAINING, IT IS OUR HOPE THAT YOU WILL BE ABLE TO RECOGNIZE THE SIGNS OF ADULT COGNITIVE IMPAIRMENT AND USE RESOURCES YOU WILL LEARN ABOUT TODAY TO BE OF ASSISTANCE. WE APPLAUD AND THANK YOU FOR VOLUNTEERING YOUR TIME AND TALENT TO PROVIDE COMPASSIONATE CARE TO VULNERABLE ADULTS. WE HOPE YOU ENJOY THIS TRAINING. THANK YOU. [ MUSIC PLAYING ] HELLO, I AM ANA OBREBSKI FROM THE SOCIAL SECURITY ADMINISTRATION. IN COLLABORATION WITH RUSH UNIVERSITY MEDICAL CENTER IN CHICAGO, I AM PLEASED TO WELCOME YOU TO THIS TRAINING ON CHANGES IN DECISIONAL CAPACITY. NOW, WHAT DO WE MEAN BY CHANGES IN DECISIONAL CAPACITY? WELL, WE'RE TALKING ABOUT THE CHANGES IN A PERSON'S ABILITY TO UNDERSTAND INFORMATION, TO APPRECIATE A SITUATION AND ITS CONSEQUENCES, AND TO REASON AND MAKE CHOICES. YOU MAY BE A FRIEND OR FAMILY MEMBER OF A SOCIAL SECURITY BENEFICIARY AND NOTICE CHANGES IN THE WAY HE OR SHE REACTS TO INFORMATION AND TO RISKS CONCERNING HEALTH CARE, FINANCIAL MATTERS, RESIDENTIAL CHOICES OR OTHER DECISIONS. PERHAPS IN SOME CASES, YOU ARE IDENTIFYING POSSIBLE ABUSE OR EXPLOITATION. THIS TRAINING IS INTENDED TO SERVE AS A RESOURCE FOR REP PAYEES AND OTHERS WITH WHO ASSIST VULNERABLE ADULTS AND SENIORS WHO NEED SUPPORT WHEN MAKING DECISIONS. IT WILL ASSIST YOU WITH RECOGNIZING INSTANCES OF CONFUSION OR CHANGES IN DECISION-MAKING ABILITIES, LENDING YOUR SUPPORT BY HELPING A PERSON UNDERSTAND THE SITUATIONS AND CHOICES THEY FACE, AND SUGGESTING AND REACHING OUT TO RESOURCES FOR FURTHER ASSISTANCE. NOW, HERE ARE SOME IMPORTANT POINTS TO KEEP IN MIND ABOUT CHANGES IN AN ADULT'S DECISIONAL CAPACITY. DIFFERENT TASKS AND DECISIONS USE DIFFERENT SKILLS. A PERSON MAY BE ABLE TO MAKE SOME KINDS OF CHOICES, BUT NOT OTHERS. FOR EXAMPLE, A PERSON COULD DECIDE WHETHER TO HAVE SURGERY, BUT NOT HOW TO INVEST MONEY, OR WHERE TO LIVE, BUT NOT HOW TO PROTECT AGAINST EXPLOITATION OR FRAUD. DON'T ASSUME THAT JUST BECAUSE SOMEONE IS OLDER, THE PERSON IS LESS ABLE TO MAKE DECISIONS. AND REMEMBER THAT PEOPLE HAVE A RIGHT TO MAKE DECISIONS ACCORDING TO THEIR OWN VALUES AND PRIORITIES. IF YOU OBSERVE CONFUSION OR MEMORY LOSS, UNDERSTAND THAT IT MAY BE TEMPORARY OR REVERSIBLE. DON'T ASSUME IT IS A PERMANENT SITUATION. PEOPLE'S ABILITIES CHANGE ALL THE TIME, OFTEN DUE TO CHANGES IN THEIR LIVING ENVIRONMENT, MEDICAL CONDITIONS, STRESS, GRIEF, PAIN, MEDICATIONS, POOR DIET OR DEHYDRATION. DON'T MISTAKE HEARING LOSS OR VISION LOSS FOR A DIMINISHED DECISIONAL ABILITY. AN IMPORTANT THING IS TO FIND WAYS TO SUPPORT THE PERSON IN MAKING HIS OR HER OWN CHOICES. IF THAT DOESN'T WORK, A PSYCHOLOGIST, COUNSELOR, SOCIAL WORKER OR A COMMUNITY RESOURCE WHO RECOMMEND STEPS TO TAKE. AND YOU ARE NOT RESPONSIBLE FOR DETERMINING WHETHER A PERSON HAS THE ABILITY TO MAKE DECISIONS ABOUT HEALTH CARE, FINANCES, HOUSING OR LEGAL TRANSACTIONS, BUT YOU HAVE AN OPPORTUNITY TO OBSERVE CHANGES AND TAKE ACTION. HERE IS A SCENARIO ABOUT RICHARD AND HIS TWO CHILDREN, MARY AND MIKE. RICHARD, AGE 76, RECENTLY AND SUDDENLY LOST HIS WIFE SHIRLEY. >> HI, DAD. >> OH, HEY, MARY. >> I SEE YOU HAVEN'T HAD A CHANCE TO SHOWER YET. DID YOU FORGET WE'RE GOING TO LUNCH TODAY? >> YEAH, I GUESS I FORGOT. I JUST CAN'T SEEM TO FOCUS SINCE YOUR MOM DIED. >> THAT'S OKAY, DAD, IT'S ONE OF THE REASONS I CAME EARLY. WHY DON'T YOU GO AND SHOWER NOW, AND I CAN CLEAN SOME OF THIS MESS UP. >> OKAY. >> HEY, MARY, ALL SET FOR LUNCH? >> NO. DAD FORGOT AGAIN. HE'S SHOWERING NOW. MIKE, I'M REALLY WORRIED, HE'S SO ABSENT-MINDED. HE STILL HAS THE SAME CLOTHES AS HE'S BEEN IN IN THE LAST THREE DAYS. I STARTED TO CLEAN UP. LOOKS LIKE HE HASN'T PAID HIS BILLS. >> OH, THE POOR GUY HAS BEEN A MESS FOR THE LAST THREE MONTHS. WHAT DO YOU THINK WE SHOULD DO? >> WE HAVE TO TAKE OVER. HE'LL JUST HAVE TO COME AND LIVE WITH ME. YOU CAN TAKE OVER THE FINANCES AND WORK ON SELLING IN THE HOUSE. >> WHOA WHOA, HOLD ON THERE. DAD IS JUST MOURNING. HE AND MOM WERE MARRIED FOR 53 YEARS, GIVE HIM A BREAK. >> MIKE, DAD IS 76 YEARS OLD. WE'RE GOING TO HAVE TO TAKE CARE OF HIM. >> I THINK HE JUST NEEDS A LITTLE TIME. >> WELL, THAT FEELS BETTER! WHERE ARE WE GOING FOR LUNCH? >> DAD, WE NEED TO TALK. >> MARY. >> ABOUT WHAT, SWEETIE? >> DAD, I FOUND THESE UNPAID BILLS ON THE COFFEE TABLE. >> OH, I WAS -- >> AND THE PLACE IS A WRECK. >> WELL, I -- >> YOU'RE JUST GOING TO HAVE TO COME LIVE WITH ME. >> MARY, KNOCK IT OFF. DAD, MARY IS JUST WORRIED ABOUT YOU. WE ALL ARE. >> I KNOW, KIDS. MARY IS RIGHT, THOUGH, THE PLACE IS A MESS. EVERY DAY I GET UP AND SAY I'M GOING TO GET IT TOGETHER, BUT THEN SOMETHING JUST STOPS ME. I CAN'T SEEM TO DO ANYTHING. I'LL START SOMETHING, LIKE THE DISHES, THEN SUDDENLY I FIND MYSELF STARING AT A STUPID MUG WE GOT WHEN WE WERE IN NEW YORK. THE PHONE RINGS AND I JUST CAN'T BRING MYSELF TO ANSWER IT. I DON'T -- I JUST DON'T KNOW WHAT I'M GOING TO DO WITHOUT HER. >> I UNDERSTAND, DAD. I DON'T KNOW WHAT I'D DO WITHOUT MY WIFE. >> AND, DAD, WE CAN HELP. I HAVE A CLEANING SERVICE THAT COMES EVERY TWO WEEKS TO MY HOME. I'M SURE THEY CAN COME OVER AND CLEAN THIS PLACE UP, TOO. >> WOULDN'T THAT BE A RELIEF? >> YES. >> WE CAN SET UP ONLINE AUTOMATIC BILL PAY, TOO. >> YOUR MOM USED TO PAY THE BILLS. >> BUT THAT DOESN'T ADDRESS THE ELEPHANT IN THE ROOM. DAD, YOU HAVE TO GET OUT OF THE HOUSE. >> MARY, HE DOESN'T HAVE TO MOVE. >> NO, I MEAN, HE CAN'T SPEND THE WHOLE DAY COOPED UP IN HERE RELIVING OLD MEMORIES. YOU HAVE TO START LIVING AGAIN, DAD. WOULD YOU BE WILLING TO SEE SEE A GRIEF COUNSELOR? >> I GUESS. SOMETHING HAS TO CHANGE. >> LIFE CHANGING EVENTS, LIKE THE DEATH OF A CLOSE FAMILY MEMBER, A MEDICAL CONDITION OR A TRAUMATIC CAR ACCIDENT CAN AFFECT SOMEONE'S DECISIONAL ABILITY, ESPECIALLY IN THE SHORT-TERM. ADDITIONALLY, AS PEOPLE GROW OLDER, THEY ARE MORE LIKELY TO EXPERIENCE SOME DEGREE OF DEMENTIA, PARTICULARLY IN THE OLDER AGE RANGE. IN YOUR ROLE AS A FAMILY MEMBER, TRUSTED FRIEND, REP PAYEE OR SOMEONE WHO ASSISTS VULNERABLE ADULTS AND SENIORS, IT IS IMPORTANT THAT YOU RECOGNIZE HOW TO SUPPORT THEM IN THEIR DECISION-MAKING AND HOW TO DISTINGUISH ONE SITUATION FROM ANOTHER. IN THE FIRST SCENARIO, AFTER LOSING HIS WIFE, RICHARD JUST STOPPED TAKING CARE OF HIMSELF. HIS ADULT CHILDREN RECOGNIZED CHANGES IN HYGIENE, PHYSICAL APPEARANCE, REACTIONS AND ROUTINES. RICHARD'S CONFUSION AND DETERIORATION WAS A TEMPORARY CONDITION BROUGHT ON BY HIS GRIEF. RICHARD WAS EXPERIENCING DEPRESSION. HIS FAMILY HELPED HIM TO BECOME AWARE OF THE CHANGES AND SUGGESTED SOLUTIONS. NOW, LET'S OBSERVE THE SAME FAMILY A SECOND TIME. [ BACKGROUND NOISE ] >> HI, DAD. I SEE YOU HAVEN'T HAD A CHANCE TO SHOWER YET. DID YOU FORGET WE'RE GOING TO LUNCH TODAY? >> OH, YEAH. >> THAT'S OKAY, DAD, ONE OF THE REASONS I CAME EARLY. WHY DON'T YOU GO AND SHOWER NOW, I CAN CLEAN SOME OF THIS MESS UP. >> NO, THAT'S OKAY. >> REALLY, DAD, YOU HAVE TO AT LEAST CHANGE. THOSE CLOTHES ARE FILTHY. >> NO, I JUST DID. >> DAD, YOU CAN'T GO TO LUNCH LIKE THAT. PLEASE GO CHANGE. DAD, PLEASE CHANGE YOUR CLOTHES. >> OKAY. >> HEY, MARY, YOU ALL SET FOR LUNCH? >> NO. DAD FORGOT AGAIN. HE'S CHANGING. MIKE, I'M REALLY WORRIED, HE'S BEEN SO ABSENT-MINDED. HE WAS STILL IN THE SAME CLOTHES HE'S BEEN IN THE LAST THREE DAYS. I STARTED TO CLEAN UP, BUT IT LOOKS LIKE HE ISN'T PAYING HIS BILLS. >> OH, THE POOR GUY HAS BEEN A MESS FOR THE LAST THREE MONTHS. WHAT DO YOU THINK WE SHOULD DO? >> CLEARLY HAVE TO TAKE OVER. HE'LL JUST HAVE TO COME WITH ME AND LIVE WITH ME. YOU CAN TAKE OVER THE FINANCES AND WORK ON SELLING THE HOUSE. >> COME ON, COME ON, THAT'S A BIT EXTREME. >> MIKE, DAD'S MEMORY IS REALLY BAD, AND HE'S NOT PAYING HIS BILLS. HE'S LIKELY TO BE TAKEN ADVANTAGE OF, AND I DON'T THINK HE'S BATHING. LOOK AT THIS PLACE. THERE'S GARBAGE OVERFLOWING IN THE KITCHEN. SOMETHING IS WRONG. >> MARY, HE'S JUST GRIEVING. HE AND MOM WERE MARRIED FOR 53 YEARS. >> NO, IT'S MORE THAN THAT. EVEN BEFORE MOM DIED, THERE WERE SIGNS. >> WELL, WHY DIDN'T YOU SAY SOMETHING? >> I GUESS I WAS IN DENIAL. MOM HAS BEEN ALWAYS COMPLAINING THAT HE WOULD FORGET THINGS. DON'T YOU REMEMBER THE TIME SHE SENT HIM TO THE STORE WITH A LIST AND HE DIDN'T COME BACK WITH ANYTHING ON IT? >> THAT WAS HILARIOUS. >> NOT TO MOM. SHE TOLD ME THEN THAT SHE WAS WORRIED ABOUT HIM, AND I JUST LAUGHED IT OFF. >> GEEZ! >> SHE TOOK OVER THE BILLS, YOU KNOW. >> WHAT? REALLY? >> SHE OPENED SOMETHING FROM THE ELECTRIC COMPANY AND FREAKED OUT BECAUSE IT SAID THEY WERE GOING TO CUT OFF SERVICE. >> WHY DIDN'T YOU TELL ME THIS? >> WELL, MOM KIND OF MINIMIZED IT, SAID THAT DAD HAD A LOT ON HIS PLATE AND JUST FORGOT THOSE THINGS, SO SHE TOOK OVER THE BILL PAYING. >> HI, MARY, HI, MIKE. >> DAD, YOU HAVEN'T CHANGED. DAD, I TOLD YOU TO CHANGE. >> CHANGE WHAT? >> CHANGE YOUR CLOTHES. DON'T YOU REMEMBER, WE'RE GOING TO LUNCH. >> THAT'S NICE. >> SEE WHAT I MEAN, MIKE? >> MARY. >> I MEAN IT, LOOK AT HIM. WE HAVE TO DO SOMETHING. >> DAD, WHAT DO YOU THINK? >> ABOUT WHAT? >> DAD, MARY IS CONCERNED ABOUT YOU, SHE WANTS YOU TO MOVE IN WITH HER. >> I DON'T WANT TO MOVE. >> DAD, LOOK AT THIS PLACE. YOU CAN'T MANAGE HERE. YOU AREN'T PAYING THE BILLS. >> I DON'T WANT TO MOVE. >> DAD, I GET IT, YOU'RE GRIEVING. WHAT CAN WE DO TO HELP? >> I DON'T WANT TO MOVE. >> MIKE, WE HAVE TO DO SOMETHING. >> WHAT, THOUGH? >> WE NEED TO GET HIM TO THE DOCTOR FIRST. THEN WE CAN TALK ABOUT CHANGES THAT NEED TO BE MADE. YOU CAN ASK SOCIAL SECURITY ABOUT GETTING APPOINTED AS HIS REPRESENTATIVE PAYEE. WE NEED TO SEE IF DAD CAN STILL LIVE AT HOME OR WHERE HE SHOULD GO. AND WE MIGHT NEED SOME LEGAL HELP. WE'LL WANT TO INVOLVE DAD IN ALL OF THIS AS MUCH AS POSSIBLE. AFTER ALL, HE CAN STILL DECIDE SOME THINGS. AND WE KNOW WHAT'S BEEN IMPORTANT TO HIM IN THE PAST. >> RIGHT. DAD, WHAT DO YOU THINK ABOUT ALL THAT? >> WHAT? >> SO HOW SHOULD RICHARD OR THOSE LIKE HIM BE SUPPORTED WHEN GOING THROUGH DIFFICULT TIMES? THERE ARE MANY OPTIONS. YOU CAN ENSURE THAT YOUR LOVED ONE, YOUR CLOSE FRIEND OR THOSE YOU ASSIST AND SERVE ARE KEEPING UP WITH THEIR HEALTH CARE BY ESTABLISHING A GOOD RELATIONSHIP WITH THE DOCTORS AND PHARMACISTS. YOU MIGHT TAKE SUPPORTIVE ACTIONS BY CALLING TO ENSURE THAT PRESCRIPTIONS ARE PICKED UP ON TIME AND THAT DOCTOR'S APPOINTMENTS ARE KEPT. PERHAPS YOU COULD ARRANGE TO HAVE BASIC NEEDS, LIKE PRESCRIPTIONS AND MEALS DELIVERED TO THEIR HOME. AND IT MAY BE IMPORTANT TO FIND A PSYCHOLOGIST OR COUNSELOR WHO CAN HELP WITH LIFE CHANGING EVENTS AND DISTINGUISH TEMPORARY PROBLEMS FROM THOSE THAT ARE LONG-TERM. FOR LONG-TERM CONDITIONS, IF YOU ARE NOT ALREADY A REP PAYEE, YOU MAY DECIDE THAT IT IS A GOOD TIME TO APPLY TO BE ONE WITH THE SOCIAL SECURITY ADMINISTRATION. AS A REP PAYEE, YOU WILL BE RESPONSIBLE FOR MANAGING THE PERSON'S SSA BENEFITS TO PAY FOR HIS OR HER NEEDS. TO FIND OUT MORE INFORMATION ABOUT BECOMING A REP PAYEE, CONTACT THE SOCIAL SECURITY OFFICE IN YOUR AREA. THAT WAY, YOU CAN HELP TO MEET THE FINANCIAL NEEDS OF THOSE YOU SUPPORT. NOW THAT WE HAVE DISCUSSED OBSERVATIONS AND WAYS TO ASSIST WITH DECISION-MAKING, WE WANT TO HIGHLIGHT SOME NATIONAL AND STATE RESOURCES THAT YOU MAY CONTACT WHICH ARE AVAILABLE TO HELP ASSIST YOU IN YOUR ROLE. >> THE NATIONAL INSTITUTE ON AGING HAS PUBLICATIONS AND OTHER RESOURCES THAT CAN HELP CAREGIVERS, ESPECIALLY WHEN CARING FOR OLDER ADULTS WITH CHRONIC DISEASES SUCH AS DEMENTIA, DIABETES OR HEART FAILURE. VISIT WWW.NIA.NIH.GOV FOR MORE INFORMATION. THE ELDERCARE LOCATOR IS A NATIONWIDE SERVICE THAT CONNECTS SENIORS AND THEIR CAREGIVERS WITH INFORMATION ON SENIOR SERVICES, INCLUDING THE STATE UNIT ON AGING AND THE LOCAL AREA AGENCY ON AGING. VISIT WWW.ELDERCARE.GOV. ADULT PROTECTIVE SERVICES. FIND THE STATE OR LOCAL AGENCIES THAT RECEIVE AND INVESTIGATE REPORTS OF SUSPECTED ELDER OR ADULT ABUSE, NEGLECT OR EXPLOITATION BY CONTACTING THE NATIONAL ELDERCARE LOCATOR. JUSTICE IN AGING PROVIDES LEGAL SERVICES TO SECURE ACCESS TO AFFORDABLE HEALTH CARE AND ECONOMIC SECURITY FOR OLDER ADULTS AND SENIORS WITH LIMITED RESOURCES, FOCUSING ESPECIALLY ON POPULATIONS THAT HAVE TRADITIONALLY LACKED LEGAL PROTECTION. FIND THEM AT WWW.JUSTICEINAGING.ORG. THE CONSUMER FINANCIAL PROTECTION BUREAU, CFPB, PROVIDING GUIDES FOR FINANCIAL CAREGIVERS HANDLING SOMEONE ELSE'S MONEY, SUCH AS AGENTS UNDER A POWER OF ATTORNEY, GUARDIANS OF PROPERTY, TRUSTEES, SSA REPRESENTATIVE PAYEES AND VETERANS ADMINISTRATION FIDUCIARIES. TO LEARN MORE, VISIT WWW.CONSUMERFINANCE.GOV/MANAGING -SOMEONE-ELSES-MONEY. THE STATE HEALTH INSURANCE ASSISTANCE PROGRAM, SHIP, IS AN INDEPENDENT PROGRAM FUNDED BY THE FEDERAL GOVERNMENT. THE PROGRAMS PROVIDE FREE HEALTH BENEFITS COUNSELING AND ASSISTANCE TO MEDICARE BENEFICIARIES AND THEIR FAMILIES OR CAREGIVERS. THERE ARE SHIP PROGRAMS IN EVERY STATE AND MANY COMMUNITIES. VISIT WWW.SHIPTACENTER.ORG. AND AGING AND DISABILITY RESOURCE CENTERS, ADRCs, PROVIDE INFORMATION AND ACCESS FOR OLDER ADULTS, THEIR CAREGIVERS AND ADULTS OVER AGE 18 WITH MENTAL HEALTH NEEDS. THESE CENTERS OFFER INFORMATION AND REFERRALS TO SERVICE PROVIDERS, CONSUMER COUNSELING AND DECISION-MAKING SUPPORT, HEALTH INSURANCE AND MEDICARE PRESCRIPTION DRUG INFORMATION, CAREGIVER SUPPORT AND COUNSELING AND MUCH MORE. FOR MORE INFORMATION, VISIT WWW.ADRC-TAE.ACL.GOV. >> THESE ARE JUST A FEW RESOURCES THAT ARE AVAILABLE TO YOU. YOU MAY ALSO CHOOSE TO CONTACT YOUR LOCAL HEALTH AND HUMAN SERVICE AGENCY IN YOUR STATE FOR MORE INFORMATION. WE WANT TO THANK RUSH UNIVERSITY MEDICAL CENTER FOR THEIR HELP WITH THIS TRAINING. WE HOPE THIS TRAINING HAS PROVIDED YOU WITH INFORMATION ABOUT CHANGES IN DECISIONAL CAPACITY AND THE IMPORTANCE OF OBSERVING, SUPPORTING AND ACCESSING HELPFUL RESOURCES, WHETHER YOU ARE A FAMILY MEMBER, TRUSTED FRIEND, REP PAYEE OR THOSE WHO WORK WITH SENIORS AND VULNERABLE ADULTS. THANKS FOR WATCHING.