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HomeMy WebLinkAbout04-27-09 (2)~ r ANNUAL REPORT OF GUARDIAN OF THE PERSON COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Bertha E. Reese No. 21-09-0054 I. INTRODUCTION David L. Reese N n o ~ -~-, +~.: 4..:..k ' "-- ~7 ]ta . i-r~ r~~ an Incas ~g{i P er~gn -1 ~" r'y ~ a +,J ` . ~: ? C~""7 / - ~ ~~~ ~~ C ~ ~ . l j C~~ ~ - -.:7 ~ ~ -~ N . "..~ ~' '~, - f -.- was appointed ~/ Plenary ^Limited Guardian of the Person by Decree of , J., dated Initial beginning ^/ A. This is the Report for the periodfi~enr lvlar'ch 11 ~ 2009 to (the "Report Period"); or ® B. This is the Final Report for the period from , to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of For a Final Report, omit Sections II through IV. Form G-03 rev. /0.13.06 J., dated Page 1 of 4 ''"V i ~ Estate of Bertha E. Reese II. PERSONAL DATA Age of the Incapacitated Person: 85 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: 770 Poplar Church Road Camp Hill, PA B. The Incapacitated Person's residence is: an Incapacitated Person Date of Birth: June 27, 1923 ^ own home /apartment ~/ nursing home ® boarding home /personal care home ® Guardian's home /apartment ® hospital or medical facility ~ relative's home (name, relationship and address) ^ other: C. The Incapacitated Person has been in the present residence since approximately March 1, 2008 If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev. 10.13.06 Page 2 of 4 1 ~ Estate of Bertha E. Reese an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Golden Living Home 770 Poplar Church Road, Camp Hill, PA James R. Harty, M.D. Hummelstown, PA IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Alzheimer's -type senile dementia B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: She receives Medical Assistance through Cumberland County Dept. of Welfare V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: ~ continue ©be modified ~ be terminated Form G-03 rev. 10.13.06 Page 3 of 4 Estate of Bertha E. Reese an Incapacitated Person The reasons for the foregoing opinion are: Dementia will get worse with time. B. During the past year, the Guardian of the Person has visited the Incapacitated Person 75 times with the average visit lasting 1 hours, minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report may be attached to supplement this Report. I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904 relative to unswnrn falcificatinn to anthnritiPc f~,nr.~ /7 , Zoo ~ DatT Signature fGuardianofthePerson David L. Reese Name of Guardian of the Person (type or print) 65 Alpine Road Address Lewisberry, PA City, State, Zip 7/7 - 43f -S7o1 Telephone Form G-03 rev. 10.13.06 Page 4 of 4