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CUMBERLAND COUNTY
AGING & COMMUNITY SERVICES
1100 CLARE'.MONT RD CARLISLE, Pr1 17015
(717) 240-6110 OR 1-888-697-0371 EXT 6110
FAX: (717) 240-6118
Barbara B Cross
One Team One Mission Chairman
Jim Hertzler
- Vice Chairman
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FINAL GUARDIANSHIP REPORT Se GaryEiecret ary
Sr
tary
c~ FOR SARA MCALICHER Terry L Barley
Director
DECEMBER 17, 2012
c Report from Guardian of Person
G in 7i Cumberland County Office of Aging
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4 , co 1 triscilla Whitman, Aging Care Manager III
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On u Lst,8; 2001, J age J. Wesley Oler appointed the Cumberland County Office of
Aging to be'Ouardian of Person and Co-Guardian of Estate for Sara McAlicher with her
son Robert McAlicher. Ms. McAlicher at that time was residing at West Shore Health
and Rehab. Her admission date to West Shore Health and Rehab was on June 7, 2001.
West Shore Health and Rehab became Golden Living Center West Shore in 2007.
Ms. McAlicher was diagnosed with senile dementia Alzheimer's type, senile and pre-
senile organic psychotic condition, arteriosclerosis cardiovascular disease, history of
UTI's, polyglandular dysfunction, congestive heart failure, degenerative joint disease,
poor skin turgor, osteoarthritis, enlarged heart, acute vascular insufficiency of intestine,
extensive detrocurvature of spine and in February 2012 was diagnosed with Adult
Failure to Thrive.
Over the past year Ms. McAlicher continued to decline in health due to her dementia
diagnosis. She became more contracted and even with nursing staff providing range of
motion exercises she eventually loss the use of her extremities. Ms. McAlicher also
within the last year became verbally non-responsive. Prior to this she would hum or sing
a few words and attempt to answer questions with a simple one worded response. She
would also try to acknowledge your presence but that too became too much for her.
Ms. McAlicher continued to require maximum assistance with all her activities of daily
living and transfers. Her movement was reduced as she spent more time sleeping. She
had a poor appetite and her diet consisted of fortified milk, ice cream, health shakes,
regular liquids and pureed foods. Her weight declined, she required more hands on care
and had episodes of skin breakdown. During her stay at the nursing home she was
eligible for Hospice four different times. Asera Care Hospice provide nursing care of
overseeing the care she received in the home, personal care to assist with the
caregivers who provided care within the home, chaplain services and social services.
Ms. Mc Alciher received quality care from Hospice and the nursing home. She enjoyed
music, prayer, scripture reading and the extra attention she received from the Hospice
staff who visited 3-4 times a week. Her personal appearance was usually good and at
EMAIL US AT aging@ccpa.net OR VISITOUR WEBSITE AT www.ccpa.net/aging
times she would have a smile on her face for those who told her how nice she looked.
She was incontinent of bowel and had a colostomy. She was also incontinent of urine
and needed frequent changing of her depends and personal care. Ms. McAlicher had a
pleasant personality and was always cooperative with the staff.
Ms. McAlicher had been in the Advanced Alzheimer's unit until she no longer benefited
from the program. She was then moved back to a nursing bed on a regular floor. By this
time she was basically bed ridden. She became increasingly tired and not interested in
any activities except those 1:1 visits from Hospice, Aging and her son Robert. He and
his companion would visit 2-3 times a week to assist with feeding. There had been an
issue of them giving Ms. McAlicher thin liquids which could have caused her to aspirate.
This was addressed by the nursing home, Hospice and Aging thru education of Ms. Mc
Alicher's Alzheimer's dementia disease and how it affects a person's ability to swallow.
Another incident with the son and companion was during the time when Ms. McAlicher
had blood in her urine which happened on September 7, 2012. Family alleged neglect
and wanted her to be sent out to the hospital. After review with the doctor who
determined Ms. McAlicher had uterine cancer but at her age of 96 and the fact she was
on Hospice medically she would not benefit from being treated. Hospice was to continue
with comfort measures and at no time did Ms. McAlicher show signs of pain or distress
even during her routine care. The family was kept informed of her decline and Ms.
McAlicher passed away on September 13, 2012.
Sullivan Funeral Home in Enola handled the funeral as The Office on Aging had made
pre-arranged funeral services for Ms. McAlicher several years ago. Two case managers
from Cumberland County Aging attended the graveside service with son Robert and his
companion Vicki. Robert had requested a private viewing of his mother prior to the
burial which Aging granted and Sullivan's Funeral Home was in agreement even though
not part of the original funeral arrangements.
Ms. McAlicher's monthly income consisted of Social Security and a state pension. Her
nursing home stay was covered by Medical Assistance. The nursing home received her
checks and applied all but the personal care allowance to the cost of the nursing home
care. Office on Aging nor Ms. McAlicher's son Robert had any involvement with her
financial affairs even though we were co-guardians. Therefore there is no final financial
report. Upon Ms. McAlicher's death the money that was in her personal account at the
nursing home was given to her son Robert.