Planning for long-term care of a brother with Autism? (Financial aspect)

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paramedic
Posts: 49
Joined: Sun Sep 11, 2016 7:26 pm

Planning for long-term care of a brother with Autism? (Financial aspect)

Post by paramedic » Wed Jun 20, 2018 9:03 am

Hey all,

I'm 33 years old. I have an older brother who is 35 years old, who has Autism Spectrum Disorder. He is "verbal" (can speak normally and such), but his social skills are very limited. He's tried to work at entry-level jobs but has been unsuccessful.

My brother currently lives with my parents. My parents have saved a total of about $3,000 for him in a trust fund. My parents are at retirement age and have about $25,000-$30,000 of assets for themselves in total. My brother receives disability totaling around $700 per month plus free (albeit limited acceptance) healthcare.

I'm single and am likely to continue to be. I have no children. When my parents pass away (in 15-20 years?), I will care for my brother. I have no other siblings. I need to plan for what would happen with my brother if something were to happen to me (e.g. if I were to die in a freak accident).

I have $455,000 in retirement assets currently (401(k)s, 403(b)s, and a bit in my HSA; almost all in index funds). I have about $40,000 cash available. At the advice of others on this forum, I have also added long-term disability insurance on myself just in case anything happens to me.

Any thoughts on how I should plan for my brother financially? My current thought is to try to build up to a $2-3 million nest egg by the time I retire, and then leave that to my brother's trust fund if I pass away before him. I'm very fit and healthy, and my brother is somewhat overweight, so I may very well outlive him, but I want to plan for the worst. Should I perhaps obtain a life insurance policy on myself?

ExitStageLeft
Posts: 814
Joined: Sat Jan 20, 2018 4:02 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by ExitStageLeft » Wed Jun 20, 2018 2:13 pm

paramedic wrote:
Wed Jun 20, 2018 9:03 am
...
Should I perhaps obtain a life insurance policy on myself?
If his well-being will be depenent upon your financial support in the future, then yes you should get a term life insurance policy with him as the beneficiary. If your brother is not able to manage his own affairs then it should be a trust as the beneficiary.

My 18 y.o. son is ASD and is going in today to fill out paperwork for his first job. We are fortunate in that so far he appears to be able to navigate the basics of social interaction and we are working on building his skills so that he can take care of himself. I'm not sure how we will plan going forward if it turns out that a job (dishwasher) is beyond his coping skills.

As you have accepted the responsibility of caring for your brother, you are wise to build that in to your long term planning. The problem I see is to what extent he can/will manage his own affairs or will need to have things in trust. There may be resources in your state or locality that offer guidance on how to plan for a special needs dependent. Perhaps the first thing would be to get a term life policy with him named as beneficiary, and update the beneficiary as you gain a better understanding of whether a trust is needed and how to set one up.

JBTX
Posts: 3943
Joined: Wed Jul 26, 2017 12:46 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Wed Jun 20, 2018 2:21 pm

paramedic wrote:
Wed Jun 20, 2018 9:03 am
Hey all,

I'm 33 years old. I have an older brother who is 35 years old, who has Autism Spectrum Disorder. He is "verbal" (can speak normally and such), but his social skills are very limited. He's tried to work at entry-level jobs but has been unsuccessful.

My brother currently lives with my parents. My parents have saved a total of about $3,000 for him in a trust fund. My parents are at retirement age and have about $25,000-$30,000 of assets for themselves in total. My brother receives disability totaling around $700 per month plus free (albeit limited acceptance) healthcare.

I'm single and am likely to continue to be. I have no children. When my parents pass away (in 15-20 years?), I will care for my brother. I have no other siblings. I need to plan for what would happen with my brother if something were to happen to me (e.g. if I were to die in a freak accident).

I have $455,000 in retirement assets currently (401(k)s, 403(b)s, and a bit in my HSA; almost all in index funds). I have about $40,000 cash available. At the advice of others on this forum, I have also added long-term disability insurance on myself just in case anything happens to me.

Any thoughts on how I should plan for my brother financially? My current thought is to try to build up to a $2-3 million nest egg by the time I retire, and then leave that to my brother's trust fund if I pass away before him. I'm very fit and healthy, and my brother is somewhat overweight, so I may very well outlive him, but I want to plan for the worst. Should I perhaps obtain a life insurance policy on myself?
We have a teenage autistic son and we are working through similar issues. It is great that you are thinking ahead, and he is lucky to have a thoughtful brother such as yourself.

I'm not an attorney nor an expert, and perhaps a few others more versed in this will chime in. But here are some things to consider:

1. I am assuming given the amount he is drawing SSI (supplemental security income) and also has medicaid. If and when you parents start drawing Social Security, he will likely be eligible for SSDI - social security disability income. Typically it will be more than SSI, and after a year or two he could be eligible for Medicare, and it is not needs based. Google SSDI and review the qualifications, and you or parents find expert in "elder law" (could be attorney or non attorney) and they may be able to advise you.

2. Do some research on 529 ABLE accounts. They are essentially a 529 for disabled adults. You can put up to $100k in total and $15k per year (combined) and if done correctly will avoid disqualifying for govt benefits (SSI/Medicaid). However, they are of limited use because if you have over $100k you lose access to SSI.

3. You mentioned trust - perhaps he already has a special needs trust. If not, look into setting one up. Maybe now, or maybe when parents or you die.

4. Seek out an experienced estate planning attorney. You already have a good start on retirement assets, and are likely to accumulate more. If you plan to pass any of that on to your brother in the event of your death, then it is best instead of passing it on to him directly, you pass it on to him in a trust (and likely supplemental needs trust)- but it should be a special type of subtrust (some call it IRA sub trust). These types of trusts will allow beneficiary to withdraw trust assets over his lifetime. A regular non IRA trust would require assets to be liquidated with 5 years after your death.

(Once you get familiar with this, there is a more complex topic relating to this for IRA trusts - conduit trusts vs accumulation trusts. That is a more complicated discussion, and I wouldn't worry about that until you get your hands around the other issues.)

5. An estate planning attorney will help you set up and estate plan, including a will, maybe a revocable living trust (depends) and likely a special needs trust (or trusts).

Talk to a couple of attorneys, and try to find one with some experience with special needs trusts or elder law. Also, if you haven't already, talk with your parents to see what they have up, and make sure you coordinate with whatever they have done.

Finally, term life insurance given your age could be a great idea. Just make sure you integrate it into your estate plan.

Best of luck.

NOLA
Posts: 327
Joined: Sun Jul 10, 2011 1:23 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by NOLA » Wed Jun 20, 2018 2:42 pm

What a great brother you are! Keep up the hard work and he is very lucky to have you.

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djpeteski
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by djpeteski » Wed Jun 20, 2018 2:49 pm

Yep some term life insurance that has a special needs trust as the beneficiary. It will not cost you much. Good work.

2015
Posts: 1833
Joined: Mon Feb 10, 2014 2:32 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 2015 » Wed Jun 20, 2018 2:55 pm

paramedic wrote:
Wed Jun 20, 2018 9:03 am
Hey all,

I'm 33 years old. I have an older brother who is 35 years old, who has Autism Spectrum Disorder. He is "verbal" (can speak normally and such), but his social skills are very limited. He's tried to work at entry-level jobs but has been unsuccessful.

My brother currently lives with my parents. My parents have saved a total of about $3,000 for him in a trust fund. My parents are at retirement age and have about $25,000-$30,000 of assets for themselves in total. My brother receives disability totaling around $700 per month plus free (albeit limited acceptance) healthcare.

I'm single and am likely to continue to be. I have no children. When my parents pass away (in 15-20 years?), I will care for my brother. I have no other siblings. I need to plan for what would happen with my brother if something were to happen to me (e.g. if I were to die in a freak accident).

I have $455,000 in retirement assets currently (401(k)s, 403(b)s, and a bit in my HSA; almost all in index funds). I have about $40,000 cash available. At the advice of others on this forum, I have also added long-term disability insurance on myself just in case anything happens to me.

Any thoughts on how I should plan for my brother financially? My current thought is to try to build up to a $2-3 million nest egg by the time I retire, and then leave that to my brother's trust fund if I pass away before him. I'm very fit and healthy, and my brother is somewhat overweight, so I may very well outlive him, but I want to plan for the worst. Should I perhaps obtain a life insurance policy on myself?
I applaud your selflessness in taking responsibility for the gift of having a brother with ASD and his future well-being. I highly recommend obtaining a life insurance policy on yourself. You might also want to access autism resources such as Autism Speaks to get guidance on best practices estate planning for your brother.

I have been working with an individual high on the spectrum whose parents neglected to obtain life insurance or engage in special needs estate planning. Only now am I finally having to accept that despite all efforts we may be unsuccessful into talking this individual into working. It's not that they can't work, and they do in fact volunteer in a position that involves significant interaction with the public. It's that they have concepts about working that channel their thinking into the idea that most employment is beneath them. Had the parents obtained something like a one or two million dollar insurance policy, they would not have to be relying on the market now to fund care once they pass on. Like your brother, and as with many individuals with ASD, this person also has issues with social skills involving tact, literal meaning, and at times a preference for rigidity, structure, and sameness in interpersonal communication.

The challenge in working with individuals with autism is that each is unique, and their challenges pertain to their own particular capabilities, thought processes, and placement on the spectrum. I personally advocate that there is nothing "wrong" or "abnormal" about people with ASD, regardless of where they are on the spectrum, and that it is the responsibility of the neurotypical to learn as much as possible about the world in which the person they are working with inhabits. This takes almost herculean patience and can be extremely difficult for us as neurotypicals because we have been conditioned with constructs that individuals with ASD do not. They have their own constructs, which I personally find much more fascinating than those we neurotypicals have been conditioned with. Unfortunately, taking the responsibility to enter the world of an ASD person can be understandably overwhelming for most families and caregivers.

I have found studying talks given by individuals with autism to be most helpful in deepening my understanding of the variety of worlds that people with ASD inhabit. These books also did more for my understanding than anything else I've read. I highly recommend them because they may help deepen your understanding and relationship with your brother, as well as your ability to provide the correct support. They did so for me:

https://www.amazon.com/Stop-That-Seemin ... 1890627763

123
Posts: 3633
Joined: Fri Oct 12, 2012 3:55 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 123 » Wed Jun 20, 2018 3:10 pm

While your parents are currently able to provide housing to your brother as they move into retirement it may get more and more difficult for them to assist him. It is not necessarily in your brother's best interests to expect that your parents and then you will be able to be there to care for him. A realistic option may be to see if a move to an assisted living environment may be possible for him since it seems he receives SSI. A move to assisted living now may be easier for him then when he is older. An assisted living environment will give him a greater number of people to interact with and build his social skills instead of being mostly isolated with family. An assisted living environment may give him a greater sense of indepedance (yes, I know that seems odd) than continuing to live at home.

Moving to an assisted living environment will make things easier for your parents, as well as likely yourself, down the road. Of course your parents and you can visit and take him out, it can make the time you are together more special and not just more of the same.

You have a right to your own life. The more you can live your life without limits, have a family if your choose, and be your own person the better example you set for your brother.
The closest helping hand is at the end of your own arm.

Dottie57
Posts: 4309
Joined: Thu May 19, 2016 5:43 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by Dottie57 » Wed Jun 20, 2018 3:32 pm

123 wrote:
Wed Jun 20, 2018 3:10 pm
While your parents are currently able to provide housing to your brother as they move into retirement it may get more and more difficult for them to assist him. It is not necessarily in your brother's best interests to expect that your parents and then you will be able to be there to care for him. A realistic option may be to see if a move to an assisted living environment may be possible for him since it seems he receives SSI. A move to assisted living now may be easier for him then when he is older. An assisted living environment will give him a greater number of people to interact with and build his social skills instead of being mostly isolated with family. An assisted living environment may give him a greater sense of indepedance (yes, I know that seems odd) than continuing to live at home.

Moving to an assisted living environment will make things easier for your parents, as well as likely yourself, down the road. Of course your parents and you can visit and take him out, it can make the time you are together more special and not just more of the same.

You have a right to your own life. The more you can live your life without limits, have a family if your choose, and be your own person the better example you set for your brother.
I agree with this very much.

Dottie57
Posts: 4309
Joined: Thu May 19, 2016 5:43 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by Dottie57 » Wed Jun 20, 2018 3:34 pm

Dottie57 wrote:
Wed Jun 20, 2018 3:32 pm
123 wrote:
Wed Jun 20, 2018 3:10 pm
While your parents are currently able to provide housing to your brother as they move into retirement it may get more and more difficult for them to assist him. It is not necessarily in your brother's best interests to expect that your parents and then you will be able to be there to care for him. A realistic option may be to see if a move to an assisted living environment may be possible for him since it seems he receives SSI. A move to assisted living now may be easier for him then when he is older. An assisted living environment will give him a greater number of people to interact with and build his social skills instead of being mostly isolated with family. An assisted living environment may give him a greater sense of indepedance (yes, I know that seems odd) than continuing to live at home.

Moving to an assisted living environment will make things easier for your parents, as well as likely yourself, down the road. Of course your parents and you can visit and take him out, it can make the time you are together more special and not just more of the same.

You have a right to your own life. The more you can live your life without limits, have a family if your choose, and be your own person the better example you set for your brother.
I agree with this very much. Also do get a life insurance policy on yourself.

ColoRetiredGirl
Posts: 122
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Location: Colorado

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by ColoRetiredGirl » Wed Jun 20, 2018 3:47 pm

NOLA wrote:
Wed Jun 20, 2018 2:42 pm
What a great brother you are! Keep up the hard work and he is very lucky to have you.
I totally agree with this statement. Please do not take this wrong but any young woman would be proud to introduce you to their parents. Read between the lines. Just say’n.

Good Listener
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Joined: Wed Dec 30, 2015 5:24 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by Good Listener » Wed Jun 20, 2018 3:55 pm

Is he "too good" to be in a group home as at that point the state takes care of almost everything. I hate to be judgemental, but haven't your parents acknowledged a need to provide more for him and try to somehow save more for him? It's a lot to be laid on you particularly if you ever decide to have your own family or enter difficult financial times.

maj
Posts: 412
Joined: Wed Jun 25, 2008 2:58 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by maj » Wed Jun 20, 2018 4:00 pm

also ask an attorney if you need to file for guardianship or ask if having general power of attorney (unrestricted) for your brother is sufficient.

I am inspired by your goodness.
Thanks for sharing.

bsteiner
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by bsteiner » Wed Jun 20, 2018 4:01 pm

You would leave your assets to him in trust just as you would for a child. As others have pointed out, you would actually provide for him in two separate trusts, one for your retirement benefits and one for you other assets. Since no one knows what the future will bring, you would give the trustees discretion as to distributions. This should be a routine matter.

The key things to consider are (i) who gets whatever's left in the trust at his death, and (ii) who should be the trustees.

stoptothink
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by stoptothink » Wed Jun 20, 2018 4:09 pm

Dottie57 wrote:
Wed Jun 20, 2018 3:32 pm
123 wrote:
Wed Jun 20, 2018 3:10 pm
While your parents are currently able to provide housing to your brother as they move into retirement it may get more and more difficult for them to assist him. It is not necessarily in your brother's best interests to expect that your parents and then you will be able to be there to care for him. A realistic option may be to see if a move to an assisted living environment may be possible for him since it seems he receives SSI. A move to assisted living now may be easier for him then when he is older. An assisted living environment will give him a greater number of people to interact with and build his social skills instead of being mostly isolated with family. An assisted living environment may give him a greater sense of indepedance (yes, I know that seems odd) than continuing to live at home.

Moving to an assisted living environment will make things easier for your parents, as well as likely yourself, down the road. Of course your parents and you can visit and take him out, it can make the time you are together more special and not just more of the same.

You have a right to your own life. The more you can live your life without limits, have a family if your choose, and be your own person the better example you set for your brother.
I agree with this very much.
As someone who has an ASD, is a regular speaker at ASD events, and has established a mentorship/internship program at their place of employment for people with ASDs and worked with Easter Seals as a mentor for for people with ASDS...this. Whenever I speak or sit on a panel about this topic I am hounded (mostly by parents of children on the ASD spectrum) as to how I was able to be a "successful functioning adult" with a family and career in spite of not being neurotypical. The answer is clear to me: I didn't have a choice. My mother couldn't treat me any different because she was too busy being the sole provider for 5 children so I was forced to do things that were really difficult for me. Of course the spectrum is very wide and everybody with a diagnosed ASD is different, but if OP's brother is otherwise somewhat normal outside of "social difficulties", the best thing for him is for your parents and you to set an example.

Calli114
Posts: 55
Joined: Tue May 16, 2017 12:54 am

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by Calli114 » Wed Jun 20, 2018 4:11 pm

I have a disabled brother who lives in an apt with a roommate and all his needs are met by SSI and MCaid, so I have an ethical dilemma in leaving him a large estate, as I have observed the offices where his caregivers' administration is are quite luxurious, so it makes me wonder how much of the money would be squandered.
I attempted to do a special needs trust, where he would just get basically pocket money for movies, clothes and eating out, but I'm not sure the language in it is clear enough, I am considering having it reviewed. In our state, he would lose MCaid if he has over $1000 of assets.

ausmatt
Posts: 75
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by ausmatt » Wed Jun 20, 2018 4:16 pm

JBTX wrote:
Wed Jun 20, 2018 2:21 pm
paramedic wrote:
Wed Jun 20, 2018 9:03 am
Hey all,

I'm 33 years old. I have an older brother who is 35 years old, who has Autism Spectrum Disorder. He is "verbal" (can speak normally and such), but his social skills are very limited. He's tried to work at entry-level jobs but has been unsuccessful.

My brother currently lives with my parents. My parents have saved a total of about $3,000 for him in a trust fund. My parents are at retirement age and have about $25,000-$30,000 of assets for themselves in total. My brother receives disability totaling around $700 per month plus free (albeit limited acceptance) healthcare.

I'm single and am likely to continue to be. I have no children. When my parents pass away (in 15-20 years?), I will care for my brother. I have no other siblings. I need to plan for what would happen with my brother if something were to happen to me (e.g. if I were to die in a freak accident).

I have $455,000 in retirement assets currently (401(k)s, 403(b)s, and a bit in my HSA; almost all in index funds). I have about $40,000 cash available. At the advice of others on this forum, I have also added long-term disability insurance on myself just in case anything happens to me.

Any thoughts on how I should plan for my brother financially? My current thought is to try to build up to a $2-3 million nest egg by the time I retire, and then leave that to my brother's trust fund if I pass away before him. I'm very fit and healthy, and my brother is somewhat overweight, so I may very well outlive him, but I want to plan for the worst. Should I perhaps obtain a life insurance policy on myself?
We have a teenage autistic son and we are working through similar issues. It is great that you are thinking ahead, and he is lucky to have a thoughtful brother such as yourself.

I'm not an attorney nor an expert, and perhaps a few others more versed in this will chime in. But here are some things to consider:

1. I am assuming given the amount he is drawing SSI (supplemental security income) and also has medicaid. If and when you parents start drawing Social Security, he will likely be eligible for SSDI - social security disability income. Typically it will be more than SSI, and after a year or two he could be eligible for Medicare, and it is not needs based. Google SSDI and review the qualifications, and you or parents find expert in "elder law" (could be attorney or non attorney) and they may be able to advise you.

2. Do some research on 529 ABLE accounts. They are essentially a 529 for disabled adults. You can put up to $100k in total and $15k per year (combined) and if done correctly will avoid disqualifying for govt benefits (SSI/Medicaid). However, they are of limited use because if you have over $100k you lose access to SSI.

3. You mentioned trust - perhaps he already has a special needs trust. If not, look into setting one up. Maybe now, or maybe when parents or you die.

4. Seek out an experienced estate planning attorney. You already have a good start on retirement assets, and are likely to accumulate more. If you plan to pass any of that on to your brother in the event of your death, then it is best instead of passing it on to him directly, you pass it on to him in a trust (and likely supplemental needs trust)- but it should be a special type of subtrust (some call it IRA sub trust). These types of trusts will allow beneficiary to withdraw trust assets over his lifetime. A regular non IRA trust would require assets to be liquidated with 5 years after your death.

(Once you get familiar with this, there is a more complex topic relating to this for IRA trusts - conduit trusts vs accumulation trusts. That is a more complicated discussion, and I wouldn't worry about that until you get your hands around the other issues.)

5. An estate planning attorney will help you set up and estate plan, including a will, maybe a revocable living trust (depends) and likely a special needs trust (or trusts).

Talk to a couple of attorneys, and try to find one with some experience with special needs trusts or elder law. Also, if you haven't already, talk with your parents to see what they have up, and make sure you coordinate with whatever they have done.

Finally, term life insurance given your age could be a great idea. Just make sure you integrate it into your estate plan.

Best of luck.
This is sound advice above. Especially the estate planning piece.

Beware the one caveat with ABLE accounts is that the government can clawback from them for any Medicaid benefits after death of the beneficiary.

I personally believe the ABLE accounts are too restrictive and limited investment options (plus bigger fees). Prefer just the irrrevocable trusts.

JBTX
Posts: 3943
Joined: Wed Jul 26, 2017 12:46 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Wed Jun 20, 2018 5:32 pm

ausmatt wrote:
Wed Jun 20, 2018 4:16 pm
JBTX wrote:
Wed Jun 20, 2018 2:21 pm
paramedic wrote:
Wed Jun 20, 2018 9:03 am
Hey all,

I'm 33 years old. I have an older brother who is 35 years old, who has Autism Spectrum Disorder. He is "verbal" (can speak normally and such), but his social skills are very limited. He's tried to work at entry-level jobs but has been unsuccessful.

My brother currently lives with my parents. My parents have saved a total of about $3,000 for him in a trust fund. My parents are at retirement age and have about $25,000-$30,000 of assets for themselves in total. My brother receives disability totaling around $700 per month plus free (albeit limited acceptance) healthcare.

I'm single and am likely to continue to be. I have no children. When my parents pass away (in 15-20 years?), I will care for my brother. I have no other siblings. I need to plan for what would happen with my brother if something were to happen to me (e.g. if I were to die in a freak accident).

I have $455,000 in retirement assets currently (401(k)s, 403(b)s, and a bit in my HSA; almost all in index funds). I have about $40,000 cash available. At the advice of others on this forum, I have also added long-term disability insurance on myself just in case anything happens to me.

Any thoughts on how I should plan for my brother financially? My current thought is to try to build up to a $2-3 million nest egg by the time I retire, and then leave that to my brother's trust fund if I pass away before him. I'm very fit and healthy, and my brother is somewhat overweight, so I may very well outlive him, but I want to plan for the worst. Should I perhaps obtain a life insurance policy on myself?
We have a teenage autistic son and we are working through similar issues. It is great that you are thinking ahead, and he is lucky to have a thoughtful brother such as yourself.

I'm not an attorney nor an expert, and perhaps a few others more versed in this will chime in. But here are some things to consider:

1. I am assuming given the amount he is drawing SSI (supplemental security income) and also has medicaid. If and when you parents start drawing Social Security, he will likely be eligible for SSDI - social security disability income. Typically it will be more than SSI, and after a year or two he could be eligible for Medicare, and it is not needs based. Google SSDI and review the qualifications, and you or parents find expert in "elder law" (could be attorney or non attorney) and they may be able to advise you.

2. Do some research on 529 ABLE accounts. They are essentially a 529 for disabled adults. You can put up to $100k in total and $15k per year (combined) and if done correctly will avoid disqualifying for govt benefits (SSI/Medicaid). However, they are of limited use because if you have over $100k you lose access to SSI.

3. You mentioned trust - perhaps he already has a special needs trust. If not, look into setting one up. Maybe now, or maybe when parents or you die.

4. Seek out an experienced estate planning attorney. You already have a good start on retirement assets, and are likely to accumulate more. If you plan to pass any of that on to your brother in the event of your death, then it is best instead of passing it on to him directly, you pass it on to him in a trust (and likely supplemental needs trust)- but it should be a special type of subtrust (some call it IRA sub trust). These types of trusts will allow beneficiary to withdraw trust assets over his lifetime. A regular non IRA trust would require assets to be liquidated with 5 years after your death.

(Once you get familiar with this, there is a more complex topic relating to this for IRA trusts - conduit trusts vs accumulation trusts. That is a more complicated discussion, and I wouldn't worry about that until you get your hands around the other issues.)

5. An estate planning attorney will help you set up and estate plan, including a will, maybe a revocable living trust (depends) and likely a special needs trust (or trusts).

Talk to a couple of attorneys, and try to find one with some experience with special needs trusts or elder law. Also, if you haven't already, talk with your parents to see what they have up, and make sure you coordinate with whatever they have done.

Finally, term life insurance given your age could be a great idea. Just make sure you integrate it into your estate plan.

Best of luck.
This is sound advice above. Especially the estate planning piece.

Beware the one caveat with ABLE accounts is that the government can clawback from them for any Medicaid benefits after death of the beneficiary.

I personally believe the ABLE accounts are too restrictive and limited investment options (plus bigger fees). Prefer just the irrrevocable trusts.
We don't have an ABLE account yet - not sure if we will get one. I'm not to terribly worried about the medicaid "clawback" scenario - our son is otherwise healthy, and that seems like a remote scenario, and it only applies to whatever is left in the ABLE account, which wouldn't be a lot, relatively speaking. The interesting thing about an ABLE is that it may be a place where you can park some shelter money that a SNT can't, but I agree it certainly doesn't replace a supplemental needs trust. It could also be a place to park some modest inflows to keep from blowing up SSI/Medicaid, such as modest inheritances, or unused mandatory distributions from RMD's via a conduit IRA trust.

2015
Posts: 1833
Joined: Mon Feb 10, 2014 2:32 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 2015 » Wed Jun 20, 2018 7:14 pm

stoptothink wrote:
Wed Jun 20, 2018 4:09 pm
Dottie57 wrote:
Wed Jun 20, 2018 3:32 pm
123 wrote:
Wed Jun 20, 2018 3:10 pm
...

Moving to an assisted living environment will make things easier for your parents, as well as likely yourself, down the road. Of course your parents and you can visit and take him out, it can make the time you are together more special and not just more of the same.

You have a right to your own life. The more you can live your life without limits, have a family if your choose, and be your own person the better example you set for your brother.
As someone who has an ASD, is a regular speaker at ASD events, and has established a mentorship/internship program at their place of employment for people with ASDs and worked with Easter Seals as a mentor for for people with ASDS...this. Whenever I speak or sit on a panel about this topic I am hounded (mostly by parents of children on the ASD spectrum) as to how I was able to be a "successful functioning adult" with a family and career in spite of not being neurotypical. The answer is clear to me: I didn't have a choice. My mother couldn't treat me any different because she was too busy being the sole provider for 5 children so I was forced to do things that were really difficult for me. Of course the spectrum is very wide and everybody with a diagnosed ASD is different, but if OP's brother is otherwise somewhat normal outside of "social difficulties", the best thing for him is for your parents and you to set an example.
Thank you for what you do. My greatest education regarding what autism is, what it is not, and how provide correct support has come from individuals with ASD themselves.

While it's extremely valuable and very admirable that you are among those with ASD educating neurotypicals, I think it's important to remember that many individuals with ASD will not have the capability to increase functioning simply as a result of neurotypicals setting some type of example. In fact, I've found the greatest issue is neurotypicals attempting to assess and instruct ASD's are unable to understand the exact and unique learning capabilities the individual has. I have repeatedly seen neurotypicals provide instruction that fails to "meet the person where they are", that is, that matches with that person's unique learning style. Neurotypicals' discomfort with stemming, for example, is a reflection of their own embarrassment rather than anything "wrong" with the ASD individual. I'll never understand the obsession with making an individual with ASD appear "normal", as stemming for example represents brilliance reflected in that individual's having taught themselves how to reduce anxiety through auto-reinforcement.

There is also the failure to grasp that many ASD individuals live deep in the world of imagination, and at times use speech best described as symbolic. As a neurotypical, to "set an example" (that is, to instruct) you have to understand the mind of the person you are interacting with. Many higher functioning individuals with ASD learn best when provided detailed, slow, step by step instruction, repeated until grasped. There are many, many other aspects of how ASD persons learn, and the answer is not an easy one as it is embedded in learning theory itself (i.e., reinforcement)

In my mind, the idea isn't to have an individual with ASD be a "successful functioning adult", but to provide supports that help bridge the gap from where the person is to the very limits of each person's ability to function in a neurotypical world. To this end, the advice to place an ASD person in assisted living could be the very worst thing for that person. Depending on placement on the spectrum, interventions can be quite intensive, time-consuming, and all-encompassing. To create expectations otherwise is to overlay neurotypical thinking over an ASD person's world.

As this thread is financially based, I can think of no better contribution to an individual with ASD than to obtain sufficient life insurance, engage in thorough estate planning, and think ahead regarding who can protect that person. There are no easy answers to caring for an individual with ASD depending on where they are on the spectrum, and some of the posts above about "living your life to the fullest" do disservice to many caregivers. There is no one shoe fits all solution, and alas, resources past age 18 and 21 are sorely lacking. OTOH, getting to see anyone on the spectrum grow themselves, regardless of improvement amount, is both an honor and a profoundly moving experience.

JBTX
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Thu Jun 21, 2018 3:57 pm

What I have seen as a parent is ASD people often have an intense focus on what they are interested in. That's great, but that often doesn't correspond directly with what one needs to do to succeed in a nuerotypical world. While it is entirely possible that an ASD person has the aptitude to hold a job, they don't have the motivation to, unless it is what they are interested in. I think this will be an issue for our son.

Occasionally you can get the best of both worlds. Temple Grandin for instance. Or we just learned a person at my wife's work is ASD, she suspected but didn't know for sure. Nobody else does. Apparently this person is intensely focused on what he does there and that serves him well. But that seems more the exception than the rule.

80% of autistic people dont have jobs. Another survey in UK showed only 12% of high functioning have jobs.

https://www.google.com/amp/www.ibtimes. ... 83%3famp=1

2015
Posts: 1833
Joined: Mon Feb 10, 2014 2:32 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 2015 » Thu Jun 21, 2018 7:41 pm

JBTX wrote:
Thu Jun 21, 2018 3:57 pm
What I have seen as a parent is ASD people often have an intense focus on what they are interested in. That's great, but that often doesn't correspond directly with what one needs to do to succeed in a nuerotypical world. While it is entirely possible that an ASD person has the aptitude to hold a job, they don't have the motivation to, unless it is what they are interested in. I think this will be an issue for our son.

Occasionally you can get the best of both worlds. Temple Grandin for instance. Or we just learned a person at my wife's work is ASD, she suspected but didn't know for sure. Nobody else does. Apparently this person is intensely focused on what he does there and that serves him well. But that seems more the exception than the rule.

80% of autistic people dont have jobs. Another survey in UK showed only 12% of high functioning have jobs.

https://www.google.com/amp/www.ibtimes. ... 83%3famp=1
Absolutely. This intense focus on an area of interest can be a source of great strength. Individuals with ASD can exhibit traits superior to neurotypicals in areas ranging from having superior memories, above-average organizational skills, strong spatial skills, and the ability to concentrate for long periods of time without fatigue. In meeting them "where they are", it is exactly their area of intense focus that can be used as the spring board to expand from. For example, a young man with intense interest in vacuum cleaners was hired by Marriott Corporation to do nothing but vacuum. He did have a job coach, but unfortunately a massive shortage exists for this support because the pay for job coaches is low.

While low functioning persons with ASD may never hold a job, the all important goal would then be to use reinforcement learning techniques to reduce their suffering as it relates to psychological pain from tasks that overwhelm. It's not at all uncommon for individuals with ASD to engage in self-harm such as biting, cutting, self-striking, and even head banging. These actions make perfect sense as they are attempts to reduce psychic pain through focus on physical pain. It takes intensive interventions to introduce and reinforce strategies alternative to self-harm for them to use to reduce psychic pain.

I have found that even though the most nonsensical actions an individual with ASD takes make perfect sense them. A person who has an intense interest in a leaf rather than making eye contact with us uses entirely different constructs than we do. If we as neurotypicals will cease attempting to overlay our own conditioning over these individuals in an attempt to make them "normal", we will stand a much better chance of understanding them, of expanding their functioning, of decreasing any suffering they may have, and of perceiving the extraordinary example they set for all of us.

Again, in my experience, the most important tasks caregivers can engage in to provide for future welfare are:

1) Obtain sufficient life insurance to provide funding for future life care;
2) Consult an attorney specializing in estate planning involving special needs individuals;
3) Create, as much as possible, a network of resources, particularly human ones, that will be available to the individual; and
4) Allow the individual with ASD to educate you on their own uniqueness and what they need to function as a result of their own proclivities.

Miriam2
Posts: 2258
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Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by Miriam2 » Thu Jun 21, 2018 8:12 pm

paramedic wrote: Should I perhaps obtain a life insurance policy on myself?
The value of life insurance for a beneficiary with special needs is that the life insurance money WILL be there for your brother when you pass. Term life insurance may not accomplish this if you outlive your term :shock: I suppose you could keep buying and stacking term life policies, but usually some form of permanent life insurance is needed to guarantee the money will be there for him.

Check out Guaranteed Universal Life (GUL) or No-Lapse Universal Life policies - which are basically term insurance up to age 120, so they are essentially permanent term life insurance that builds little or no cash value. They are more expensive than term insurance but less expensive than whole life insurance policies.

JBTX
Posts: 3943
Joined: Wed Jul 26, 2017 12:46 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Thu Jun 21, 2018 8:13 pm

2015 wrote:
Thu Jun 21, 2018 7:41 pm
JBTX wrote:
Thu Jun 21, 2018 3:57 pm
What I have seen as a parent is ASD people often have an intense focus on what they are interested in. That's great, but that often doesn't correspond directly with what one needs to do to succeed in a nuerotypical world. While it is entirely possible that an ASD person has the aptitude to hold a job, they don't have the motivation to, unless it is what they are interested in. I think this will be an issue for our son.

Occasionally you can get the best of both worlds. Temple Grandin for instance. Or we just learned a person at my wife's work is ASD, she suspected but didn't know for sure. Nobody else does. Apparently this person is intensely focused on what he does there and that serves him well. But that seems more the exception than the rule.

80% of autistic people dont have jobs. Another survey in UK showed only 12% of high functioning have jobs.

https://www.google.com/amp/www.ibtimes. ... 83%3famp=1
Absolutely. This intense focus on an area of interest can be a source of great strength. Individuals with ASD can exhibit traits superior to neurotypicals in areas ranging from having superior memories, above-average organizational skills, strong spatial skills, and the ability to concentrate for long periods of time without fatigue. In meeting them "where they are", it is exactly their area of intense focus that can be used as the spring board to expand from. For example, a young man with intense interest in vacuum cleaners was hired by Marriott Corporation to do nothing but vacuum. He did have a job coach, but unfortunately a massive shortage exists for this support because the pay for job coaches is low.

While low functioning persons with ASD may never hold a job, the all important goal would then be to use reinforcement learning techniques to reduce their suffering as it relates to psychological pain from tasks that overwhelm. It's not at all uncommon for individuals with ASD to engage in self-harm such as biting, cutting, self-striking, and even head banging. These actions make perfect sense as they are attempts to reduce psychic pain through focus on physical pain. It takes intensive interventions to introduce and reinforce strategies alternative to self-harm for them to use to reduce psychic pain.

I have found that even though the most nonsensical actions an individual with ASD takes make perfect sense them. A person who has an intense interest in a leaf rather than making eye contact with us uses entirely different constructs than we do. If we as neurotypicals will cease attempting to overlay our own conditioning over these individuals in an attempt to make them "normal", we will stand a much better chance of understanding them, of expanding their functioning, of decreasing any suffering they may have, and of perceiving the extraordinary example they set for all of us.

Again, in my experience, the most important tasks caregivers can engage in to provide for future welfare are:

1) Obtain sufficient life insurance to provide funding for future life care;
2) Consult an attorney specializing in estate planning involving special needs individuals;
3) Create, as much as possible, a network of resources, particularly human ones, that will be available to the individual; and
4) Allow the individual with ASD to educate you on their own uniqueness and what they need to function as a result of their own proclivities.
While I understand and agree with most of what you are saying, from a practical matter it is a neurotypical world. We can debate all we want whether ASD is a "disorder", "disability" or just a "difference", but in a world of neurotypicals, to be able to function you have to function in a neurotypical world. We can all hope that one day there will be ample resources available who have the expertise to enter the world of ASD and modify work environments for ASD, but realistically that will not likely happen soon enough to materially benefit my son.

So for those where there is a convergence of interest and career opportunities, they have a chance to function "normally". For the rest it becomes an exercise is how to keep them engaged on a day to day basis and afford to support them since they can't support themselves.

JBTX
Posts: 3943
Joined: Wed Jul 26, 2017 12:46 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Thu Jun 21, 2018 8:16 pm

Miriam2 wrote:
Thu Jun 21, 2018 8:12 pm
paramedic wrote: Should I perhaps obtain a life insurance policy on myself?
The value of life insurance for a beneficiary with special needs is that the life insurance money WILL be there for your brother when you pass. Term life insurance may not accomplish this if you outlive your term :shock: I suppose you could keep buying and stacking term life policies, but usually some form of permanent life insurance is needed to guarantee the money will be there for him.

Check out Guaranteed Universal Life (GUL) or No-Lapse Universal Life policies - which are basically term insurance up to age 120, so they are essentially permanent term life insurance that builds little or no cash value. They are more expensive than term insurance but less expensive than whole life insurance policies.
I'd say it would make more sense to get a long term term policy, and by the time you are in your sixties, rely on your savings to pass on to him.

mrsbetsy
Posts: 120
Joined: Mon Jun 26, 2017 12:16 am

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by mrsbetsy » Thu Jun 21, 2018 8:57 pm

You are a wonderful person and brother. Thank you for serving your family in this way.

I agree with so much said here, but I would like you to consider that money isn't going to provide everything he needs. We have a 21 year old with autism and already have everything in place (trust, term insurance, and ABLE account). When we went to our eldest daughter and told her of the plans, she was completely on board. Our son is conserved and she is on the conservatorship so she can make decisions for him in our absence.

However, with tears in her eyes she told us that while she loves her brother and will always make sure he is cared for that we need to understand that he can not live with her. She expressed how sad she was to tell us this, but she said it is beyond her ability to care for him. She lovingly told us that we needed to widen his community of care and make sure he has people in his life to care for the majority of his needs. We appreciated her wisdom.

Please make sure your parents are not his entire world. While we have the means to care for him without government entitlements, we have no idea how long we are able to do so. Protecting those entitlements is really important.

Make sure you know the services available in your state and keep them active. Some things to consider:

1) In home support services
2) Respite services
3) Paratransit services
4) Department of Rehabilitation is a great help in finding and securing work
5) Protect his Medicaid (MediCAL in California)
6) His SSI is low. Our son gets $910 so find out why it's only $700.
7) Affordable housing in a group home or some place like that. Consider that he might need to get out of the parents home so that when they do pass, he knows how to navigate and/or has people in his life to help him. Otherwise that is going to fall squarely on you. He could live nearby, just on his own.

I'm in CA and we have a ton of safety nets for this population and I know it isn't the same everywhere, but do some digging and find resources that can help.

All the best to you.

2015
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Joined: Mon Feb 10, 2014 2:32 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 2015 » Fri Jun 22, 2018 12:19 pm

JBTX wrote:
Thu Jun 21, 2018 8:16 pm
Miriam2 wrote:
Thu Jun 21, 2018 8:12 pm
paramedic wrote: Should I perhaps obtain a life insurance policy on myself?
The value of life insurance for a beneficiary with special needs is that the life insurance money WILL be there for your brother when you pass. Term life insurance may not accomplish this if you outlive your term :shock: I suppose you could keep buying and stacking term life policies, but usually some form of permanent life insurance is needed to guarantee the money will be there for him.

Check out Guaranteed Universal Life (GUL) or No-Lapse Universal Life policies - which are basically term insurance up to age 120, so they are essentially permanent term life insurance that builds little or no cash value. They are more expensive than term insurance but less expensive than whole life insurance policies.
I'd say it would make more sense to get a long term term policy, and by the time you are in your sixties, rely on your savings to pass on to him.
As in all investing as it pertains to the spectrum ranging from luck to skill, having insurance helps to move outcomes from the luck end to skill end, from an open, uncontrolled system with unpredictable outcomes to a closed system with more predictable outcomes (LMP versus SWR is an example in investing). Yes, term life may not accomplish one's goals of providing financial support, but it's a superior bet to relying on a complex adaptive system such as the market.

On a different note, this article in the Los Angeles Times provides an excellent example of meeting individuals with ASD "where they are" with respect to employment:

http://www.latimes.com/business/la-fi-w ... story.html
Meanwhile, some companies are discovering the benefits of a more inclusive workplace, said Michelle Krefft, a director at Iowa Vocational Rehabilitation, a state agency that connects disabled workers to jobs.

“People with disabilities, as a group, have generally experienced barriers living in a world that is not designed for them,” Krefft said. “They are innovators by nature. More companies are waking up to this.”

Ernst & Young, the global consultancy firm, recently swapped out traditional job interviews for hands-on auditions for candidates with developmental disorders, said Hiren Shukla, EY’s neurodiversity program leader.

“We don’t want to get hung up on ‘Did you make eye contact?’” he said.

Over the last two years, the firm has hired 14 people with autism as account-support associates. EY hopes to add six more this summer.

“We think we have hit upon an untapped workforce,” Shukla said.

JBTX
Posts: 3943
Joined: Wed Jul 26, 2017 12:46 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by JBTX » Fri Jun 22, 2018 2:17 pm

2015 wrote:
Fri Jun 22, 2018 12:19 pm
JBTX wrote:
Thu Jun 21, 2018 8:16 pm
Miriam2 wrote:
Thu Jun 21, 2018 8:12 pm
paramedic wrote: Should I perhaps obtain a life insurance policy on myself?
The value of life insurance for a beneficiary with special needs is that the life insurance money WILL be there for your brother when you pass. Term life insurance may not accomplish this if you outlive your term :shock: I suppose you could keep buying and stacking term life policies, but usually some form of permanent life insurance is needed to guarantee the money will be there for him.

Check out Guaranteed Universal Life (GUL) or No-Lapse Universal Life policies - which are basically term insurance up to age 120, so they are essentially permanent term life insurance that builds little or no cash value. They are more expensive than term insurance but less expensive than whole life insurance policies.
I'd say it would make more sense to get a long term term policy, and by the time you are in your sixties, rely on your savings to pass on to him.
As in all investing as it pertains to the spectrum ranging from luck to skill, having insurance helps to move outcomes from the luck end to skill end, from an open, uncontrolled system with unpredictable outcomes to a closed system with more predictable outcomes (LMP versus SWR is an example in investing). Yes, term life may not accomplish one's goals of providing financial support, but it's a superior bet to relying on a complex adaptive system such as the market.

On a different note, this article in the Los Angeles Times provides an excellent example of meeting individuals with ASD "where they are" with respect to employment:

http://www.latimes.com/business/la-fi-w ... story.html
Meanwhile, some companies are discovering the benefits of a more inclusive workplace, said Michelle Krefft, a director at Iowa Vocational Rehabilitation, a state agency that connects disabled workers to jobs.

“People with disabilities, as a group, have generally experienced barriers living in a world that is not designed for them,” Krefft said. “They are innovators by nature. More companies are waking up to this.”

Ernst & Young, the global consultancy firm, recently swapped out traditional job interviews for hands-on auditions for candidates with developmental disorders, said Hiren Shukla, EY’s neurodiversity program leader.

“We don’t want to get hung up on ‘Did you make eye contact?’” he said.

Over the last two years, the firm has hired 14 people with autism as account-support associates. EY hopes to add six more this summer.

“We think we have hit upon an untapped workforce,” Shukla said.
This sounds great, but isn't yet widespread and my guess is it is really only applicable to very high functioning (high Iq) individuals. I am seen a couple of crazy smart people on the spectrum and they have amazing potential, it is just figuring out how to accommodate and channel it. For those on the lower high functioning and below it may be more of a challenge.

My only thought on the universal life is it may be fairly expensive and not necessarily the best use of limited funds in supporting an ASD loved one.

2015
Posts: 1833
Joined: Mon Feb 10, 2014 2:32 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by 2015 » Fri Jun 22, 2018 2:47 pm

JBTX wrote:
Fri Jun 22, 2018 2:17 pm
2015 wrote:
Fri Jun 22, 2018 12:19 pm
JBTX wrote:
Thu Jun 21, 2018 8:16 pm
Miriam2 wrote:
Thu Jun 21, 2018 8:12 pm
paramedic wrote: Should I perhaps obtain a life insurance policy on myself?
As in all investing as it pertains to the spectrum ranging from luck to skill, having insurance helps to move outcomes from the luck end to skill end, from an open, uncontrolled system with unpredictable outcomes to a closed system with more predictable outcomes (LMP versus SWR is an example in investing). Yes, term life may not accomplish one's goals of providing financial support, but it's a superior bet to relying on a complex adaptive system such as the market.

On a different note, this article in the Los Angeles Times provides an excellent example of meeting individuals with ASD "where they are" with respect to employment:

http://www.latimes.com/business/la-fi-w ... story.html
Meanwhile, some companies are discovering the benefits of a more inclusive workplace, said Michelle Krefft, a director at Iowa Vocational Rehabilitation, a state agency that connects disabled workers to jobs.

“People with disabilities, as a group, have generally experienced barriers living in a world that is not designed for them,” Krefft said. “They are innovators by nature. More companies are waking up to this.”

Ernst & Young, the global consultancy firm, recently swapped out traditional job interviews for hands-on auditions for candidates with developmental disorders, said Hiren Shukla, EY’s neurodiversity program leader.

“We don’t want to get hung up on ‘Did you make eye contact?’” he said.

Over the last two years, the firm has hired 14 people with autism as account-support associates. EY hopes to add six more this summer.

“We think we have hit upon an untapped workforce,” Shukla said.
This sounds great, but isn't yet widespread and my guess is it is really only applicable to very high functioning (high Iq) individuals. I am seen a couple of crazy smart people on the spectrum and they have amazing potential, it is just figuring out how to accommodate and channel it. For those on the lower high functioning and below it may be more of a challenge.

My only thought on the universal life is it may be fairly expensive and not necessarily the best use of limited funds in supporting an ASD loved one.
It isn't widespread because a dearth of support exists for families or caregivers of individuals with ASD over age 18. It's like they fall off a cliff, and is somewhat akin to what happens to young people at some point in the foster care system. This is why the earlier the better it is to provide underlying supports bridging the gap between where an ASD person is and what is expected of them in a neurotypical based culture. It's unfortunate that employers continue to cling to their antiquated, sub-optimal recruitment and selection systems, as much talent, including, but not limited to persons with ASD, is overlooked by adhering to these systems.

Cognitive based therapy has had some success in increasing the ability of some spectrum persons to think about their own thinking, and to increase capacity for self-regulation. I also advocate intensive skills based training as task overwhelm is probably the greatest source of frustration for ASD people, in addition to communication difficulties and denial of access to their favorite activities, objects, or people (highly individual independent). I don't advocate discriminating between low and high functioning persons, except to diagnose person dependent support.

Financially, I was thinking of term life only. There are no easy answers, only perhaps better ones. For caregivers, it's helpful to remember that while people with autism may at times experience their own brand of suffering, they are free of much of the suffering neurotypicals experience as a result of biological, psychological, and cultural conditioning. Removing ones own neurotypical prejudices allows for receiving the gift people with autism represent.

paramedic
Posts: 49
Joined: Sun Sep 11, 2016 7:26 pm

Re: Planning for long-term care of a brother with Autism? (Financial aspect)

Post by paramedic » Sat Jun 23, 2018 3:45 pm

Thank you, everyone, for your replies. I clearly have some more research ahead of me.

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