Care home

The Hale household

Margaret, 78, supports her son David, 44, at home in Richmond, Virginia. Their plan is complete, confirmed by Margaret, and ready to guide the people they chose.

Ask Relay about the Hales

Relay answers from a plan like this one: what David needs before pickup, who to call first, what to do if a dose is missed. Here it plays a few pre-written conversations with this made-up family.

Ask Relay

Today, Tuesday, July 28

Caregiver
Margaret Hale, 78Home and well. Answered today’s check-in.
Person supported
David Hale, 44At home today, at Bright Path tomorrow.
Medication due
Keppra at 8:00 PM500 mg, crushed into applesauce.
Nearby today
Margaret, with Tom close bySarah is the first contact if plans change.

David’s care plan

Written from Margaret’s own answers and confirmed by her, one care area at a time. Each fact below is fictional.

About David

Identity, preferences, strengths, and the life he wants to keep living.

  • David Hale is 44 and lives in the family home in Richmond, Virginia.
  • He is autistic and needs intermittent support with transitions, medication, transportation, and unfamiliar decisions.
  • He loves train videos, sorting his postcard collection, grilled-cheese lunches, and quiet drives by the river.
  • Speak to David directly, offer two concrete choices, and allow at least 20 seconds for a response.

Confirmed by Margaret Hale

Daily rhythm

A complete weekday and weekend routine, including what must stay in order.

  • Wake at 7:30 AM; breakfast comes before dressing. Reversing the order often causes refusal.
  • Bright Path Center pickup is 9:15 AM on Monday, Wednesday, and Friday; backpack and headphones wait by the door.
  • Dinner is at 6:00 PM, followed by one hour of train videos. Evening medication is at 8:00 PM and bedtime at 9:30 PM.
  • On weekends, keep the same wake and medication times. A river drive after lunch is his preferred outing.

Confirmed by Margaret Hale

Communication & comfort

How David communicates pain, refusal, distress, joy, and consent.

  • David uses short phrases and may repeat the last option when a question has too many choices.
  • Pain signal: he goes quiet and presses his right palm against his jaw. Ask, “Does your mouth hurt?” and show the pain card.
  • Refusal: he turns his shoulder away and says “later.” Pause for ten minutes; do not repeat the demand rapidly.
  • Distress improves with lowered lights, one familiar person, his blue headphones, and a written first/then card.

Confirmed by Margaret Hale

Health & medication

Medication, allergies, clinicians, pharmacy, and health signals that need action.

  • Levetiracetam (Keppra) 500 mg twice daily for seizure prevention: crushed into applesauce at breakfast and 8:00 PM.
  • Vitamin D3 1,000 IU each morning with food. No known medication allergies; penicillin caused a rash in childhood and remains flagged.
  • Neurology: Dr. Priya Shah, Riverbend Neurology, (804) 555-0188. Next visit October 14, 2026 at 10:30 AM.
  • Call the neurology nurse for a missed Keppra dose or any seizure. Call emergency services for a seizure lasting over five minutes.

Confirmed by Margaret Hale

Behavior & safety

Known triggers, prevention, calming strategies, and clear emergency thresholds.

  • Primary triggers are an unexpected schedule change, overlapping voices, bright waiting rooms, and being rushed while eating.
  • Prevent escalation by previewing changes with the kitchen calendar and offering headphones before entering a crowded place.
  • If David paces and hums, reduce language and give him space near the living-room window. Sarah or Tom may stay nearby quietly.
  • David has never wandered. Exterior doors stay unlocked while he is home; the kitchen smoke alarm and medication lockbox were checked July 1.

Confirmed by Margaret Hale

Services & community

Providers, transportation, programs, and the people responsible for each handoff.

  • Bright Path Center provides day support three days each week. Coordinator Lisa Moreno receives schedule changes.
  • CareRide Virginia provides waiver transportation; standing pickup ID CRV-20418 is synthetic and stored with the plan.
  • Sarah coordinates temporary in-home support. Tom can open the home but is not authorized to make health or financial decisions.
  • David prefers the quiet room at Bright Path and carries a laminated communication card in his backpack.

Confirmed by Margaret Hale

Benefits, legal & finances

Coverage, renewals, decision support, key documents, and known legal gaps.

  • SSI and Virginia Medicaid HCBS waiver are active. Annual waiver recertification is due September 30, 2026.
  • Margaret is representative payee. Sarah is the named backup contact but no payee transfer has been initiated.
  • Supported decision-making agreement, health summary, insurance cards, and benefits letters are in the green binder in the hall cabinet.
  • No guardianship order is on file. If Margaret cannot resume care, the case manager will initiate legal-services review with David present.

Confirmed by Margaret Hale

The circle of support

Named before they are needed. Open a person to see how to reach them, what they are responsible for, and what they are allowed to see.

  • Sarah Hale-OrtizOlder sister, first continuity contactConfirmedShow detailsHide details
    Location
    Denver, Colorado
    Availability
    Any time for urgent calls; weekdays after 5 PM for routine questions
    Responsible for
    Confirms whether a handoff should begin, coordinates family, and approves temporary care arrangements.
    Can see
    Full verified care plan, benefits summary, clinician contacts, and continuity packets.
  • Tom AbaraNeighbor of 18 years, local responderConfirmedShow detailsHide details
    Location
    Two houses away
    Availability
    Home most evenings and weekends; text first unless urgent
    Responsible for
    Performs an in-person safety check, opens the home for authorized helpers, and stays with David until family arrives.
    Can see
    Home-entry instructions, David’s one-page communication guide, and emergency contacts only.
  • Lisa MorenoHCBS case manager, services leadConfirmedShow detailsHide details
    Location
    Richmond Community Supports
    Availability
    Monday–Friday, 8:30 AM–4:30 PM; agency on-call line after hours
    Responsible for
    Protects waiver services, coordinates replacement support, tracks recertification, and convenes provider planning.
    Can see
    Benefits, legal, services, provider, risk, and case-manager continuity packet.
  • Rachel BrooksCousin, planned backup caregiverConfirmedShow detailsHide details
    Location
    Petersburg, Virginia, 35 minutes away
    Availability
    Overnight backup with four hours’ notice; unavailable Tuesdays
    Responsible for
    Provides short-term overnight care and maintains David’s established home and medication routine.
    Can see
    Full daily-care packet after Sarah confirms activation; no benefits or banking records.

Coming up

  • Tomorrow, 9:00 AM

    Caregiver check-in

    Email Margaret, then call after two hours if unanswered.

  • Friday, 9:15 AM

    Bright Path pickup

    Backpack, headphones, lunch card and medication note ready by the door.

  • September 30

    Waiver recertification

    Lisa owns the renewal; Sarah has copies of the required records.

If Margaret stops answering

A rehearsal with the same fictional family, from the first missed check-in to a confirmed handoff. Each step shows who decided: the system for routine retries, a named person for everything that matters. No real messages were sent.

  1. July 6 at 9:00 AM

    Stage 1: One missed check-in

    One check-in went unanswered. Synic Relay is quietly retrying another way. Nobody else has been contacted.

    Check-in scheduled for 9:00 AM was not answered by end of day

    Decided by the system, as a routine step

    Suggested by AI, 96% confidentShow details
    Model
    escalation-reasoner
    Confidence
    96 out of 100
    When
    July 6 at 9:00 AM
    Based on
    “Advance to stage 1 and quietly retry on the phone channel”

  2. July 7 at 9:00 AM

    Stage 2: Two missed check-ins

    Two in a row unanswered. A gentle direct message went out on every channel. Still nobody else contacted.

    Second consecutive check-in missed (email, then phone call)

    Decided by the system, as a routine step

    Suggested by AI, 94% confidentShow details
    Model
    escalation-reasoner
    Confidence
    94 out of 100
    When
    July 7 at 9:00 AM
    Based on
    “Advance to stage 2; send a direct low-stakes message on all channels”

  3. July 8 at 11:20 AM

    Synic Relay isn’t sure, so it stopped.

    The reply shows the phone was used, but it does not confirm Margaret is safe. This is neither an answered check-in nor a missed one. Holding for human review instead of guessing.

    Nothing was decided automatically. A person makes this call.

  4. July 9 at 9:00 AM

    Stage 3: Asking the circle

    Three misses. The first circle contact has been asked one question: can you confirm everything is okay?

    Third consecutive miss; held reply reviewed by Sarah (tier 1)

    Decided by Sarah Hale-Ortiz, a named person

    Suggested by AI, 88% confidentShow details
    Model
    escalation-reasoner
    Confidence
    88 out of 100
    When
    July 9 at 9:00 AM
    Based on
    “Ask tier 1 to confirm the caregiver is okay”

  5. July 9 at 2:45 PM

    Stage 4: Event confirmed, preparing

    A person confirmed something happened. The circle is being notified and handoff packets are prepared, but not released.

    Sarah confirmed: Margaret was admitted to the hospital this morning

    Decided by Sarah Hale-Ortiz, a named person

    Suggested by AI, 91% confidentShow details
    Model
    escalation-reasoner
    Confidence
    91 out of 100
    When
    July 9 at 2:45 PM
    Based on
    “Notify the full circle and case manager; prepare packets; do not release”

  6. July 9 at 3:10 PM

    Stage 5: Activated

    A named person confirmed activation. Handoff packets have been released to the people you chose, and every access is logged.

    Sarah Hale-Ortiz explicitly confirmed activation

    Decided by Sarah Hale-Ortiz, a named person

    Suggested by AIShow details
    Model
    escalation-reasoner
    Confidence
    Not applicable
    When
    July 9 at 3:10 PM
    Based on
    “The system does not recommend activation. It can only be confirmed by a named person.”