There are many different types of elder law practices. Some focus on the broad spectrum of issues that effect seniors, as our firm does. Others focus solely on Medicaid asset protection. Many attorneys, including myself, have come to realize that older adults who are facing health challenges, and the families, that care for them, need more than just asset protection and legal advice. This is how life care planning developed. Since life care planning is not well understood, I asked our care coordinator, Lori Kayne, to provide a couple of examples of how she and I worked together to help families outside of the Medicaid planning context. (Of course, the names and details have been changed so our clients cannot be identified.)
The Jones family came to our office in a panic. Their dad, Fred, had suddenly had a massive stroke and was in a rehabilitation facility. Ethel had Alzheimer's disease and was not safe to be alone due to hr poor memory and other physical impairments. Their parents had no legal documents and the family was not able to access any of their funds or make medical decisions for either parent. After evaluation we determined that Fred still had the mental capacity to understand legal documents and we drafted a power of attorney and health care proxy. This allowed his son to access Fred's finances and make medical decisions for him. Unfortunately Ethel did not have mental capacity and we had to initiate an emergent guardianship action. This allowed her son to access her bank accounts and we assisted him with locating a nursing home that would meet both parents' medical and financial needs. The couple lived together at the nursing home until Fred's death. Ethel is still at the nursing home and has many friends there now. She has used the couple's assets and we have filed a Medicaid application and are working with the nursing home to ensure that there are no financial issues while we wait for Medicaid to be approved.
Donna lived alone in the large home where she raised her children. She was diagnosed with Parkinson's disease and had become increasingly frail. She had multiple falls, some of them resulting in hospitalizations. Her children felt strongly that Donna should move to a nursing home, but Donna was adamant she would not leave her home. After evaluating her in her home, we worked out a plan to improve her safety. She agreed to wear an emergency response system and hired a home health aide. She also agreed to work with a physical therapist to improve her balance. She hired a contractor we recommended to modify her home to improve the safety. Based on our knowledge of her physical needs and financial status, we recommended a few assisted livings for her to tour, so she could begin to prepare for her eventual move. Donna remained in her home for two years. She had occasional falls but was not seriously injured. During each hospitalization, we were with Donna and her family and assisted them in determining what the next step should be. After a bout of pneumonia and rehabilitation admission, we suggested that this would be the right time to move to assisted living. We did not want Donna to spend all of her funds on home care because her choice of facilities would be limited if she could not afford a substantial period of private pay. We helped her choose a facility that would ensure she could continue there when her funds ran out or her care needs increased. We assisted her with arranging services to pack and get her home ready to be sold. We also attended the initial care meetings to help Donna with the transition. She has adjusted well and has become involved in daily card games.