WhyElderLaw
How would you explain elder law to someone who is unfamiliar with the law?
Elder law is an extension of estate planning that helps people in their older years plan for assistance they may need, whether it is related to medical decision-making, financial management, or long-term care. It is a very dynamic practice area that covers a lot of different issues, from estate planning to long-term care planning and everything in between.
Some people are planners. I am a planner. I like to know what is coming up. At our law firm we adopted the tagline, “Your life … planning for what’s next.” Whether it’s a young family planning for their children as they grow up, or someone older planning for nursing home care or for what happens after they’re gone, we are there to help people navigate that process.
Of course, you can make a plan, and it may not always turn out that way. But you can put the pieces together for what you hope will be the best outcome.
When did you know you wanted to become an elder law attorney?
It wasn’t a straight path. I was a church music director for the first 15 years of my professional career. I directed choirs and worked in churches, and then I got to the point where I thought, “Is there something more I can do professionally that does not require me to work every weekend and holiday?” But the seeds were probably planted when I was in college and worked a part-time and summer job in a nursing home as a certified nursing assistant; I saw that people in advanced infirmity can be really vulnerable and depend on others for help. That kind of hands-on care made me realize that there is a need for caring professions and that this practice area could become a caring profession for those who are older.
A good friend of mine practiced in this area; she is now retired. When I was thinking about going to law school, I talked to her about her career because I thought something in estate planning would be interesting. We discussed what her work was like, so that got me interested in elder law. After I graduated from law school, I worked with her at her firm. Then she became a mentor, and I really started practicing in elder law from the beginning.
How has elder law grown as a field during the time you have been in it?
I’m not sure if the field has grown or if my awareness of its variety has expanded, but when I started, elder law to me meant practicing advanced estate planning, probably some Medicaid or long-term care planning, and guardianship work when someone needed that additional protective arrangement. But there is so much more to it. Special needs planning has always been a parallel or adjacent practice area because at least some areas overlap.
You realize the range of people’s experiences as they age, and if there is a situation where they may need legal help, that falls into elder law. It might involve discrimination — age discrimination, housing discrimination, or related issues — but it also could mean working through administrative bureaucracy like a Medicaid program, a Social Security issue, or something like that.
You do not get bored in elder law. You can make it as expansive or as focused as you choose.
What do you consider to be a few of the most pressing issues within elder law today?
Medicaid was, at least 15 or 20 years ago, almost a foregone conclusion for many people entering nursing home care or planning to become eligible. It is still critical for a lot of people, but Medicaid rules and resources have become more challenging to navigate, and it should not be a one-size-fits-all approach.
When I meet with clients now about long-term care planning, and there is not an imminent need for nursing home care, we will discuss a variety of options: paying out of pocket, long-term care insurance, a reverse mortgage on their home, or Medicaid if that is needed. It is not one-size-fits-all. The Medicaid program has gotten more constricted, and the nursing home industry has gotten a lot more challenging too. There is not a long-term care system in this country.
Another urgent issue is scams or financial abuse. Scams get a lot of attention, and they steal billions of dollars from people every year. Helping people become aware of these risks and giving them tools to avoid them in the first place can be challenging. Sometimes we use trusts, power of attorney documents, or even guardianships to provide some protection.
I am also fascinated by the balance in elder law between personal autonomy and protective measures. There is a concept — more from disability law, but it applies to older adults too — called the “dignity of risk.” It’s the idea that people have the autonomy to make their own decisions, and if those decisions don’t work out, that’s part of being an independent human being. But if someone takes risks that threaten their personal welfare or finances, then intervention may be necessary. Finding that balance is an interesting thing to navigate and to contemplate.
What brings you joy in your work?
I enjoy working with my clients. Sure, a lot of my work involves drafting documents or preparing Medicaid applications, but it’s the client interaction that energizes me because that’s where I see the purpose in what I do.
It’s also giving my clients real value for what they are paying me. They receive sound estate planning advice and documents. If someone needs nursing home care, they get help securing Medicaid benefits to pay for it. They gain information, peace of mind, and assurance that someone has helped them with a problem they could not solve on their own.
That is probably true of many attorneys — you are helping somebody with an issue they can’t resolve alone — but in this field, it feels especially personal. Older clients often come to us with some level of vulnerability. It might be declining health, dwindling financial resources, or deteriorating relationships with family members. They bring those vulnerabilities with them, and we help them navigate that.
What is your hope or vision for the future of elder law?
I am pleased that elder law has expanded beyond a one-, two-, or three- track practice. Again, maybe that is just my perspective, and it has always been this expansive, but elder law as a practice area emerged in the 1980s and ‘90s out of estate planning or disability law. Now that practice area has started to mature, and we see these different aspects of it almost like facets on a jewel or a prism.
Another topic that is emerging is end-of-life decisions. Issues like hospice care, do-not-resuscitate orders, and physician-assisted or medically assisted dying reflect people’s desire for autonomy and choice in how they spend their final years or months. That seems to be expanding beyond living wills and advance directives.
Like many areas of law, we are also seeing more diversity in populations who need legal services. We have to adapt our practices to address cultural diversity, racial diversity, and diversity in gender and sexual orientation. I serve on NAELA’s DEI Committee, and we are looking at how the association can respond as well, through law school engagement, member programming, and the topics we include in our publications. In NAELA News, for example, I have written an article about LGBTQ+ clients.
No individual attorney can be aware of all the possible dynamics that may arise with diverse cultural, ethnic, racial, and LGBTQ+ clients. But we can at least be mindful of these issues and remain open to what our clients bring to us. The same is true of religious diversity. I have worked with Muslim, Hindu, and Buddhist clients, and aspects of their faith sometimes shape their planning, whether it is end-of-life care, what they want to do financially as a charitable bequest in their estate, or how they think about family caregivers.