Our clients include senior citizens, their families, agencies who work with seniors, disabled persons needing trusts or trust management services, persons seeking guardianship, heirs seeking fair treatment under a will, and many others with diverse legal needs. While no single description can cover all of the work we do, the following are some common situations in which we provide legal assistance.
1. Clients in Immediate Health Crisis
A health care crisis is one of the most common reasons that clients visit an elder law attorney. Many seniors and their families do not plan their affairs before developing major long-term illness, such as a stroke or progressive neurological disease. These clients find themselves faced suddenly with the ruinous cost of home care, assisted living or a nursing home, with no plan in place to avoid using up their life savings, or eventually losing their home, to pay for such care.
While last-minute planning rarely is ideal, it is never too late to avoid worst-case outcomes. Depending upon circumstances, individuals or families may discover options and benefits that they did not know were available. Having come face-to-face with catastrophic health care costs, clients who do not plan ahead often are tremendously relieved and grateful for the help they receive even at the last minute.
2. Clients Who Plan in Advance
The best results in financing long-term care costs are achieved when clients visit us long before there is any need for such care. Many clients are persons over age 60 who are in good health, and who are motivated to see an attorney at least partly by the desire to create (or update) their wills, living trusts and other estate planning instruments.
Estate planning for these clients often can be combined with measures to protect the estate against the cost of long-term care. For example, a person who may be considering a revocable living trust in order to avoid probate costs may be able to consider other kinds of trusts that would protect assets in case of nursing home care. Others may be able to afford long-term care insurance, which may become unaffordable if they wait just a few years longer. In cases like these, there usually is time and opportunity fully to protect the home and significantly or fully to protect other assets.
3. Families Protecting Younger Disabled Members
Sometimes the focus of consultation is not the older generation, but a disabled minor or adult child. A special needs trust for the child often helps these clients, allowing resources to be preserved for the disabled child when family members are not available in the future to provide support.
Special needs trusts can be written so as to allow the child to continue receiving as much support as possible from public programs, such as Medicaid and the Supplemental Security Income program (SSI), and allowing trust funds to be used only to provide for personal needs that those programs do not cover.
Some of the clients who request trusts also request professional trustee services. Trustee services can be provided as sole trustee, or as co-trustee with either a family member or a financial institution serving as custodial trustee. The advantage of having a knowledgeable attorney as trustee is the assurance that funds will not be used in a manner that would jeopardize the beneficiary's entitlement to Medicaid, SSI or other public benefits.
4. Protective Proceedings
Another important group of clients are those who seek guardianship or conservatorship on behalf of a loved one. There are many reasons for such proceedings, all of which derive in one way or another from the loss of competence by the loved one.
Sometimes the issue is nursing home care, where no provisions have been made to protect the home or preserve part of the estate. In those cases, a guardianship may be the only way to change ownership of assets remaining in the name of the person who has lost capacity.
In other cases, the issue is health care decision-making. The incapacitated person may be unable to understand the need for appropriate care, or unable to express consent to it. If the person created no health care proxy while they were competent, guardianship may be the only way to act on their behalf.
5. Litigation Clients
A percentage of clients are persons involved in disputes which require adjudication by public tribunals, either in administrative venues or in state or federal courts.
Denial of benefits for Medicaid or SSI can be a reason to see an elder law attorney. Another reason may be to protect an interest in the probate of an estate, or in the estate of a person under guardianship. A small but growing area of litigation involves patient rights in nursing homes, including cases of mistreatment or medical error.
Most cases that go to litigation eventually are resolved without a trial. Those that are not, however, sometimes end up in appeal. Our law office has participated in appeals at the highest levels in Massachusetts.
6. Other Clients
In addition to the above client groups, we assist people with traditional estate planning, real estate transactions, probate administration and other matters of personal or financial importance. We strive to help all of our clients with professional, practical and productive legal solutions, to address their needs and improve the outcome no matter what the issue may be.
