In my opinion, it’s important for a lawyer to specialize in a given field. When a client asks me about another area of the law (such as family law or bankruptcy law), my ability to advise them properly is greatly diminished. I tend to only know those other areas to the extent those areas of the law affect my area of the law.
On the other hand, when a client asks me a question about elder law, I tend to either know the answer or know where I can find the answer to the question. Over my sixteen years of practicing in the elder law field, I have developed a network of attorneys throughout the state and, even, throughout the country to whom I can turn when faced with a difficult question of elder law. I’m confident enough in my knowledge of elder law to know when I need the help of my fellow elder law attorneys on a given question.
Being a lawyer, I like to focus on the law. Sometimes, a client will ask me a question that I think is better suited for a geriatric care manager. A geriatric care manager is a social worker who specializes in providing care to and arranging care for elderly individuals.
Sometimes, elder law and care management are so closely related for the client that it is difficult for the client to see the distinction. Where dad receives his care and how he pays for that care may be so interconnected to the client that the client might not see the difference between the two issues—but there are distinctions as surely as there are distinctions between a surgeon and an anesthesiologist when it comes to performing surgery.
Let’s say a family comes to me looking to qualify the father for Medicaid while preserving assets for the benefit of their mother who will remain at home. The family needs to make appropriate care arrangements for the father, and they are uncertain if his care needs are best served at home, in an assisted living residence, or in a nursing home. In short, they want to make sure both the mother and father have a method of supporting themselves in the most appropriate environment.
When it comes to paying for long-term care, there are two primary methods of payment—private payment and Medicaid. Private payment simply means that the client pays for his own care from his own funds.
Medicaid is government payment program that will assist with the payment of long-term care costs. If a person qualifies for Medicaid, Medicaid will pay for nursing home care or a home health aide.
My practice involves qualifying individuals for the Medicaid program. I have extensive knowledge of the relevant portions of the Medicaid Act that relate to a person’s qualification for benefits. I have assisted thousands of clients in qualifying for the Medicaid program.
I do not assist clients with arranging for proper care. If a client has a question about the appropriate care setting—home, assisted living residence, or nursing home—then I would suggest that the client contact a geriatric care manager to arrange for that care.
Geriatric care managers can ensure that the client receives appropriate care in the most appropriate setting. A care manager can help the client in selecting a nursing home or assisted living residence that is right for the client or can help arrange for home health aides to care for the client at home.
Overlaps in the two fields can occur when attorneys hire social workers to work at their firm as part of their practice (I do not have social workers who work for me) or when geriatric care managers assist clients in applying for Medicaid. I think it’s fine if a care manager applies for Medicaid for a family; however, like I do with my practice, I think it is important for everyone to know their limitations.
Because Medicaid is a complex law, I believe in cases in which the family is seeking to maximize their savings, consulting with an attorney in the Medicaid planning process can produce the best result for the family. As a lawyer might hire a care manager to work in his firm, care managers should not shy away from referring families to elder law attorneys to develop a proper Medicaid plan.
The strongest long-term care plans consider every aspect of a person’s life. Addressing legal, financial, and personal concerns together provides the greatest peace of mind.