What is Elder Law?

by Brian Andrew Tully  –  An old Pennsylvania Dutch proverb says, “We get too soon old and too late smart.” Unfortunately, this happens to a number of our Nation’s senior citizens when it comes to the concept of elder law. Quite frequently, an elder law attorney will be contacted by a child or spouse who is suddenly faced with the reality that their loved one requires some form of skilled nursing or long-term care. Usually, the flood of questions and “what if” scenarios from other family members and health care professionals can start to overwhelm even the strongest of spouses or the most reliable of children.

While much of the emotion and uncertainty in common situations like this cannot be preempted or resolved in advance, some of the most complicated matters, such as establishing who will make the health care decisions? what health insurance coverage exists? and what the best way is to protect the family home can be addressed by an experienced elder law attorney before you get “too soon old.” Failure to address these issues in advance of a health care crisis will certainly cost more money and cause more stress, and usually requires court intervention. You can plan ahead to avoid a crisis situation by being armed with accurate knowledge and having in place the necessary tools and mechanisms to help if such a situation arises.

The field of elder law, like estate planning, is not an isolated field of law confined to a single set of statutes and regulations, as you would typically find with other areas of the law. Rather, elder law is defined by the various needs of the client to be served. For example, elder law encompasses most issues a typical senior citizen will face dur­ing the second half of his or her life: legal; financial; tax; health insurance; asset protection; housing; and government benefits. Addressing these issues in advance will help you to avoid a crisis situation. While everyone should establish a proper estate plan when we begin our family and/or our careers, a good rule of thumb in establishing our “elder law plan” is to meet with an experienced elder law attorney when you receive your Medicare card at 65 years of age.

A typical elder law plan includes both advice and legal documentation. The advice revolves around achieving the following common goals: maintaining your current standard of living; ensuring all of your hard-earned assets go to your family how and when you choose; reducing or eliminating taxes and administration expenses; establishing who will handle your financial and health care decisions; and planning for and minimizing the expense of potential long-term health care needs.

The experienced elder law attorney can help you achieve these goals by advising you of the legal and financial strategies available and helping you evaluate the benefits and limitations of the Medicare and Medicaid programs, long-term care insurance and the concept of self-insuring.   Moreover, the elder law attorney can help you implement an elder law plan through documentation that balances these goals and issues. Your elder law plan must be completed before incapacity strikes, as you must have the ability to understand and express your decisions regarding the necessary legal documents such as a Durable Power of Attorney for Medical decisions (sometimes called a Health Care Proxy), Durable Power of Attorney for Finances, a Living Will, a Last Will and Testament and even a Trust.

The exorbitant costs of long-term health care are typically the motivator when it comes to addressing the various elder law concerns. Long-term health care, which is usually not paid for by Medicare, is typically required when someone suffers from a chronic or disabling condition that requires either skilled nursing care or custodial assistance with common activities of daily living such as bathing, walking, and toileting. The out-of-pocket costs for these services can range from $2,000 per month up to $20,000 per month depending on the level of care needed and the market rate for the services in your region.

There are only a few payment options when the need for this type of care exists. First, Medicare offers only a limited benefit for those services that are skilled or therapeutic in nature. When Medicare coverage ends, families that have not planned in advance are faced with the extreme costs of paying for the needed care themselves until eligibility for Medicaid is obtained. The eligibility process for this second option can cost upwards of 50% of a single person’s assets. If a person is married, eligibility can usually be obtained earlier but there is a very serious risk; the spouse who is not in need of the long-term care faces the potential of being sued for reimbursement by the local Medicaid agency.

The third, and most recommended option for elder law planning, is to consider long-term health care insurance. A properly placed long-term care insurance policy can help protect the lifestyle of your spouse and/or family from the high cost of long-term care and can help protect your assets for your heirs. Each state is encouraging its residents to consider purchasing this type of health insurance. The New York State Office of the Aging confirms this on their Web site with the following advice: “insurance is an important part of securing your financial goals. Long-term care insurance can help to safeguard your assets and protect your financial stability…[it] is an important tool to help you with the high cost of long-term care services.” There are several variables to consider when obtaining this type of health insurance. Your elder law attorney can help you sort through the various options.

While most agree that we do get “too soon old” it is very important to realize we do not also have to be “too late smart.” Be encouraged in that there are proactive steps you can take in advance of any long-term health care need that can help you maintain control and security even as you face new challenges.  Start the process by sitting down with an experienced elder law attorney and explore your options.

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Stanley H. Rosen

On Nov 6, 2012 our beautiful country died….Obama killed it and will continue to do so…and Bernanke is his acomplice..

Obama needs to be impeached and gotten out of office before he cando more damage to America….He is a muslim, an anti-semite and doesn’t give a damn about the middle class or any class as long as he gets what he wants from us….look what the idiot did in Egypt did…that is exactly what Obama wants…and hopefully he won’t get it.


You have a special gift for wrniitg. You can express your thoughts in unique, original content. This information is formatted in easy to read terminology that nearly any reader can understand. Thank you for sharing.


At 58, life sure isn’t what I had pictured in my youth. It would be great to live back in the ’50s again, sadly our nation has “progressed” to such a Liberal state that next year my retiree health coverage will be dropped and I will be forced to join the ranks of Obamacare. We all vent these problems, yet when someone stands up and demands action no one will support them. I think it’s time we all took a long, hard look into the mirror and decide if we’ll be sitting on the sidelines or doing something about the direction our country is headed. The Right is criticized as curtailing all the Liberties our Constitution has granted, yet the Left is granting far more than our forebears ever had in mind. Who will lead us out of this morass? We need a viable leader and I don’t see it… Read more »


I have an elder care attorney who has advised me and my siblings on some issues. How do I find out, without getting several more opinions from other attorneys, whether his advice is for our good or his own?

Robert,USN, Ret

Thank you,, Joe Reisinger. Everyone should note those comments. “Elder law”specialist” is just the same as “Sanitation Specialist”. It is a deviation in the English language. An Attorney at Law, and a Janitor. Much the same as the writer that uses the term Pennsylvania Dutch. Incorrect. Originally referred to the German immigrants that settled in that area. Pennsylwanisch Deutsch, as in Deutschland (for Germany). Thus, Germans of Pennsylvania. Maybe were some Dutch, but the two are separate identities. Pennsylvania Dutch joins the long list of other inappropriate terms that arose from incorrect pronunciation. Much the same as the word Negro. Black in several languages. Slurred into what became the hated “N” word, and further prostituted by the PC crowd that speaks of African-Americans. No such animal! Black Americans, White Americans, et al—best—just Americans. Native Americans? That is anyone born in this Republic. Amerinds, (American Indians) is better. Less derogatory. Another… Read more »

B. Dalton

As far as most of us care you should BURN Ruth Bader G. At the stake!!!!!!!!!


Great reminder to take care of business sooner rather than later. Some people might be skeptical about this new concept of elderlaw but I definetaly trust them since they do specialize in their field just like a criminal lawyer specializes in their area .

Montana Bud

Very good article and responses. I to would like more info. on who to dontact for “elder law”n issues.

Joe Reisinger

In response to “Iuine” above, avoiding probate should not be particularly high on your lift of values for having good counsel. In most, if no all, states, the cost of probate is regulated by the judicial and the costs are relatively minimum. By properly probating an estate, the beneficiaries are able to cut off an ongoing accumulation of debts which may or may not have been properly accounted for. Probates are generally straight forward, simple, and relatively inexpensive. Alternatively, in 40 years of law practice, with only a couple of exceptions, I have NEVER seen an inexpensive conservatorship. A conservatorship is traditionally what you get when the party becomes unable to care for themselves, but hasn’t yet died. Death is pretty simple, it is finite and cuts off the accrual of obligations. On the other hand, a conservatorship lasts as long as necessary until recovery or death comes about. If… Read more »


My grandmother is 99 and I don’ t think she should have to pay taxes anymore. She usually pays 500.00. She is on a very limited income but lives in assisted living which takes all her monthly income and some savings. What would be the ramifications if nothing was done tax wise. I would almost love to see the IRS try to prosecute a 99 year old. I feel she has paid her fairness share.


I was able to secure Log-Term Health Care insurance for myself but not my wife due to the pre existing condition of MS.
Finding a good elder-law attorney was not difficult. I already had an attorney that I have used for years and he recommended one for me. It turned out well.


The only recourse left to senios, such as myself, is to vote Obama out of office. In addition to health care Harry Reid managed to put in an outrageous death tax! If you don’t vote you don’t have a voice so VOTE!!


A very poorly writen article ! No mention of the best option for a married couple, annuities! My parents have a house worth about $500,000 and savings of $200,000 and are both in their 80’s I went to five so called elder law attorneys and not one of them gave me all the answers, one even refused to work with me after I refused to sign a cover page without seeing the complete document. I ended up getting the best advice from a general attorney. What I found out was that in order to qualify for medicaid assistance when one spouse goes into a long term care facility, whether assisted living or a nursing home they can not have over $2000 in assets, plus a home and a car. I protected their assets by selling the not allowed assets and quit claiming the remaining to the spouse not needing LTC… Read more »

Robert Pfeiffer

There could be more money available for Senior care in later life if our leaders would change the laws allowing Illegal’s to come here and have their “Anchor Babys”.& then get on the “system”. Our Seniors have worked their life & paid taxes & are certainly more entitled to state & federal entitlements then are the illegals that are invading us.


every senior need to know before they are put in a nursing home.

Dr. Michael Caudle

At age 65, and with a wife who will turn 65 next month, we are among the huge Boomer generation that is beginning to retire and face the final chapter of life’s realities. While we are both relatively healthy, we are seeing the signs of oncoming physical issues. It is unfortunate that most of us don’t think about this eventuality until we’re there. I guess it’s normal. But, the reality is, when you wait until this stage of life to consider Long Term Care insurance, it is so expensive. Just at the time when we’re thinking we’re about ready to step into the next phase of our lives, we are faced with the real possibility that we’ll have to shell out big premiums for care that we may never need. So, the conundrum is, do we pay now and see a big reduction in our discretionary income that will pretty… Read more »


It would be great if AMAC had a list of attorneys who specialize in this – It took MONTHs to find such an attorney when we were dealing with my mother’s affairs.


In my opinion, the Constitution is as fresh today as the day it was written. It is full of life and energy and carries with it the hope of “Life, liberty and the pursuit of happiness” for all who embrace it. I think the only thing “rather old” is Justice Ginsburg!


This is a timely article, one which hopefully many will follow. I purchased long-term care insurance soon after my husband died in 1995 and am so grateful for the investment. One thing I failed to do was to include an inflation clause and when I inquired about it, the price was more than I thought I wanted to pay. I have a fairly decent monthly income and a bit of investments, and no mortgage so, am hoping should I ever need the care I can get it. My mother was in a wonderful health care center here in Central Florida, and I’ve advised my sister that should I ever need the care, that is where I want to be. A year of observing the care she received was very impressive. I also volunteer for our local Hospice care center so I also know how patients there are cared for, One… Read more »


Thanks, we need to be reminded to take care of the later life issues, and ways to avoid probate,and court issues.