ELDER LAW NEWS & NOTES from the use of the information in this

newsletter.

DECEMBER 2009 /NUMBER 65

WE NEED MORE GERIATRICIANS
LAW OFFICE OF WILLIAM J. BRISK
1340 CENTRE STREET, SUITE 205
NEWTON CENTER, MA 02459 The efforts to create a private-public national health system for
TEL: 617-244-4373 all Americans has, surprisingly, ignored the increasing need for
FAX: 617-630-1990 physicians to treat the most rapidly expanding portion of our
WWW.BRISKELDERLAW.COM populations, elders. Dr. Lewis A. Lipsitz, a leading geriatrician who
teaches at Harvard Medical School and co-directs the Institute for
Aging Research at Hebrew Senior Life, recently noted in a column he
published in the November 25, 2009 Boston Globe, that “It’s ironic that
at a time when thousands of Americans are struggling to find
MEMBER AND FELLOW OF appropriate care for their failing parents, the field of geriatric medicine
THENATIONAL ACADEMY OF appears to be vanishing.”
ELDER LAW ATTORNEYS
He notes that in 2008, 7,128 physicians were certified as
ATTORNEYS: “January 1946: London is emerging from the
specialized shadow
to serve theofspecial
the Second World
medical needsWar,
of and writer
elders andJuliet Ashton is
WILLIAM J. Blooking
RISK for her next book subject.
estimates that within 20 years, to accommodate aging babyaboomers,
Who could imagine that she would find it in a letter from man she’s
never met, a native of the island
ELLEN B. SCULT of Guernsey, who has come across her name written
we will need almost 30,000 more. Yet, the number of graduatinginside a book by
CHERYL B. STRUNSKY
Charles Lamb…. physicians who train as geriatricians declined from 167 in 2003 to 91
DAVID C. VALENTE
in 2007. That number will barely cover the number of present
”As Juliet and her new correspondent exchange
geriatricians letters,
who retire orJuliet is drawn
die, leaving into the world
a shortfall of overof20,000
this man and his
PARALEGAL:
friends—and what a wonderfully eccentricat
specialists world
the it is. they
time The Guernsey
are most Literary and Potato Peel Pie Society—
needed.
JENNIFER A. DUHAIME-BAKER
born as a spur-of-the-moment alibi when its members were discovered breaking curfew by the Germans
occupying their
PROBATE ADMINISTRATOR : island—boasts a charming, Therefunny,
are those deeply
whohuman cast of characters,
say physicians don’t needfrom pig farmers
special training to
LISA C. BILBOphrenologists, literature lovers all.
to treat aging patients. I disagree. The field of elder law has
developed precisely as we recognized that seniors’ legal needs
“Juliet
ADMINISTRATIVE : begins a remarkable correspondence
require attorneyswithwhothe society’s members,
are particularly trainedlearning
in andabout their island,
concerned with their
DEBRA L. BELANGER
taste in books, and the impact the the recent Germanand
aging process occupation has had particular
have developed on their lives.
skillsCaptivated
– and mannersby their
stories, she sets sail for Guernsey, and what she finds will change her forever.
– to deal with elders and their families. While there is an evident call
for highly specialized physicians, as well as highly specialized
IN THIS ISSUE:
“Written with warmth and humor as a series
lawyers, thereofisletters,
also a thisneednovel is a celebration
for professionals whoofdon’t
the written
forget word in all its
to treat
Topic Page:connection in the most surprising ways.” *
guises, and of finding the patient as well as the diseased organ. Dr. Lipsitz states a point
Geriatricians 1
Book Club 2 that has not been sufficiently made in our national health care debate.
Web site Articles 3Please joinGeriatricians,
William Brisk
who know their patients, “actually save health care
as he headsavoiding
a “Bookunnecessary
Club” discussion at
Claire Bartholome Standish 3 Village dollars
of Lower
by planning
Mills located
ahead:
at 1190 Adams Street,
hospitalizations,
Dorchester, MA
Stages of Senior Care 4 tests, medications, and treatments; reducing hospitalization and
On
surgical complications; shortening lengths of stay; and facilitating the
safeJanuary
transfer 12, 2010 atto
of patients 6:00PM – 7:30PM
appropriate rehabilitation settings and care
at home.” He recommends a controversial feature of one of the
Tea, Coffee,
currently proposed andbillsSnacks will be reimbursement
– Medicare served. for physicians’
serious discussions with their patients on end-of-life care. His goal is
not to create “death panels,” but rather to engage in timely
All are welcome
discussions with allto patients
attend, just pick
about uplevel
the book! of care, the amount of
th
Please RSVP by January 5 Jennifer @ 617-244-4373
pain they can tolerate, and the support they truly x 10 or
want.
via email:jenniferduhaime@briskelderlaw.com
This newsletter is not intended as a As elder law attorneys, we believe in maximizing self-
substitute for legal counsel. While determination in legal matters. The stakes are even higher when
every precaution has been taken to
critical medical care is involved since billions are being spent today on
make this newsletter
* Source:accurate, we
http://www.leebooksellers.com/book
assume no responsibility for errors or patients who, if they had been carefully interviewed by a physician,
omissions, or for damages resulting might have insisted that they not undergo certain procedures.
 WEB SITE ADDS
THREE MORE ARTICLES

We try to keep our web site fresh and accurate by adding new articles to
www.briskelderlaw.com. Readers may find the following articles particularly useful:

• “Appealing Nursing Home Discharge.” Nursing homes cannot legally discharge

residents, even for nonpayment, until they have arranged for subsequent care. The
general law and Attorney General regulations applying consumer protection to nursing
home residents gives them the right to appeal, threatened discharges to administrative
hearing staying eviction.

• “Medicare Benefit for Skilled Nursing Can Continue After ‘Plateau’. It is commonly
believed, but wrong, that nursing home residents lose the post-hospitalization
rehabilitation or skilled nursing care provided by Medicare and supplemental carriers
once a physician decides that they have ‘plateaued’,” i.e. when their condition no longer
improves as the result of the care or therapy. In fact, federal law allows such subsidies
to continue if it can be shown that, without continuing therapies, the patient’s condition
is likely to regress. This has been vital to many of our clients.

• “Subsidized Support at Home.” An increasing number of our clients are choosing to

remain at home, rather than face institutionalization, but their safety and health requires
regular support. Paying for such support can be extremely expensive and is rarely
covered by typical health insurance policies. The Medicaid program and other social
programs subsidize such care for persons with relatively low incomes. The good news
is that ASAPs (Aging Services Access Points) can help with clients wishing to apply for
such programs. 2
 ADDITION TO THE OFFICE

Claire Bartholome has recently joined the Law Office of William J. Brisk as an attorney specializing
in the development of estate plans, support for litigation, and elder law. Most recently, Claire
worked as the Manager of Regulatory Affairs for Harvard Catalyst, an NIH funded entity within
Harvard Medical School, where she was responsible for coordinating standards and policies
across the Harvard-affiliated medical centers to facilitate multi-institutional research. Prior to her
work at Harvard, Claire spent five years in the Public, Government,
The Complete and Regulatory
All-in-One Affairs Division
Care Guide
of Blue Cross Blue Shield of Massachusetts, where she researched Federal and State laws and
regulations to assess their impact
Choosing on corporate
the best practices,
care for your aging benefits
parents administration, andinpolicies.
and other seniors your life is not only
complex, with multiple options available, it's also highly personal and often emotional. This
In addition to her work in health
essential care, Claire
resource hasby
–written experience
the foundersin state government,
of Home having Care,
Instead Senior served asworld's largest
the
Legislative Director to Senate Majority Leader Emeritus, Linda Melconian. She has been involved
provider of nonmedical care for seniors, guides you through a comprehensive range of things
with several community organizations,
to consider, step byincluding
step, so Health
you canLaw makeAdvocates, the legal
better informed arm of Health
decisions and be confident that the
Care for All. Claire hopes
senior toin expand
your lifeinto more complex
is receiving the best estate
care planning
possible.with an emphasis on the
particular legal issues facing married and unmarried same-sex couples in Massachusetts.
Checklists and diagnostics will help you:
Claire is an alumna of Mount Holyoke College, and recently received her law degree from Suffolk
• Decide if at-home care is the right choice for you and your loved ones
University Law School, with a concentration in Health Law, where she was the Lead Articles Editor
of the Journal of Health •andEvaluate
Biomedicalthe Law. Claire
pros and is admitted
cons to practice
of retirement law in Massachusetts,
communities, adult care centers, nonmedical
and currently lives in Chelsea. She and her partner, attorney Meg DeMarco, have plans
caregivers, assisted living facilities, nursing homes, and hospice to marry
this summer.
• Determine the costs of senior care options and find helpful support networks
"This is not just another book about caring for aging parents. It's a great reference you'll use
again and again. Stages doesn't shy away from the hard questions. Rather, it shows you how
to confront them."? SUZANNE MINTZ, President/CEO, National Family Caregivers
Association

"Recognizing that there is no one-size-fits-all solution, this salient volume compassionately

addresses a full range of hard-to-discuss subjects."--PUBLISHERS WEEKLY
All of the authors' profits from the sale of this book will be donated to the Home Instead Senior
Care Foundation. This book is now 3 available at Barnes & Noble, Amazon.com and Borders.
Law Office of William J. Brisk
1340 Centre Street, Suite 205
Newton Center, MA 02459