ELDER LAW NEWS & NOTES

DECEMBER 2009 /NUMBER 65

LAW OFFICE OF WILLIAM J. BRISK

WE NEED MORE GERIATRICIANS
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
THE NATIONAL ACADEMY OF appears to be vanishing.”
ELDER LAW ATTORNEYS
He notes that in 2008, 7,128 physicians were certified as
ATTORNEYS: specialized to serve the special medical needs of elders and
WILLIAM J. BRISK estimates that within 20 years, to accommodate aging baby boomers,
ELLEN B. SCULT
we will need almost 30,000 more. Yet, the number of graduating
CHERYL B. STRUNSKY
DAVID C. VALENTE physicians who train as geriatricians declined from 167 in 2003 to 91
in 2007. That number will barely cover the number of present
PARALEGAL: geriatricians who retire or die, leaving a shortfall of over 20,000
JENNIFER A. DUHAIME-BAKER specialists at the time they are most needed.

PROBATE ADMINISTRATOR: There are those who say physicians don’t need special training
LISA C. BILBO to treat aging patients. I disagree. The field of elder law has
developed precisely as we recognized that seniors’ legal needs
ADMINISTRATIVE:
require attorneys who are particularly trained in and concerned with
DEBRA L. BELANGER
the aging process and have developed particular skills – and manners
– to deal with elders and their families. While there is an evident call
IN THIS ISSUE: for highly specialized physicians, as well as highly specialized
Topic Page: lawyers, there is also a need for professionals who don’t forget to treat
Geriatricians 1 the patient as well as the diseased organ. Dr. Lipsitz states a point
Book Club 2 that has not been sufficiently made in our national health care debate.
Web site Articles 3 Geriatricians, who know their patients, “actually save health care
Claire Bartholome 3 dollars by planning ahead: avoiding unnecessary hospitalizations,
Stages of Senior Care 4 tests, medications, and treatments; reducing hospitalization and
surgical complications; shortening lengths of stay; and facilitating the
safe transfer of patients to appropriate rehabilitation settings and care
at home.” He recommends a controversial feature of one of the
currently proposed bills – Medicare reimbursement 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
discussions with all patients about the level of care, the amount of
pain they can tolerate, and the support they truly want.
This newsletter is not intended
as a substitute for legal counsel. As elder law attorneys, we believe in maximizing self-
While every precaution has been
taken to make this newsletter
determination in legal matters. The stakes are even higher when
accurate, we assume no responsibility critical medical care is involved since billions are being spent today on
for errors or omissions, or for patients who, if they had been carefully interviewed by a physician,
damages resulting from the use of might have insisted that they not undergo certain procedures.
the information in this newsletter.

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“January 1946: London is emerging from the shadow of the Second World War, and writer Juliet Ashton is
looking for her next book subject. Who could imagine that she would find it in a letter from a man she’s
never met, a native of the island of Guernsey, who has come across her name written inside a book by
Charles Lamb….

”As Juliet and her new correspondent exchange letters, Juliet is drawn into the world of this man and his
friends—and what a wonderfully eccentric world it is. The Guernsey Literary and Potato Peel Pie Society—
born as a spur-of-the-moment alibi when its members were discovered breaking curfew by the Germans
occupying their island—boasts a charming, funny, deeply human cast of characters, from pig farmers to
phrenologists, literature lovers all.

“Juliet begins a remarkable correspondence with the society’s members, learning about their island, their
taste in books, and the impact the recent German occupation has had on their lives. Captivated by their
stories, she sets sail for Guernsey, and what she finds will change her forever.

“Written with warmth and humor as a series of letters, this novel is a celebration of the written word in all its
guises, and of finding connection in the most surprising ways.” *

Please join William Brisk as he heads a “Book Club” discussion at

Standish Village of Lower Mills located at 1190 Adams Street, Dorchester, MA
On
January 12, 2010 at 6:00PM – 7:30PM

Tea, Coffee, and Snacks will be served.

All are welcome to attend, just pick up book!

Please RSVP by January 5th Jennifer @ 617-244-4373 x 10 or
via email:jenniferduhaime@briskelderlaw.com

* Source: http://www.leebooksellers.com/book

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 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.

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, and Regulatory Affairs Division of Blue Cross Blue Shield of
Massachusetts, where she researched Federal and State laws and regulations to assess their impact
on corporate practices, benefits administration, and policies.

In addition to her work in health care, Claire has experience in state government, having served as
Legislative Director to Senate Majority Leader Emeritus, Linda Melconian. She has been involved with
several community organizations, including Health Law Advocates, the legal arm of Health Care for All.
Claire hopes to expand into more complex estate planning with an emphasis on the particular legal
issues facing married and unmarried same-sex couples in Massachusetts.

Claire is an alumna of Mount Holyoke College, and recently received her law degree from Suffolk
University Law School, with a concentration in Health Law, where she was the Lead Articles Editor of
the Journal of Health and Biomedical Law. Claire is admitted to practice law in Massachusetts, and
currently lives in Chelsea. She and her partner, attorney Meg DeMarco, have plans to marry this
summer.

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