In counseling families who are attempting to address a loved one's health crisis, it often helps to remember those clients with whom we had the greatest impact. Sharing our success stories can inspire a more holistic approach to a family's concerns. The stories I share with you today are about folks who benefited most from an emphasis on aging in place advice, rather than from a more limited focus on merely qualifying for government benefits.

Mr. A, as I will call him, was struggling to keep his wife at home despite her declining health. Mrs. A suffered from Alzheimer's Disease and the burden of her care was beginning to impact Mr. A's own health. Mr. A feared he would have to place his wife into a nursing home, something he was not prepared emotionally to do. We counseled him on a middle ground accepting assistance in the home. The first thing we suggested was that Mrs. A be evaluated for hospice benefits, an entitlement under Medicare. Congress placed significant benefits for Alzheimer's patients within the hospice program that are triggered in the latter stages of the disease. For Mrs. A, her inability to bathe herself and her limited coherent speech, along with a recent weight loss, demonstrated that the disease had progressed sufficiently to trigger hospice benefits. From hospice, Mrs. A received assistance with bathing twice a week, was assigned a nurse and social worker to help oversee her care, and Mr. A received some needed respite from caregiving duties. Although Mrs. A had a long term care insurance policy, Mr. A was under the impression that he needed to save those benefits for a time when Mrs. A was sure to need nursing home care. Instead, we counseled him to begin using those benefits for assistance in the home. Over the course of the next year or so, Mrs. A was able to stay at home with the assistance of hospice and home health care paid for by the long term care insurance. Mr. A's health improved as he accepted daily help with his wifes care that allowed him the needed breaks. Only when Alzheimers had robbed Mrs. A of nearly all her abilities was nursing home care inevitable. By that time, Mr. A was emotionally prepared to place her outside the home. He remained lovingly attentive, visiting the nursing home every day, until her death some few months later. Mr. A expressed that with the aging in place assistance we rendered, he was able to provide for his wife at home longer than he expected and was left with no regrets or lingering doubts about his wife's quality of life.

During Mr. B's first visit to our office, he appeared overwhelmed by his wife's complex medical condition and the mixed messages he was receiving regarding her prognosis. He was frustrated by inconsistent physical therapy regimens, and worried about how to provide her with the quality of life she deserved. Mrs. B was mentally alert, but her body was failing her. She wanted to return home and Mr. B hoped to accomplish that, but was unsure whether she could be provided the level of care needed at home. We first suggested that Mrs. B be independently evaluated by a geriatric care management team consisting of a social worker and registered nurse. We then consulted with home health agencies with specific experience caring for someone with Mrs. B's limitations. Mr. B gained confidence in his ability to provide for Mrs. B at home and ultimately made the decision to try to bring her home. Although Mrs. B requires round-the-clock care, she is getting stronger. Mr. B attributes that to the individual attention she receives from therapists and caregivers outside an institutional setting. Outings seemed an impossibility a few months ago, but Mrs. B will soon be visiting the beauty shop and enjoying an occasional restaurant meal.

These, and our many other success stories, encourage us to advocate for the highest quality of care and highest quality of life for our clients. That's what we feel elder law is clearly all about.