Trending Now: Client-Centric Elder Law

It was 1990.  Tim Takacs had been working as a general practice attorney in Hendersonville, Tennessee for about a decade when an older gentleman came to his office looking for help. The man’s wife had been admitted into a nursing home. Though Takacs had no experience in elder law, he eventually found the answer to the man’s question and decided to dedicate his career to the practice of this complicated and constantly-changing specialty of law. 

As Elder Law Practice of Timothy L. Takacs grew, Takacs realized that the legal and financial problems his clients presented were a small piece of a much larger care-related puzzle that each family had to solve on its own, thanks to the highly fragmented way in which long-term care services are delivered in the U.S.

Takacs saw the results of this fragmentation in his office every day. The wills, trusts, powers of attorney, and asset protection plans he drafted didn’t solve all his clients’ problems. Families were entering the long-term care maze and getting lost. “Overwhelmed with tasks like assessing needs, identifying community resources, coordinating medical and non-medical care, dealing with housing transitions, and dealing with the nursing home, families were struggling,” said Takacs. “They needed a guide.” 

Those clients became his teachers and Takacs’ approach to elder law expanded, eventually crystalizing into Life Care Planning, a support model that grafts personal care-related services onto a traditional asset focused elder law practice. It was an unprecedented move for a law firm—and not just because it involved the assembly of legal staff and non-legal professionals working as a team. It was revolutionary because it was the first time a law firm had organized its services for the convenience of elderly clients and their families instead of for the convenience of the firm. Ultimately, it meant bringing tasks that elder law attorneys had always considered out of scope—services like care coordination, care advocacy, care transition management, and medical benefits support—in house. It was a bold move that rewrote the book on elder care law. 

Attorney Barbara Boone McGinnis, a geriatric nurse practitioner and long-term care facility executive who joined Elder Law Practice of Timothy L. Takacs in 2011 after graduation from law school, was attracted by the firm’s elder-centric approach. “When I first learned about Life Care Planning, I knew that I wanted to dedicate my career to this type of law,” said McGinnis, who became partner in Elder Law Practice of Timothy L. Takacs (now known as Takacs McGinnis Elder Care Law) in 2016.  “After so many years of seeing families burn themselves out trying to manage the personal challenges of elder care, I knew that Life Care Planning would make a real difference.”

Since Takacs introduced Life Care Planning in 1998, more than 200 elder law attorneys nationwide have adopted this approach. Other industries have followed suit, developing their own versions of client-centered, care coordination-focused business models aiming to reduce service fragmentation and improve the experience for clients and consumers. In the public benefits world, the movement to patient-centered care received significant impetus in 2001 with the publication of Crossing the Quality Chasm: A New Health System for the 21st Century by the Institute of Medicine (IOM). In that publication, the IOM listed the six "Aims for Improvement" of the health care system, one of which is that care should be "patient-centered." From these aims came, in 2008, The Triple Aim, which Centers for Medicare and Medicaid Services adopted as the guiding framework for health care ("a health care system that results in better care, smarter spending, and healthier people"). 

One practical implementation of this aim is The Medical Neighborhood, a concept that features groups of medical and non-medical care providers in a geographic area who come together to provide coordinated health care for patients. Patient-centered care, an approach adopted by the nursing home industry that creates a home-like living setting organized around the needs and lifestyles of its residents rather than for the convenience of staff, is similar. Even the VA is on board with care coordination initiatives that aim to improve health outcomes, prevent gaps during transitions, and support a positive and engaging patient experience. 

When companies listen to the needs of their customers and design services to meet those needs, entire industries—like elder law—are transformed in the process.


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