Legal Information & Services for Elderly People

Transcription

1 Mid-Atlantic Law & Society Association, October 19-20, 2012 /Work-in-Progress Presentation: Special Plenary Session Crossing Borders & Barriers: Older Adults Access to Legal Advice & Effective Justice Presentation By Katherine C. Pearson & Matthew McDonald Research in conjunction with: Joseph Duffy (Social Work) & Subhajit Basu (Law) Funding: Borchard Foundation s Center for Law and Aging

2 Overview for Today Preliminary Work is Represented Here What we request from Audience: What Findings Intrigue? What Observations seem unsupported? What Additional Data is needed? What are additional Recommendations?

3 Background Northern Ireland Study: Digital Divide, Older Adults and Online Legal Advice Joseph Duffy (Social Work) at Queen s University Belfast Subhajit Basu (Law) at University of Leeds June 2009: Study on how UK older adults acquired legal information & legal representation Key Findings included: Many UK older adults were reluctant to seek legal information and advice from legal professionals Perceptions re: cost of legal services were significant barrier to accessing legal information or advice

4 Additional Background 2011: Older People and Legal Advice: The Need for Joined Up and Creative Approaches, by Duffy, Basu & Pearson, published in (U.K.) Journal of Social Welfare and Family Law (Spring 2012) Key: Need for earlier access for older adults to legal justice, requiring better coordination among social, medical and legal service providers. 2012: Borchard Foundation s Center for Law and Aging Policy research grant: to bring CAP research questions to the US

5 Mixed-Methods Research June 2009: Northern Ireland Study Seven Focus Groups from Older Adults (N=83) 25 Semi-Structured Interviews of Service Providers Pennsylvania Focus Groups: 11 total Regions: Philadelphia, Pittsburgh, Northern, Central, and South Central Pennsylvania Ages 42 through 95, median Age = 73 Backgrounds: Urban, Suburban, Rural Total number of participants (N=112) Focus Group Sessions: minutes Written Survey : 23 Questions Recruitment of Participants: Senior centers Advocacy groups Adult housing (including Continuing Care Retirement Community) Family support groups Community organizations PSU Dickinson Elder Law Clinic Law Firms

6 Methodology 8-12 participants (one session included 17 participants) per session Survey used during orientation of group Focus Group Themes: How adults & family members find legal information and assistance relevant to aging Attitudes about attorneys Family member roles in legal and financial decisions Pennsylvania s Filial Support Law Effects of economic recession and legal consequences Concerns about financial fraud and abuse Medical care, long-term care & end-of-life decisions Internet as source of legal information or advice

7 Today s Focus: 5 Themes What is an Elder Law Attorney? What is awareness of Public Benefit Programs to Support Long-Term Care? How do Potential Clients Evaluate trustworthiness? Do Clients see Legal Services as Cost Effective? What is the Internet s Role in Effective Legal Services for Older Adults? Bonus Topic: Reaction to Filial Support Laws?

8 1. What is an Elder Law Attorney? National Academy of Elder Law Attorneys: Elder Law attorneys specialize in areas of law that involve counseling and assisting seniors and their families on a variety of legal issues: From estate planning to long-term care issues Many Elder Law attorneys address the client s perspective from a holistic viewpoint including legal, medical, financial, social and family issues.

9 Focus Groups: Elder Law Attorney Responses: Never heard of it, I m not old enough yet. Participant I Carlisle Older Adult Community Housing I think of it as a retired gentleman, maybe. He s retired and he wants something to do by just going back and giving free legal advice. Participant G Pittsburgh Urban I just think about a more statesman attorney; an elder in a firm. Participant D Philadelphia LGBT Men I ve heard of the term. I know in Philly there s at least one organization that deals strictly with seniors. Participant B Philadelphia LGBT Women

10 Findings: Elder Law Attorney The majority of participants not familiar with the specialized legal field of Elder Law Observation: Public visibility of this legal field is still low

11 2. What Public Benefit Programs Exist to Support Long-Term Care? Medicaid (Medical Assistance) Veterans Assistance, including Aid & Attendance Medicaid and VHC provide long-term carecoverage and health care expenses for eligible seniors. They are significant sources for facility-based or home and community-based care

12 Focus Groups: Benefits Responses I would be going on Medicare in a month, and I m relatively educated, and it s really been a difficult process. Participant F Philadelphia LGBT Men Regarding applying for and receiving Medicaid benefits: Unfortunately, we had $27 too much to qualify The county office of aging was fantastic, but because we had that $27 they couldn t do anything. Participant G Carlisle Elder Law Clinic They treated me nice, and all, but it s all about money, you know they gave me two [artificial] legs one was covered and one wasn t. Participant L Philadelphia Urban

13 Findings: Benefits Many participants demonstrated that they do not plan ahead for long-term care financing; instead focus is on immediate needs Observation: More than any other topic, the theme of longterm care and medical benefits demonstrated the confusion, frustration and misinformation Crisis-driven response, rather than planning appears likely

14 Responses: 3. What generates trust? The attorney [who] understands me, that speaks in my language (Spanish). Participant L Philadelphia Hispanic they were really patient Participant G Carlisle Elder Law Clinic I was assigned a pro bono attorney who was very, very, very good. He was excellent [and] spent a whole lot of time [on my problem]. Participant B Philadelphia LGBT Men

15 Findings: Trust Many participants spontaneously raised question of how to know whether any source of legal information is trustworthy Many participants talked about amount of time spent by attorney Many participants talked about communication style of attorney Observation: Two most prominent factors associated with trustworthy attorneys: Communication Style ( Patience ) Time spent by Attorney with Client

16 Response: 4. Do Clients see Legal Services as Cost Effective? I figured I needed some help from an attorney [A]n elder care attorney that had been recommended to me did a very good job, but I ll be frank, the cost was really prohibitive in some cases How can the average person who is retired afford that cost to have legal help?...i said I was too rich [for Medicaid benefits], but I wasn t too rich after that was over. Participant K Central Pennsylvania

17 Cost Effective Legal Services (cont.)? On why he procrastinated taking care of his legal problems: I guess one of the things I m most afraid of is the anticipation of the cost of legal service. Participant I Philadelphia LGBT Men On whether she would use legal services: if they were back in our neighborhood, we d find ourselves going to them more often. Because, if we go downtown and go in one of [those] buildings, we think: Oh God, how much is this going to cost?! It s the first thing. Participant D Philadelphia Urban

18 Findings: Cost Effective Legal Services Many participants demonstrated a lack of understanding of billing structures This lack of understanding causes delay in seeking legal advice Observation: Legal Service Providers must continually educate public in order to overcome fear of cost and demonstrate importance of early planning

19 5. What is the Internet s Role in Effective Legal Service for Older Adults? Quantitative Survey Results: Frequency of Internet Usage Daily 25% Three to five times per week 15% Once a week 8% Rarely or never 54% Over median age (73): 74% rarely or never use Internet Under median age: 27% rarely or never use Internet

20 Focus Groups: Internet s Role Responses: One of the things that I have a problem with [on] the internet is when you type in [a search engine], five thousand things pop up Participant A Philadelphia LGBT Women I think if you went to a site and started reading you really wouldn t know what you re reading For me, it would be pretty difficult for a non-lawyer to figure out what s going on. Participant D Carlisle Elder Law Clinic I wouldn t trust information that I collected on a legal matter from the web because I would have no way to vet [its] authenticity after all, that s what lawyers are qualified to do. Participant J Philadelphia LGBT Men

21 Findings: Internet Findings: Many (most) participants did not see internet as a significant tool in getting legal information The older the participant the less likely they would be to use internet for legal information (or most purposes) Some used family members as the intermediary in accessing information on the internet Trustworthiness of information on the internet was a concern Observations: Internet is not currently a significant source of legal information or advice deemed trustworthy for older adults; More traditional modes for information and advice, including person-to-person, telephone hot-lines and traditional print media are still important

22 Bonus Material How do older adults feel about use of Pennsylvania s filial support law to mandate financial assistance from adult children? Responses: What?! They can go after your children? Participant E Pittsburgh Urban That law would be horrible because our children are already married and they have their own obligations and they have children. Participant H Philadelphia Hispanic Why don t they do something about this stuff? It makes me mad, they prey on elderly people especially I don t like it. Why should children be stuck with it Participant D Somerset County

23 Preliminary Conclusion Trustworthiness of any attorney providing advice to older adults, including an Elder Law Attorney, depends on Willingness to spend time with client to listen Cost Cost is a factor often because the cost is not understood, or because delay in seeking advice has increased cost

24 Preliminary Recommendations Make better use of established social networks to reach potential clients Support Groups (Dementia or Health Care Support) Community Centers & Senior Centers Colleges & University Partnerships Older adults cherish interaction with Law Students Make law students or recent graduates part of the communication team

25 Preliminary Recommendations to Elder Law Attorneys Greater education is needed by reaching out to the older adult community through their established social channels Print media still important In-person education generates trust Greater patience with family members needed as this legal field expands Greater clarity useful regarding pricing

26 FINAL WORDS: Focus Groups on Younger Advisors The students are very helpful. They are very energetic...especially for me, younger is better because they are so full of energy. Participant D Carlisle Elder Law Clinic I think that would be great if they had a center where folks could go just to talk to folks like [these students] who [are] doing elder care studies you would at least have a knowledge of people who could help. Participant K Central Pennsylvania [The students] got into it and gained my confidence so well that their age didn t matter I thought, Wow! They re young. They re smart. Participant L Carlisle Elder Law Clinic

27 Next Steps Responses needed from upper income users of elder law services Use of qualitative evaluation software for more comprehensive identification and assessment of themes Evaluation & comparison of multi-state responses to written surveys Funding for interviews of service providers Publications

28 Special Thanks Special thanks to the Borchard Foundation s Center for Law and Aging for their generous funding of this study For more information on the Borchard Foundation s Center for Law and Aging and their mission please visit