The Medical Side of Elder Law

Elder Law Clinic

Director Kathy Long introduces Alina Buccella to Senior Services’ Williams Adult Day Center.

Jasmine Pitt observed the medical center’s Geriatric Consultation Clinic, where doctors assess patients with memory problems.  One patient appeared normal at first, but his cognition turned out to be impaired. When asked the question, “What year is it?” he replied “Fifteen minus ten.” Other elements of the mental screening test were a challenge for him. His score of nineteen out of thirty surprised Jasmine. She noted:

He is only a few years older than my parents. I realized that even though I have seen a couple of sixty-five-year-old clients who leave no question as to their mental competency, I may have clients of the same age who are at a completely different mental capacity level.

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Client Reviews

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Seeing the Big Picture

Caring for a spouse with dementia is tough.  Even tougher is figuring out how to pay for years of in-home care, assisted living, and nursing home care.  Mario Ramsey helped a family understand the complex eligibility rules of health care coverage.  He reassured them that the healthy spouse would not lose the couple’s home.  Mario’s background in public health gives him a unique perspective on a social need that will grow in coming years.

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Jasmine Pitt helps a client understand her options.

Moving to the Beach

LaRita Dingle & Aimee Smith

LaRita Dingle talks with her client and attorney Aimee Smith (’02) before court.

It’s not just the rich who dream of moving to the sunny coast after retiring.  Alina Buccella’s client heard that housing for low-income seniors can also be found near the beach, with reduced rents.  So, she got on the waiting list and is ready to move if an opening comes up.

There is one problem, though: moving may cause her to break her lease in Winston-Salem.  She is worried about being sued for a few months of rent and about her $1,250 monthly income being taken if she does this.  She is also afraid of losing her thirteen-year-old car if she is sued by her landlord one day.

Alina reassured her that Social Security income is protected from creditors and that her car is safe under state laws.  Also, Alina explained that the landlord has a duty to try to re-rent her unit, so this would lower the amount owed.  Now, it’s time to wait for a phone call from the coast!

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The Helicopter Daughter

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Mario Ramsey reviews documents with a client.

Some parents hover like helicopters over their young children. Similarly, adult children can be overprotective towards their older parents. It sure isn’t easy to find the right balance between independence and protection. Fortunately, older people are entitled to a court hearing before their children can make decisions for them.

LaRita Dingle handled a case in which she determined that the older gentleman should not lose decision making rights. The man she was court-appointed to represent was well oriented and socially appropriate. However, his daughter didn’t like his choice of an assisted living facility and thought his memory lapses were grounds to declare him incompetent.

Fortunately, LaRita found that medical testing showed her client was doing well. Family dynamics were causing a bit of a power struggle and this gentleman was caught in the middle! The case was dismissed and the man gets to continue making his own decisions.

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Clinic Students Look Back

  • Every client meeting that I walked into, I knew one thing for sure: nothing was for sure!  Often there were one or two issues that a client mentioned on an intake form but after just a few minutes of conversation, three or four issues percolated to the surface.  What once appeared to be an urgent problem became a non-issue; a single question about insurance turned into a conversation about Medicare and Medicaid. It was always interesting.
  • I improved how I handled and managed interviews. I use the term “manage” because I learned in clinic that the attorney might have to take charge of the interview and help the client stay focused. I also learned to connect clients to outside resources to address their non-legal needs.
  • The traditional classroom setting does not give you many ways to immediately cement and test your understanding of the law.  In the Elder Law Clinic, while learning about the law or soon after learning about the law, I was able to work on cases with clients who had those issues. This enabled me to issue spot in practice and to see how the law impacts a client’s life in a very practical way.
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Cataracts, arthritis, and hearing impairments—what do they feel like? Our students learned how these conditions can make life challenging—from medicine bottles to complex legal documents!

  • Since taking this clinic, I have become more comfortable discussing personal and sometimes sensitive topics with clients.  I also got better at looking at the big picture and thinking long-term: a client may have come in wanting one thing, and I am now able to help the client see if that is what he really needs or what else will enable him to fulfill his wishes.  Perhaps most importantly, I can now help my family members plan for their own long-term care.
  • This semester has definitely increased my desire to practice law.  Dealing with a client and having a name, face and story to associate with a case made me realize that every action you take, or decide not to take, can impact the life of that client.
  • I had to become comfortable with not having an answer to every question that clients asked.  It is okay to undertake research after the interview in order to follow up with the client about a very narrow or unique legal issue.  In fact, offering to research an issue further is not a sign of weakness or lack of knowledge. Rather, it shows that you have taken a genuine interest in the client’s case and that you are willing to go the extra mile to find a solution.

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Alumni News

cartoon for website articleJesse Hynes (’14) practices with WanderPolo & Siegel in New Jersey. He writes:  The craziest things that I deal with are contested guardianships and contested estates.  For example, we handled a guardianship where a son had used his mother’s power of attorney to steal her money and put her in a nursing home against her will.  She is now incapacitated. He also got a reverse mortgage on her property and spent all the proceeds.

Jonathan Williams (’11) has changed firms, joining Walker Lambe in Durham. He handles elder law, estate planning, and administration cases.

Katie Hatcher Muhlenkamp (’13) has joined the Chapel Hill firm of Trust Counsel, PA, which also has offices in Florida and New York.

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Clinic News

Professor Kate Mewhinney gave two presentations at Wake Forest Baptist Medical Center, sponsored by the Bioethics Committee:

“The Closet Door is Open: How Are You Caring for LGBT Patients and Families?”  Her co-presenters were Kaycee Sink, MD, MAS, and Jennifer Harriss, a long-term care ombudsman with the regional Area Agency on Aging.

“Grappling With Guardianship: Ethical Dilemmas.”  Her co-presenter was Linda Childers, MSW, LCSW, ACM, who is a Manager of Care Coordination at the medical center.

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Hannah McKay (left) is the clinic’s new Client Coordinator.  She is at

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Student’s Advocacy Goes National

 Erin McKee organized a voter education program last fall.  Taking this work to the next level, she created a website that lists the voter ID requirements, including exceptions for older and disabled voters, for all fifty states.  Visit the website at  The American Society on Aging recognized the importance of this effort by inviting Erin to attend its annual meeting in Chicago, where she gave a poster presentation about these voting rights issues.

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A Peek Into the Criminal Side

Crissy Dixon will continue to learn in the Elder Law Clinic by working there half-time this summer. The rest of the time, she will work with the Forsyth County District Attorney’s office, focusing on cases of elder abuse, exploitation, and neglect.

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