Clinic helps seniors by teaming law, nursing students

Helping senior citizens overcome both legal and health problems is the aim of an innovative new collaboration that links UW–Madison law and nursing students with elderly patients.

The Elder Law Clinic began operating in two Madison medical outpatient clinics late last month, putting law students to the test by offering free legal advice on topics such as Medicare and insurance eligibility and directives for health care.

But the program goes farther, connecting the work of health care professionals and lawyers to better serve elderly patients, according to Betsy Abramson, a clinical assistant professor at the Law School who directs the program.

“The idea is that lawyers will do a better job of advocacy if they are in contact with the client’s health care providers,” says Abramson, who oversees the legal work. “Health care providers often don’t have time or expertise to research Medicare regulations, but we do. That kind of communication allows health care providers to make better decisions to advocate for the patient.”

The Elder Law Clinic, which this semester involves six law students and one nursing student, is operating out of the UW Health Clinic at University Station, 2880 University Ave. and out of the new East Side Dean Clinic at 1821 S. Stoughton Road.

Barbara Bowers, professor of nursing, says the program helps health care professionals understand the importance of legal issues to their patients and opens up a new world for aspiring lawyers.

“It’s important for nursing students to hear what patients tell law students when asked questions that the nursing students generally don’t ask,” Bowers says. “Hearing the answers makes it clear that health care providers probably should be asking questions they have not been asking.”

The Elder Law Clinic is based on a Boston program called the Family Advocacy Program that provides in-hospital lawyers to help improve children’s health by addressing legal issues affecting them. The Elder Law Clinic is backed by grants from the Retirement Research Foundation and the Helen Bader Foundation.

Abramson, a long-time Madison public interest lawyer who joined the faculty last fall, said elderly clients often assume that if they are denied insurance or Medicare coverage, they are simply not entitled to it.

“Older people often don’t recognize their problems as legal. They assume that if you don’t have something, you do without it,” she says. “We’re trying to make the connection that, if you get the benefits you’re entitled to, your health could improve.”

Having nursing students involved can help law students provide better advice for elderly clients, Abramson says. For example, she says that there are many medical reasons why an elderly person may show signs of memory loss.

“It may be that an elderly patient doesn’t need to be placed in assisted living. It may be a drug reaction problem, depression or simply a faulty hearing aid,” Abramson says. “There’s a lot of cross-learning that goes on here.”

Bowers says that health care professionals are not always knowledgeable about the complexities of insurance, guardianship and estate concerns.

“I think the beauty of this course is that it puts nursing and law students together so that they can understand what each is doing and the sorts of issues each is dealing with on a daily basis,” Bowers says.

Having legal services available in medical clinics is another key to providing better health care for seniors, Abramson says. Older people are often more likely to see a lawyer if their physician tells them to, she adds.

Students involved in the Elder Law Clinic must have taken or be enrolled in a three-credit Law School course called Law and the Elderly taught by Abramson and Madison elder law attorney Jim Jaeger.

“Students are very eager to explore the issues of elder law and the older people love the students. Younger people being involved with older people tells seniors they still have value,” Abramson says. “Nothing makes it real for law students like real clients.”

In addition to their work with seniors, the students will be assigned a public policy or consumer education project. Those can involve educational presentations to physicians on such topics as Medicare benefits and access to long-term care, or doing talks or preparing brochures aimed at seniors on health care issues.

One of the challenges of the course is making complex legal concepts understandable to seniors who are seeking help.

“We want to provide information that older people can use,” Abramson says. “Maybe securities firms want something they can’t understand from a lawyer because they feel they’re getting their money’s worth, but that doesn’t work for elderly clients who need information.”