By Julieanne E. Steinbacher, J.D., CELA, LL.M.

The estate planning and elder law fields need specific planning options geared at not just the legal documents but the aging and health care network that exists.

Gone are the days when people seek out a “general practitioner.” Today, clients demand specialized providers and best-in-class care, with elder law being no different. As attorneys in estate planning and elder law, we can make a positive impact in our communities by providing the very best planning for individuals, family members and caregivers of those with a dementia or Alzheimer’s diagnosis. For my central Pennsylvania law firm, I do this by asking the Three Questions.

Before we dive into these questions, we need to review some statistics on why more focused and comprehensive planning is needed along with understanding the role benefits can play in this process.

Why Dementia Planning is Right for You

1. After studying the seven locations of my firm across the state of Pennsylvania, we found on average 1 out of every 2 clients that walk through the door already have a diagnosis that needs this planning. The Alzheimer’s Association says there are nearly 7 million Americans living with Alzheimer’s and expect it to hit 13 million by 2050. The demand and need are here to stay.
2. Follow the 80/20 rule. As Pareto determined long ago, 80% of your profits will come from 20% of your customers. For a dementia care plan – it takes more on the back end to do correctly, but when done right you can increase your profits while simultaneously increasing client’s legacy and health care outcomes.
3. Start within. I encourage firms just starting out with Dementia Planning to review their current client list to see who may qualify and be a good fit for a specialized plan. This costs no marketing dollars and can be done during a simple brainstorming meeting, then set time during their next appointment to address how you can solve their current headaches or gaps through a dementia care plan. After doing this for several years under continuous improvement processes, we have multiple offices with their own department dedicated to this type of planning – providing navigation for the dementia journey along with expanding the profitability of each location.

The Cost of Alzheimer’s (Alzheimer’s Association 2020)

• $305 billion is spent annually for Alzheimer’s care
  • The total lifetime cost for an individual with a diagnosis is $341,840

• $143,735 in the value of informal care

• $95,441 in out-of-pocket expenses related to care

The Caregiver Toll

• Caregivers spend 18.4 billion hours annually caring for Alzheimer’s patients. (Alzheimer’s Association 2024).
  • That is 21.9 hours per week.

• 83% of the help provided to older adults in the U.S. comes from family, friends or other unpaid caregivers. (Alzheimer’s Association 2020).

• 68% of caregivers manage finances. (Northwestern Mutual 2018)
  • 1 in 5 caregivers of people with Alzheimer’s or other dementias report problems dealing with a bank or credit union when helping with finances.

• 57% of family caregivers report they’ve provided care for four or more years. (Alzheimer’s Association 2020).

The Role of a Dementia Planner in the Law Firm

To offer world-class service to your clients, you must have a staff member dedicated to dementia planning that goes beyond the basic estate planning. Some firms may argue that they already are doing this for clients, but the vast majority are not getting paid for it. When you don’t get paid for something, you often fail to allocate the appropriate time and resources, resulting in a plan that can be underwhelming for the clients’ true needs. My office has a specific role dedicated to creating the best possible outcome for the client. This staff member:

• Guides clients and their family members to understand the legal, financial, and social implications of dementia.

• Work closely with staff attorneys to provide clients with a broad range of services, including counseling and guidance on the selection of long-term care options

• Creates a Dementia Care Plan for the caregiver and helps connect the client’s family with the right resources and services

Different Kinds of Dementia

In order to successfully do this at your office, I encourage everyone at your firm to gain a deeper understanding of the different potential diagnoses to establish better self-awareness. Additionally, never lose sight of the core value of being people-first-oriented for your clients. Some facts to brush up on:

• Alzheimer’s Disease
  • The most known form–problems recognizing family, impulsive behavior, wandering and getting lost, repeating questions.

• Frontotemporal Dementia
  • Difficulty planning and organizing, shaky hands, problems with balancing and walking, emotional flatness or excessive emotions.
  • Most often between individuals ages 45 to 65.

• Lewy Body Dementia
  • Inability to concentrate, muscle rigidity, insomnia, visual hallucinations.
  • Most often in individuals ages 50 and up.

• Vascular Dementia
  • Forgetting current or past events, misplacing items, trouble following instructions or learning.
  • Caused by blood clots, disrupt blood flow in the brain.
  • Typically found in individuals over age 65.

The Three Questions

As Elder law attorneys, the Three Questions will help you provide your clients in the second half of life with comprehensive service and planning below:

1. What happens if I die?  What should clients do today to make sure their assets transfer to their loved ones in the simplest, most tax-advantaged manner?
2. What happens if I do not die, but rather get sick and need care? What should clients do today to protect their assets and home?
3. What happens if I get Alzheimer’s or Dementia?  By 2050, it is predicted that someone will be diagnosed with Alzheimer’s every 33 seconds, bring the total number affected to 14 million.

As someone with an education and background in gerontology, that last statistic is more than a little scary. Our aging population is growing, the future is likely to have fewer healthcare workers and family members are less likely to physically care for a loved one. On top of that, our country’s healthcare system is too large to change quickly enough to manage the growing need. Elder law attorneys can play a key role in changing the outcome for many within their communities. This is something my office has done for several years, which allowed my firm to grow and become more profitable than ever. The late Zig Ziglar once said, “You can have everything in life you want, if you will just help other people get what they want.” This truth is what motivates me to help other forward-thinking elder law attorneys leverage dementia-focused planning to their clients while also growing their firm.

WANT HELP TO ADD THIS TO YOUR PRACTICE?

The challenges of running a successful elder law or estate planning firm are greater than ever. With the rapid evolution of technology, increasing demands for dementia planning, and the need to adapt to a constantly changing legal landscape, it’s crucial to stay ahead.  That’s why prioritizing your professional education is an invaluable investment in your firm’s future and your clients’ well-being.

On Friday, January 31, and Saturday, February 1, at the Grand Hyatt in Tampa Bay, Florida, the Million Dollar Solution will be hosting a 2-day event entitled, “Advancing to Prosperity, an Elder Law and Estate Planning Summit”.  This career-changing event is designed to provide you with the tools, knowledge, and strategies you need to elevate your practice.  You’ll hear from renowned experts in elder law and estate planning, and long-term care insurance, dementia-focused planning and more.  Use promo code Ultimate2025 and save $600 on your registration fee (EXPIRES 12/15/2024 or while there’s space!).

ABOUT THE AUTHOR

Julieanne E. Steinbacher is the President and Master Profitability Coach of The Million Dollar Solution–a coaching group that helps attorneys nationwide elevate their practice and profitability through personal, one-to-one coaching. Julieanne is a Certified Elder Law Attorney (CELA) through the National Elder Law Foundation, a TedX speaker, an author, and sought after lecturer on diverse topics such as trust and estate planning, special needs planning, wealth protection, succession planning, leadership, and work-life balance.

After working as a dedicated service as a geriatric social worker, Julieanne E. Steinbacher established her own law practice – in her garage – offering superior legal support for seniors since 2002. Specializing in asset protection for long-term healthcare, guardianships, and care management, her firm has expanded to seven offices across Northern and Central Pennsylvania with over 50 professionals, including long-term care planners and elder care navigators.

Honored with the 2015 Pennsylvania Bar Association Special Achievement Award for her dedication to the Association’s Quality of Life & Balance Committee, which she has co-chaired for three years, Julieanne is also a Certified Dementia Practitioner.