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Elder Law – a Re-Introduction

In some ways I feel like Yogi Berra, the quotable Yankee catcher and Hall-of-Famer, having “deja vu all over again” as I begin this re-introduction to Keystone Elder Law.  The firm has been in existence since 2010, and this, our first article in The Sentinel, originally appeared on September 30, 2012.  A few updates have been made to this article to reflect the growth of our practice, and I hope that our readers would agree that all of our weekly articles over the past eight years have demonstrated our commitment to provide useful information to older adults and their families.

If you are wondering what Elder Law is, you are not alone. Elder Law is a relatively new profession, not having any real focus until the formation of the National Academy of Elder Law Attorneys (NAELA) in October 1987. That was ten years after the organization of the Pennsylvania Area Agencies on Aging.

I discovered Elder Law, not as a lawyer, but as a consumer when my wife, Marcia, and I needed specific help to pay for nursing home care for my in-laws, whose financial stability had been eroded without our knowledge. It quickly became clear that a couple of my in-laws’ unfortunate and irreversible investment decisions had been influenced by Alzheimer’s disease. We found an Elder Law attorney who advised us about nursing home costs, but found no organization with expertise or interest to help to develop a care plan, select a facility or help with other details of our parents’ transition.

Marcia and I were really surprised by the dysfunction within the extended care system. We were shocked when one well known facility called us and told us to pick up my father immediately because they could not manage his behavioral issues related to Alzheimer’s disease. We have numerous stories of events which occurred over eight years with our four parents.

Despite our professional and business experience, my legal education, and our many friends and contacts in the community, what was going on with our parents had us feeling stonewalled and confused. After we had recovered from caregiving and grieving, we began to wonder what we might have missed that others must have known about. Much soul searching and local investigation did not ease our sense of frustration.

Then I discovered a model of practicing law which encourages clients to interact with support staff of diverse expertise and includes care coordination by an experienced geriatric medical counselor. I imported this new approach of Elder Law to Cumberland County, which became the first practice of its kind in south-central Pennsylvania.  It remains unique today.

We belong to several national organizations, and each has a slightly different purpose. Our services necessarily include the preparation of legal documents and also the coordination of services to address the various issues which aging adults are facing.   Having been a family caregiver and advocate for eight years, and ten years as a holistic Elder Law attorney, my varied experiences have provided an opportunity to learn and observe much content to share in numerous articles.

Various staff members contribute insights to this column. Attorney Patrick Cawley joined the firm at the end of 2019.  His prior positions in state government provided him with extensive courtroom experience and legislative knowledge.  This expertise enables him to personally assist our clients and their families with sensitive situations such as estate planning, guardianship, public benefits, and financial exploitation.

Keystone’s Care Coordinator, Karen Kaslow, is a registered nurse with decades of experience in acute and long-term care settings.  She has also served as a caregiver for a family member. Karen admits that, before joining us in 2013, she really had no idea what Elder Law was about either.  The education and advocacy she provides, in conjunction with the legal skills of our attorneys, is essential to our team’s ability to guide families effectively on their elder care journey through the long-term care system.

A weekly column has given us the opportunity to cover many topics. Previous articles are available in the blog section of our website (, as well as in our book, Long Term Care Guide: Essential Tips for Solving the Elder Care Puzzle (available at Whistlestop Book Shop in Carlisle or on Amazon  We welcome your feedback and suggestions for future columns.

Once a couple reaches age 65, there’s a fifty-fifty chance that one of them will eventually need extended care. The sooner one begins to plan, the more options will exist later, both to get the best care and to preserve assets. Many of us may fail to act because we assume we’ll either be among the healthy half, or we’ll die suddenly.  Maybe you can help us to reach a friend or loved one who might have some difficulty facing up to the reality that most of us who are fortunate enough to live a long life will eventually become at least a little bit frail. 

Sharing a newspaper clipping about a relevant topic can be a good icebreaker when an older adult is hesitant to participate in proactive planning or acknowledge changes which may be occurring, so we’ll keep writing.  Thank you, readers, for your interest in this column; and we appreciate our long-standing relationship with The Sentinel.    

Dave Nesbit, Attorney