"I sit here very apprehensively," said Rosemary Saltzman to Peter J. Strauss, a New York City attorney whose law firm, Strauss & Wolf, specializes in the problems of the elderly.
She had come, after months of urging by her two daughters, to ask about ways to protect her estate against future large medical expenses for her husband, Daniel, who has had a stroke and whose memory is failing.
Saltzman (not her real name), a retired public school teacher, cares for Daniel at home, so far without help. "There are times when I must have some relief," she said. "I'm reaching a point of no return."
"And of anger?" Strauss asked.
"Anger? Not anger," she replied. "Frustration."
"One of the things we have to look at is whether the degree of frustration you feel affects your ability to care for Daniel," Strauss said. "Whether or not he wants it, we may have to arrange a way we can get you some help."
By the end of their hourlong appointment, Strauss had referred Saltzman to an accountant for her 1987 taxes and begun the process of transferring the couple's assets into a trust fund so that Daniel will be eligible for Medicaid (known as Medi-Cal in California) should he require nursing home care in the future. He advised her to make a new will and recommended that she sign a medical durable power of attorney. He also had pushed across his desk to Saltzman two brochures of private geriatric case management firms.
It is not unusual, he said later, for clients who come for legal and financial advice to open up about the pressures they are feeling in caring for a chronically ill relative. His expertise extends beyond the legal problems of aging to the social and psychological skills required to help older clients.
'Struggling With Pride and Autonomy'
"This is a woman who's struggling with pride and autonomy," he said of Saltzman. "This woman was a piece of cake on the surface, but under the surface there was an explosion. You have to understand the client to be able to talk about death and disability."
Strauss is one of a small but growing number of attorneys who specialize in the problems of aging. About 40 attended a special session on aging and the law at the American Bar Assn.'s annual meeting last August, where they voted to form a national association of "elder-law" attorneys.
As the elderly population grows, these attorneys anticipate increasing demand for their special blend of skills. "The lawyer who knows estates and wills, by and large, doesn't know anything about Medicare and Medicaid and the problems of aging," Strauss said.
Charles Sabatino, associate staff director of the ABA's Commission on Legal Problems of the Elderly--a 15-member body that includes physicians among its members--said the commission was formed in 1979 because "there was an incipient awareness that older persons have a complicated variety of legal problems that weren't being sufficiently addressed by the legal profession."
For example, middle-class elderly are affected by numerous government programs, Sabatino explained, and have a growing number of housing options about which they need to be apprised. Nursing home and other long-term-care expenses require careful financial planning. And elderly people may be the victims of age discrimination, consumer fraud and elder abuse.
For Rosemary Saltzman, the appointment with Peter Strauss left her somewhat shaken. "How are you feeling about all of this?" Strauss asked her as she rose to go.
"Please understand that I'm a child of the Great Depression," Saltzman said. "The thing I worry about the most is, will there be enough money for everything."
Strauss, closing out the day's first appointment, nodded that he understood.