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Elder Law

The practice area that brings together the legal problems of aging: paying for long-term care, Medicaid eligibility, planning for incapacity, guardianship, and protection from abuse and financial exploitation.

Informational only - this is not legal advice. These definitions explain general legal vocabulary in plain English. They are not advice about your situation, reading them creates no attorney-client relationship, and the law differs from state to state and changes over time. For advice you can rely on, speak to a lawyer licensed in your state.

Looking for a lawyer rather than a definition? Skip to the state-by-state list of Elder Law firms.

What it means

Elder law is defined by the client rather than by one statute. An elder law attorney handles the cluster of problems that arrive with age and illness, and the work is as much about planning as about disputes. The largest single issue is usually paying for long-term care. Medicare covers hospital and medical care but only short, limited stays in a skilled nursing facility; Medicaid pays for long-term nursing home care and, in most states, for care at home, but only for people whose income and assets fall below the program's limits. Medicaid eligibility rules include a look-back at transfers made before the application, a penalty period for assets given away during it, protections for a spouse who remains at home, and the state's right to recover what it paid from the recipient's estate after death (see Medicaid estate recovery). Planning done well ahead of need, and planning done at the point of crisis, follow different rules, and the state's choices within the federal framework matter.

The second cluster is incapacity: who decides when a person no longer can. Documents signed while competent, including a durable power of attorney for finances, a health care proxy and a living will or advance directive, let the person choose their own decision-maker; where none exist, a court guardianship or conservatorship is the fallback, with its cost, loss of autonomy and ongoing court supervision. Supported decision-making agreements are now recognized by statute in a growing number of states as a less restrictive alternative. Elder law also covers nursing home residents' rights under the federal Nursing Home Reform Act, Social Security and Medicare appeals, veterans' pension benefits for long-term care, and the tax and estate issues that overlap with estate planning.

The third cluster is protection. Elder abuse, neglect and financial exploitation are addressed by every state's adult protective services statute, by criminal law, and by civil remedies that in some states include enhanced damages (see elder abuse and adult protective services). Financial institutions in many states may now delay a transaction they suspect is exploitation and report it. The federal Older Americans Act funds the long-term care ombudsman program in every state, legal assistance for older adults through area agencies on aging, and elder justice programs, and the Elder Justice Act created federal coordination and reporting duties for long-term care facilities.

Where this comes from

Medicaid long-term care eligibility: 42 U.S.C. § 1396p (transfers of assets, trusts, estate recovery), § 1396r-5 (spousal impoverishment protections), and each state's Medicaid plan and regulations. Medicare skilled nursing coverage: 42 U.S.C. § 1395d. Nursing Home Reform Act: 42 U.S.C. §§ 1395i-3, 1396r; 42 C.F.R. Part 483. Older Americans Act: 42 U.S.C. § 3001 et seq., including the long-term care ombudsman program at § 3058g. Elder Justice Act: 42 U.S.C. § 1397j et seq., and the facility reporting duty at § 1320b-25. Guardianship, powers of attorney, health care decisions, adult protective services and supported decision-making are state law; many states follow the Uniform Power of Attorney Act and the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act.

When people hire a lawyer for this

See an elder law attorney before a crisis if you can: Medicaid planning is far more effective years ahead of need than at the nursing home door, and incapacity documents can only be signed while the person is competent. Bring the complete financial picture, including any gifts or transfers already made, and every existing will, trust, power of attorney and health care directive. Many elder law attorneys are also estate planners; ask whether the firm handles Medicaid applications and appeals, guardianship cases and nursing home disputes, since not all do. Area agencies on aging and legal aid programs provide free help with some of these matters for older adults regardless of income.

Worried about the cost? A lawyer can be hired for one part of a case only (limited-scope representation), may be paid from what a claim recovers (contingency fee), or may be free through a pro bono program or legal aid; a court can also waive its own filing fees.

Find Elder Law firms in your state

Choose your state to see Elder Law firms in the city where we list the most; your city may be under “other cities”, A to Z. A state marked “Estate Planning” has no Elder Law listing yet and opens the broader page.

Alabama (Birmingham)
+1 other city
- Montgomery
Alaska (Anchorage)
Arizona (Chandler)
+6 other cities
Arkansas (Little Rock)
California (Long Beach)
+19 other cities
- Anaheim
- Chula Vista
- Fontana
- Fremont
- Irvine
- Modesto
- Oakland
- Sacramento
- San Francisco
- San Jose
- Santa Ana
- Stockton
- and 7 more with fewer listed firms
Colorado (Aurora)
+2 other cities
- Colorado Springs
- Denver
Connecticut (Bridgeport)
Delaware (Wilmington)
District of Columbia (Washington)
Florida (Jacksonville)
+5 other cities
Georgia (Atlanta)
Hawaii (Honolulu)
Idaho (Boise)
Illinois (Chicago)
Indiana (Fort Wayne)
+1 other city
- Indianapolis
Iowa (Des Moines)
Kansas (Kansas City)
+1 other city
- Wichita
Kentucky (Lexington)
+1 other city
- Louisville
Louisiana (Baton Rouge)
+2 other cities
- New Orleans
- Shreveport
Maine (Portland)
Maryland (Baltimore)
Massachusetts (Boston)
Michigan (Detroit)
Minnesota (Minneapolis)
+1 other city
- Saint Paul
Mississippi (Jackson)
Missouri (Kansas City)
+1 other city
- St. Louis
Montana (Billings)
Nebraska (Lincoln)
+1 other city
- Omaha
Nevada (Henderson)
+3 other cities
New Hampshire (Manchester)
New Jersey (Newark)
+1 other city
- Jersey City
New Mexico (Albuquerque)
New York (Buffalo)
+2 other cities
- New York City
- Rochester
North Carolina (Charlotte)
+5 other cities
North Dakota (Fargo, Estate Planning)
Ohio (Cincinnati)
+3 other cities
Oklahoma (Oklahoma City)
+1 other city
- Tulsa
Oregon (Portland)
Pennsylvania (Philadelphia)
+1 other city
- Pittsburgh
Rhode Island (Providence)
South Carolina (Columbia)
South Dakota (Sioux Falls)
Tennessee (Memphis)
+1 other city
- Nashville
Texas (Houston)
+12 other cities
Utah (Salt Lake City)
Vermont (Burlington)
Virginia (Chesapeake)
+3 other cities
Washington (Seattle)
+2 other cities
- Spokane
- Tacoma
West Virginia (Charleston)
Wisconsin (Madison)
+1 other city
- Milwaukee
Wyoming (Cheyenne)

Related terms

Other entries in the same area of law, each written from the same primary sources.

« All glossary terms

Part of the LawyerLand plain-English legal glossary. Definitions are written from primary sources - statutes and court rules - and each entry states the authority it rests on, or says plainly when the doctrine is state law with no national rule.

If you cannot afford a lawyer, civil legal aid programs provide free help with many of these problems: civil legal aid programs by state.

Related free reference tools: statute of limitations for a personal-injury claim, by state, quoted from each state's official text - part of LawyerLand's legal reference tools.