“No one really talked to [my] mom [about her options for health care],” Curler said. “I talk to seniors. [I try to find out] what they want in [long-term care]. My process is unique, in the moment.”

She tells her clients that they must be prepared with documentation and a plan of care for their loved ones.

“[You need to] bring in documents and other proof [to start the process for arranging care],” Curler said. “You need to be a daughter. I was a lawyer, doctor and daughter. You have to decide if he or she [an aging parent] has to be [in a] home [or not].”

She advises her clients to hire lawyers and promises them that if they seek her own services for a $2,000 retainer, she will deliver results and help them secure the best medical care possible.

Inspired by her parents’ illnesses, Curler volunteers and supports the work of the Juvenile Diabetes Research Foundation International, Union League Club of Chicago, American Heart Association, American Stroke Association, Planned Parenthood Federation of America, Alzheimer’s Association, Girls on the Run-Chicago, Chicago Endurance Sports, Yoga Journal and Small Business Advocacy Council].

Curler is a member of the Chicago Bar Association’s Probate and Elder Law committees, the Small Business Advocacy Council’s (SBAC) Membership Committee and the board of directors for the Center for Law and Social Work in the community of Uptown on Chicago’s North Side.

In 2011 and 2014, her legal work and research led to co-author a chapter on termination and modification of guardianship for the publication, Guardianship for Disabled Adults, Advance Directives and Mental Health Law.

“[I tell them,] ‘you need a power of attorney,’” Curler said. “‘It can protect you. You [can] have [one] written by someone [or] by myself.’ For healthcare, someone [must] get a second opinion.

“[Typically, with my clients, I provide counsel and planning services with] assisted living, congregate care and independent living. [With] home health care, [I advise my clients not to] wait to make decisions. I don’t [want my clients to] end up in [a] situation [in which] they lose everything.”

When asked, Curler said that she had not encountered any cases with Obamacare, also known as the Patient Protection and Affordable Care Act (PPACA), which also affects Medicare coverage for seniors, especially with reductions in reimbursements to providers of the different categories of care such as hospice and home health care, support for increasing students and practitioners in the health care professions and greater prescription drug coverage, especially eliminating the donut hole by 2020. Still, she plans to navigate the law and determine how it affects her clients.

She said she wants to address the problem of Medicare beneficiaries being placed in observation status instead of being admitted to hospitals, especially acute care hospitals, as inpatients. Observation status describes the outpatient status of a patient in a hospital bed who is not considered an inpatient. Such patients receive medical and nursing services, tests, medications and food and are present among inpatients.

While Medicare requires patients to have at least three days of inpatient not counting discharge to qualify for coverage in a skilled nursing facility, if they are not considered inpatients, then they are not covered by Part A and neither are their prescription drugs.

“[With Medicare, however,] I have [seen patients placed in] hospitals that put them under [patient] observation and admissions,” Curler said. “[When you are prepared to leave for] rehabilitation [at a skilled nursing facility,] Medicare will not pay. You end up [in a] nursing home.”

Read This Story From The Beginning: Part One

This article was originally published March 10, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.