1. Class 5 – September 22 nd, 2009 Health and Medical Research for Lawyers: 524.01 Molly Brownfield brownfield@law.duke.edu

2. Today’s Agenda  Review of Take-Home Assignment #2  Clip from The Rainmaker  Overview of Medical Issues in Elder Law and Disability Law  Research Resources Resources for Elders and Family Members Professional and Government Organizations Legal Research Guides/Portals Primary/Practice-Oriented Sources  In-class Exercise

26. Topics in Duke Law Elder Law Course include:  Broad ethical issues (representation, capacity)  Examination of specific laws and practices to assist clients in planning for retirement, possible incapacity, and death  Estates matters including planning tools for retirement, possible incapacity, and death - guardianships; wills & trusts  Medicare and Medicaid; health care decision-making; long-term care; and social security/income support.

27. Medical Issues in Elder & Disability Law Elder Law  Estates: End of life issues – advance directives, “persistent vegetative state”, mental capacity to sign a will, enter into a contract, etc.  Retirement Social Security Disability and Private Disability Insurance Qualifying for Medicare Disability Law  Reasonable accommodations  Proof of a qualifying disability in discrimination cases under ADA or Rehab Act  What treatment is “medically necessary”  Medical aspects of special education

28. http://www.elder-abuse- information.com/pain_management/pain_elder_abuse.htm

29. http://newoldage.blogs.nytimes.com/

33. Resources for Elders and Family Members  Administration on Aging – Elders and Families: http://www.aoa.gov/AoARoot/Elders_Families/index.aspx http://www.aoa.gov/AoARoot/Elders_Families/index.aspx  Select State Nursing Home Resources (Prepared by individual states, but with national applicability) : http://www.health.state.ny.us/facilities/nursing (New York) http://www.health.state.ny.us/facilities/nursing http://www.oag.state.md.us/consumer/nurshome.htm (Maryland) http://www.oag.state.md.us/consumer/nurshome.htm  CareScout - http://www.carescout.comhttp://www.carescout.com  Elder Abuse and Neglect: In Search of Solutions - http://www.apa.org/pi/aging/eldabuse.html http://www.apa.org/pi/aging/eldabuse.html

34. Administration on Aging – Elders and Families: http://www.aoa.gov/AoARoot/Elders_Families/index.aspx http://www.aoa.gov/AoARoot/Elders_Families/index.aspx

35. CareScout - http://www.carescout.comhttp://www.carescout.com

37. http://www.health.state.ny.us/facilities/nursing

38. http://www.oag.state.md.us/consumer/nurshome.htm

39. Elder Abuse and Neglect: In Search of Solutions: http://www.apa.org/pi/aging/eldabuse.html http://www.apa.org/pi/aging/eldabuse.html

42. National Guardianship Association: http://www.guardianship.org/ http://www.guardianship.org/

43. AARP - http://www.aarp.org/http://www.aarp.org/

45. U.S. Dept. of Health & Human Services: http://www.medicare.gov/ http://www.medicare.gov/

46. http://www.medicare.gov/nursing/overview.asp

47. National Center on Elder Abuse: http://www.ncea.aoa.gov/ http://www.ncea.aoa.gov/

48. Social Security Administration Website - http://www.socialsecurity.gov/ http://www.socialsecurity.gov/

50. Americans with Disabilities Act Home Page: http://www.ada.gov/ http://www.ada.gov/

54. ABA Commission on Mental and Physical Disability Law: http://www.abanet.org/disability/ http://www.abanet.org/disability/

57. Pace Law Library’s Elder Law Research Guide: http://www.pace.edu/page.cfm?doc_id=30228 http://www.pace.edu/page.cfm?doc_id=30228

58.  Nice that this resource includes many links to freely available primary resources

59. Georgetown Law Library’s Disability Law Research Guide: http://www.ll.georgetown.edu/guides/disabilitylaw.cfm http://www.ll.georgetown.edu/guides/disabilitylaw.cfm

60.  Note that this guide is geared towards law students and attorneys with access to legal databases

61. ElderLaw Answers - http://www.elderlawanswers.com http://www.elderlawanswers.com

63. Senior Law Homepage - http://www.seniorlaw.com http://www.seniorlaw.com

65. Megalaw.com’s Elder Law Page - http://www.megalaw.com/top/elder.php http://www.megalaw.com/top/elder.php

67. IntelliConnect Database - http://www.law.duke.edu/lib/lresources http://www.law.duke.edu/lib/lresources

72.  All kinds of very specialized information on Medicare and Medicaid, including DRG (Diagnosis-related groups) information, etc.

73. Cornell LII’s Disability Law page: http://topics.law.cornell.edu/wex/Disability_law http://topics.law.cornell.edu/wex/Disability_law

79. http://www.medicare.com/equipment-and-supplies/electric-wheelchairs.html  Imagine we have a client who received a prescription from her doctor for an electric wheelchair, but was denied by Medicare  Before she challenges the decision, she wants to see how courts have interpreted “an honest medical need.”

80.  How would we search for cases on this topic?

88. How might we use some of these resources to research whether someone like Brooke Astor or Miss Birdie was mentally competent?

89. http://newoldage.blogs.nytimes.com/2009/05/11/the- tricky-question-of-competence/

96. In-Class Exercise Hypo  Our clients, Mr. and Mrs. King, are filing a wrongful death suit against the North Winds Nursing home in Lee’s Summit, MO. Mrs. King’s 70-year-old mother, Martha James, a resident at North Winds, suffered from dementia. She was left unattended and fell down the stairs. Her fall resulted in internal bleeding, which ultimately resulted in her death. The Kings believe that Mrs. King would not have fallen if she had been properly attended, and they claim North Winds failed to provide proper staffing, and their negligence resulted in Mrs. King’s untimely death.

97. In-Class Hypo Questions 1. What sources could we consult to find some background information on this nursing home? 2. What statutes/regulations govern nursing homes in Missouri? Are there any that speak specifically to staffing requirements or standard of care? 3. Are there any current awareness resources that might address short-staffing in nursing homes? 4. Are there any relevant Missouri cases that involve negligence/wrongful death claims against nursing homes? 5. What resources could we consult for guidance as to damages, especially since Mrs. James was at an advanced age and suffering from a chronic illness at the time of her fall and subsequent death?

98. http://www.elderlawanswers.com/elder_info/elder_article.asp?id=699

99. http://www.aarp.org/family/caregiving/articles/state_gui de_to_nursing_home.html