EJC 2017: Applying Principles of Person-Centered Care on a Senior Legal Hotline

By Mike Walters, Legal Hotline Managing Attorney, Pro Seniors, Inc.

Applying medical principles to legal ethics is often an impossible task. Social workers, medical providers, and lawyers simply don’t speak the same languages. Nevertheless, particularly in the context of providing legal assistance to seniors, some of the medical community’s approaches seem both relevant and valuable. The Administration for Community Living recently circulated draft principles for a person-centered approach to serious or advanced illness, which provide some insight on how person-centered care can be applied in the context of delivering legal services on a telephone hotline. Ellen Cheek, who is the Elder Justice Coordinator with the Florida Senior Legal Helpline, Toni Allen, who serves as the Ombudsman Care Management Supervisor with the Allegheny County Area Agency on Aging, and I presented a workshop at the Equal Justice Conference regarding how to apply these principles of person-centered care in the context of delivering legal services on a hotline. Some general principles which we discussed:

  1. Respect the autonomy of the client. As in any attorney client relationship, the attorney provides options. The client makes the ultimate decision.
  2. Ascertain the client’s goal(s) in seeking legal advice. Tailor the advice, to the extent possible, toward achievement of that goal.
  3. Provide full information to the client. Although it is advisable to provide advice in simple understandable language, it is not acceptable to “dumb down” advice by leaving out critical information. Do not omit negative consequences in an attempt to avoid upsetting the client or avoid presenting too much information.
  4. Always mention advance planning tools, such as power of attorney documents, even when the legal issue does not involve questions about advance planning. Utilize self-help tools to facilitate availability of advance planning documents for hotline clients, but be cautious about possible misuse of self-help forms.
  5. Remember the ethical mandate that when counseling a client with diminished capacity, to the extent possible a normal attorney-client relationship should be maintained.
  6. Consider supportive decision-making for clients with diminished capacity. Don’t apply rigid prohibitions against including the client’s caregivers in decision making if the client requests inclusion of caregivers.
  7. Adopt a broad policy allowing clients to follow up on the hotline as their legal issue develops and facts change.
  8. To the extent possible, make your hotline accessible to those with disabilities and diminished capacities. Avoid creating unnecessary obstacles to obtaining services.
  9. Affordable access to services for clients is essential. Legal hotlines fill an important need by providing a convenient point of access, especially as full service legal services programs become more overwhelmed.

Leave a Reply

Your email address will not be published. Required fields are marked *