How Care Managers Improve Results and Reduce Stress
Legal planning often breaks down when clients hit a care crisis. This Lunch & Learn focuses on how care managers serve as practical partners to elder law and estate planning attorneys—helping stabilize difficult cases, improve client outcomes, and reduce crisis-driven stress on the practice.
- When care managers add the most value in elder law and fiduciary matters
- How care managers stabilize crises such as hospitalizations, unsafe discharges, and caregiver burnout
- Practical support for guardianship and conservatorship cases
- How ongoing care management reduces attorney “fire drills” and protects professional boundaries
Presenters
Emily Apyan, LMSW, CCM, ALFA & Heidi M. Travis, MA, CMC
ElderTree Care Management — DC Metro Area
Licensed Master Social Worker, Certified Case Manager, and Certified Care Manager providing assessment, advocacy, crisis intervention, and guardianship-related care management for older adults and adults with disabilities.
Website: www.eldertreecare.com
Jessica L. Young, BS, CMC
Ferretto Young Care Management Consulting — Baltimore Metro Area
President and Certified Care Manager working with attorneys and fiduciaries on care coordination, education, and placement in complex matters.
Website: ferrettoyoung.com
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Guardianship Differences Between Maryland and DC
This Lunch & Learn program explores the key procedural and substantive differences between guardianship practice in Maryland and the District of Columbia.
Elena Sallitto and Robert Bullock will compare how each jurisdiction approaches guardianship—from filing and notice requirements to court oversight, reporting obligations, and practical considerations that affect both practitioners and families.
The session is designed for estate planning and elder law attorneys who regularly advise clients across jurisdictions or who want a clearer roadmap for navigating guardianship matters efficiently and ethically.
Registration includes access to the live program and the recording.
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Lunch & Learn: How Care Managers Improve Results and Reduce Stress in Your Practice
Presented by: Jessica L. Young, BS, CMC; Emily Apyan, LMSW, CCM, ALFA; and Heidi M. Travis, MA, CMC
Summary by: David Jonathan Taylor, CELA
March 12, 2026
About the Presenters
Jessica L. Young is President of Ferretto Young Care Management Consulting, which serves clients in the Baltimore area. Emily Apyan and Heidi M. Travis are with ElderTree Care Management Services, which serves clients in the Washington area.
How Care Managers Improve Results and Reduce Stress
The NAELA MD/DC Chapter hosted a Lunch & Learn on how care managers support elder law planning when legal documents alone are not enough. The presentation focused on the practical gap between having authority on paper and having someone available to coordinate care, respond to crises, and keep vulnerable clients safe.
The Wake-Up Call
The first scenario involved John and Elaine, an older couple living independently with no children or nearby family. John has dementia, and Elaine manages the household. When Elaine falls and cannot get up, John cannot call 911 or understand what is happening. Two days pass before a neighbor checks on them.
The crisis revealed the problem:
- No power of attorney
- No healthcare proxy
- No financial structure
- No support system
A care manager becomes involved during Elaine’s hospitalization, helps assess the risk created by John’s dementia, supports discharge planning, identifies safety concerns, arranges home care, coordinates appointments, and brings in an elder law attorney while Elaine still has capacity.
The Attorney’s Role and the Care Manager’s Role
The attorney creates the legal framework: durable power of attorney, healthcare documents, and other essential planning documents.
The care manager provides the practical support: crisis response, healthcare coordination, continuity of care, and real-time advocacy.
The presentation’s point was direct: the attorney provides legal protection, but the care manager helps make the plan work in daily life.
When Aging Parents Are Still the Lifeline
The second scenario involved Margaret and Robert, aging parents caring for Daniel, their adult son with a developmental disability. Daniel can manage some basic routines, but he cannot manage finances, navigate healthcare, understand complex decisions, recognize safety risks, or advocate for himself.
The family had a legal plan:
- Special needs trust
- Updated wills
- Powers of attorney
- Healthcare directives
But when Margaret has a stroke and Robert begins showing cognitive decline, Daniel’s support system starts to fail. Bills go unpaid, transportation is missed, medication routines lapse, and SSI reporting deadlines are missed.
The legal plan existed. The operational plan did not.
The Care Manager Becomes Involved
The care manager helps stabilize Daniel’s daily structure, coordinates with the special needs trustee, communicates with benefits specialists, supports Robert, and helps ensure Daniel’s routines continue.
As Margaret’s recovery becomes uncertain, the care manager works with the elder law attorney to clarify future decision-making authority and align healthcare proxy roles with Daniel’s real-world needs.
The Takeaway
Special needs and elder law planning often assume that once the documents are signed, the future is protected. The presentation challenged that assumption.
The practical questions are:
- Who notices breakdowns?
- Who interprets real-time need?
- Who coordinates systems?
- Who protects routines?
- Who becomes the consistent voice?
Legal authority creates structure. Care management brings it to life.
Where Collaboration Matters
When care management is engaged early:
- Families are less likely to face reactive guardianship decisions
- Trust planning is more likely to remain intact
- Benefits continuity is better protected
- Healthcare proxy roles are clearer and more functional
- Systems stay coordinated during instability
- Dependent adults are less likely to be destabilized when a caregiver declines
Session Materials
PowerPoint Presentation (PDF):
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