Caregivers Using Technology to Better Serve Seniors

August 22, 2019 · 6 min read

The Centers for Medicare and Medicaid Services are looking to the future of the US health care system, and it is projected to be overloaded with seniors needing medical care. In 2010 the US elderly population accounted for about 13 percent of the US population yet accounted for 34 percent of the total health care expenditure. That percentage will continue to increase because of increasing longevity in the growing senior community. Depending on the region, estimates about the future costs of elderly health care may more than double between the ages of 70 and 90.Government medical programs and services, insurers and manufacturers are tasked with finding ways to reduce the enormity of health care costs in particular as it pertains to senior care needs solutions. Lower costs and increasing efficiencies are the mandates to address the looming potential expenditure crisis. Enter the Internet of Medical Things (IoMT).Digital technologies and their application to senior medical needs offer the best hope to address existing and future needs. You may have already read about the Internet of Things (IoT) which is a network of devices such as home appliances, software actuators, and vehicles including wheelchairs, not traditionally extended to internet connectivity. The IoMT is similar but reserved for a collection of medical devices and their applications that connect to healthcare information technology systems through online computer networks. The medical devices are digitally linked to Wi-Fi that allows machine-to-machine communication and throughputs of data collection. The captured data can be stored and analyzed all the way from individual to metadata levels. The importance of controlling senior medical costs now and in the future cannot be understated.Vitals-tracking wearables are already well-known medical devices. These devices monitor everything from daily physical activity levels, hypertension, cardiac ailments, diabetic levels and more. The devices send vital signs over the internet to medical monitoring staff who can alert health care providers when vital signs are out of the patient's range of normal. Vitals-tracking wearables are also used in assisted living facilities, nursing homes and hospitals to help nurses and off-site physicians continuously monitor seniors’ vital signs passively.Medication adherence tools are an electronic reminder system for proper consumption of prescription and other medications. These tools reduce the chances of missing or overdosing on medications. Medical adherence tools can decrease the number of hospitalizations or 911 calls prompted by the potentially serious consequences of improper dosing of medications thus saving costs on unintended medical attention.Virtual home assistants are increasingly found in senior homes providing daily assistance such as environmental controls, medical advice, calendar reminders, as well as social connections to family and friends which reduces the risk of isolation and therefore can reduce depression. All of the benefits that a virtual home assistant can provide considerably reduce unnecessary life stresses and health problems which reduce costs.Biomarker portable diagnostic devices are a staple in the senior age group as they need to be tested more frequently than most segments of the population. Rather than a trip to a pathology lab for blood testing et al., these smart and portable diagnostic devices can allow the senior to perform testing in the comfort of their own homes and get results that are formatted to be instantly shareable with medical care providers. The convenience factor and proactive nature of these devices allow for more frequent testing which can lead to early disease detection and its treatment which lowers the costs of health care.Emergency assistance, fall detection, and “navigation guidance” back to their residence for dementia patients are all part of the personal emergency response systems available to seniors. Some of the fall detection systems are now equipping seniors with sensor belts that can identify a change in gait and can even deploy airbags to prevent injuries due to unintended falls.Fall-related health care costs can be staggering as it can include hospitalization in the event bones are broken, or a severe head injury occurs. These fall detection systems will trigger alerts to designated emergency contacts in the event of fall, emergency medical need, or re-homing of dementia or Alzheimer patient.Seniors with disabilities including sensory and cognitive impairment can use disability assistance tools to control selection and volumes of streaming music, on-off switch programs for televisions, lights and thermostat controls. Many of these systems are being developed for voice recognition to reduce the need to interact with screens and buttons. Some of the existing tools include customizable colored buttons installed in the residence of the senior that alerts them to perform daily tasks like brushing their teeth. Upon completion of the task, the senior presses the button and the device activates the next task in the customized sequence. When a senior can manage their environment without the constant need for supervision, it lowers health care costs.Nearly everyone is familiar with the concept of the smart implant known as the pacemaker that controls the heart rhythm of the wearer and can communicate patient data via smartphone apps to their physician. Now there are newer smart implants. These include glucose sensors, dedicated readers, smart knee, shoulder and spine implants, and orthopedic implants which can communicate post-surgery performance. These implants provide real-time data of patient condition to medical professionals who quickly assess if early intervention is required when a problem arises thus lowering medical costs.Smart home senior facilities have arrived. Residences receive wrist-worn wearables that can free up care providing staff as the devices are tied into machine learning and predictive analytics determining insights into deviations from the senior’s daily routine. Some are designated into three types of color-coded alerts such as red for night wandering or potential fall, orange for changes in the routine of daily living such as irregular eating, and yellow for environmental issues such as leaving a stove on or a refrigerator open. This technology allows health care professionals to monitor patients while multi-tasking other facility operational tasks saving health care costs. Similarly, family caregivers can use remote monitoring tools that enable oversight without having direct contact with their loved one. Alerts are sent when daily routines are detected to deviate from the norm allowing the family member to contact their senior to ensure all is well. Remote monitoring tools can help family caregivers remain at work and on-task in their own lives while still adequately watching over their loved one.While the internet of medical things holds great promise to curb excessive increases in senior health care costs, there are some cautionary tales. What if an internet service provider "goes down" and no Wi-Fi is available to maintain connectivity to health care professionals? Lately, the number of natural disasters in this country calls attention to what will happen to senior digital monitoring when the lights go out during a fire, flood, hurricane or tornado. Will there be a backup generator to keep the devices online? Will there be anyone in the affected disaster zone online to interpret the medical data a vital tracking wearable uploads? What if the medical device fails for mechanical reasons? Can all aging seniors cope with this level of technology?While these remain potential disaster scenarios the more massive disaster is not addressing the overwhelming costs of senior health care for an increasingly elderly population. The internet of medical things is the logical, efficient, and effective solution for now.If you have questions about what you have read or would like to speak with us about you or a loved one’s legal needs, please don’t hesitate to reach out. You can reach Elville & Associates at our Columbia, Maryland office by dialing us at (443) 393-7696 or by clicking here to send us a message.

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Thinking about a life estate in Maryland? Learn the benefits, risks, Medicaid concerns, and alternatives before adding children to your deed.

Jan 19, 2026 in Blog

Life Estates in Maryland: When They Make Sense and When They Don’t

A life estate can be a useful planning tool for some Maryland families who want to protect a home, avoid probate, and plan ahead for the future. At the same time, life estates create permanent legal and financial consequences that are often misunderstood. Knowing when a life estate works well and when it creates long-term problems is essential before moving forward. This article explains how life estates function in Maryland, common risks families encounter, how life estates interact with Medicaid planning, and alternatives that may offer greater flexibility. What Is a Life Estate? A life estate allows more than one person to hold ownership interests in the same property at different times. In Maryland, this typically allows a parent to live in and control a home for life while naming children or other individuals to receive the property automatically after death. The person living in the home is called the life tenant. The individuals who will receive the property later are known as remaindermen. While remaindermen cannot take possession during the life tenant’s lifetime, they hold a present ownership interest in the property. Life estate deeds are often used to avoid probate, support long-term planning goals, and simplify the transfer of a home. These benefits must be balanced against the legal limitations created by the deed. When a Life Estate May Make Sense In limited situations, a life estate can serve a practical purpose. This is most common in straightforward family arrangements where a parent intends to remain in the home for life and wants the property to pass directly to a specific individual without probate. Life estates may also be considered when flexibility is not a priority and future long-term care needs are unlikely. Even in these situations, careful legal review is critical before creating the deed. When Life Estates Create Problems for Maryland Families Limits on Selling or Refinancing Once a life estate is created, the life tenant generally cannot sell or refinance the property without the consent of all remaindermen. This can create serious challenges if care needs change or the property must be sold to cover expenses. Some families explore tools such as a testamentary power of appointment or a nominee realty trust to increase flexibility, but these options require careful planning and are not appropriate in every case. Difficulty Changing Ownership Removing a remainderman from a life estate deed is far more complex than changing a beneficiary on a financial account. Once added, that ownership interest is legally significant and often cannot be undone without consent or legal action. Exposure to Remainderman Issues After a remainderman is added to the deed, their legal and financial issues may affect the property. Court judgments, tax liens, divorce proceedings, or bankruptcy can complicate ownership and create unexpected risks. If a remainderman passes away before the life tenant, their interest may pass through their estate, potentially requiring probate and introducing new parties into the ownership structure. Medicaid Look-Back Concerns Creating a life estate involves transferring a property interest. If long-term care is needed within five years of that transfer, Maryland Medicaid rules may impose a penalty period. Timing and structure matter, and mistakes can be costly. Nursing Home Recovery Risks If the home is sold while the life tenant is receiving nursing home care, the state may assert a claim against the proceeds to recover Medicaid benefits paid. This outcome often surprises families. Life Estates and Medicaid Planning in Maryland A common misconception is that a life estate automatically protects a home from Medicaid. While a life estate may avoid probate, it does not replace a comprehensive Medicaid planning strategy. Medicaid planning is highly timing-sensitive and should be coordinated with broader elder law goals. Families often benefit from reviewing life estates alongside other options discussed in our Maryland elder law resources. Alternatives That Offer Greater Flexibility Depending on family goals, other planning tools may provide better long-term outcomes. Revocable trusts, irrevocable trusts, and coordinated elder law planning strategies often allow for asset protection while preserving flexibility and control. These approaches may integrate more smoothly with Medicaid planning and incapacity planning and can reduce risk as circumstances change. Reviewing a Life Estate as Part of a Larger Plan Life estates affect more than property ownership. They influence taxes, Medicaid eligibility, and the ability to respond to future care needs. For this reason, they should always be evaluated as part of a broader estate and elder law plan rather than used in isolation. If you are considering a life estate or already have one in place, guidance from a Maryland elder law attorney can help clarify risks and identify options before a crisis occurs. To schedule a confidential consultation, contact us online, call our Columbia office at 443-339-5638, or reach our Rockville office at 240-456-1657.

Jan 13, 2026 in Blog

Life Estates in Maryland: Benefits, Risks, and Better Planning Options

A life estate can be a helpful tool for Maryland families looking to protect their homes, avoid probate, and plan for Medicaid. It is important to understand the risks involved. This article explains common life estate issues and why careful legal planning matters before deciding if this approach fits your situation. What Is a Life Estate? A life estate allows multiple people to hold interests in the same property at different times. In Maryland, this often means a parent keeps possession and use of their home while ensuring it passes to their children without going through probate. By creating a life estate deed, families may avoid probate, reduce Medicaid exposure, and receive a step up in tax basis. The person living in the home is known as the life tenant and retains control during their lifetime. The individuals who inherit the property are the remaindermen. Although they cannot take possession until the life tenant passes away, they hold a current ownership interest. When a Life Estate May Still Be Appropriate In limited situations, a life estate can serve a practical purpose. Some families use a life estate when a parent wants to remain in the home for life and ensure the property passes directly to a specific individual without probate. This is most common in straightforward family situations where long term care needs are unlikely and flexibility is not a primary concern. Even in these cases, careful review is important. A life estate permanently alters property rights, and future changes often require agreement from all parties involved. Five Issues Maryland Families Should Know 1. Limits on Selling or Borrowing Against the Property A life tenant generally cannot sell or refinance the property without agreement from all remaindermen. A testamentary power of appointment may allow the life tenant to change who inherits the property through a will, providing additional flexibility. A nominee realty trust may allow one or more children to act as trustee for all remaindermen, with decisions made by majority vote. This can be helpful when family members disagree. 2. Difficulty Removing a Remainderman Removing a remainderman from a deed is far more complex than changing a beneficiary on a financial account. In many cases, removal is not possible without consent or court involvement. 3. Legal Issues Affecting the Property Once a remainderman is added to the deed, their financial or legal issues may affect the property. Court judgments or tax liens may attach to the home Divorce or bankruptcy can complicate ownership If a remainderman passes away before the life tenant, their estate may require probate These issues may not force the life tenant to leave the home, but they can create significant complications. 4. Medicaid Look Back Period Transferring a property interest through a life estate can affect Medicaid eligibility if long term care is needed within five years of the transfer. 5. Nursing Home Reimbursement If the property is sold while the life tenant is in a nursing home, the state may have a claim against the sale proceeds to recover care costs. Why Life Estates Often Create Long Term Challenges Many families create life estates without fully understanding the limitations involved. Selling or refinancing the property usually requires consent from the remainder beneficiary, which can become problematic if care needs change or funds are needed. Life estates also expose the property to risks tied to the remainder beneficiary. Financial hardship, divorce, or creditor claims affecting that individual can impact the property even while the life tenant continues to live there. Life Estates and Medicaid Planning in Maryland A common misconception is that a life estate automatically protects a home from Medicaid rules. While a life estate may avoid probate, it does not automatically shield the property from Medicaid eligibility requirements or recovery claims. In some situations, transferring a remainder interest can create a Medicaid penalty period if it is not structured properly or completed at the right time. Because Medicaid planning is highly timing sensitive, a life estate should never be used as a substitute for a comprehensive elder law strategy. Alternatives That Offer More Flexibility Than a Life Estate Depending on a family’s goals, other planning tools may provide better long term results. Revocable trusts, irrevocable trusts, and coordinated elder law planning strategies may offer asset protection while preserving control and adaptability. These options often integrate more effectively with Medicaid planning and incapacity planning. Choosing the right structure depends on health, family dynamics, finances, and anticipated care needs. A solution that works well for one family may create serious limitations for another. Is a Life Estate the Right Option? For some Maryland residents, life estates can provide benefits, particularly when probate avoidance is a primary goal. The risks involved mean this approach is not appropriate for every situation. Understanding both the legal and financial impact is critical. Reviewing a Life Estate as Part of a Bigger Plan Life estates affect more than property ownership. They impact taxes, Medicaid eligibility, and a family’s ability to respond to changing circumstances. For this reason, life estates should be reviewed as part of a broader estate and elder law plan rather than used alone. If you are considering a life estate or already have one in place, speaking with a Maryland elder law attorney can help clarify risks and identify options before a crisis occurs. To schedule a confidential consultation, contact us onlin e, call our Columbia office at 443-339-5638, or dial 240-456-1657 to reach our Rockville office.

2026 Maryland Super Lawyers and Rising Stars Lists

Dec 19, 2025 in Blog

Managing Principal Stephen Elville, Principal Attorneys Shannon Goodwin and Shannon Ladner, and Associate Attorney Sara von Stein Echeverria Honored on the 2026 Maryland Super Lawyers and Rising Stars Lists

Authored by: Jeffrey D. Stauffer – Community Relations Director It was announced on Friday, December 19 th that Managing Principal Stephen Elville, Principal Attorneys Shannon Goodwin and Shannon Ladner, and Associate Attorney Sara von Stein Echeverria were honored on the 2026 Maryland Super Lawyers and Rising Stars Lists. Stephen R. Elville, J.D., LL.M. — Managing Principal Stephen R. Elville, President, CEO, and Managing Principal of Elville & Associates, P.C., has again been selected to the 2026 Maryland Super Lawyers List — his 11th overall and 10th consecutive year receiving this recognition. Mr. Elville’s practice centers on helping individuals and families through challenging legal landscapes with clarity, compassion, and technical skill. He leads the firm’s work in estate planning, elder law, special needs planning, tax planning and asset protection and preservation, long-term care planning, and more. Clients working with Mr. Elville benefit from his deep experience navigating both pre-crisis planning and complex crisis situations — giving them peace of mind and a personalized, long-term strategy. Throughout his career, Mr. Elville has built a reputation as one of Maryland’s most respected attorneys. His broad legal-technical knowledge, combined with a caring and client-focused approach, enables him to address a wide range of legal matters with confidence and clarity. In addition to his client work, he is a seasoned educator and speaker, regularly offering webinars and workshops for clients and the surrounding community, along with continuing education events for financial advisors. Mr. Elville is an active member of several professional organizations including the National Association of Elder Law Attorneys (NAELA), WealthCounsel, the Academy of Special Needs Planners, and as well as the EPIC Peer Group where he travels around the country each quarter learning from and teaching likeminded attorneys. He has held leadership roles including the past Chair of the Estates & Trusts & Elder Law Sections of the Howard County Bar Association, past President of the Coalition of Geriatric Services (COGS), and past Chair of the Elder Law & Disability Rights Section Council of the Maryland State Bar Association. He was also the long-term Chair for Law Day Maryland and recently served as Chair of the Pro Bono Subcommittee of the Elder Law Disability Rights Section Council. Outside of his legal practice, he is President of the Friends of Baltimore Classical Music, Inc. and Founder of the Elville Center for the Creative Arts, Inc. — a nonprofit dedicated to furthering music education for students with limited means. Mr. Elville had a feature story written about him in the national Super Lawyers Magazine about the Elville Center and his efforts surrounding this initiative. Along with his charitable endeavors, Mr. Elville also supports community organizations such as the Autism Society of Maryland, the Brain Injury Association of Maryland, the National Alliance on Mental Illness of Howard County, the Howard County Public Library System Veterans Book Group program, and more. Shannon Goodwin, J.D. — Principal Attorney Shannon Goodwin has been named to the 2026 Rising Stars List for a third consecutive year. In her role as Principal Attorney, she leads Elville and Associates’ Estate and Trust Administration Department along with estate planning and tax planning. Ms. Goodwin guides clients through every aspect of administering estates — from the probate process and inventory reporting, to accountings, final distributions, and all detailed estate tasks. Her insight and dedication help families navigate what can often be complicated and emotionally difficult processes. Her background includes undergraduate studies at North Carolina State University, followed by law school — during which she distinguished herself as a member of the Syracuse Law Review. After graduation, she gained important legal experience working as a Judicial Law Clerk for three years in the Circuit Court for Washington County, and in the District Court for Washington and Frederick Counties. She joined Elville and Associates in 2021, bringing with her a strong foundation and commitment to client care. Shannon F. Ladner, J.D. — Principal Attorney Shannon F. Ladner has earned her place on the 2026 Rising Stars List for the fourth year in a row. She leads the firm’s Estate Planning Department, where she assists clients through every stage of planning — from initial consultation to plan design and implementation, and ongoing updates as laws and life circumstances evolve. Ms. Ladner’s practice emphasizes estate planning and special needs planning. Her work is grounded in a thoughtful, client-centered approach, ensuring that each plan reflects the client’s values, goals, and unique family situation. During law school, she contributed her talents to the Human Trafficking Prevention Project Clinic, representing victims of human trafficking as a Rule 19 Student Attorney. After receiving her J.D., she served as a Judicial Law Clerk for Magistrates Susan M. Marzetta and Lori Joy Eisner in the Circuit Court for Baltimore City. Before joining Elville and Associates, she practiced at a small law firm in Towson, Maryland where she gained valuable experience representing clients in family law and criminal matters. Sara von Stein Echeverria, J.D. — Associate Attorney 2026 is Sara von Stein Echeverria’s first of what we see as many future inclusions on the Maryland Rising Stars list. Ms. von Stein Echeverria focuses her practice on estate planning, estate and trust administration, special needs planning, asset protection, and tax planning. She is known for her thoughtful, client-centered approach and her ability to guide individuals and families through complex planning decisions with clarity, empathy, and care. Sara works closely with clients to develop comprehensive plans that protect loved ones, reflect personal values, and provide long-term peace of mind. Sara earned her Juris Doctor, summa cum laude, from the University of Baltimore School of Law, where she distinguished herself through academic excellence and legal scholarship. She also holds a Master of Science from Birkbeck College, University of London, and a Bachelor of Arts, cum laude, from Dickinson College. Prior to joining Elville and Associates, her work included humanitarian and immigration-related legal advocacy, experience that continues to inform her compassionate and inclusive approach to client service. Sara is admitted to practice in Maryland and is an active member of the Maryland State Bar Association, the American Bar Association, and the Baltimore City Bar Association. To learn more about this year’s honorees and the entire team at Elville and Associates, please visit www.elvilleassociates.com. The firm is steadfast in its commitment to client education, compassionate legal service, and providing peace-of-mind solutions across estate planning, elder law, special needs planning, and beyond. Super Lawyers, a Thomson Reuters business, is a rating service of outstanding lawyers from more than 70 practice areas who have attained a high degree of peer recognition and professional achievement. The annual selections are made using a patented multiphase process that includes a statewide survey of lawyers, an independent research evaluation of candidates and peer reviews by practice area. The result is a credible, comprehensive and diverse listing of exceptional attorneys. The Super Lawyers lists are published nationwide in Super Lawyers Magazines and in leading city and regional magazines and newspapers across the country. Super Lawyers Magazines also feature editorial profiles of attorneys who embody excellence in the practice of law. For more information about Super Lawyers, visit SuperLawyers.com. #elvilleeducation