Filling Gaps in Elder Care: Truhlsen Elder Care Law of Nebraska

The opportunity to objectively solve problems is one of the reasons Rachel Truhlsen, owner of Truhlsen Elder Care Law of Nebraska, enjoys being a lawyer. But, when clients began asking questions she couldn’t answer, she saw the opportunity to evolve.

“We’re a relationship community and firm,” she said. “When I felt like I couldn’t help them I felt like I wasn’t doing what I was supposed to do and what they had counted on me to do.”

The evolution began seven years ago with the introduction of Medicaid planning, which Truhlsen said was a natural transition from the bulk of her business, estate planning.

This year, the firm took a major step when it rebranded from Rachel A. Truhlsen Estate Planning and Elder Care Law Center to Truhlsen Elder Care Law of Nebraska.

The announcement publicly defined the trajectory of the firm as it angles toward offering a continuum of care for elders. In particular, it emphasized life care planning, a service not widely offered in Nebraska.

An Evolution Of Care

While asset protection and estate planning define what will happen financially and materialistically, life care planning handles the more human aspect of aging.

It helps carve out plans for the “what ifs” of aging — the uncomfortable, hard- to-talk-about topics families tend to avoid, or disagree about.

What if a spouse/parent needs help with day-to-day activities? What if a home isn’t safe for aging? What if a spouse/parent has a medical condition such as dementia?

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“It’s coming alongside the family and putting a plan in place,” Truhlsen said. “That way we’re not doing something in a reactive way, it’s in a controlled capacity where they (the client) has a decision.”

Guiding clients through their journey is certified Elder Care Coordinator Janice Fitchhorn, who has spent the past 20 years in health care.


“My educational and career background is in occupational therapy,” Fitchhorn said. “My career goals have always been to care for others and assist them to be safe and independent in the appropriate level of care.”

Her experience in rural health care, geriatrics, and management gives her an advantage.

For one, she’s trained to assess the safety of a home, which is one of the first things she does with clients during a situational assessment.

Her experience also means she’s well versed in medical terminology, giving her the ability to be a bridge between doctors, clients, and their families.

“We have a lot of clients who have children out of state, so what Janice will do is work with the clients locally, like going to doctor’s appointments with them, so she can be that extra set of ears and communicate,” Truhlsen said.

She noted that it’s not uncommon for clients to nominate Fitchhorn as their speaker during doctor visits.

“A doctor will ask about medications, and what’s going on, and the client will look at Janice and say ‘talk to her, she knows better than I do,’” Truhlsen said.

“She becomes part of the family. She becomes the person who communicates.”

Mediating Tough Conversations

Sometimes, though, being the care coordinator means having tough conversations.

Whether it’s a discussion on moving to a different level of care, needing in-home assistance, or medication, relations can become strained.

“We hear from clients that they think everything is fine, but then we look at their kids and their kids are saying it’s not fine,” Truhlsen said.

“As a parent, a child is always a child, so when they have a child that’s telling them they need to do something, oftentimes the parent is going to push back.”

Spouses, too, have a tendency to cover for each other, she said. But, when a third party steps in, it takes some of the resistance out of the conversation.

Fitchhorn is able to facilitate conversations and find solutions. For example, in a home setting, she can plug-in services to help with cooking, bathing and dressing,“things that really ware on a caregiver over time.”

“Caregiving is really difficult and it wares on a relationship,” Truhlsen said. “We want to come alongside the family so they can be the wife, husband, or child and really enjoy that role rather than feeling that burden.”

The Big Challenge: Awareness

Emerging in 1985 as a part of the book “A Guide to Rehabilitation” by Paul M. Deutsch and Horace Witt Sawyer, life care planning has slowly gained steam.

But, “Life Care Planning has been kind of a nebulas to explain to people,” Truhlsen said.
With that in mind, the team launched a drawing for free eldercare situational assessments to coincide with its rebranding, hoping to draw attention and awareness.

Starting in July, and running through the end of the year, each monthly drawing highlights a different category of individuals Truhlsen described as“heroes.”

“We wanted to recognize folks who took on a lot of responsibility, extra work, and emotional tolls [during the pandemic],” she said.

On the list are educators, caregivers, first responders, and veterans. The assessment functions as a first step in life care planning.

Within the next year, it will add Social Security benefits consulting.