Most of us have heard of hospice and a few have experienced it. Still, there are many misconceptions about what hospice is, what it does, and how it works in our health care delivery system. In the United States, hospice is a philosophy designed to support physical, psychosocial and spiritual needs of terminally ill patients and their families, their caregivers, and significant others. According to Medicare, “Hospice is a special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. Hospice care is given by a public agency or private company approved by Medicare. It is for all age groups, including children, adults, and the elderly during their final stages of life. The goal of hospice is to care for you and your family, not to cure your illness.”
Among services provided by Medicare, hospice includes medical and support services, such as nursing care, medical social services, doctor services, counseling, homemaker services, and various other types of services. A team approach is utilized and includes doctors, nurses, home health aides, social workers, counselors and trained volunteers, with most care provided in the patient’s home. Patients may also have hospice care in a hospice facility, hospital, nursing home, assisted living facility or adult care home. The core of hospice is the interdisciplinary team. This team is equipped to deal with almost all of the symptoms and issues patients and families face – physical, psychological, emotional, and spiritual.
What’s missing? Many patients and families experience legal issues. There is a new awareness, partly associated with health care reform, of how legal issues impact health at all stages of life. This impact, however, can be particularly pronounced at the end of life.
There are many legal issues that can arise at or near the end of life. Sometimes those issues are related to estate planning. The patient had not planned with a will, trust, powers of attorney, or advanced directives. Sometimes hospice social workers help with advance directives, but they were not always as effective as they could be. Sometimes, a dying patient’s biggest concern is what will happen to the loved ones left behind? They often need the peace of mind provided by a thorough estate plan.
Other legal issues may impact the dying process. Creditor issues, housing issues, benefit issues (health care, pension, etc.), employment issues. In some cases a guardianship or conservatorship is necessary. Often, family caregivers need to address employment and benefit issues to allow them to care for the patient. Creditors may be harassing the family and families may face eviction proceedings. Other types of discrimination issues may arise, and problems relating to financial exploitation of vulnerable adults and even elder abuse are far too common. All of these legal issues, sometimes referred to as social determinants of health, can have a great impact on health, safety, and well-being. All of these issues can impact the dying process and make the difference between a “good death” and a more difficult one.
Hospice social workers may help identify issues and can facilitate contact with an attorney. Sometimes, patients and families have the resources to hire an attorney or they may already have an attorney they work with. This works well when patients and families have financial resources to pay for legal services.
More often, however, families do not have the resources to hire an attorney, creating a huge void. Last year, a group of attorneys and health care providers discussed this need and decided to apply the hospice philosophy to legal services. They created an agency designed to provide pro-bono or affordable legal services for people dealing with terminal illness.
Hospice Education and Legal Partnership, Inc. (H.E.L.P.) is an Arizona nonprofit corporation and a 501(c)(3) organization. In addition to patients with life-limiting illness, family members, caretakers, and other persons associated with the provision of medical, social, spiritual, or health care services to the patient are eligible for related pro-bono or affordable legal services from H.E.L.P..
Patients and families need not be on a hospice service to receive legal services. They may be receiving palliative care services, or aggressive treatment. Anyone dealing with a terminal illness, and meeting income guidelines, is likely eligible for service. Our generous and compassionate volunteer attorneys provide most services, but we also have volunteer document preparers, paralegals, fiduciaries, and mobile notaries. All volunteers receive special training to help prepare them to work with these clients.
H.E.L.P. is looking for all types of volunteers interested in this area. Learn how you can support this organization by visiting their website, hospicelegalline.org. Volunteering your time, knowledge, compassion, and expertise can impact the legacy and health of a dying person. If you know of a person diagnosed with a terminal illness, or a caretaker needing legal services, please refer them to H.E.L.P.. H.E.L.P.is supported by not only volunteers, but also the generous tax deductible donations from members of the community. H.E.L.P kindly asks that you consider supporting their mission with a donation easily contributed on their website, www.hospicelegalline.org. You can also contribute by designating the Arizona Tax Credit for the Working Poor to Hospice Education and Legal Partnership, Inc. when preparing your annual taxes. Your support will support HELP in helping those in need.
Editors note: Ron Zack has been writing for Tucson Happenings for many years. Ron has decided to discontinue his monthly feature indefinitely while he focuses on his practice and helping the community. We would like to extend our sincere gratitude to Ron for his contributions over these many months/years. Thank you Mr. Zack!
About the Author:
Ronald Zack is a partner at Udall Law, Tucson Office. His legal focus is Elder Law and Estate Planning. You can write him directly at firstname.lastname@example.org.
NOTE: The information contained in this article is provided for informational and educational purposes only, and should not be construed as legal advice on any subject matter. Ronald Zack provides legal advice and other services only to persons or entities with which he has established a formal attorney-client relationship.