Important Things To Know About Hospice Care – BEFORE You Need It!
• Hospice is not a place you “go to die.” Hospice is a philosophy of treatment. The care is centered on making someone comfortable at the end of their life’s journey.
• Hospice care is NOT just for people in the last days to week of their life. Hospice care should be started at the moment the person and/or family (if the person isn’t able to make those decisions for themselves,) decide to pursue a comfort care approach versus aggressive therapies.
• Patient’s can be on service up to 6 months or even longer! It’s not just “6 months or less” anymore.
• Most of the care is done at home through intermittent nursing visits. The care team is comprised of Physician’s, Social Workers, Nursing Assistants, Chaplains and Volunteers.
• Hospice patients “always” should have the opportunity to have their regular community physician direct the plan of care. If needed – the hospice medical director can fill in to direct the plan of care.
• Medicare is the major reimbursement source for all hospice care, but commercial insurance also reimburses for hospice care.
• All medical equipment (electric bed, oxygen, bedside commode, etc.) should be provided by the hospice agency – along with all medications related to the life limiting illness the hospice is seeing the patient for (pain meds, meds for difficulty breathing, sleeping, anxiety, etc.)
• All hospices are NOT the same. No two hospice companies are interconnected (i.e. “hospice is not hospice is not hospice.”) Of the 50+ hospices in Maricopa County, only 2 are legitimate “not for profit” hospices – the rest are all “for profit.”
• Hospice of the Valley is the largest “not for profit” independent hospice in the United States serving over 3000 patients daily in 3 counties (Maricopa, Pinal and Pima.)
• Hospice of the Valley will accept/give excellent care to patients REGARDLESS of their ability to pay or insurance status.
• If you think you or your loved one could use hospice care, call an agency of your choice. Hospice of the Valley has 24/7 phone and visit coverage. You NEVER get an answering service when you call. We don’t need a physician order just to “eval” you or your loved one – we only need an order to initiate the services once the decision to pursue hospice care is made.
• For those patients who do not think they are ready for hospice, Hospice of the Valley has a “AZ Palliative Home Care” program that is a separate community agency providing palliative care to those patients/families still pursuing aggressive treatments/therapies – but still want 24/7 nurse or social worker help. It’s a “care management” model so there’s not any hand’s on care – but the nurses/social workers collaborate with you and your physician(s) to make sure you are receiving all the aggressive therapies and pain/symptom management concurrently.

• For anyone with any questions or wanting more info – please don’t hesitate to give Adam a call at 602-391-0282.

In this portion, I will be adding referrals to professionals in various fields that have shown integrity for their respective professions. They come highly recommended.

Jeff Hall is an attorney focusing on Estate Planning and Probate. Information can be found on his website at

Phoebe L. Harris, Associate Attorney with the Law Offices of Walter L. Henderson, P.C. Main Practice areas: Estate Planning, Wills/Trusts/Powers of Attorney, Long-term Care Planning; Asset Protection; Elder Law, Probate & Trust Administration; Will Contests; Guardianships/Conservatorships; Real Estate; Corporatons/LLCs. Free Initial Consultation. Contact information:;; Green Valley Office: 210 West Continental Road, Suite 126, Green Valley, Arizona, 85622; Tucson Office: 6700 N. Oracle Road, Suite 119, Tucson, Arizona 85704; 520.625.6811.

William R. Whittington of Boyle, Pecharich, Cline, Whittington & Stallings, PLLC; 125 N. Granite Street, Prescott, AZ 86301. 928.445.0122; E-mail:; Website: Mr. Whittington has been practicing law in Prescott, Arizona since 1981 and a partner with the law firm of Boyle, Pecharich, Cline, Whittington and Stallings, PLLC since 1983. The firm has been serving Northern Arizona since 1952. The firm’s practice emphasizes probate, estate planning, business law and related transactions. Mr. Whittington is a member of the probate and trust and business sections of the State Bar and has served on the executive Board for the Arizona State Bar Probate and Trust section, and has served as an adjunct professor at Yavapai College, teaching both estate planning and business law;

Brian Starr, is an attorney focusing on Estate Planning and Probate. Starr Law Firm, PLLC, 1110 E. Missouri Avenue, Suite 160, Phoenix, AZ 85014; 602.795.0700. E-mail:

More to follow…

Andre’ Pennington, PENNINGTON LAW, Estate Planning and Probate…623.229.0463

A good friend of mine wrote the following:
My 80-something friend has found a way to honor the life of his beloved wife who died several years ago. He misses her terribly, especially during the holidays. So he started a new tradition. He creates a photo calendar with images of her to use for the upcoming year. As he shared the calendar with me, he told me about each months’ photo…where they were…what they were doing. Warm remembrances help us grieve in a healthy way!

Did you know…in the State of Arizona, if you are widowed and your home is in a Trust, you will not qualify for the widow’s exemption for property taxes. This can cost you hundreds and hundreds of dollars. This was yet another thing I learned the hard way. Check with your State’s County Assessor’s Office to see if that is the case for you

Hi all:

There is a free pdf download offered by the American Bar Association entitled: Legal Guide for the Seriously Ill. To get it, do a Yahoo search for: Legal Guide for the Seriously Ill, and the pdf download will pop up. When I did it, it was top of the list. If you have ANY problems getting this, please email me at . This is a 51 page booklet that is full of necessary information.

A workshop attendee asked a question about a Do Not Resuscitate form. The following contributing information is from Adam, Hospice Nurse, Phoenix, Arizona.

Now – as for the answer to that question. I think she was talking about “What are the limitations of treatment if a person has a DNR (do not resuscitate) provision/wish in their advanced directives often found in living wills.” That’s actually a good question and I thought we touched on that a little bit during the conference, but probably not enough. Too many people get confused about DNR’s. At face value, it means that if a person is found to be unresponsive and not breathing/without a pulse – that they do not want heroic measures used to bring them back to life. Usually this encompasses defibrillator shocking of the heart, CPR, the use of medications to “jump start” the heart, and/or placing the person on a ventilator to keep them breathing. What often confuses people however is that a DNR/”do not resuscitate” does NOT mean “do not treat”! By no means should the DNR be interpreted to mean that if a person has an infection or serious illness that they shouldn’t receive proper medical care. The DNR is only meant to cover should the person stop breathing and/or have no pulse. **However, many people have special provisions in their advanced directives/living wills that spell out SPECIFICALLY what treatment they would like to receive or not receive should they become ill and it’s THOSE wishes regarding treatment that cover the important things that if NOT instituted would normally LEAD to a person’s breathing and heart stopping. Often these special provisions cover artificial feedings -either via IV or feeding tubes, receiving antibiotic treatments for infection, and even whether or not someone wants to be hospitalized should they become ill. The trend today in society is to cover your bases as much as possible so your loved ones are not left scratching their proverbial heads and wondering what they THINK you would want done if you were not able to make healthcare decisions for yourself at that moment. For example – in my own living will I’ve written in my own special provision directing my Medical Power of Attorney (MPOA,) that should a day come where I can not feed myself AND I do not present as “enjoying” food anymore, that I want any/all assisted feedings to stop. I made this decision based on many years of visiting group homes and nursing homes and witnessing people who were unable to talk/communicate being led to tables, sat down, and hand-fed pureed “goop” by nursing staff. There often was no joy in those folk’s eyes and their quality of life had definitely diminished drastically. I decided that I don’t want to be one of those poor souls. That kind of a decision is a “quality of life versus quantity of life” dilemma. I share this personal example just because it shows that there is NO end to what special provisions you can put into your advanced directives. A DNR is a great place to start if that’s the decision you’ve made when it comes to foregoing heroic measures to save your life either in a traumatic instance (this applies to much older people normally,) or anyone with a terminal illness that realizes what the inevitable outcome will be down the road and wants to make sure no heroic measures are taken. But DNR does not on it’s own mean “do not treat” those things that if left untreated could lead up to a persons potential demise…so make sure you spell out any/all provisions related to other types of medical treatment in your advanced directives/living will. And NO adult is too young to start making these provisions known. You can update/amend your advance directives any time you choose – so don’t be afraid that once you make a decision that it’s set in stone. Your healthcare decisions are just that…yours!