There are more than 20 million veterans in our country, and more than half of them are over age 65. While about 1,800 veterans die each day, few receive hospice care at end of their life. Social workers remind us that veterans have specific needs due to their time in service that hospice teams are specifically trained to address. While many veterans suffer chronic pain, presumptive disease, and traumatic injuries, a wider range of issues and concerns may also exist that may complicate end of life for veterans:
- PTSD (which may not surface until this point in life)
- Anxiety
- Traumatic grief
- Depression
- Survival guilt
- Troubling memories resurface.
- Reluctance to seek help for pain causes many to reject hospice care because they feel they need to be stoic and “fight on.”
- Anger due to pain, injury, or illness caused by war.
- Psychological issues of guilt, shame, or need for forgiveness and understanding due to having participated in war.
Hospice Care for Vets
Hospice Care is comfort care provided to Veterans and their families if the Veteran has a terminal condition with less than 6 months to live and is no longer seeking treatment other than palliative care. Hospice Care can be provided at home, in an outpatient clinic, or in an inpatient setting. In 2015, social workers began a quest to bring hospice and palliative care to all VA medical centers and, over time, to make it available beyond these centers as well. The VA was able to obtain funding from Congress, and each VA facility had the opportunity to submit for grant funding to establish an inpatient hospital unit if it did not already have one. Now, all veterans have covered access to comprehensive hospice and palliative care services, whether at one of the 152 VA medical centers, at community health centers, or at home.
The VA criteria for hospice care states that veterans must:
- Be diagnosed with a life-limiting illness.
- Have treatment goals focused on comfort rather than cure.
- Have a life expectancy, deemed by a VA physician, to be 6 months or less if the disease runs its normal course.
The hospice interdisciplinary approach to care is well-suited to meet veterans’ specific needs. Factors such as the branch of service, war, rank achieved, and whether a vet saw combat can affect aspects of the patient’s care. The hospice team carefully considers all these factors when managing a vet’s care.
Complete Care
- Care in their home or wherever they call home – private residence, assisted living or skilled nursing facility.
- Pain and symptom management by an interdisciplinary team: doctor, nurse, aide, social worker, chaplain, and volunteer(s).
- An individualized plan of care based on their goals and wishes.
- Spiritual and emotional care
- LCFL Vet-to-Vet volunteer(s) to provide companionship as only a fellow service member can.
- Support, education, and grief care for family members
- Exclusive availability of inpatient hospice care centers if pain and symptoms cannot be managed at home.
- Assistance with navigating veterans’ benefits
We Honor Veterans
As the VA acknowledged the limitations of its ability to care for all veterans at the end of life, it reached out to the National Hospice and Palliative Care Organization (NHPCO) to see how together they could improve care. It was clear to social workers that no one organization or entity had the capacity to meet all the needs of the growing number of veterans and that the solution would have to be reached through partnership and collaboration.
We Honor Veterans was launched with the goal to provide seamless care at the end of life to all who served. Today about 3,800 organizations are actively involved in the campaign, including 2,794 hospices that have signed on, along with other community health care providers such as assisted living and long-term care facilities, home health agencies, and even funeral homes.
For additional help with resources for veterans please visit Veterans Guide. Their mission is to assist veterans with various issues they might face including disability compensation, financial assistance, information on the GI Bill and more. We are including the following calculators to help veterans calculate how much their VA rating should be:
VA Disability Calculator - veteransguide.org/va-disability-calculator/
VA Disability Appeals - veteransguide.org/va-disability/appeals/
Thank you to our friends at Veterans Guide for the information.
