End-Of-Life Care For Veterans

End-Of-Life Care For Veterans

A recent article in the Tribune Newspapers discusses an extensive effort that the Department of Veterans Affairs (VA) is making to improve end-of-life care for veterans. The VA has recently completed a new training curriculum called the Education on Palliative and End-of-Life Care for Veterans Project, which should be used in all 153 VA medical centers by the end of 2011. The goal of the project is to educate VA medical center personnel, including physicians, nurses, chaplains, social workers, and psychologist about best practices for veterans nearing the end of their lives.  In 2011, and estimated 670,000 veterans are expected to die of various ailments, including heart disease, cancer, and stroke. All veterans have been entitled to hospice and palliative care since 2008.

The VA recognizes that many veterans pass away outside of VA medical centers.  As a result, the VA has recently started a partnership with the National Hospice and Palliative Care Organization, We Honor Veterans.  This organization is dedicated to addressing issues related to military service that may surface near the end of life.  One issue that may arise is post-traumatic stress disorder that can surface as emotional defenses weaken.  Deborah Grassman, director of hospice and palliative care at Bay Pines VA Medical Center in St. Petersburg, Florida, says "Many seriously ill soldiers become distraught as they begin to lose control; others associate death with the horror and helplessness they felt on the battlefield."  She notes that for other veterans, memories of their wartime experiences can be a source of lingering, excruciating guilt.  Ms. Grassman has written a book, "Peace at Last: Stories of Hope and Healing for Veterans and Their Families."  She wrote about one veteran named Sam, who had terminal cancer, and who was haunted by the image of the Viet Cong soldiers he had killed.  He had never talked about his experiences or feelings.  When he finally voiced his need for forgiveness, he was able to accept his imminent death.  Some veterans maintain a stoic, grin-and-bear-it attitude and won't admit to having pain; this can impair the ability of caregivers to relieve that pain.  F. Amos Bailey, M.D., director of palliative care at the Birmingham, Alabama, VA Medical Center, says that veterans who once turned to alcohol or drugs to escape the lingering aftereffects of trauma may be afraid that they may once again become addicted to painkillers.  Other issues that veterans may have faced include homelessness and military sexual trauma.  The war in which a veteran served may also affect palliative care because of the varied situations that the veterans experienced in different wars.

The article lists some things that people can do to assist veterans in their families who served in wartime. The family members can let the veteran know that they respect and honor the veteran's service to our country. They can ask if their loved one is troubled by memories from war; the family members should not push if the veteran does not want to answer. Family members should be aware that irritation, frustration, anger, and fear can be signs of unresolved conflicts, and some of those conflicts can be related to wartime experiences.  The family should share their knowledge of the veteran's service with the veteran's medical providers.

For more information on We Honor Veterans, please visit http://www.wehonorveterans.org/.


The attorneys at Oast & Hook can assist clients with their estate, financial, investment, long-term care, life care, veterans benefits, and special needs planning issues.

Sandra L. Smith joined Oast & Hook in 2003.  Oast and Hook has served Southeastern Virginia and North Carolina for more than 80 years. Visit their website at www.oasthook.com for more information. Ms. Smith practices primarily in the areas of elder law, estate planning, estate and trust administration, special needs planning, asset protection planning, long-term care planning and Veterans' benefits. She is certified as an Elder Law Attorney (CELA) by The National Elder Law Foundation (NELF). In 2008, Ms. Smith was named as a Rising Star by Virginia Super Lawyers magazine. Rising Stars names the state's top up-and-coming attorneys.