End-Of-Life Care For Veterans

February 25, 2011
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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 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.

Ask Allie

O&H: Allie, we’ve heard that an Annandale, Virginia, civic association has a unique new president.  Please tell us about her.
Allie: Sure!  The Hillbrook-Tall Oaks Civic Association recently elected Ms. Bertha Lee as its new president.  The association streamlined its election procedures and only announced the names and qualifications of the candidates.  Ms. Lee was described as “a relatively new resident, interested in neighborhood activities and the outdoors, and who had experience in Maine overseeing an estate of 26 acres.”  The association members were happy to have a new volunteer, and Ms. Lee was elected.  The association’s newsletter revealed that Ms. Lee is a Wheaten terrier who promised to “govern with an even paw.”  Some residents were embarrassed that they had elected a dog as president, while others were amused.  Ms. Lee is the pet of the former association president, Mark Crawford, who could not run for re-election, and who was frustrated at the lack of interest in the post.  Mr. Crawford serves as vice-president, and said, “We wanted to send a message to the neighborhood that they needed to get involved and get engaged.”  He and the nominating committee reviewed the association’s bylaws and decided that Ms. Lee met the basic qualifications of being a resident of the neighborhood and had attained the age of majority (in dog years.)  Ms. Lee delegates a lot of her duties to other association officers and usually attends the monthly board meeting.  It’s too early to tell if more people will get involved in running the association.  Well, Ms. Lee sure sounds busy. Good for her!  I know I was busy working at Oast & Hook, and now I’m really enjoying retirement!  See you next week!


Oast & Hook will present a free seminar to those who think they could be affected by the Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010.  Oast & Hook will present this seminar twice on March 2, 2011, at the Russell Memorial Library, 2808 Taylor Road, Chesapeake, Virginia 23321. The first presentation begins at 10:00 a.m., and the second presentation begins at 4:00 p.m.  Make sure your estate plan and your plan for health care are not obsolete.  Reserve your seat now.  If you have any questions about this seminar or if you would like to register for it, then please phone Oast & Hook’s Jennie Dell at 757-399-7506.

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