Veterans have unique physical, emotional and spiritual needs near the end of their lives. Some of the most common issues they face include post-traumatic stress disorder, survivor guilt and chronic pain. An increasing number of veterans are choosing hospice so they can receive multidisciplinary care and enjoy the final phase of their life as much as possible, often in the comfort of their own home.
How do you find a hospice program that is a good choice for your patient or loved one? Here are a few important qualities to look for in a veterans hospice:
Participation in the We Honor Veterans Program
We Honor Veterans is a program of the National Hospice and Palliative Care Organization and the Veterans Administration. If a hospice agency participates in the We Honor Veterans program, it has committed to providing high-quality, compassionate care for terminally ill veterans. There are four levels of tiered recognition. The higher the level, the better able the hospice agency is to meet the unique needs of veterans in end-of-life treatment.
Military Cultural Competence
Effective veterans' hospice care requires an understanding of the unique values and demands of military life. With this understanding, hospice agencies can individualize care to each person’s needs. Veterans don’t have to explain their need to build trust and safety or change their language. They can be who they are and be embraced by people who understand.
“We do a full military history with our veteran patients,” says John DaSilva, an Amedisys hospice bereavement coordinator in East Providence, RI. “We may approach them differently depending on the war they served in. For example, Korean War and Vietnam War veterans were often forgotten, with no chance to talk to others with similar experiences. Many were never thanked or recognized for their service. Knowing these differences helps us approach our veteran patients with sensitivity and understanding and tailor care to their needs.”
Some hospice agencies provide staff with specialized education and training on veterans’ needs. Trainings might address such topics as:
- Service-related physical illnesses
- Emotional issues such as depression, anxiety and substance abuse
- Medications and special considerations for veterans with post-traumatic stress disorder
- Spiritual uncertainty and need for forgiveness
- Creating a safe, supportive environment for sharing stories, if desired
- Ideas for how to honor veterans
Staff may also have additional training. For example, DaSilva is an Opus Peace ambassador, which means he completed several specialized trainings and workshops about soul injury and related veterans' issues.
Veteran volunteers play a critical role in veterans hospice programs. By speaking a common language and sharing a cultural bond, veteran patients can let down their guard and trust someone else with their stories. Some of the services veteran volunteers may provide include:
- Companionship from someone with similar service experiences
- Respite care so family members and caregivers can take a break
- Help understanding and accessing veteran benefits
- Telephone check-in calls
- Veteran to veteran letters
“Some of our veterans have things they need to get off their chest, and they don’t want to burden their families with it,” says Mary Rhoden, an Amedisys hospice volunteer coordinator in Montgomery, AL. “When I introduce a veteran patient to a veteran volunteer, within five minutes they don’t even know I’m there. It doesn’t matter if they were in different branches or wars, they have instant connection and camaraderie.”
Special Veterans Ceremonies and Services
Simple acts of gratitude mean a great deal to a veteran who has never been thanked for their service. Different hospice programs honor veterans in different ways, but there should be special efforts made to acknowledge their sacrifices. Here are some examples of ways hospice agencies thank veterans for their service:
Many communities have special parades to honor veterans, often on Veterans Day or Memorial Day. For veterans in end-of-life treatment, the challenge is getting there to be honored. Karen Powell, an Amedisys hospice volunteer coordinator in Methuen, MA came up with a clever solution: “One year, we rented a trolley so our veteran patients, together with their nurses and home health aides, could ride in our town’s veterans parade,” she says. “They all had tears in their eyes as the crowd clapped and thanked them for their service.”
Cynthia Robotham and Judith Hunter, two hospice volunteer coordinators from Beacon Hospice, an Amedisys company, in Hyannis, MA, developed vet-to-vet cafés, a concept that is being incorporated into the We Honor Veterans program level 5 tier. These are monthly coffee hours at various assisted living facilities and nursing homes, where veterans can have coffee, juice and a baked good and share their stories or listen to others talk about their service. “Vet-to-vet cafes fill an important gap,” says Robotham. “They give veterans a chance to be with other veterans and talk about their experience, sometimes for the first time in their lives.”
Veteran Support Groups
DaSilva leads support groups for veterans on topics like PTSD and recovery at assisted living and other elderly care facilities. But it’s his “Peace at Last” group that is consistently attended every single week by veterans and their families. “That’s what they really want – to make peace with what happened to them or their loved one,” says DaSilva.
Operation Adopt a Soldier
Every year, the hospice program in Hyannis, MA, adopts a military family in need at Christmas and buys gifts from the children’s wish list. The motto of Operation Adopt a Soldier is “You will never be forgotten.”
Veteran Pinning Ceremonies
Pinning ceremonies give thanks to veterans for the sacrifices they’ve made for our country. Family members and staff gather to watch the veteran receive a plaque or certificate and pin in appreciation of their service.
“We do our research so we can make the pinning special and personal for each veteran,” says Kristy Corbett, an Amedisys hospice volunteer coordinator in East Providence, RI. “Every single pinning we do is touching. We’ve found it’s never too late to say, ‘Welcome home. We appreciate your sacrifice.’ Many respond by telling us, ‘No one has ever thanked me’ or ‘I can’t believe people still care.’”
Veteran Honor Flight
Some hospice agencies work with Veteran Honor Flight, a nonprofit that takes veterans to Washington, DC, to visit memorials that honor their service.
Nicole Finitsis, an Amedisys hospice volunteer coordinator in Portsmouth, NH, had a veteran relative who needed hospice care. In trying to find a hospice, one issue that was important to her was community outreach. “You can tell how much a hospice program truly cares by the way they give back to the community – not just their patients but all veterans,” she says.
At her hospice program in Portsmouth, they actively seek out and honor veterans and their families. They’re a Vietnam Memorial Commemorative Partner and offer veteran pinning ceremonies not only to their own patients but to all veterans at the long-term care facilities they serve.