Looking For A Few Good Caring End of
Life Professionals
Hospice Veteran Partnership (HVP)
By:
Dr. Leslye Pennypacker
Building Partnerships to Better Serve Veterans
A Population in Need of Quality End-of-Life Care
Mr. C is
an 86-year-old veteran with end-stage heart failure and moderate dementia.
After surviving some of the toughest fighting in World War II, he went on to
earn a law degree and establish a successful practice. Mr. C never talked about
the war with his family. They never thought to mention it to his doctors or the
nursing home staff. Now, as he lies in bed, Mr. C is haunted by memories from
more than half a lifetime ago. Observing his frequent tears and periods of
profound depression, his family and the nursing home staff realize something is
wrong but they don’t know how to comfort him.
Mrs. J is
a 67-year-old veteran who served as a nurse in
Although
she still wants to maintain contact with VA staff, she is no longer able to
make the trip to the VA
Mr. L is
a 56-year-old veteran with end-stage liver disease and a limited prognosis. He
lost a leg in
These
stories represent just a few of the 674,000 veterans who are expected to die
this year. The emotional and spiritual components of hospice care can be
especially meaningful to veterans, who often face issues near the end of life
relating to their military experiences. Support is even more crucial for
veterans who do not have a strong network of family and friends.
A Fragmented System
Anyone
who has tried to navigate the health care system in
* More
than 1,800 veterans die each day. This represents a quarter of all deaths in
*
Approximately 85 percent of them do not receive care through the Department of
* Veterans Affairs (VA) health care system.
* Most
veterans who are enrolled in the VA health care system still die in the
community.
Only four
percent of veterans die in VA facilities.
These
statistics highlight the importance of partnerships among VA and community
health providers as well as organizations that serve veterans. There is a great
need for education about hospice care and how it can be accessed.
Hospice
care is part of the basic eligibility package for veterans enrolled in the
Veterans Health Administration (VHA). If hospice care is appropriate for
enrolled veterans—and other funding is not available—VA medical centers will
either provide hospice care directly in their facilities or purchase it from
community hospice agencies.
All
Medicare-eligible veterans, whether or not they are enrolled in VHA, have
access to hospice care through Medicare. Veterans not eligible for Medicare may
have hospice benefits through Medicaid or other private insurance. However,
like
90
percent of Americans, most veterans simply don’t know that these options exist.
The need
for education extends beyond the public to community hospice and VA providers
as well. Many community hospice agencies are unaware of the dedicated inpatient
hospice units that exist in VA facilities. Likewise, VA facilities are often
unfamiliar with the services community hospices can offer and how to work with
them. There are also complex issues surrounding payment reimbursement and
administration.
Hospice-Veteran Partnerships
With a
focus on improving end-of-life care for veterans, the Department of Veterans
Affairs established the VA Hospice and Palliative Care Initiative (VAHPC) in
November
of 2001. One of the programs launched by VAHPC is the National Hospice-Veteran
Partnership (HVP) Program, which is working with Rallying Points, the National
Hospice and Palliative Care Organization, the Center for Advanced Illness
Coordinated Care, and other end-of-life care advocates to create a national
network of HVPs.
HVPs are statewide or community-based partnerships
dedicated to increasing veterans’ access to hospice and palliative care. Their
goals are to strengthen relationships between community hospices and VA
providers and educate veterans and their caregivers about end-of-life care
options.
The VA’s
National Hospice Veterans Partnership Group headed by Diane Jones presents the
information provided here in the HVP toolkit. This is the introduction to the
toolkit, which can be accessed at http://www.va.gov/oaa/archive/hvp_toolkit3.pdf
. The numbers reflect what is taking place nation wide. There is little need to
point out
HVP has
its roots in Florida, during the last few years we have had some challenges.
Our desire and goal is to develop and effective partnership that enhances the
quality and continuity of care delivered to our veterans. If you would like
more information on HVP or if you would like to be involved with HVP program in
your area contact one of the following:
Dr. Leslye Pennypacker
(352) 374-6104
Carla
Anderson MSN, RN
(727) 319-1247
Chaplain
Jim Maudlin
(904) 301-2510
For the
National HVP web site go to: http://www.hospice.va.gov/Missalaneous/HVP.htm
Cassie
Donovan, Senior Director of Operations and Clinical Services at Haven Hospice
(352)
378-2121