Hospice Provides Comfort for Veterans and Their Families

ID 59996578 © Oleg Dudko | Dreamstime.com

The following is a reprint of an excellent article from Veterans Family Matters and VAGA News:

At the end of life, every patient is unique. When a patient with an advanced illness is ready to start the conversation, hospice care focuses on improving quality of life. When that patient is a veteran, providing appropriate care requires insight into the challenges they face throughout life, not only at its end.

In general, hospice patients are estimated by their physicians to have six months or less to live. But receiving hospice care doesn't mean "giving up" or compromising comfort and dignity. As part of the Medicare Part A hospice benefit, hospice patients are entitled to whatever their terminal diagnosis requires. This includes medications, home medical equipment, supplies, supportive services and care from a team of experts.

The interdisciplinary hospice team-nurse, hospice aide, social worker, physician, chaplain, bereavement specialist and volunteers-provides clinical, spiritual and psychosocial care to the patient and their family wherever they call home. 

Unique Care for Veterans

Veterans face experiences throughout their military careers that test the limits of the human body and mind. The repercussions of these experiences may linger long after a veteran's service ends, and their needs at the end of life can be severe and varied.

Hospice experts are trained to support these difficult circumstances, including financial and benefit concerns, post-traumatic stress disorder, unresolved issues associated with military service, depression and suicide. Veteran liaisons ensure the patients have access to every benefit to which they're entitled.

Some hospice providers also participate in We Honor Veterans, a program developed by the National Hospice and Palliative Care Organization and the VA to improve care for vets in hospice. Veterans are shown how much their service is valued through special events and activities, including trips to the Washington, DC, war memorials via the Honor Flight Network®.

 For patients with advanced illness, hospice helps make the best of those final months, weeks and days. Hospice patients enjoy being home among loved ones, free of medical expenses, and in the care of a team dedicated to their comfort and dignity.

Larry Robert, Bereavement Services Manager/Veteran Liaison

VITAS Healthcare of Atlanta

www.vitas.com

Covid-19 and Elder Abuse- Increasing Risk to an Already Vulnerable Population.

Coronavirus disease 2019 (COVID-19) is particularly destructive to older adults.  In addition to the heightened risk of morbidity and mortality, there has been a massive increase in reports of elder abuse during the pandemic.  Reports of elder abuse range from financial scams to incidents of family violence.  Warnings of abuse have been issued by the Federal Trade Commission (FTC) and the American Bar Association (ABA), as well as countless advocacy groups and service organizations.

The Centers for Disease Control and Prevention (CDC) defines elder abuse as an intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult. Abuse of older adults can be physical, emotional, financial, neglect, or any combination of these.

This knowledge regarding the health risks likely exacerbates already high rates of depressive and anxiety symptoms,resulting in an even greater multidimensional state of vulnerability. The many necessary social distancing programs currently in place additionally create a growing dependency on others for the completion of daily living activities, and this dependency can be viewed as another vulnerability.The documented negative health effects of social isolation and loneliness in old age will undoubtedly intensify during the pandemic.  Social isolation is one of the strongest social characteristics contributing to the risk of elder abuse.

Shelter-in-place” orders in effect to promote social distancing, and increased dependency of older adults on others, means the potential for elder abuse is  heightened; perpetrators of abuse are often close relations.  The risks also increase as more strangers opportunistically attempt to take advantage of the fearful situation to exploit older adults for financial gain. 

Older adults with dementia or declining cognitive abilities are known to have much  higher risk for abuse and neglect. With the shuttering of adult daycare programs,senior centers, and outpatient programs occurring concomitantly with adult children working from home, the possibility of unbuffered time together may contribute to circumstances leading to greater incidents of abuse.  Add to that the inability or hesitance of younger family members to check in or monitor their elderly family members, and the risk of abuse by third parties also likely increases. 

One cannot discuss elder abuse without exploring both ageism and confirmation bias.  The World Health Organization (WHO) defines ageism as “the stereotyping, prejudice,and discrimination against people on the basis of their age.  A recent systematic review found ageism to be associated with numerous negative health consequences worldwide. The review, which is the most comprehensive survey of ageism, to date, included over 7 million participants.  The participants spanned five continents, and concluded ageism to be pervasive, harmful, and arguably a primary underlying contributing factor in elder abuse. According to the survey, ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. 

The coronavirus pandemic has inspired ageist thoughts and comments given its predilection toward harming older adults. As the consequences of necessary social distancing increase, ageist views will continue to rise to the surface.  We have already witnessed the potentially  tragic and unjust utilitarian conversations regarding “the needs of the many versus the needs of the few.”  Add to this conversation lackluster investigation and enforcement arising from claims of abuse, and a dangerous indifference to the claims, needs, and goals of the elderly, and the pandemic provides a recipe of ingredients making the elderly only more vulnerable and susceptible to abuse.