We Honor Veterans Partner Networking Call Recording 12/06/17

Katherine Kemp – NHPCO Access Manager

  • Welcome and introductions.
  • We Honor Veterans would appreciate your feedback and suggestions about how we can best support you and provide the best resources to better care for Veterans and their families at the end of life. The survey will only take you approximately five minutes or less to complete. Your input will greatly help us to address your specific needs as we develop the program and future WHV educational activities and resources.

Please complete the survey before December 31st, 2017.

Dr. Ed Tick – Soldier’s Heart

  • Dr. Tick is the author of Sacred Mountain, The Practice of Dream Healing, The Golden Tortoise, Wild Beasts and Wandering Souls and the award-winning book War and the Soul. His most recent book is Warrior’s Return: Restoring the Soul After War.
  • Dr. Tick and his staffs’ mission is to transform the emotional, moral, and spiritual wounds that often result from war and military service.
  • Soldier's Heart was founded in 2006 by Dr. Ed Tick, and Kate Dahlstedt. The team conducts retreats and trainings and have established a national network of trainers and leaders. They work with the military, universities, faith communities, and other organizations throughout the US and the world.
  • There were approximately 2.7 million Veterans who served in Vietnam; there are now less than 1 million alive. Diseases like Agent Orange, stress related diseases, and suicide have been far more deadly than combat itself. We need to make meaning of the service and help our Veterans decide how they want to be remembered.
  • Dr. Tick has made 17 trips to Vietnam with Veterans for grieving, healing, and reconciling that cannot be done stateside or through counseling. Dr. Tick shared stories of the rituals and the effects that these trips have had on Veterans who were able to participate in the practice.
  • Further information and resources can be found on https://www.soldiersheart.net/

Q&A

Q: Are there things that can be done now for active duty service members to prevent the hardships that may come later in life?
A: Yes, interventions and practices can be done to help prevent burdens later in life. Some chaplains are running prayer services for all of the fallen. World warrior traditions teach us that we have a responsibility for the souls of the lives we have taken. There is a lot we can do and should be doing immediately, the sooner the better. The only military workers that retain confidentiality are chaplains. Behavioral health workers such as psychologists and social workers are required to document visitations.

Q: What is being done to ameliorate the negative reception that Vietnam Veterans received when they returned to the U.S? What can be done for Vietnam Veterans who may not be dying but are wrestling with the reception they received?
A: Unlike the reception received when returning to the US, when returning to Vietnam  citizens there honor and thank American Veterans. They do not blame Veterans for the war but rather congratulate them on being a good warrior. Within the US there are large and small gatherings, parades, and various different events being held to properly welcome home Vietnam Veterans. It is important for us to educate our communities on Veterans and the costs they pay. 

Q: How do you handle the very short length of stay in helping deal with these issues? Several hospice patients only have a matter of days in our care, how can we assist in a Veteran’s healing in this short time period?
A: Having the right volunteer is essential. If you cannot get a Veteran volunteer, consider having someone who was involved in the region and time that the Veteran served in. With such little time, it is important to determine what is most valued to the Veteran and how he/she would like to be remembered. It is not enough, but it can go a long way in resolving some of the lingering issues.

Taryn Thomas, Seasons Hospice – Integrating Music Therapy in WHV

  • The profession of music therapy formally began following WWII. Community musicians were volunteering at Veteran Hospitals and performing for Veterans. As a result, patients were experiencing notable and emotional responses to the music. Hospitals then began hiring musicians to the hospital staff. Hospital musicians quickly realized that a higher level of training was required and thus the curriculum of music therapy was formed.
  • Taryn Thomas has been practicing music therapy since 2009 and hospice music therapy since 2012.
  • During WHV honoring ceremonies the music therapist will perform patriotic songs, as well as the Veterans branch of service song.
  • Therapy sessions with Veterans involve music making, music listening, and legacy projects in an attempt to assist with the Veteran’s emotional expression, coping with PTSD, pain, and motor skills.
  • Music making can be especially impactful for Veteran musicians of the service. This often involves having the Veteran tap on the therapist’s guitar or bringing in a drum for them to beat. 
  • Music listening is a supportive practice, giving patients an opportunity to open up and share stories with the therapist or a family member sharing in the exercise. Having music playing in the room has been proven to create a feeling of a safe environment, allowing people to feel comfortable in sharing their feelings.
  • The legacy project involves recording the patient’s stories and then creating songs or poetry from that story for the Veteran to leave for their family.

Scott Shreve – Department of Veterans Affairs

  • More than 3,400 community hospices have made a commitment, by enrolling in the We Honor Veterans program, to improve care to terminally ill Veterans. It feels like it is becoming a natural part of our culture to say thank you for your service.
  • Through listening to the call, it is evident that the Veteran-to-Veteran Volunteer program has been extremely impactful in hospice communities. The No Veteran Dies Alone program is a curriculum that can be done online to train Veterans on being volunteers to other Veterans.
  • Scott recently spoke with the CEO of NHPCO to discuss improvement of care to all people at the end of life and moving that care upstream in the healthcare system so that people are receiving it sooner.
  • Concurrent care for dually eligible Veterans that have access to Medicare hospice benefits and are also eligible for treatments of their illness that could be provided through their VA, there are barriers for the Veteran to receive both benefits at the same time. The VA is trying to collaborate better with Medicare and work through some of the regulatory barriers.

Q&A

Q: The VA office in my community informed me that I would have to apply to the VA in a different community. We were told the physicians at the VA cannot give an order for a patient to go to hospice. Some Veterans do not go to see a physician outside of their VA, so if we can’t get the order from the VA how can I service them? 
A: This is an unusual situation. VA physicians order hospice care daily, nationwide. If VA is paying for the hospice care the VA physician must sign off that the Veteran is hospice eligible. Contact Veterans@nhpco.org with the specifics of your situation and we do our best to solve any misunderstanding.     

Q: Is there any visibility on a process where communities hospices can identify connect to Veterans who are pre-hospice and may be experiencing a decline in health, maybe discharge coordinator loops?
A: The VA has developed an algorithm called the care assessment needs score to predict hospitalization for death in Veterans and it uses 160 variables. It gives a prediction of how risky every Veteran who has had at least one clinic appointment with the VA system is for hospital admission or death in the next 90 days. The palliative care program then evaluated the sickest of them and decided whether or not they needed a palliative care appointment.

Q: If somebody comes on hospice could it be a presumed need for aid and attendance?
A: Aid and attendance is under VBA and is a monetary benefit and should not impact the provision of hospice care. If you believe Veterans are being denied aid and attendance under the VBA, please let us know so that we can have you connected with the correct people within the VBA.

Partner networking

  • One thing that works well with our Vietnam Veterans is encouraging the Veterans to write letters to their families to receive after their passing. This allowed them to be open and uncharacteristically emotional with their words and feelings. We have seen this bring about a lot of healing to the Veteran before the death and a lot of healing to the family after the death.
  • A reminder to take care of the families as well as the Veterans. There are a lot of disconnected or disoriented families who have been affected by their loved one’s service. We did a Veterans recognition service, pinning 47 Veterans for their service. The mayor was present and it was a wonderful event for our community and the program.
  • On Veterans Day we held a Veterans honoring ceremony. We were connected with the Veterans Volunteer Coordinator on Base, who sent out our request for Veteran and active duty members to assist us in the honoring ceremony. We had 15 Veterans being honored and 15 active duty members who wanted to come and thank the Veterans for their service. Our state’s Senator was present at the event as well.
  • We had the Wall that Heals at our facility and presented a brick to Pat O’Neal. Bricks are given to people who have had an impact in improving things in relation to Vietnam. John McCain has received two bricks, Madeline Albright received a brick, and three ambassadors in Vietnam received bricks. It was an outstanding event.
  • We have over 50 Veteran Volunteers and we were able to salute and pin over 1,500 Veterans this past November. We also presented over 1,000 widows of Veterans with a flower. On Memorial Day we do a ceremony to honor widows, they are always overwhelmingly well received.
  • National Military Spouse Appreciation Day is always the Friday before Mother’s Day. We honor the military spouses on this day every year. It is always very well received and an amazing day for all involved.
  • We encourage everyone to read the original declaration declaring Mothers’ Day a National Holiday. It was originally founded by women who had lost loved ones during the civil war and was meant to be an honoring of women during a memorial time of the fallen. 

Wrap-up

  • Thank you to all of our partners for another wonderful year, our next Partner Networking Call will take place in mid-March. We look forward to 2018!