Building a Veteran to Veteran Volunteer Program

Transcription

1 Building a Veteran to Veteran Volunteer Program Presented by Tray Wade, MA, MHA Vice President of Patient and Family Care, HCI Care Services Objectives Describe why it is important to improve our knowledge and understanding of veterans needs. Describe how we can best meet the needs of veterans and their loved ones. Recognize unique issues that veterans may face at end of life. Describe how to engage the veteran community in improving end of life care. Outline steps to develop a veteran to veteran volunteer program. 1

2 U.S. Veterans The Facts 26 million veterans are alive today One in four adult men is a veteran Median age is 58 years old More than 1,800 veterans die each day The VA cares for a minority of veterans at the end of life Veterans Among Us Era = Casualties WWII ( ) = 292,131 Korea ( ) = 33,667 Vietnam ( ) = 47,393 1 st Gulf War ( ) = 148 Afghanistan (2001 now) = 441 Veteran Population Peacetime = 6,142,000 WWII = 3,151,000 Korea = 3,086,000 Vietnam = 7,956,000 Gulf Wars (since 1990) = 4,646,527+ Iraq (2003 now) = 4,000+ 2

3 Why Pair Veterans with Veterans? Military training and the culture of stoicism can often prevent veterans from sharing difficult experiences. When one veteran talks to another, stoicism and secrecy dissolve. Veterans share a common language and code of conduct. Sharing supports life review and healing! Veteran Volunteers who Work with Veterans in Hospice: Bring their military training and history to their hospice work Offer unique opportunities that support life review and healing Are able to share a common language Share a cultural bond that opens doors of trust, Share codes of conduct and honor Help dissolve barriers of stoicism and secrecy (especially combat veterans) 3

4 The Potential Impact Documentation from one of our first visits: We spent an hour talking and covered a lot of ground. Apparently the incident with the gas mask that may have caused his breathing difficulty occurred while he was on a ship to New Calidonia, where he served. He could remember how long he was there to the exact number of days, like me (I was in the army for one year, one month and 19 days). It s interesting how that kind of thing stays with you. We also covered his time in the Civilian Conservation Corps in Delta, Missouri, where he also learned to drive. I learned he had a son who was born in 1940 and died in It sounded like the son led a wild life and may have met a violent end. Other than the disappointment he felt about not having a greater influence on his son, he was in a pretty good place. He does like to talk and would talk about anything. He said I could come back anytime, and I'd like to visit with him weekly. Veterans Unique Needs America s veterans and their loved ones may have unique needs. These needs are influenced by: A combat or non combat experience The specific war in which they served If they were POWs If they have PTSD The branch of service and their rank Whether they were enlisted or drafted 4

5 War Experience World War II Korean Conflict Vietnam War Gulf War Other conflicts around the world Peacetime Military Cultural Norms Influences on end of life experience: Stoicism promoted Fear and admitting pain seen as a sign of weakness Big boys don t cry No pain, no gain A few good men Once a Marine, always a Marine 5

6 Possible Outcomes from Combat Experience Some are able to integrate experience into their lives, especially if they: Are naturally resilient Have good family and social support Had a positive war outcome Talked about their war experiences Potential Issues from Traumatic Combat Others struggle with traumatic combat memories and may need support related to: Alcohol/drug abuse Social isolation Anxieties Anger outbursts Difficulty concentrating Post Traumatic Stress Disorder (PTSD) 6

7 Post Traumatic Stress Disorder (PTSD) Exposure to a traumatic event Persistently re experienced through: Recollections/flashbacks Nightmares Sensory distress cues Individual persistently avoids associated traumatic stimuli Thoughts, feelings, conversations about trauma Situations triggering sensory distress cues Other persistent symptoms Post Traumatic Stress Disorder (PTSD), continued The onset of PTSD can be acute, chronic or delayed How it will manifest and who it will affect is unpredictable Immediate treatment and ongoing support helps 7

8 Types of Responses to War Trauma 1. Integrated Response to Trauma Trauma has been processed Healing occurs, life goes on 2. Incomplete Integration of Trauma PTSD is prolonged 3. Apparent Integration of Trauma Trauma is kept in the unconscious and everything seems to go on Lingering effects of war trauma Undiagnosed/delayed onset Source: Deborah Grassman, VA Hospice, Bay Pines, FL Encourage Your Veteranto Veteran Volunteers to: Offer camaraderie. Keep the focus on the veteran, not you. Remember the veteran s experience may be different than yours. Open the door, but never push. 8

9 Recommended Interventions with All Veterans Make the environment emotionally safe. Affirm the feeling aspect of their conversation. Remember that stoicism might interfere with acknowledging physical, emotional or spiritual pain. Recommended Interventions with All Veterans, continued Recognize female veterans: Military nurses saw trauma/mutilation Thank older female veterans for paving the way Look for PTSD in women May have been sexually assaulted in the military 9

10 Remember Non combat veterans may have served on dangerous assignments. Combat veterans may have served in safe areas. Avoid making assumptions. Not all people who have suffered trauma will experience PTSD. Suicide Risk and Depression in Veterans It is important to: Take threats seriously. Answer cries for help. Contact the volunteer coordinator or other staff members. 10

11 What NOT to DO Make sure you do NOT: Leave the person alone Assume the person is not the type Keep it a secret Act shocked Argue or reason Analyze Shock or challenge HCI Care Services Veteran to Veteran Volunteer Program HCI Care Services received 1 of 5 NHPCO Veteran Affairs (VA) Grants Reaching out to veterans at end of life Multitude of focus areas among grantees Grant Provided Funding Veteran volunteer outreach coordinator Materials and promotion Staff and volunteer education 11

12 Critical Steps to Success Veteran volunteer outreach coordinator Building partnerships Staff orientation and education Creating processes and procedures Celebrating successes Veteran Volunteer Outreach Coordinator The ideal qualifications of a coordinator: A veteran Outgoing and enthusiastic Able to build relationships Comfortable speaking to groups Capable of recruiting volunteers 12

13 Building Partnerships VA hospital staff Community groups Veteran support networks Military Staff Orientation and Education Orient teams on the program Bring in VA staff to assist in orientation of coordinators and staff Provide veteran specific end of life development to direct care staff 13

14 Processes and Procedures Incorporate full Military Checklist into the admission process Create tracking to identify those veterans who have been trained and patients served Orientation manual Build in debriefing with veteran volunteers Outline duties Range of Volunteer Services Provide transportation Make regular volunteer visits Provide telephone assurance calls Give respite for family members/caregivers Provide education about and assistance with veteran benefits Offer opportunities to reminisce and life story telling ovisit and listen as patients reminisce orecord or videotape patients life stories oproduce a memory book 14

15 Honoring Veterans Volunteers may: Visit veterans on Veterans Day in homes, nursing facilities, assisted living facilities and hospitals Assist long term care facilities and assisted living facilities in celebrating Veterans Day/Memorial Day Provide hospice education to veterans groups Volunteers who are veterans may wear their uniform and take part in the service. Honoring Veterans, continued Recognize each veteran patient by: Visiting on Veterans Day Awarding the veteran with a framed certificate of appreciation Engaging with team specific outreach One team delivered breakfast to each veteran; another gave cards of thanks made by local youth. 15

16 Barriers Scheduling and orientating volunteers Marketing and promotion Change management Program Results Key Statistics Started in November of 2010 Currently have 11 Veteran to Veteran volunteers oriented Currently have eight potential Veteran to Veteran volunteers scheduled for orientation Nine patients served within the program 16

17 Resources We Honor Veterans NHPCO HVP of Iowa Questions For future assistance, contact: Tray Wade, Vice President of Patient and Family Care HCI Care Services (515)