They served our country in war, and now health care professionals are learning to better serve them during end-of-life care. Learn how wartime issues impact hospice care and how some folks are making a difference.
More than 23 million veterans live in the U.S. today and most have served during a time of war. Vietnam War veterans comprise the largest segment and, as they age, their need for specialized end-of-life care is rising. Hospice Care of America, in Rockford and Freeport, is committed to providing the best possible care to dying veterans and their families.
“We have the knowledge, tools and passion to care for the specialized needs of veterans,” says Barb Martin, hospice consultant and Hospice Care of America Veteran Advocate. “They served us. It’s time we served them.”
Veterans of all eras were exposed to natural elements, man-made chemicals and traumatic experiences few non-veterans can comprehend. This fact contributes to their need for unique end-of-life care. All veterans have a higher risk of war-related health conditions such as hepatitis C, Agent Orange exposure, a range of infectious diseases, substance abuse, mental health issues such as Post-Traumatic Stress Disorder (PTSD), depression and more. Diseases directly related to war experience account for more than 70 percent of veteran hospital admissions.
Vietnam War veterans often have a particularly difficult time at the end of their lives, because of the controversies surrounding that war and the failure of the U.S. to meet its military objective. Veterans of wars prior to Vietnam were treated as heroes at their homecoming. By contrast, Vietnam veterans often found themselves personally under attack by war protestors. They were caught in the middle of a divided country and the lasting impact often affects their end-of-life experiences dramatically.
Veterans who served in combat, traumatic duty or dangerous situations sometimes develop into PTSD. This disorder is characterized by fear, anxiety, depression, guilt, anger and behavior changes caused by painful memories related to the traumatic experience. There’s also a high correlation between PTSD and substance abuse. Some veterans returned home from war and, having no other way to cope with the painful feelings, felt that numbing those feelings was the only way to deal with life.
“While PTSD is widely recognized and treated today, many of our past veterans came home with little help or understanding and had to readjust to civilian life the best they could,” says Julie Sanderson, Hospice Care of America medical social worker. “We’ve found that many veterans who have seen combat duty will not or cannot talk about their experiences, yet veterans who have become hospice patients share stories from combat or traumatic situations. This generally happens, during the dying process, as the veteran begins what we call a ‘life review,’ in which they examine their lives and bring closure to areas that have not been dealt with.”
Veterans walk differently, love differently and commit to others differently; it makes sense that they die differently, too, says Martin. “The ongoing need for specialized end-of-life care for veterans is urgent. Our training and understanding of veterans’ unique needs has helped us to improve our hospice program, from the way we do admissions, to our policies and procedures. We’re not just taking care of the patient, but the entire family, holistically, using our entire team and volunteers.”
In determining the unique needs of veterans at the end of their lives, Hospice Care of America first evaluates whether they were in combat or not, which war they served in, if they were a prisoner of war, whether they suffer from PTSD, what branch of service they were in and whether they were enlisted or drafted. These six answers help to determine the proper course of care. However, each veteran is a unique individual and requires care specific to him or her. Among the obstacles hospice workers often face, when caring for veterans, are veterans’ stoicism and refusal to admit to having pain, since many veterans view their pain as a weakness. During their service, phrases like “big boys don’t cry,” “no pain, no gain,” “few good men,” and “once a Marine, always a Marine” were ingrained in their minds and may drastically impact the way they die.
Hospice Care of America enjoys strong ties to local veterans’ groups and the U.S. Department of Veterans Affairs. The staff works hard to provide hospice veterans with the help they need. To learn more about their work with stateline-area veterans, and how you can help, visit hospicecareofamerica.com or call the Rockford office, at (815) 316-2700.