Posts tagged ‘Veteran’s Administration’

Nov 10

Veteran’s Day

When I looked up Veteran’s Day on the internet earlier in the week, the first links that appeared were related to office closures such as banks and public offices. There was nothing about actual men and women who served in the Military. But, there is a lot going on with the Veteran’s Health Administration and I learned some shocking facts about Veterans when researching this post. First, approximately 8 percent of our prisoners are veterans. The good news is that the number is falling and while there are probably a few veterans who simply committed crimes unrelated to their service to our country, many of them have PTSD.

Prison is the extreme but there are many more veterans who are suffering from PTSD. I never thought of it as a condition that affected the elderly but Dementia and PTSD have a relationship. Additionally, the traditional treatment of long term use of benzodiazepines to manage anxiety with PTSD is now suspected of contributing to Alzheimer’s Disease and other Dementias. Medication recommendations have changed and are successful, but Dementia and PTSD are still closely correlated. These are our patients – Medicare beneficiaries who fought in wars that ended long ago continuing to suffer from PTSD and losing the cognitive ability to cope.

Although younger men and women in the military are taught how to recognize PTSD and get help when needed, the older generation lived in an age when they were supposed to ‘suck it up’. They viewed mental illness as weakness. They had a preconceived notion that men were supposed to be ‘strong’ and boys didn’t cry. Some of them have lived miserable lives. But as they are approaching the end of their lives, you can help them by learning to assess for PTSD and assist your patient in getting the help they need.

The Veterans Health Administration has a seemingly unlimited amount of information available for Veterans and Healthcare Providers. There are continuing education courses online at no cost for nurses that grant credit. There are teaching guides that can be downloaded that will help you teach your patients about PTSD. They are yours by clicking the blue box.

When I worked in critical I took care of a patient shot six times by her retired husband. According to her family, they were the perfect couple but a flashback to a combat zone ultimately caused the death of my patient. A few years later, in the cath lab, a patient with Alzheimer’s Dementia became very angry when a physician of Asian decent walked into his room prompting the patient to scream something about killing those Japs. The physician was a kind man and didn’t take offense but imagine how very frightened my patient was thinking that the ‘enemy’ had found him.

Jails are now designating areas for Veterans. The Hospice Benefit has a program to recognize veterans. Home Health nurses won’t wait for a program to formally assist Veterans. Let’s get started by learning about PTSD and getting our Veterans Treatment.

They were willing to die for us. We can lighten the pain of their ongoing suffering.

May 14

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The VA’s Dirty Little Secret List

A couple of years ago, I was in a client’s agency when a woman came in to ask about her father’s home visit schedule. The case manager was confused because the gentleman had been sent to the VA hospital in Texas a few days prior and the agency had no idea he had returned home.

I pulled his chart while they were talking. The nursing notes described a stasis ulcer to the lower extremity with wound care for almost a year. The wound continued to deteriorate. The patient had a physician at the VA clinic in Alexandria who took excellent care of the patient and worked together with the nurses to get the leg to heal. It did not heal. In fact, it continued to deteriorate. The odor of rotting flesh was so bad that the nurses had to ensure that the windows were opened for their visits. The doctor referred him to the VA hospital in Texas for an amputation. After less than 24 hours, the patient was discharged because he had less than an ‘honorable discharge’.

The daughter explained that she finally found out that when father returned home from Viet Nam, he did not return a rental car in Washington DC. He left it at the airport but forgot to turn in the keys. Pardon me for being overly cynical, but I figured there was more to the story. The case manager placed a call to the VA’s office in Alexandria and confirmed the story. It didn’t seem to matter that he had been receiving VA benefits for years and did not apply for Medicaid when he was eligible because he was a vet and he trusted the VA system. It did not matter that he had been disabled for years but he would not be eligible for Medicare until he had been on Medicaid for two years.

He was just a vet – a sick and damaged individual no longer of use to the country he served.

The hospital wheeled him out to the sidewalk and luckily he had a niece in Texas who came and picked him up and took him to her house until his daughter could make the six hour ride to Houston in a truck that did not start very often.

We called The Department of Health in TX and left a message. The immediately returned my call but explained that they did not have the authority to survey VA hospitals. She gave me a number to call and I called it numerous times for about a week. I left messages. The agency did the same thing. Nobody was interested in the vet with the necrotic leg.

Now they have a secret waiting list that shows that veterans are waiting months for appointments but they altered their data to show that patients are being seen within the guidelines. The wait time is horrible in itself. The complicated steps to hide the list and create the appearance of compliance with the VA rules is nothing short of immoral. My clients would be accused of fraud if they altered any records and I would be in the courtroom testifying against them if they allowed people to die and hid the evidence.

This type of disrespect for our veterans of war could only be the result of a culture that fires anyone who presents a problem. Only in a system where individuals know that nothing they can do will ever make a change would this sort of thing happen.

Secretary Eric Shinseki has failed as a leader. He has created a culture where it somehow makes sense to lie, cover up and let people die rather than report the truth about how our veterans are treated. If this were one hospital or a dozen patients, I could believe it was hidden to him. He had a responsibility to know about 40 deaths on his watch. If he didn’t, it was because he chose not to know.

In spite of that, I do not want Secretary Eric Shinseki to resign. I want to see him fired. He does not deserve the dignity of being allowed to resign. If the President wants to show any conviction regarding the state of our VA hospitals, he needs to step up to the plate and get rid of Shinseki loudly and publicly.

It isn’t enough for Eric Shinseki that we send these young men and women to battle fields to risk their lives for our freedom. It doesn’t matter to Eric Shinseki that a good many of these same men and women who make it back home are permanently scarred or broken because of the battles they fought for him. The only thing that matters to Eric Shinseki is that he doesn’t look bad in the press. He fires a couple of people and assumes the situation will go away because that is how narcissists handle problems. They blame everyone else and sever ties with those that do not reinforce their inflated self image. I would have had so much more respect for the man if he was as horrified as I was about the delays and set about working towards a solution instead of defending his image. He should have stuck with making bad decisions about army fashion.

The toll-free number for the Veterans’ Benefits Office is 1-800-827-1000.

You can also go here to contact your elected officials and most government agencies. I am running very short on time this week but I will take the time to email everyone I can about this. I hope you do, too, because the who have been tasked with taking care of our veterans are an embarrassment to the United States.

Your comments are most welcome. Please feel free to include a link to this post in your correspondence if you agree with it. If you know anything that I don’t know, please share.