Shay said, “It’s not just that they cost less. They’re better. People prefer them. They prefer to stay at their home and have someone drop in a few hours a day compared to their having to leave their home and be in an institution. And ironically it’s much cheaper to have somebody stop in to provide care. Let’s say you have your own home but you can’t clean and cook anymore. Somebody can come in two hours a day, prepare a couple of meals for you and make sure your house is clean, and that’s all the difference between your staying in the house healthy or going into an institution, and it costs a third as much. That sounds like a win-win. That’s exactly what goes on – not just with the VA but for management of dependent persons in the general population.”
“They prefer to stay at their home and have someone drop in a few hours a day compared to their having to leave their home and be in an institution.”
The mission of the GRECCs consists in large part of keeping families together and aged veterans within their own homes as long as possible. Availability of vacant beds within health care settings often means people go home “sicker and quicker” than in past decades, both within and without the VHA community. The GRECCs developed an impressive array of services to better handle the needs of elderly veterans, many so innovative and effective that they have been adopted by private-sector health systems.
Alyce Dixon served in the Army between 1943 and 1945. The fiesty former corporal is the oldest resident at the Washington D.C. VA Medical Center and keeps those around her in stitches with her jokes and stories. DoD photo by Samantha Quigley
When an aging veteran can no longer live alone in his or her home and needs more than short-term periodic help, a family member usually becomes the caregiver for the aging parent, often (even usually) to her own detriment. It’s an enormous responsibility and amount of work to care for an elderly family member. Early on, GRECCs recognized the importance of taking care of the caregiver, and developed several strategies that have been widely adopted in private-sector health care.
Respite care plays a central role in preserving the health and well-being of the caregiver. Whether it’s a few hours per week that allow a spouse to go shopping or keep a personal doctor’s appointment or a two-week vacation that allows the caregiver an opportunity to “recharge the batteries,” the GRECCs respite program is an integral part of keeping an elderly veteran in his or her own home.
In many cases, the veteran’s primary caregiver has employment outside the home in addition to taking care of a parent. While an aging veteran may be quite capable of staying alone during the day and only needs help bathing and getting in and out of bed, another may need constant monitoring. This is especially true of elderly veterans suffering from Alzheimer’s or other cognitive impairment.
While an aging veteran may be quite capable of staying alone during the day and only needs help bathing and getting in and out of bed, another may need constant monitoring.
Adult day health care takes some of the pressure off the caregiver, allowing him or her to remain in the workforce, thereby preserving the integrity of the veteran’s home. While many health care systems make some provision for adult day care, Shay said GRECC goes one step further. “Adult day health care is basically daycare for an adult. But it’s a little bit ramped up from the adult daycare that’s available in the community because elderly veterans have a higher rate of other health care needs, whether it’s insulin injection during the day or a carefully controlled diet or the need to accommodate someone with vision problems. So in VA adult day health care, health professionals take care of the group of adults, as well as providing supervision, companionship, recreation, and activities. People get involved in gardening, in reminisce with other veterans, sometimes about wartime but also about life experiences.”
Providing health services within the home is yet another GRECC initiative aimed at delivering care to veterans with a minimum disruption to daily life. Home-based primary care brings the expertise of physicians, nurses, therapists, and pharmacists to veterans who may otherwise be too frail to travel or who lack the means to reach a clinic easily.
In essence, GRECC prides itself on its patient-centric outlook, using whatever means necessary to best meet the needs of its aging warriors. Its exemplary care functions as a powerful recruitment and retention tool as well. “We often interview former trainees who are now the occupational therapists and the nurses who are staff at the hospital, and they always say, ‘I really hoped when I was in training at the GRECC that I could stay here because I love how the VA takes care of old people,’” Shay said.