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Getting to Know Veterans: Knowledge to Improve Care at End of Life

Shannon Pointer MSN, RN

Community Educator

Hospice & Palliative Care Center of Alamance-Caswell

Innovation and Excellence in Advanced Illness at End of Life 41st Annual Hospice & Palliative Care Conference – September 2017 – Asheville, NC

What Will I Learn?

• This Session Will Provide:

– An Overview of The US Armed Forces, America’s Wars as well as Agencies and Organizations that can help improve your ability to care for Veterans at End of Life.

• Review and be able to name resources available to view national and local statistics on Veteran populations.

• Define the branches of US Armed Forces.

• Review America’s Wars and be able to discuss differences between certain war time periods.

Innovation and Excellence in Advanced Illness at End of Life The Carolinas Center’s 41st Annual Hospice & Palliative Care Conference – September 2017 – Asheville, ,NC

What Will I Learn?

• Identify some inappropriate and appropriate communication strategies with Veterans as well as ways to conduct a self-assessment related to military culture.

• Identify and gain a better understanding of the Department of Veterans Affairs.

• Identify Veteran resources and organizations available in the community.

• Define the We Honor Veterans Program

Innovation and Excellence in Advanced Illness at End of Life

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National Statistics

• Veteran Population projections

– Projected Population 21,368,000 Veterans

Question - How do you find national statistics on Veterans?

Answer - The National Center for Veteran Analysis and Statistics


Reference: US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2017). VA benefits and healthcare utilization pocket card. Retrieved from https://www.va.gov/vetdata/docs/pocketcards/Spring_17_Sharepoint.PDF

Future Trends Nationally?

• Veteran population is declining

• Expected increase in Minority and Hispanic Veteran populations

• Decrease in WWI, Korean and Vietnam Era Veterans and increase in Gulf War Veterans

• Veterans moving to the West and South


Reference: US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2017). The Veteran Population Projection Model 2016 (VetPop2016) VetPop2016 infographic. Retrieved from https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/Vetpop_Infographic_Final26.pdf

State Statistics: NC


North Carolina Veteran Population FY 2016

Total: 731,378

WarTime Veterans: 567,157

Gulf War: 294,564

Vietnam Era: 233,717

Korean Conflict: 45,516

References: US Department of Veteran Affairs: VA National Center for Veteran Analysis and Statistics. (2016). Veteran population fiscal year 2016. Retrieved from www.va.gov/vetdata/veteran_population.aspUS Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2015). North Carolina state summary. Retrieved from http://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_North_Carolina.pdf

North Carolina Veteran Population FY 2016

WWII: 18,095

Peacetime: 164,221

Female: 80,382

Male: 650,996

https://www.va.gov/vetdata/

https://www.va.gov/vetdata/docs/pocketcards/Spring_17_Sharepoint.PDF

https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/Vetpop_Infographic_Final26.pdf

http://www.va.gov/vetdata/veteran_population.asp

http://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_North_Carolina.pdf

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State Statistics: SC


South Carolina Veteran Population FY 2016

Total: 403,948

WarTime Veterans: 318,926

Gulf War: 156,696

Vietnam Era: 142,111

Korean Conflict: 26,381

References: US Department of Veteran Affairs: VA National Center for Veteran Analysis and Statistics. (2016). Veteran population fiscal year 2016. Retrieved from www.va.gov/vetdata/veteran_population.aspUS Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2015). South Carolina state summary. Retrieved from https://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_South_Carolina.pdf

South Carolina Veteran Population FY 2016

WWII: 10,578

Peacetime: 85,022

Female: 41,802

Male: 362,146

State Resources: NC and SC

• UNC Carolina Population Center: Carolina Demography. (2014). Data snapshot: North Carolina veterans. Retrieved from

https://demography.cpc.unc.edu/2014/11/10/nc-veterans-2013-data-snapshot/• North Carolina Military and Veterans Affairs. (2015). 2015 NC

veterans annual report. Retrieved fromhttps://ncdmva.s3.amazonaws.com/s3fs-public/press-release/files/2015-ar-final-download_1.pdf• The South Carolina Division of Veterans Affairs Websitehttp://va.sc.gov/index.html• The South Carolina Military and Veteran Services Websitehttp://www.sc.gov/Government/Pages/militaryAndVeteranServices.aspx


Local Statistics (2011-2015)


Location Veterans (2011-2015)

Alamance County, NC 10,096

Caswell County, NC 1,682

Durham County, NC 15,811

Orange County, NC 5,953

Charleston (city), SC 9,124

North Carolina 696,119

South Carolina 378,959

United States 20,108,332Reference: US Census QuickFacts. Veterans, 2011-2015. Retrieved from https://www.census.gov/quickfacts/table/PST045216/00


https://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_South_Carolina.pdf

https://demography.cpc.unc.edu/2014/11/10/nc-veterans-2013-data-snapshot/

https://ncdmva.s3.amazonaws.com/s3fs-public/press-release/files/2015-ar-final-download_1.pdf

http://va.sc.gov/index.html

http://www.sc.gov/Government/Pages/militaryAndVeteranServices.aspx

https://www.census.gov/quickfacts/table/PST045216/00

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Who Is In Charge?

Pre

sid

ent

Secretary DoD Pentagon

Every time zone and every climate!

References: US Department of Defense. (2017). About the department of defense (DoD). Retrieved from http://www.defense.gov/About-DoDMilitary.com. (2016). U.S. armed forces overview. Retrieved from http://www.military.com/join-armed-forces/us-military-overview.html

DoD Headquarters

Military Branches


DOD

Dept. of the ArmyArmy

Army Chief of Staff

Dept. of the Air Force

Air Force

Air Force Chief of Staff

Dept. of the Navy

Navy

Chief of Naval Operations

Marines Commandant of

the Marine Corps

Coast GuardDept. of Homeland Security

Reference: US Department of Veterans Affairs: VA Mental Health. (2017). Community provider toolkit Understanding military culture structure & branches. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/structure_branches.pdf

Categoriess

• Active Duty• Reserve Forces• Guard Forces• Veterans

• Military Retirees• POW/MIA

Others to Remember• Family Members

• Friends• Employers


http://www.defense.gov/About-DoD

http://www.military.com/join-armed-forces/us-military-overview.html

http://www.mentalhealth.va.gov/communityproviders/docs/structure_branches.pdf

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Ranks

• Ranks

–Enlisted

–Non Commissioned

–Warrant Officer

–Commissioned Officer


References: -US Department of Veterans Affairs: VA Mental Health. (2017). Community provider toolkit: ranks.Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/ranks.pdf-US Department of Defense. (2017). The United States military rank insignia. Retrieved from http://www.defense.gov/About-DoD/Insignias

Abbreviations/Medals

• Abbreviations

• Medals– Question: Can you name some types of military

medals?


Reference: US Department of Veterans Affairs. (2016). National Cemetery Administration. Branch of service abbreviations. Retrieved from http://www.cem.va.gov/CEM/docs/abbreviations/Branch_of_Service.pdf

Medals


Quiz Time!

http://www.mentalhealth.va.gov/communityproviders/docs/ranks.pdf

http://www.defense.gov/About-DoD/Insignias

http://www.cem.va.gov/CEM/docs/abbreviations/Branch_of_Service.pdf

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Army, Army Reserve and Army National Guard

• Established: June 14, 1775

• Call Them: Soldiers

• What they do: The dominant land power – land operations, logistics and supports other branches

• Motto: “This We’ll Defend”

• “I’ll Try Sir”

• Song: “The Army Goes Rolling Along”


References: The United States Army. (2017). Retrieved from https://www.army.mil/US Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from http://www.va.gov/opa/publications/celebrate/militarysongs.pdfUS Department of Veterans Affairs: VA Mental Health. (2016). Expression of values and ideals by service branch. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

Navy and Navy Reserve

• Established: October 13, 1775

• Call them: Sailors

• What they do: Maintain freedom of the seas, deter aggression

• Motto: “Semper Fortis, Always Courageous” also “Non sibi sed patriae" (Not self but country)” (unofficial)

• Song: Navy March “Anchors Aweigh” and Navy Hymn “Eternal Father, Strong to Save”


References: The United States Navy. (2017). Retrieved from http://www.navy.mil/US Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from http://www.va.gov/opa/publications/celebrate/militarysongs.pdfUS Department of Veterans Affairs: VA Mental Health. (2017). Expression of values and ideals by service branch. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

Marines and Marine Corps Reserves

• Established: November 10th 1775

• Call them: Marines

• What they do: Disciplined warrior - Trained first as a rifleman

• Motto: Semper Fidelis “Always Faithful”

• Song: “The United States Marine Corps Hymn”


References: The United States Marine Corps. (2017). Retrieved from http://www.marines.mil/The United Sates Marine Corps. (2017). Retrieved from http://www.marines.com/homeUS Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from http://www.va.gov/opa/publications/celebrate/militarysongs.pdfUS Department of Veterans Affairs: VA Mental Health. (2017). Expression of values and ideals by service branch. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

https://www.army.mil/

http://www.va.gov/opa/publications/celebrate/militarysongs.pdf

http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

http://www.navy.mil/



http://www.marines.mil/

http://www.marines.com/home



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Coast Guardand Coast Guard Reserve

• Established: August 4th, 1790

• Call them: Coast Guardsman

• What they do: Maritime safety, maritime security, maritime stewardship

• Motto: Semper Paratus “Always Ready”

• Song: “The Coast Guard Marching Song”


References:The United States Coast Guard. (2017). Retrieved from http://www.uscg.mil/US Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from http://www.va.gov/opa/publications/celebrate/militarysongs.pdfUS Department of Veterans Affairs: VA Mental Health. (2017). Expression of values and ideals by service branch. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

Air Force, Air Force Reserve,

Air National Guard


References:The United States Air Force. (2017). Retrieved from http://www.af.mil/The United States Air Force. (2017). Retrieved from https://www.airforce.com/US Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from http://www.va.gov/opa/publications/celebrate/militarysongs.pdfUS Department of Veterans Affairs: VA Mental Health. (2017). Expression of values and ideals by service branch. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf

• Established September 18th, 1947

• US military first aircraft purchase: 1909

– Aeronautical Section, Signal Corps (1909)

– Aviation Section, Signal Corps (1914)

– United States Army Air Service (1918)

– United States Army Air Corps (1926)

– United States Army Air Forces (1941)

• CALL THEM: AIRMEN

• WHAT THEY DO: AIR AND SPACE

• MOTTO: “AIM HIGH … FLY-FIGHT-

WIN”

• SONG: “US AIR FORCE”

Military Health History

• Military Health History Pocket Card


References: US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Military health history pocket card for clinicians. Retrieved from https://www.va.gov/oaa/pocketcard/default.asp

http://www.uscg.mil/



http://www.af.mil/

https://www.airforce.com/



https://www.va.gov/oaa/pocketcard/

https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdf

https://www.va.gov/oaa/pocketcard/default.asp

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America’s Wars Resource

• Reference:

US Department of Veterans Affairs. (2017). Americas wars. Retrieved from http://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf


WWII (1941-1945)

References: Defense Casualty Analysis System (DCAS). (2017). Conflict casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtmlUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). World War II. Retrieved from https://www.va.gov/oaa/pocketcard/worldwar.asp?p=6


Korean War (1950-1953)

References: Defense Casualty Analysis System (DCAS). (2017). Conflict casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtmlUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Korean War. Retrieved from https://www.va.gov/oaa/pocketcard/korea.asp?p=5


http://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf

https://www.dmdc.osd.mil/dcas/pages/casualties.xhtml


https://www.va.gov/oaa/pocketcard/worldwar.asp?p=6



https://www.va.gov/oaa/pocketcard/korea.asp?p=5

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Cold War

References: US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Cold War. Retrieved from https://www.va.gov/oaa/pocketcard/coldwar.asp?p=4


Vietnam (1964-1975)

References: Defense Casualty Analysis System (DCAS). (2017). Conflict casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtmlUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Vietnam War. Retrieved from https://www.va.gov/oaa/pocketcard/vietnam.asp?p=3


Desert Shield/Desert Storm –

Persian Gulf War (1990-1991)

References: Defense Casualty Analysis System (DCAS). (2017). Conflict casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtmlUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdf US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Gulf War. Retrieved from https://www.va.gov/oaa/pocketcard/gulfwar.asp?p=2



https://www.va.gov/oaa/pocketcard/coldwar.asp?p=4



https://www.va.gov/oaa/pocketcard/vietnam.asp?p=3


https://www.va.gov/oaa/pocketcard/gulfwar.asp?p=2

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Other Wars• Global War on Terror (October 2001 - )

• Overseas Contingency Operations (OEF, OIF, OND, OIR & OFS Combined)

• Operation Iraqi Freedom (OIF)

• Operation New Dawn (OND)

• Operation Enduring Freedom (OEF)

• Operation Inherent Resolve (OIR)

• Operation Freedom's Sentinel (OFS)


Reference:Defense Casualty Analysis System (DCAS). (2017). Conflict casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtmlUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history: Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdfUS Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. Retrieved from https://www.va.gov/oaa/pocketcard/oefoif.asp?p=1

Effective Communication

• Ask permission to discuss military service

– Don’t be afraid to ask, just make sure the Veteran wants to discuss their military history with you.

– Do not assume that they want to share – ASK FIRST!

• Thank you for your SERVICE!

• Welcome Home!

• Most Important – LISTEN!


References: The Story. (2016). Things to say and not to say to a vet. Retrieved from http://www.thestory.org/things-say-and-not-say-vetOperation We Are Here. (2015). Insights in caring. Retrieved from http://www.wehonorveterans.org/sites/default/files/public/THINGS_YOU_SHOULD_AVOID.pdf

Ineffective Communication

• Questions about whether or not they killed someone

• Questions about what they saw: “Did you see anything gross or nasty?”

• Statements about being glad they are “home” or asking if they are glad to be “home”

• Offering prayer without permission/request from the Veteran

• Why did you go there?

• Was it worth it?

• Others?


Reference: Operation We Are Here. (2015). Insights in caring. Retrieved from http://www.wehonorveterans.org/sites/default/files/public/THINGS_YOU_SHOULD_AVOID.pdf



https://www.va.gov/oaa/pocketcard/oefoif.asp?p=1

http://www.thestory.org/things-say-and-not-say-vet

http://www.wehonorveterans.org/sites/default/files/public/THINGS_YOU_SHOULD_AVOID.pdf


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Other Factors to Consider• PTSD at End of Life:

– References: • Scott Janssen, MSW, LCSW. (2017, August 17). PTSD can happen at the end

of life. Retrieved from http://www.kevinmd.com/blog/2017/08/ptsd-can-happen-end-life.html

• National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint (NCTIC). (2017). Retrieved from https://www.samhsa.gov/nctic

• PTSD: National Center for PTSD. (2017). Retrieved from https://www.ptsd.va.gov/

• Sounds - Think about how sounds could impact a Veteran:– Popping popcorn– Dropping phone on desk– Fireworks– Others?

• Self Assessment – Reference: Uniformed Services University Center for Deployment Psychology. (2016). Self awareness exercise. Retrieved from http://deploymentpsych.org/self-awareness-exercise


Veteran Agencies

• US Department of Veterans Affairs

• ADMINISTRATION

– Veterans Health Administration (VHA)

– Veterans Benefits Administration (VBA)

– National Cemetery Administration (NCA)


Reference: US Department of Veterans Affairs. (2017). US Department of Veterans Affairs. Retrieved from http://www.va.gov/US Department of Veterans Affairs. (2017). US Department of Veterans Affairs About VA. Retrieved from http://www.va.gov/landing2_about.htm

Getting to Know Veterans

• It’s All About Relationships!


http://www.kevinmd.com/blog/2017/08/ptsd-can-happen-end-life.html

https://www.samhsa.gov/nctic

https://www.ptsd.va.gov/

http://deploymentpsych.org/self-awareness-exercise

http://www.va.gov/

http://www.va.gov/

http://www.va.gov/landing2_about.htm

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NC Resources Veteran Service Officers (VSO)

• NC Department of Military & Veterans Affairs

– Veteran Service Officers

• Local Veteran Service Office contact sheet

• Veteran representatives in Congress and Senate


Reference: North Carolina Military and Veteran Affairs. (2016). Veterans affairs. Retrieved from http://www.milvets.nc.gov/landing-page/veterans-affairs

Veteran Organizations

• VFW - https://www.vfw.org/

• American Legion - http://www.legion.org/

• Marine Corp League - http://www.ncmcl.org/

• Montford Point Marines - http://www.montfordpointmarines.com/

• DAV - https://www.dav.org/

• Others:

– Community Colleges

– Goodwill

– Register of Deeds

– Dreams for Veterans

– Veterans Oral History Project

– Others?


Survivor Resources

• Contact information for the Office of Survivors Assistance:

– Mail: Department of Veterans Affairs; Office of Survivors Assistance; 1717 H Street NW; Washington, DC 20006

– Phone: 202-461-1077

– Fax: 202-495-5985

– Website: www.va.gov/survivors/

– Email: [email protected]


http://www.milvets.nc.gov/landing-page/veterans-affairs

https://www.vfw.org/

http://www.legion.org/

http://www.ncmcl.org/

http://www.montfordpointmarines.com/

https://www.dav.org/

http://www.va.gov/survivors/

mailto:[email protected]

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VA Caregiver Support

• https://www.caregiver.va.gov/

– Durham VA Medical Center508 Fulton Street, Durham, NC 27705Phone: 919-286-0411 Or 888-878-6890

Gretchen Horton, MSW, LCSW : 919-695-2432Jasmine Moore, RN: 919-417-6349 Jency Brogden, MSW, LCSW: 919-384-6208


We Honor Veterans

• Recruit

• Level 1 – Military History Checklist

• Level 2

• Level 3

• Level 4


References: We Honor Veterans. (2017). Retrieved from www.wehonorveterans.orgWe Honor Veterans. (2017). Intake/Admissions: Military history checklist. Retrieved from http://www.wehonorveterans.org/get-practical-resources/resources-topic/intakeadmissionWe Honor Veterans. (2017). We honor veterans campaign fact sheet. Retrieved fromhttp://www.wehonorveterans.org/sites/default/files/public/WHVeteransFactSheet.pdfWe Honor Veterans. (2010). Standards of practice for hospice programs veteran related standards. Retrieved from https://www.wehonorveterans.org/sites/default/files/public/Vet_Related_Standards_Practice.pdf

How Can We Honor Veterans?

• Appreciation Ceremonies

• Medal Ceremonies

• Pinning

• Wall of Honor

• What else can we do to honor Veteran hospice patients in homes, facilities, hospice home, as well as all Veterans within our communities?


https://www.caregiver.va.gov/

http://www.durham.va.gov/

http://www.wehonorveterans.org/

http://www.wehonorveterans.org/get-practical-resources/resources-topic/intakeadmission

http://www.wehonorveterans.org/sites/default/files/public/WHVeteransFactSheet.pdf

https://www.wehonorveterans.org/sites/default/files/public/Vet_Related_Standards_Practice.pdf

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Honoring Veterans Examples


See Slideshow photos during live presentation!

Veterans and ACD

• Help Veterans to Express Their Wishes! • VA Advance Directives• Non-VA Advance Directives

Reference: US Department of Veterans Affairs. (2017). Geriatrics and extended care advance care planning. Retrieved from https://www.va.gov/GERIATRICS/Guide/LongTermCare/advance_Care_Planning.asp


References

Please see reference sheet handout for all references used in the development of this

educational activity.


https://www.va.gov/GERIATRICS/Guide/LongTermCare/advance_Care_Planning.asp

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Contact Information

Shannon Pointer MSN, RN Community EducatorHospice & Palliative Care Center of Alamance-CaswellOffice: 336-532-0100 Cell: 336-264-9387 Email: [email protected]

“I would like to especially thank all of the We Honor Veterans planning committee members, all of our community

Veterans and agencies who serve Veterans who helped me to learn more so that I can better serve those who served us!”



-

As of 4/25/2017

To help a Veteran in crisis, call the 24 hour Crisis Hotline at 1-800-273-8255 option 1

“HOW CAN I HELP YOU?” VA Facility Locator

VA Facility Locator VA facilities including additional state and local resources

Information available at: www.va.gov/landing2_locations.htm

Transition and Veteran Employment Services

Veterans Employment Services Office (VESO)

Helps Veterans and transitioning Military Service Members find federal careers

Military Skills Translator, Resume Builder and Federal Job Search functions

Note: Visit http://explore.va.gov/ to learn about other employment resources provided by VA.

Information available at: www.vaforvets.va.gov 1-855-824-8387

http://explore.va.gov/employment-services

Transition Assistance Program (TAP)

TAP may include: Transition from Service briefings and assistance

Information available at: www.benefits.va.gov/TAP/

Veterans Health Administration

Health Care Benefits or Application Questions

VHA provides: Primary care Mental health care (including Veteran-specific

treatment for PTSD, TBI care, etc.) Preventative care A wide variety of specialty care Inpatient and outpatient pharmacy Geriatric care Long term care and support

Note: For basic information and an easy to understand eligibility quiz with digital resource links go to: http://explore.va.gov/.

Program Information: www.va.gov/healthbenefits/ 1-877-222-VETS (8387)

Eligibility Information: www.va.gov/healthbenefits/apply/veterans.asp

How to Apply: www.vets.gov/healthcare/apply/application/introduction

Application and General Information available at: http://explore.va.gov/health-care provides basic information to Veterans and their families and directs them to the latest online information and application sites. The site’s video gallery holds Veteran testimonial videos about health care.

Access to Patient Medical information

My HealtheVet is VA’s online personal health record system designed to help VA patients manage their healthcare records and notes from medical providers

Blue Button allows you to share info between VA and non VA providers.

Information for both resources available at: www.myhealth.va.gov/index.html 1-877-327-0022

Women Veteran Support

The Women Veterans Health Program addresses health care needs of women Veterans to ensure that timely, equitable, high-quality, comprehensive health care services are available and provided

Information available at: www.womenshealth.va.gov Women Veterans Call Center: 1-855-VA-WOMEN (829-6636)

Rural Veteran Support

The VA Office of Rural Health helps rural Veterans access medical care through VA facilities

Information available at: www.ruralhealth.va.gov

Mental Health Support

Authoritative mental health information and resources for Veterans and their families.

Self-help toolbox Where to get help Comprehensive guide to VA Mental Health Services Veterans Crisis Line website has a live chat function

Information available at: www.mentalhealth.va.gov http://maketheconnection.net/ https://www.veteranscrisisline.net/ (includes chat function) Hotline: 800-273-8255 Press 1

Guide to VA Mental Health Services for Veterans and Families: www.mentalhealth.va.gov/docs/MHG_English.pdf

Veteran (Vet) Center information

Vet Centers provide: Individual and group counseling Discharge upgrade information Community, social service and medical referrals Employee assistance referrals VA Benefits assistance referrals

Information available at: 1-877-WAR-VETS (927-8387)

Locate a Vet Center near you at: www.va.gov/directory/guide/vetcenter.asp

Caregiver Support Program

Caregiver Support provides: Links and resources for caregivers of Veterans Additional support for Caregivers of Veterans with

service connected injuries incurred on or after 911 Phone based support and education

Information available at: www.caregiver.va.gov

Caregiver support line: 1-855-260-3274

Homeless Veteran Immediately call the 24-hour National Call Center for Homeless Veterans 1-877-4AID-VET (4243-838)

For information about VA Health Care, call the VHA Helpline: 1-877-222-VETS (8387) Monday Friday 8am-8pm EST*

*Call back service may be available after hours

-

To help a Veteran in crisis, call the 24 hour Crisis Hotline at 1-800-273-8255 option 1

As of 05/25/2016

“HOW CAN I HELP YOU?” Veterans Benefits Administration

Benefits Information Basic information about programs, eligibility, links to Information available at: & Eligibility online application sites, testimonial videos, and an easy www.benefits.va.gov/benefits/ Questions to understand eligibility quiz with digital resource links

are available on http://explore.va.gov/ A hardcopy and online handbook is available for

benefits and qualifications information Further benefits and eligibility information is available at

ebenefits.va.gov

1-800-827-1000

http://explore.va.gov/

Benefits Handbook: www.va.gov/opa/publications/benefits_book.asp

Benefits Applications Information, forms, and phone numbers are available All forms and applications available at: & Claim Questions online for Veterans and their dependents

Links to online application sties and other online resources where Veterans can get answers are on http://explore.va.gov/.

www.ebenefits.va.gov/

Videos that explain how to fill out select forms: www.benefits.va.gov/BENEFITS/videos.asp

Home Loan Guaranty Program Questions

or Payment on a VA-Provided Home Loan

VA guarantees loans made by private lenders. The VA provides Specially Adapted Housing (SAH) grants for severely disabled Veterans

Note: VHA provides HISA grants to eligible Veterans for use in modifying a home. These are smaller grants.

All forms and information available at: www.benefits.va.gov/homeloans/index.asp 1-877-827-3702

http://explore.va.gov/home-loans-and-housing

Vocational The VR&E program provides: Information available at: Rehabilitation and Assistance in finding employment with programs such www.benefits.va.gov/vocrehab Employment (VR&E) as vocational assessments, counseling, education Information tuition/stipends related to employment and employment

planning Note: Links to VR&E as well as other employment resources can be found on http://explore.va.gov/

http://explore.va.gov/employment-services

Education and Post- The post-9/11 GI Bill pays higher education tuition, Information available at: 9/11 GI Bill Benefits housing, and stipends for Veterans, service members

or their dependents Eligibility - served at least 90 days on active duty after

9/10/2001 An important starting point - GI Bill Comparison Tool

www.benefits.va.gov/gibill/ 1-888-GIBILL-1 (442-4551)

http://explore.va.gov/education-training www.vets.gov/gi-bill-comparison-tool

Pension Pension benefits descriptions, eligibility, and application forms are available online.

Basic info, forms and links to resources for Veterans Pensions, Survivors Pension and Special Monthly Pension for Veterans on http://explore.va.gov/.

Information available at:

www.benefits.va.gov/pension/

http://explore.va.gov/pension

Fiduciary Program for Veterans and other beneficiaries who, due to injury, disease, or due to age, are unable to manage their financial affairs

Apply for benefit or to become a fiduciary for a Veteran

Information available at:

www.benefits.va.gov/fiduciary

Insurance and Veterans are eligible for: All forms and information available at: TSGLI/SGLI Service-Disabled Veterans Insurance (S-DVI), Service www.benefits.va.gov/insurance Questions members’ Group Life Insurance (SGLI), Veterans’

Group Life Insurance (VGLI), and/or Veterans’ Mortgage Life Insurance (VMLI), SGLI Traumatic Injury Protection (TSGLI), Servicemembers’ Group Life Insurance Disability Extension (SGIL-DE), Family Servicemembers’ Group Life Insurance (FSGLI),

1-800-419-1473

http://explore.va.gov/life-insurance

Disability Disability compensation is a tax-free benefit paid to All forms and information available at: Compensation eligible Veterans www.benefits.va.gov/compensation/types-disability.asp Questions Eligibility is determined by injuries/diseases

from/aggravated by service http://explore.va.gov/disability-compensation

Dependency & Dependents may be awarded tax-free benefits for: All forms and information available at: Indemnity Death during military service or post-service related to www.benefits.va.gov/compensation/types-Compensation for a service-connected disability dependency_and_indemnity.asp Veteran’s Death after extended period of 100 percent disability Dependents Note: Links and information to VA benefits and services

available to dependents, survivors and spouses are available on http://explore.va.gov/. DIC is just one of many benefits available to this group

http://explore.va.gov/spouses-dependents-survivors

For information about benefits, call the VBA Hotline: 1-800-827-1000 Monday Friday 8am-9pm EST* *Call back service may be available after hours

As of 05/25/2016

“HOW CAN I HELP YOU?”

National Cemetery Administration

Burial and Memorial Benefits Information

VA offers Veterans and their dependents: Burial and honoring services, including gravesites and

grave liners Maintenance of national cemeteries Headstones, markers, and presidential memorial

certificates Note: VBA manages additional memorial benefits

Information available at: www.cem.va.gov 1-800-535-1117

Application and benefit information about both VBA and NCA managed memorial benefits available at: http://explore.va.gov/.

Board of Veterans Appeals

Claims Appeal Process information

A Veteran or dependent/caregiver has a full year to appeal a denied claim regarding any VA benefit. To appeal, file a Notice of Disagreement with the Administration that denied the benefit

The appeals process has many stages, and most of the appeals processing and resolutions take place in the Administration that made the initial claims decision

Information available at: www.bva.va.gov

Appeal Process Pamphlet: www.bva.va.gov/docs/Pamphlets/How-Do-I-Appeal-Booklet--508Compliance.pdf

General VA Resources

Other VA resources To access the VA social media properties go to the VA homepage and click on the icons on the right hand top of the page. Or use the links below.

Links available at: www.va.gov

Facebook https://www.facebook.com/VeteransAffairs

Twitter https://twitter.com/DeptVetAffairs/

Flicker https://www.flickr.com/photos/VeteransAffairs/

Instagram https://www.instagram.com/deptvetaffairs/

Youtube https://www.youtube.com/user/DeptVetAffairs

Vantage Point blog http://www.blogs.va.gov/VAntage/

MyVA blog https://myva.va.gov/blog/

VA Pulse https://www.vapulse.net/welcome

ExploreVA Explore social media content cleared by VA, VHA, VBA and NCA for internal and external sharing

https://explore.va.gov/outreach-sharing

General VA Resources Continued

VA Website www.va.gov

One stop Information Service 1-844-698-2311

VA Benefits Info 1-800-827-1000

VA Health Care Info 1-877-222-VETS (8387)

24-Hour Hotline for Homeless Vets 1-877-4AID-VET (4243-838)

24-Hour Veteran Crisis Hotline 1-800-273-8255 option 1

General VA Information VA Website

1

Getting to Know Veterans: Knowledge to Improve Care at End of Life- List of references used for developing this educational activity:

1. US Department of Veterans Affairs. VA National Center for Veteran Analysis and Statistics. (March, 2017). Profile of veterans: 2015 data from the american community survey. Retrieved from https://www.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2015.pdf.

2. US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2017). VA benefits and healthcare utilization pocket card. Retrieved from https://www.va.gov/vetdata/docs/pocketcards/Spring_17_Sharepoint.PDF

3. US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2017). The Veteran Population Projection

Model 2016 (VetPop2016) VetPop2016 infographic. Retrieved from


4. US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2015). North Carolina state summary. Retrieved from http://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_North_Carolina.pdf

5. US Department of Veteran Affairs: VA National Center for Veteran Analysis and Statistics. (2016). Veteran population fiscal year 2016. Retrieved from www.va.gov/vetdata/veteran_population.asp

6. US Department of Veterans Affairs: VA National Center for Veteran Analysis and Statistics. (2015). South Carolina state summary. Retrieved from https://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_South_Carolina.pdf

7. UNC Carolina Population Center: Carolina Demography. (2014). Data snapshot: North Carolina veterans. Retrieved from https://demography.cpc.unc.edu/2014/11/10/nc-veterans-2013-data-snapshot/

8. North Carolina Military and Veterans Affairs. (2015). 2015 NC veterans annual report. Retrieved from https://ncdmva.s3.amazonaws.com/s3fs-public/press-release/files/2015-ar-final-download_1.pdf

9. The South Carolina Division of Veterans Affairs Website. Retrieved from http://va.sc.gov/index.html 10. The South Carolina Military and Veteran Services Website. Retrieved from

http://www.sc.gov/Government/Pages/militaryAndVeteranServices.aspx 11. United States Census Bureau. (2016). US census quickfacts. Retrieved from https://www.census.gov/quickfacts/table/PST045216/00 12. US Department of Defense. (2017). About the department of defense (DoD). Retrieved from http://www.defense.gov/About-DoD 13. US Department of Veterans Affairs: VA Mental Health. (2016). Community provider toolkit: understanding military culture structure &

branches. Retrieved from http://www.mentalhealth.va.gov/communityproviders/docs/structure_branches.pdf 14. US Department of Veterans Affairs: VA Mental Health. (2016). Chain of command & authority. Retrieved from

http://www.mentalhealth.va.gov/communityproviders/docs/command_authority.pdf 15. US Department of Veterans Affairs: VA Mental Health. (2016). Common terms & lingo. Retrieved from

http://www.mentalhealth.va.gov/communityproviders/docs/terms_lingo.pdf 16. US Department of Veterans Affairs: VA Mental Health. (2016). Community provider toolkit. Retrieved from

http://www.mentalhealth.va.gov/communityproviders/military_culture.asp 17. US Department of Veterans Affairs: VA Mental Health. (2017). Community provider toolkit: ranks. Retrieved from


https://www.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2015.pdf

https://www.va.gov/vetdata/docs/pocketcards/Spring_17_Sharepoint.PDF


http://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_North_Carolina.pdf


https://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_South_Carolina.pdf

https://demography.cpc.unc.edu/2014/11/10/nc-veterans-2013-data-snapshot/

https://ncdmva.s3.amazonaws.com/s3fs-public/press-release/files/2015-ar-final-download_1.pdf

http://va.sc.gov/index.html

http://www.sc.gov/Government/Pages/militaryAndVeteranServices.aspx

https://www.census.gov/quickfacts/table/PST045216/00

http://www.defense.gov/About-DoD

http://www.mentalhealth.va.gov/communityproviders/docs/structure_branches.pdf

http://www.mentalhealth.va.gov/communityproviders/docs/command_authority.pdf

http://www.mentalhealth.va.gov/communityproviders/docs/terms_lingo.pdf

http://www.mentalhealth.va.gov/communityproviders/military_culture.asp


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18. US Department of Veterans Affairs: Integrated Mental Health Strategy. (2017). Retrieved from http://deploymentpsych.org/system/files/member_resource/MCT_Provider_Resources_Military_Rank_Chart.pdf

19. US Department of Veterans Affairs. (2016). National Cemetery Administration. Branch of service abbreviations. Retrieved from


20. US Department of Defense. (2016). The United States military rank insignia. Retrieved from http://www.defense.gov/About-DoD/Insignias

21. The United States Army. (2017). Retrieved from https://www.army.mil/ 22. US Department of Veterans Affairs. (2017). Military songs inspire troops, preserve tradition. Retrieved from

http://www.va.gov/opa/publications/celebrate/militarysongs.pdf 23. US Department of Veterans Affairs: VA Mental Health. (2016). Expression of values and ideals by service branch. Retrieved from

http://www.mentalhealth.va.gov/communityproviders/docs/values.pdf 24. Military.com. (2016). U.S. armed forces overview. Retrieved from http://www.military.com/join-armed-forces/us-military-overview.html 25. Military.com. (2016). Guard and reserve frequently asked questions. Retrieved from http://www.military.com/join-armed-forces/guard-

and-reserve-faqs.html 26. The United States Navy. (2017). Retrieved from http://www.navy.mil/

27. The United States Marine Corps. (2017). Retrieved from http://www.marines.mil/ 28. The United Sates Marine Corps. (2017). Retrieved from http://www.marines.com/home 29. The United States Coast Guard. (2017). Retrieved from http://www.uscg.mil/ 30. The United States Air Force. (2017). Retrieved from http://www.af.mil/ 31. The United States Air Force. (2017). Retrieved from https://www.airforce.com/ 32. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (April, 2017). Military health history:

Pocket card for health professions, trainees & clinicians. Retrieved from https://www.va.gov/OAA/archive/Military-Health-History-Card-for-print.pdf

33. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Military health history pocket card for clinicians. Retrieved from https://www.va.gov/oaa/pocketcard/default.asp

34. US Department of Veterans Affairs. (2017). Americas wars. Retrieved from (http://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf

35. Defense Casualty Analysis System (DCAS). (2017). Conflict Casualties. Retrieved from https://www.dmdc.osd.mil/dcas/pages/casualties.xhtml

36. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). World War II. Retrieved from https://www.va.gov/oaa/pocketcard/worldwar.asp?p=6

37. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Korean War. Retrieved from https://www.va.gov/oaa/pocketcard/korea.asp?p=5

http://deploymentpsych.org/system/files/member_resource/MCT_Provider_Resources_Military_Rank_Chart.pdf




https://www.army.mil/



http://www.military.com/join-armed-forces/guard-and-reserve-faqs.html

http://www.military.com/join-armed-forces/guard-and-reserve-faqs.html

http://www.navy.mil/

http://www.marines.mil/

http://www.marines.com/home



http://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf


https://www.va.gov/oaa/pocketcard/worldwar.asp?p=6

https://www.va.gov/oaa/pocketcard/korea.asp?p=5

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38. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Cold War. Retrieved from https://www.va.gov/oaa/pocketcard/coldwar.asp?p=4

39. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Vietnam War. Retrieved from 40. https://www.va.gov/oaa/pocketcard/vietnam.asp?p=3 41. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Gulf War. Retrieved from

https://www.va.gov/oaa/pocketcard/gulfwar.asp?p=2 42. US Department of Veterans Affairs: Veterans Health Administration, Office of Academic Affiliations. (2017). Operation Enduring

Freedom/Operation Iraqi Freedom/Operation New Dawn. Retrieved from 43. https://www.va.gov/oaa/pocketcard/oefoif.asp?p=1 44. Operation We Are Here. (2015). Insights in caring. Retrieved from

http://www.wehonorveterans.org/sites/default/files/public/THINGS_YOU_SHOULD_AVOID.pdf 45. The Story. (2016). Things to say and not to say to a vet. Retrieved from http://www.thestory.org/things-say-and-not-say-vet 46. Scott Janssen, MSW, LCSW. (2017, August 17). PTSD can happen at the end of life. Retrieved from

http://www.kevinmd.com/blog/2017/08/ptsd-can-happen-end-life.html 47. National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint (NCTIC). (2017). Retrieved from

https://www.samhsa.gov/nctic 48. PTSD: National Center for PTSD. (2017). Retrieved from https://www.ptsd.va.gov/ 49. Uniformed Services University Center for Deployment Psychology. (2016). Self awareness exercise. Retrieved from

http://deploymentpsych.org/self-awareness-exercise 50. US Department of Veterans Affairs. (2016). US Department of Veterans Affairs. Retrieved from http://www.va.gov/ 51. US Department of Veterans Affairs. (2016). US Department of Veterans Affairs. About VA. Retrieved from

http://www.va.gov/landing2_about.htm 52. US Department of Veterans Affairs. (2017). Veterans Health Administration. Retrieved from http://www.va.gov/health/ 53. US Department of Veterans Affairs. (2017). Veterans Benefits Administration. Retrieved from http://www.benefits.va.gov/benefits 54. US Department of Veterans Affairs. (2017). National Cemetery Administration. Retrieved from https://www.cem.va.gov/ 55. North Carolina Military and Veteran Affairs. (2016). Veterans affairs. Retrieved from http://www.milvets.nc.gov/landing-page/veterans-

affairs 56. Veterans of Foreign Wars. Retrieved from https://www.vfw.org/ 57. The American Legion. Retrieved from http://www.legion.org/ 58. National Montford Point Marine Association. Retrieved from http://www.montfordpointmarines.com/ 59. Department of North Carolina Marine Corps League. Retrieved from http://www.ncmcl.org/ 60. Disabled American Veterans. Retrieved from https://www.dav.org/ 61. Dreams for Veterans. Retrieved from www.dreamfoundation.org/veterans 62. NC Veterans Oral History Project. Retrieved from http://www.ncvetoralhistory.org/about-1.html 63. Office of Survivor Assistance. Retrieved from https://www.caregiver.va.gov/

https://www.va.gov/oaa/pocketcard/coldwar.asp?p=4

https://www.va.gov/oaa/pocketcard/vietnam.asp?p=3

https://www.va.gov/oaa/pocketcard/gulfwar.asp?p=2

https://www.va.gov/oaa/pocketcard/oefoif.asp?p=1


http://www.thestory.org/things-say-and-not-say-vet

http://www.kevinmd.com/blog/2017/08/ptsd-can-happen-end-life.html

https://www.samhsa.gov/nctic

https://www.ptsd.va.gov/



http://www.va.gov/

http://www.va.gov/landing2_about.htm

http://www.va.gov/health/

http://www.benefits.va.gov/benefits

https://www.cem.va.gov/



https://www.vfw.org/

http://www.legion.org/

http://www.montfordpointmarines.com/

http://www.ncmcl.org/

https://www.dav.org/

http://www.dreamfoundation.org/veterans

http://www.dreamfoundation.org/veterans

http://www.ncvetoralhistory.org/about-1.html


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64. Durham VA Medical Center. Retrieved from https://www.durham.va.gov/ 65. VA Caregiver Support. Retrieved from https://www.caregiver.va.gov/ 66. We Honor Veterans. (2017). Retrieved from www.wehonorveterans.org 67. We Honor Veterans. (2017). Intake/Admissions: Military history checklist. Retrieved from http://www.wehonorveterans.org/get-

practical-resources/resources-topic/intakeadmission 68. We Honor Veterans. (2017). We honor veterans campaign fact sheet. Retrieved from

http://www.wehonorveterans.org/sites/default/files/public/WHVeteransFactSheet.pdf 69. We Honor Veterans. (2010). Standards of practice for hospice programs veteran related standards. Retrieved from

https://www.wehonorveterans.org/sites/default/files/public/Vet_Related_Standards_Practice.pdf 70. US Department of Veterans Affairs. (2017). Geriatrics and extended care advance care planning. Retrieved from

https://www.va.gov/GERIATRICS/Guide/LongTermCare/advance_Care_Planning.asp Other References: - DVAMC Contact Info Sheet 2017 - Veteran Service Officer Sheets Example - NC Veteran Resource Guide 2017 -VA “How Can I Help You” Sheet





http://www.wehonorveterans.org/sites/default/files/public/WHVeteransFactSheet.pdf

https://www.va.gov/GERIATRICS/Guide/LongTermCare/advance_Care_Planning.asp

Military Health History

General Questions

Sexual Harassment, Assault, and Trauma

Compensation & Benefits

Call VA at 1-800-827-1000 or 844-MyVA311 (698-2311)Office of Academic Affiliations

www.va.gov/oaa/pocketcard/

Post-DeploymentHealth Services

www.publichealth.va.gov/about/postdeploymenthealth/

Veterans Health InitiativeIndependent Study Courses

www.publichealth.va.gov/healthinitiative/

War-Related Illness andInjury Study Center

www.warrelatedillness.va.gov

Information for Veterans:Compensation & Pension Benefits

www.benefits.va.gov/compensation/

Living Situation

Living Situation

“I had some unique experiences while serving our country, many that civilians would never have. Some of those experiences may be affecting my health, and that

is why I am here at VA.”

“Help me understand my medical condition, and

please be patient with me. Some of my memories may be painful or difficult to discuss.”

Do you have a service-connected condition?Would you like assistance in filing for compensationfor injuries/illnesses related to your service?

Would it be ok if I talked with you about your military experience? When and where did you/do you serve and in what branch?What type of work did you/do you do while in the service?Did you have any illnesses or injuries while in the service?

Would it be ok to talk about sexual harassment or trauma thatyou might have experienced? Have you ever experienced physical, emotional, or sexual harassment or trauma?Is this past experience causing you problems now?Would you like a referral for some help with that? Many people find it helpful to get some support.

Would it be ok to talk about your living situation? Where do you live and who do you live with? Is your housing safe?Are you in any danger of losing your housing?Do you need assistance in caring for yourself and/or dependents?

POCKET CARD FOR HEALTH PROFESSIONS TRAINEES & CLINICIANS

“Help me understand my medical condition.”

Asking the questions on this card will be helpful inunderstanding my medical problems and concerns.

“Can you tell me more about that?”

If your patient answers “Yes” to any of the following questions, ask:

Did you ever become ill while you were in the service?Were you or a buddy wounded, injured, or hospitalized?Did you have a head injury with loss of consciousness,loss of memory, “seeing stars” or being temporarily disoriented?Did you see combat, enemy fire, or casualties?Were you a prisoner of war?

Veterans Health AdministrationOffice of Academic Affiliations

IB 10-463, P96532APRIL 2017

Ask all military service members and all Veterans Common Service-Related Exposure Concerns

Exposure Concerns Military Environmental Exposures (Any Era)

Gulf War/Southwest Asia (Afghanistan, Kuwait, Iraq)

Vietnam, Korean DMZ & Thailand

Cold War

WWII & Korean War

Behavior

Blood Borne Viruses (Hepatitis & HIV)

Veterans Crisis Line 1-800-273-8255 (Press 1)or 1-844-MyVA311 (698-2311)

Would it be okay if I asked about some things you may have been exposed to during your service?

Would it be okay if we talked about emotional responses during your service?

What... were you exposed to?

PTSD: Have you been concerned that you might suffer from Post-Traumatic Stress Disorder? Symptoms can include numbing, re-experiencing symptoms, hyperarousal/being on guard, and/or avoiding situations that remind(s) you of the trauma.

Burn Pit SmokeCold InjuriesContaminated Water(benzene, trichloroethylene, vinyl chloride)Endemic DiseasesHeat Stroke/Exhaustion

Animal Bites/RabiesBlunt TraumaBurn Injuries (Blast Injuries)Chemical or Biological AgentsChemical Munitions DemolitionCombined Penetrating InjuriesDepleted Uranium (DU)Dermatologic IssuesEmbedded Fragments (shrapnel)

Occupational Hazards: Asbestos, Industrial Solvents, Lead, Radiation,Fuels, PCBs, Noise/Vibration, Chemical Agent Resistant Coating (CARC)

Immunizations: Anthrax, Botulinum Toxoid, Smallpox, Yellow Fever,Typhoid, Cholera, Hepatitis B, Meningitis, Whooping Cough, Polio, TetanusInfectious Diseases: Malaria, Brucellosis, Campylobacter jejuni,Coxiella burnetii, Mycobacterium tuberculosis, nontyphoid Salmonella,Shigella, visceral Leishmaniasis, West Nile Virus

Hexavalent ChromiumMustard GasNerve AgentsPesticidesRadiation (Ionizing & Non-Ionizing)Sand, Dust, Smoke, and ParticulatesTCDD, herbicides, other dioxins

Malaria Prevention: Mefloquine – LariamMental Health IssuesMulti-Drug Resistant AcinetobacterOil Well FiresReproductive Health IssuesSpinal Cord InjuryTraumatic AmputationTraumatic Brain InjuryVision Loss

Depression: Have you been experiencing sadness, feelings of hopelessness/helplessness, lack of energy, difficulty concentrat-ing, and/or poor sleep?Risk Assessment: Have you had thoughts of harming yourself or others?

What... precautions were taken? (Avoidance, PPE, Treatment)How... long was the exposure?How... concerned are you about the exposure?Where... were you exposed?When... were you exposed?Who... else may have been affected? Unit name, etc.

Chemical (pollution, solvents, weapons, etc.)Biological (infectious diseases, weapons)Psychological (mental or emotional abuse, moral injury)Physical Blast or explosionMunitions or bullet wound

RadiationShell fragmentHeat

Vehicular crashNoise/VibrationOther injury

Do you have tattoos? Have you ever injected or snorted drugs, such as heroin, cocaine, or methamphetamine?Have you ever been screened for Hepatitis C or HIV? If not,would you like to be screened for these?

Agent Orange Exposure

Chemical Warfare Agent Experiments

Cold Injuries

Nuclear Weapons Testing or Cleanup

Nuclear Weapons Testing or CleanupBiological Warfare Agents

Hepatitis C Risks

www.myhealth.va.govTell your patient about VA’s

Gateway to Veteran Health Benefits and Services

Chemical Warfare Agent ExperimentsCold Injuries

Find out more about military exposureswww.publichealth.va.gov/exposures/

Durham VA Fact Sheet for Hospice Partners Durham VAMC

508 Fulton Street Durham, NC 27705 Phone: (919) 286-0411 Fax: (919) 286-6825 Toll-Free: (888) 878-6890 Name and contact for Regional (VISN) office: VA Mid-Atlantic Health Care Network (VISN6) 300 W. Morgan Street, Ste. 700 Durham, NC 27701 Phone: (919) 956-5541 Fax: (919) 956-7152

Palliative care contact and alternate: name, title, phone number; fax; email: Jamie Grant, LCSW, Hospice & Palliative Care Coordinator Phone: 919 286-0411 X 7218 Fax: 919-416-8012 [email protected]

Toni Cutson MD, MHS, Medical Director Phone: 919 286-0411 X6448 or page 919 970-5067 [email protected]

After hours contact: Dr. Cutson

Service area covered by VA: NC, southern VA

Palliative Care Consult Team: Toni Cutson MD, Brian Talbott MD, Katja Elbert-Avila MD, Michaelene Moore NP, Jamie Grant LCSW, Christine Milam Chp, Jessica Fulton Psych, Anne Adams RN, Cindy Johnson Pharmacist Inpatient Unit: 10 bed Hospice Unit Palliative Care Services: Our consult team sees veterans in both the inpatient and outpatient settings as requested. We currently have a formal outpatient clinic on Tuesday, Wednesday and Thursday mornings. For community and home hospice services the VA collaborates with community hospice agencies to provide this care in their community. The veteran may choose to use his/her Medicare or VA pay as payer source.

Process for expedited enrollment and approval of VA-paid hospice services: [Include the name and contact information and a brief description of the process]: Referred to VSO in county

Name and contact information for approval of VA paid hospice, changes in hospice levels of care or changes in hospice levels of care: Jamie Grant SW or Toni Cutson MD (above)

Death notification requirement: Community hospice contact Decedent Affairs or Palliative Care

Business office contact for reimbursement and billing issues: Fee Basis, Hillandale Office 919 286-0411 X 6979, 6097

Decedent Affairs Officer: Mr. James Lawson, 919 286-0411 X 6226

PTSD resource: name, title, phone number: Josephine Allen 919 286-0411 X 7977

Homeless coordinator: name, title, phone number: Bob Williamson, 919 286-0411 X 6045

Vet Center: Raleigh Vet Center 1649 Old Louisburg Rd Raleigh, NC 27604

RESOURCES: National Suicide prevention Lifeline: 1-800-273-TALK National Cemetery information: www.cem.va.gov/

Death and Burial benefits www.cem.va.gov/bbene/benvba.asp

Military discharge information: www.vba.va.gov/vba/benefits/offices.asp

We Honor Veterans: www.wehonorveterans.org



http://www.cem.va.gov/

http://www.cem.va.gov/bbene/benvba.asp

http://www.vba.va.gov/vba/benefits/offices.asp


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