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Veterans, families, and their experiences at end of life
1. About 25% of all Americans who are dying are veterans men and women who have served our country as members of the Armed Forces. Yet only 4% of dying veterans die within the Veterans Affairs (VA) Healthcare Network; the majority of veterans are cared for by hospice and Health care professionals in the community.
2. Veterans share a unique culture. However, veterans from different wars may have had different experiences in battle or upon returning home, and these experiences may greatly impact end-of-life care.
3. The concept of "stoicism" an indifference to pleasure or pain is taught to soldiers for a valuable reason; it is essential on the battlefield. But when a veteran is facing illness and death, being "strong" and not allowing oneself to experience pain can sometimes interfere with peaceful dying or effective bereavement.
4. Some veterans who served in a dangerous duty assignment might have PTSD (Post-Traumatic Stress Disorder). If PTSD surfaces at the end of life, counselors should be contacted to respond to the veteran's needs.
5. Many hospices utilize veterans and their family members as hospice volunteers. Pairing a veteran volunteer with a dying veteran patient often results in a strong, mutual camaraderie; veterans and their families have a strong sense of unity toward each other.
6. One simple, but important question, to ask upon admission to hospice or a Health care setting is: "Have you ever served in the military?" This question not only provides important information about the veteran, but it also may serve as a useful way to elicit military stories or any unfinished business around the military experience.
7. Hospices and other organizations can find ways to thank veterans for serving their country, as well as thanking family members who are often the "unsung heroes." Certificates of gratitude or an American Flag pin are simple yet meaningful ways to demonstrate that their service and sacrifice are valued.
8. Some veterans have seen, or feel they have caused, trauma that still troubles them. Hospice professionals can appropriately explore a possible need for forgiveness, which may facilitate inner peace.
9. Hospices can collaborate with veterans in a number of ways, such as designating one person to act as liaison with the VA Hospice & Palliative Care team. Many hospices have found that as they solve problems, work through issues, and plan co-sponsored events together, a team emerges that can respond to veterans' needs, including veterans and their families helping each other through grief and bereavement.
10. Veterans and their families should also be apprised of their hospice benefit upon admission. Every veteran who is enrolled in the VA system is entitled to hospice care paid for or provided by the VA; this entitlement is available regardless of category or service-connection.