Geriatrics and Extended CareUpdated: March 31, 2020
The Department of Veterans Affairs has a set of programs that fall under the VA heading “Geriatrics and Extended Care” that are designed to help veterans who are diagnosed with chronic health issues and/or “life-limiting illness.”
The services available in this area include some very important care planning, goal setting, and using a “patient-aligned care team” in certain cases to help vets suffering from multiple chronic issues, declining mental or physical abilities, etc.
Some may consider what the VA offers here as “end-of-life care” but the truth is, the services offered by the Department of Veterans Affairs in this area are intended for those at all stages of the applicable conditions. Veterans do not need to be in imminent need of hospice facilities, inpatient treatment, or related types of health care typically considered to be end-of-life to qualify.
The real qualifications have more to do with the number of chronic issues and how those issues affect quality of life, as we will discover below.
VA Geriatrics And Extended Care Mission Statement And Goals
This type of VA care offered to qualifying veterans is designed to “Honor Veterans preferences for health, independence, & well-being in the face of aging, disability, or illness by advancing expertise, programs, & partnerships,” according to the VA official site.
The VA has stated a list of priorities for this kind of care; VA Geriatrics and Extended Care policies include offering balanced care, optimized access to long-term service, and improved care coordination.
According to the VA official site, the goals of this program include offering a “system-wide continuum of evidence-based, Veteran-centric GEC programs and services to meet the needs of Veterans, families, and their caregivers” while making sure that vets have “reliable access to quality care in facility, community, and home-based settings.”
What The VA Offers
There are a variety of options, assessments, and planning that come with participating in VA’s Geriatrics and Extended Care plan. Veterans who get care through this VA program will be assigned a Geriatric Patient Aligned Care Team, also known as GeriPACT.
According to the VA official site, GeriPACT “integrates traditional healthcare services with community-based services.” Such teams are comprised of primary care providers and multi-disciplinary care provider groups who understand the special health care needs of vets with chronic illnesses and declining abilities.
Using GeriPACT means planning, and one of the earliest experiences a veteran has while under this kind of care is called a Geriatric Assessment.
The assessment includes the participation of a doctor, nurse, and other caregivers; the Geriatric Assessment is meant to be a tool for the veteran to select the right kinds of services that meet the vet’s needs, independence preferences, etc.
Other Planning Tools That Could Be Used With GeriPACT
Shared Decision Making is another VA-provided care planning option described as “a collaborative, patient-directed decision making process that helps Veterans, together with their family caregivers and health care team, set goals and priorities, and make choices that meet patient needs while honoring patient values and preferences”.
This kind of planning is crucial for those who need long-term care as treatment options, payment, and veteran preferences are all addressed in detail. Veterans will complete a self-assessment as part of this type of planning that can help guide future decision-making, especially for those who may be in the early stages of dementia, Alzheimer’s, or other conditions that affect memory.
Another option is Advance Care Planning, described by the VA as “a process of clarifying your values and health care choices for use at a future time if you are no longer able to make decisions for yourself”.
The VA recommends veterans, family members, and caregivers consider the types of treatment options that may be required in the future, including options the veteran does NOT want. This type of planning can make all the difference for those suffering from memory issues and conditions that may affect the veteran’s ability to make decisions in the future.
Who The VA Says Is Eligible For GeriPACT
GeriPACT is open to veterans who face challenges related to having multiple chronic medical issues, dementia or other declines in mental abilities, and/or “geriatric syndromes” related to multiple medications, falls, memory loss, and related issues.
The VA official site warns that GeriPACT is not offered to veterans with untreated substance abuse issues. This program may also not be appropriate for vets who “only need a prescription refill for a medicine like Aricept (used to treat Alzheimer’s),” according to the VA.
Services Offered Via GeriPACT
The VA official site lists the following services made available to qualifying veterans:
- Integration and coordination of health care services provided by VA along with community-based services or care.
- Helping veterans to “optimize independence and quality of life.”
- Providing health care team members with suitable medical expertise and advanced training “to assess and address the illnesses and issues of vulnerable and elderly Veterans.”
- Offering a “level of care that is not generally available to them through a regular patient aligned care team” for those with “complex” medical needs.
More specifically, veterans who qualify for GeriPACT services may be eligible to receive home-based care, outpatient services in the local community (as partnered with by the VA), nursing home, day care, inpatient, and much more. There is no one-size-fits-all treatment solution; each veteran is given individual planning and treatment options.
VA care plans include:
- Homemaker and Health Aide services
- Home-based primary care
- Patient-directed care
- Remote care (via computer or phone)
- Respite care (for those with dedicated caregivers who need a break from care for personal needs or work-life balance)
- Skilled in-home care
- Inpatient services
Specific Conditions That May Be Treated Under GeriPACT
While there are many chronic medical issues that qualify for this type of care, the VA official site also singles out certain age-related mental issues for attention by GeriPACT teams. These conditions include dementia, Alzheimer’s, and delirium.
While it’s true that a larger range of VA services is offered for these and related issues, under GeriPACT there will be discussions and planning about which of these options is best for the individual veteran (again, based on veteran-directed needs and goals as well as the treatment needs of the condition itself).
The options available include home based primary care, assistance provided by homemakers and home health aides, respite care, adult daycare, outpatient and inpatient hospital services, etc.
Other options include nursing homes, palliative care, and hospice.
Under GeriPACT, care is available for veterans who experience issues with delirium. Unlike Alzheimer’s or dementia, delirium is a condition that may be an indication of a more serious underlying medical issue. Delirium is described as feelings of sudden confusion often coupled with difficulty in rousing or getting the attention of the patient.
This can include, but is not limited to, the following set of symptoms:
- Difficulty focusing or maintaining attention
- Difficulty making eye contact
- Problems waking the patient
- Mumbling or incomprehensible speech
- Hallucinations (auditory or visual)
- Anxiety or other emotional disturbances with no discernible cause
The VA official site says of this condition, “Even if there has simply been a change in the elder’s thinking or behavior, most caregivers and family members will know that something is not right. It’s important to contact a doctor as soon as possible so that he or she can find the cause of the delirium and treat the underlying problem.”
Symptoms of delirium should be taken seriously and addressed immediately; loved ones, caregivers, and those helping veterans who are not yet part of a VA program or who need GeriPACT services should consider getting in touch with the VA as soon as possible to discuss GeriPACT options.
Paying For Geriatric And Extended Care
VA services may be offered to veterans at no charge in certain cases, but in other instances some payment may be required. The VA official site reminds veterans they may be able to pay for long-term care via the VA, but there are also federal and state program options such as Medicare and Medicaid, plus insurance and privately paid options.
The VA official site advises vets that their eligibility for long-term care is determined “based on your need for ongoing treatment, personal care, and assistance, as well as the availability of the service in your location. Other factors, such as financial eligibility, your service-connected (VA disability) status, insurance coverage, and/or ability to pay may also apply.”
You can learn more about payment options, VA long-term care, and GeriPACT requirements by calling 1-877-222-VETS (8387) or contact the nearest VA medical center to your home.