Hospice Veteran Partnership Overview

"The veterans we serve today have survived the battles - battles they fought to preserve our freedom. It is our privilege and our responsibility to be there for them, to offer comfort, support and care as they face their final days. Together, with pride and urgency, we steadfastly pursue our VA mission in hospice and palliative care - to honor veterans' preferences for care at the end of life."
Dr. Thomas Edes, MD, MS, FACP, Chief, Home & Community Based Care, Offices of Geriatrics and Extended Care, Department of Veterans Affairs.

With a focus on improving end-of-life care for veterans, the Department of Veterans Affairs established the VA Hospice and Palliative Care Initiative (VAHPC) in November of 2001. One of the programs launched by VAHPC is the National Hospice-Veteran Partnership (HVP) Program.  HVPs are coalitions of Veterans Affairs (VA) facilities, community hospices, end-of-life care or community organizations and others, working together to ensure that excellent end-of-life care is available for our nation's veterans and their families.

HVPs are statewide or community-based partnerships dedicated to increasing veterans' access to hospice and palliative care. Their goals are to strengthen relationships between community hospices and VA providers and educate veterans and their caregivers about end-of-life care options.

The HVP in Ohio is hosted by LeadingAge Ohio. Participants include VA and community health providers as well as other organizations that share the vision of improving end-of-life care for veterans and their families. Ohio HVP has developed a strategic plan to best serve veterans in its area. The following activities are examples of the many ways a partnership can have a positive impact.

• Conducting assessments to determine veterans' needs in the community
• Sharing information with veterans' groups about advance care planning, available resources, and care options
• Holding statewide events to educate community hospice providers and VA facilities about opportunities for partnership
• Establishing networks of mentors and experts to assist community hospices and VA facilities with staff and program development
• Developing speakers' bureaus for outreach activities to veterans service organizations, community agencies, and VA facilities
• Educating community agencies about veterans' issues and benefits
• Holding town meetings for veterans and their caregivers

Interested in learning how to become involved with Hospice Veteran Partnership (HVP) of Ohio? Contact Jill Dunmire Siddiq at 216-791-3800 ext. 6627 or email jill.dunmiresiddiq@va.gov or Carole Quackenbush at 513.657.8867 or email carole.quackenbush@vitas.com.

Facts and Demographics

Facts and Demographics of America's Veterans and VA Health System

1. Over 37 percent of the veteran population is 65 years old or older, compared with 13 percent of the general population. The challenge to care for these 9.5 million men and women is met through a variety of programs, including more than 137 nursing home care units in medical centers, adult day care, home health aide services and community residential care, contracts with 3,500 community nursing homes, and support to 112 state veterans homes. Additionally, VA conducts nationwide research on the causes and treatment of Alzheimer's disease and other dementias and funds 20 geriatric research centers.
2. Aging Demographics of American Veterans: Overall, the veteran population is declining 1.7 percent per year. From 2000 to 2010 - veterans 65 plus decrease 9 percent from 9.3 million to 8.5 million. However, veterans 75 plus increase 12 percent from 4 million to 4.5 million, and veterans 85 plus triple from 422 thousand to 1.3 million.
3. The largest percent decline is projected for the youngest group, under age 45. This is expected in light of a relatively smaller military.
4. Those aged 65 to 84 are projected to increase between 2010 and 2015 as the Korean Conflict and Vietnam era cohorts age.
5. As the veteran population ages, the demand for geriatric and all forms of long-term care should increase significantly relative to acute care. In particular, nursing home care policies, programs, and services will require continual monitoring and assessment.
6. An increasing number of deaths from an older population means greater demands for services from NCA, including casket and cremation burials, headstones, markers and Presidential Memorial Certificates.
7. VA's health care system has grown to 163 hospitals, with at least one in each of the 48 contiguous states, Puerto Rico and the District of Columbia. VA operates more than 850 ambulatory care and community-based outpatient clinics, 137 nursing homes, 43 domiciliaries and 73 comprehensive home-care programs. VA health care facilities provide a broad spectrum of medical, surgical and rehabilitative care.
8. During the last five years, VA has put its health care facilities under 21 networks, which provide more medical services to more veterans and family members than at any time during VA's long history.
9. VA has experienced unprecedented growth in the medical system workload over the past few years. The total number of patients treated increased by over 11 percent from 2000 to 2001 more than twice the prior year's rate of growth.
10. More than 4.2 million people received care in VA health care facilities in 2001. VA is used annually by approximately 75 percent of all disabled and low-income veterans. In 2001, VA treated about 587,000 patients in VA hospitals and contract hospitals, 87,000 in nursing homes and 45,000 in domiciliaries. VA's outpatient clinics registered approximately 42.9 million visits.

HVP FAQs

What is Hospice?

A hospice program is a coordinated program of palliative and supportive services provided in both home and inpatient settings for persons in the last phases of incurable disease so that they may live as fully and as comfortably as possible. The program emphasizes the management of pain and other physical symptoms, the management of psychosocial problems and the spiritual comfort of the patient and the patient's family or significant other. Services are provided by a medically-directed interdisciplinary team of health care providers and volunteers.

Where are Hospice Services Provided?

Hospice is provided in a patient home, hospice residence, hospital, long term care and assisted living facility and in a VA Hospital or VA Nursing Home. Some VA facilities have dedicated hospice units that provide a home-like setting.

How is Hospice Provided?

A team develops a care plan that meets each patient's individual needs for pain management and symptom control. The team usually consists of:

• The patient' s personal physician;
• Hospice physician (or medical director);
• Nurses;
• Home health aides;
• Social workers;
• Clergy or other counselors;
• Trained volunteers;
• Speech, physical, and occupational therapists, if needed.
• Bereavement services for at least one year following the death

Are there other Supportive Services?

Yes. Respite Care, Anticipatory Grief Support for the Veteran and Family or Significant Intimates and Post-death Bereavement Support for the Family or Significant Intimates are available. 

What is Respite Care?

Respite care is a program that provides veterans with short-term services to give the caregiver a period of relief from the demands of daily care for the chronically ill or disabled veteran or the terminally ill veteran. Respite care is planned in advance for the benefit of the caregiver, and is coordinated through a social worker at the local VA facility.

How can I participate in HVP?

For more information about starting or joining an HVP, contact Jill Dunmire Siddiq at 216-791-3800 ext. 6627 or email jill.dunmiresiddiq@va.gov or Carole Quackenbush at 513.657.8867 or email carole.quackenbush@vitas.com. For more information about the VA Hospice and Palliative Care Initiative contact Diane Jones at (202) 273-8379 or Diane.Jones@hq.med.va.gov.

HVP Resources