A legacy for female Veterans since WWII

February 19, 2016--Back in September, we mentioned that the oldest living female WWII Veteran had turned 108. We noted that Corporal Alyce Dixon, affectionately known as “Queen Bee” by those who knew her and cared for her at the Washington, D.C., VA Medical Center (VAMC), had quite a story and quite a personality. Rocking a tiara on top of her head for the occasion, she was queen for the day. Fellow Veterans, volunteers, staff and family members celebrated her life at a special ceremony held Sept. 11.

A few weeks ago, we received word that Ms. Dixon had passed away. Shortly thereafter, VA Secretary Bob McDonald honored her in a special Black History Month message.

We also couldn’t help but think of how she had pioneered the way for the many female Veterans of all races that the VA is now serving – a number that will reach 10 percent of all Veterans in just a few years.

 She joined the military in 1943 and was stationed in both England and France with the postal services. She was one of the first African-American women in the Army as part of the “Six Triple Eight” (6888^th Central Postal Directory Battalion) – the only unit of African-American women in the Women’s Army Corps to serve overseas during WWII.

They amazed one and all by beating the standards in the speed and thoroughness with which they kept the frontlines in touch with the home front. After the war, she continued serving America, working for the federal government as a civilian, retiring in 1973. Now 1973 to 2016 – that’s a long retirement to stay healthy and keep active, which Alyce Dixon did.

Alyce Dixon appreciated the care and goodwill she received as the Queen Bee of the VAMC. With the number of female Veterans using VA health services increasing dramatically, up 80 percent between 2003 and 2012 according to VHA, we recognize that there is much more to be done. In future blogs, we will talk about how VA is working toward accommodating the needs of today’s female Veterans. One resource to consider is the Center for Women Veterans (CWV).

This increase in female Veterans, of course, calls for an increase in female professionals throughout VA. So I’d like to invite you to take a look at all of the job opportunities available and Join VA. When you work here, you’ll have an excellent salary, outstanding benefits and great work-life balance, plus, like Alyce Dixon, an opportunity to serve beyond your days in uniform.

VA care at home, Veterans choose the medical foster home program instead of a nursing home

February 19, 2016--Elderly Veterans and Veterans who require around the clock care have numerous options available to them through VA. Annually, thousands of Veterans turn to VA for care, whether it in a community residential care center, adult family home, community living center or a community nursing home partner.

Most Veterans do not want to go in to an institution for their aging care, so VA has been working to expand its medical foster home program that allows caregivers to care for Veterans in their own home. 

It’s a win-win situation for both VA and the Veterans that chose the option, as they are able to receive personalized care in a home setting and it is less expensive than institutionalized care.

“Veterans love this program because it gives them an opportunity to be apart of a loving family,” said Beau Williams, one of the Medical Foster Home Program coordinators for the Tampa, Florida area.

Beau is charged with not only marketing the program and placing the Veterans in these loving homes, but also interviewing and approving the caregivers.

“I look for caregivers with not only the qualifications required, but most importantly that they have a good heart,” Williams said.

Many caregivers are already medically trained and VA provides classes and specialized training such as spinal cord injury care for their live-in patients. VA then sends home-based care specialists to the Veterans on a weekly basis for any additional assistance they require.

Caregiver Tammy Norton moved to Florida to care for her father through the VA Medical Foster Home Program. She also took in two additional Veterans, Clayton and Nat. Her father recently passed away, but she continues to care for her “new family,” as she put it.

The Veterans use their VA benefits to pay Tammy for the home based care, which includes everything from meals to bathing, but it’s so much more than that. The three go on outings together, attend church, even vacation together. They are a family.

Depending on the level of care required, some Veterans do miss the opportunities to socialize with others outside of their home that they may receive in a nursing home. VA organizes regular foster care socials where all foster home Veterans and their caregivers are invited to spend time together.

These ‘Vet-togethers’ are loved by not only the Veterans, but also the caregivers as it gives them a chance to learn from each other’s experience.

Make a Difference Day

Even though most of the Veterans in the foster home program are somewhat limited to their home, they are still involved with their community.

The Tampa VAMC Voluntary Services team saw the benefit of bringing community partners and the foster home Veterans together and organized the event in conjunction with Make a Difference Day.

Make a Difference Day is a national service day where volunteers look for opportunities to enrich the lives of others. 

The Hillsborough Bar Association has supplied and distributed the Veteran gift bags for the past four years.

“My father is Veteran so this is very near and dear to my heart. It’s amazing to see the love in those homes, so wonderful to give them a little bit a joy in their day,” said Kathy Gilbert of the Hillsborough Bar Association who has participated in this event for three years.

While many volunteers spend days gathering and creating the gift bags and strive to fulfill the Veteran’s wish lists, the most rewarding part are the home visits. The Veterans and foster care providers open their doors with wide eyes and giant smiles. They visit, laugh and enjoy the company of their new friends and visitors.

Clayton and Nat both showed off their rooms with pride, pointing to picture after picture. Nat has a picture of the iconic Mount Suribachi flag raising on Iwo Jima to honor his grandson who is in the U.S. Marine Corps. He also shared his experience flying over the island on his way to Japan.

“You’ll find the Veterans greatly appreciate the support. I’ve heard them say that it is their home; it gives them an opportunity to be apart of a loving family,” said Tampa’s Beau Williams. “They are very happy with that.”

To learn more about the VA’s Medical Foster Home Program 

visit http://www.va.gov/geriatrics/guide/longtermcare/medical_foster_homes.asp#

Why we honor Veterans of Pearl Harbor 74 years later

Posted in Honoring Vets  by James W. Killen

December 14, 2016--On December 7, 1941, a foreign force launched a surprise attack that killed 2,403 American Service members

America has hundreds of epic and hard fought battles in the history books, but battles like Belleau Wood, Arnhem, Inchon, Hue and the too many others to list are not widely known, despite having profound and significant impact on the United States military and the study of warfare.

So why, with so many significant battles, do we all know about the attack on Pearl Harbor?

Ask any adult about the Battle of Inchon and you’re likely to get a blank stare, but ask any fourth grader about Pearl Harbor and you’re likely to get a history lesson about the attack that thrust America into World War II.

On December 7, 1941, a foreign force launched a surprise attack that killed 2,403 American Servicemembers. The event effectively etched into the American psyche because it was not only an attack on Pearl Harbor, it was an attack on the decency and on the soul of the American people.

Americans were stunned by the attack, and suddenly all opposition to our active involvement in World War II was ended. Americans resolved to avenge what the Tokyo Trials would eventually call a war crime.

Seventy-four years later we still remember the event with the moniker “We Will Never Forget.” 

Four generations after the attack, school children gather in remembrance, news outlets run feature stories on the survivors who are still with us, Sailors, Marines, Soldiers and Airmen don dress uniforms and attend ceremonies from Pearl Harbor to Washington D.C., and the world takes just a moment to commemorate “the date which will live in infamy.”

Following the attack, Japanese Admiral Isoroku Yamamoto feared it awakened a sleeping giant, referring to the resolve of the American people. We may have our differences, our conflicts with one another, and our opinions on the direction of the country, but when attacked by an outsider we pull together as one powerful and steadfast opponent.

We remember Pearl Harbor because it was an attack on our heart; it was an assault on our national soul.

We remember because to forget is to dishonor the memory of those who gave their lives that day and those who would eventually give their lives in the defense of liberty and freedom.

We remember because our unity stands as a staunch reminder to potential foes that an attack on the American people will be avenged. That our resolve is our strength.

The Department of Veterans Affairs, ASTRO and Washington University Combine Forces to Drive Better Care for Veterans with Cancer

Newswise, November 19, 2015 — Washington, District of Columbia, November 18, 2015—The Department of Veterans Affairs (VA) today announced a new Radiation Oncology Practice Assessment (ROPA) program to leverage recent advances in information technology to improve radiation therapy cancer care for our nation’s Veterans.

VA is working with the American Society for Radiation Oncology (ASTRO) and Washington University to provide radiation oncologists for the first time with continuous feedback on the progress of cancer therapy.

“We are pleased to be working with this country’s leading-class organizations on this innovative program, the first of its kind nationwide. Our Veterans deserve nothing less,” said Dr. Maureen McCarthy, VA acting assistant deputy undersecretary for health and patient care services.

Radiation is one of the three major treatments for cancer along with surgery and chemotherapy, with about 60% of cancer patients receiving radiation therapy. In recent years, there have been substantial clinical and technical advances in radiation oncology, resulting in new regimens with increased survival and improved quality of life.

Under ROPA, data will be abstracted from the VA’s highly-sophisticated electronic medical record (EMR) system and the treatment management systems used to control radiation therapy delivery. Feedback reports will be provided to VA radiation oncologists with a detailed analysis of each patient treatment compared against national standards.

Combined with the traditional cancer outcome measures of recurrence and patient survival, this assessment will provide the oncologist with a complete picture of the accuracy of each patient’s therapy and the patient’s response to therapy.

Washington University is excited to take the lead role in managing the program. “We have significant experience working with the National Cancer Institute to provide the platform we will use for these assessments. We are excited to bring that experience to bear on this landmark project on behalf of our nation’s Veterans,” said Jeff Michalski, MD, Washington University’s vice-chair of radiation oncology.

“We are also pleased to engage a local radiation oncology informatics company, Radialogica LLC, who will provide a platform and services for data security, extraction and management.”

In the first year of the project, ASTRO’s disease-site specific experts will review measures for prostate and lung cancers, identifying metrics from the EMR to assess each one.

“ASTRO is deeply committed to improving the quality of cancer care for our Veterans and all Americans. Our cancer experts are enthusiastic about this new opportunity to better measure and enhance radiation delivery with the goal of producing high quality patient outcomes,” said Bruce D. Minsky, MD, FASTRO, chair of ASTRO’s Board of Directors.

Once ROPA is fully implemented, VA radiation oncologists will receive continuously updated electronic peer reviews of each patient’s cancer evaluation, treatment and treatment outcome.

Currently, VA hospitals, similar to community hospitals, use traditional, sporadic peer-reviews in a process referred to as On-going Professional Peer Evaluation (OPPE). ROPA peer reviews go well beyond the traditional OPPE and practice accreditation to create comprehensive, patient-centered reports in a web-based environment. VA radiation oncologists will see how changes in their clinical practice impact the success of each Veteran’s cancer treatment. 

ABOUT ASTRO

ASTRO is the premier radiation oncology society in the world, with nearly 11,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology • Biology • Physics (www.redjournal.org), Practical Radiation Oncology (www.practicalradonc.org) and Advances in Radiation Oncology (www.advancesradonc.org); developed and maintains an extensive patient website, RT Answers (www.rtanswers.org); and created the Radiation Oncology Institute (www.roinstitute.org), a nonprofit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org.

Caregivers of Veterans Benefit from Purple Heart Homes Aging In Place Program

November 18, 2015 /PRNewswire/ -- November is National Caregivers month and Purple Heart Homes adaptations made to Veterans' homes helps make life easier for caregivers by creating safer barrier free environments both inside and out.

According to a March, 2014 Rand study entitled 'Hidden Heroes:  America's Military Caregivers', there are 5.5 million caregivers across the US.  Of that, 1.1 million care for Veterans that served in Afghanistan and Iraq.  

The remaining 4.4 million are caring for WWII, Korea, Vietnam, Desert Storm or those that were injured during training missions.

Staff Sergeant Cory Collins, two-time Purple Heart Recipient, was the sole survivor of an IED explosion on November 2, 2005 that left him with 30 broken bones in his body.  His hip is held together with what his wife Paula calls two lag bolts.  He suffers from PTSD, TBI and had his left leg amputated above the knee. 

Paula Collins says getting Cory up each morning is her biggest challenge because he is on 10 different pain medications.

Purple Heart Homes adapted the Collins home making doorways wider, a bathroom handicap accessible, installed hardwood floors throughout the first floor, replaced all the round door knobs with lever handles and built a handicap ramp and deck.

"Before the home was handicap accessible Cory would watch TV. He would skin his knuckles in narrow doorways, and helping him get into a bathroom was a major issue," said Paula Collins.  "The adaptations made to our home has given me time so I can take an hour for myself to workout at a gym, because I know he can move safely throughout the house with ease," Collins added.

Vietnam Veteran Joe Recupero suffers from severe Parkinson's disease as a result of exposure to Agent Orange.  Recupero had to climb 12 steps from his driveway to get into his home.  His existing bathroom floor was rotting out.  Getting in and out of the tub shower with no grab bars was dangerous and difficult.

Debbie Fiori, Joe's caregiver and significant person in his life said, "when Purple Heart Homes moved the driveway and built a ramp to the front door it made it easier for both Joe and me." 

Purple Heart Homes built an addition on to Recupero's home so he could have a handicap accessible bathroom, higher toilet seat and grab bars. 

Debbie Fiori said, "I have been a nurse for 38 years and the adaptations made to Joe's home enables me to continue to work and have peace of mind that he can move about safely in the home. His Parkinson's has not advanced that he needs his wheelchair, but when he does he will have no problem going from room to room and using the bathroom, which eases my future caregiving responsibilities."

Caregivers of Veterans experience loss of employment, thus loss of needed income when care is given 24/7.  They suffer from emotional and physical stresses.  According to the Rand study, military caregivers consistently experience more serious health issues, have greater strains in family relationships and more workplace problems than non-caregivers, and post 9/11 military caregivers fare worst in these areas.

"We have expanded our Veterans Aging in Place program to be able to help more Veterans and their caregivers with the creation of chapters to do less costly projects that make a world of difference – like a simple ramp, wider doorways, grab bars, lever door handles and handicap accessible bathrooms," said John Gallina, Executive Director of Purple Heart Homes.  The majority of applications received for needed renovations come from Veteran Caregivers.

All needed adaptations for approved older Veterans are done at no cost to the Veteran or family thanks to generous support received from foundations, in-kind donations of materials and generous support from communities and individual donations.

Purple Heart Homes salutes all caregivers providing comfort, support and daily assistance to our Veterans.  They work quietly behind the scenes and deserve not only our support, but also our entire nation.

To learn more about Purple Heart Homes Aging in Place program, to submit an application, to form a chapter and to make a donation see: www.phhusa.org.

Physician Anesthesiologists Oppose Legislation Risking Veterans’ Lives

Doctors Should Not Be Replaced with Nurses for Anesthesia Care during Surgery

Newswise, November 16, 2015– To protect our nation’s Veterans, the American Society of Anesthesiologists (ASA) urges extreme caution when considering the “Veterans Health Care Staffing Improvement Act,” S. 2279. 

As currently drafted, this legislation contains a misguided provision that removes physician anesthesiologists from surgery and replaces them with nurses.

Veterans will receive a lower standard of care, jeopardizing their safety and lives, if physician involvement is eliminated from anesthesia care in surgery.

Although the purpose of the legislation, introduced Nov. 10 in the U.S. Senate, is admirable, proposing to ease the transition of military health care providers to the Department of Veterans Affairs (VA); it also includes provisions abandoning the physician-nurse team-based model of care for all advanced practice registered nurses (APRN), including nurse anesthetists, in the VA.

Senators sponsoring the legislation note the act proposes “common-sense” changes in staffing policies to improve Veterans’ care at health care facilities by addressing the shortfall of medical staff. However, there is no shortage of physician anesthesiologists or nurse anesthetists in the VA system.

Surgery and anesthesia care inherently contain risk, and this is true even more so for Veterans, who often have complex medical conditions that pose a heightened risk of complications during surgery. Physician involvement when performing surgery on our Veterans is much more critical than providing typical primary care or treating chronic health conditions.

The legislation would eliminate the existing and proven model of care where physician anesthesiologists and nurse anesthetists work together as a team to ensure our Veterans receive the highest quality and safest anesthesia care.

“Taking physicians out of surgical care is not a common-sense solution for our VA patients who are often sicker, older and have multiple medical conditions that put them at greater risk for complications,” said ASA President Daniel J. Cole, M.D.

“The team-based model of care ensures all Veterans have access to a physician anesthesiologist should an emergency or complication occur. This legislation will place our Veterans at increased risk. There can be no compromise on the highest-quality, safest medical care for those who have served our country”

Similar dangerous proposals have been considered, and when it comes to the subject of substituting nurses for physicians in anesthesia care, the VA’s own experts on surgical anesthesia care, the Chiefs of Anesthesiology, have told VA leadership that a policy substituting nurses for physicians “would directly compromise patient safety and limit our ability to provide quality care to Veterans.” (Letter from VA Chiefs to Secretary Shinseki, Dr. Petzel, and Dr. Jesse - Oct 1, 2013.)

Physician anesthesiologists receive 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care and pain control, with the necessary knowledge to understand and treat the entire human body. By comparison, nurse anesthetists have only about 1,650 hours of clinical training.

The Veterans Health Care Staffing Improvement Act was introduced by Senators Merkley (Oregon) and Rounds (South Dakota). The bill has also been co-sponsored by Senators Tillis (North Carolina), Warner (Virginia), Shaheen (New Hampshire), Wyden (Oregon), Tester (Montana) and Brown (Ohio). ASA strongly urges reconsideration of the provisions that lower the standard of care for Veterans and puts their health and lives at risk in surgery.

More information about the proposed legislation and the importance of physician-led, anesthesia care is available at www.asahq.org.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS®
Founded in 1905, the American Society of Anesthesiologists (ASA®) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves. 

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit www.asahq.org/WhenSecondsCount

Timely Health Care for Veterans Supported in Bipartisan Senate Bill

CRNAs and Other APRNs back Veterans Health Care Staffing Improvement Act

Newswise, November 13, 2015—Bipartisan legislation introduced in the U.S. Senate on Nov. 10 expands access to timely, quality healthcare for America’s veterans by directing the Veterans Health Administration (VHA) to allow Certified Registered Nurse Anesthetists (CRNAs) and other advanced practice registered nurses (APRNs) to provide patient care to the full extent of their education and abilities.

The “Veterans Health Care Staffing Improvement Act” was introduced by Sens. Jeff Merkley (D-OR), Mike Rounds (R-SD), and other co-sponsors from both parties, and is supported by the 49,000-member American Association of Nurse Anesthetists (AANA).

In addition to directing the VHA to extend full practice authority to CRNAs and other APRNs, the bill also removes bureaucratic barriers to healthcare professionals’ privileging and credentialing within the VHA, and encourages former military healthcare personnel to join the VHA for healthcare services. 

“Veterans are waiting too long for quality healthcare that they deserve and have earned,” said AANA President Juan Quintana, CRNA, DNP, MHS. “The AANA strongly supports this legislation which will reduce veterans’ wait times for high quality healthcare by recognizing CRNAs and other APRNs to their full practice authority.”

The legislation is the result of an independent assessment that Congress ordered of the VA and published last month, which recommended that allowing CRNAs and other APRNs to practice to the full extent of their education and abilities would increase veterans’ access to care, reduce wait times, and save money.

The proposal is also consistent with recommendations made previously by the Institute of Medicine, and is supported by more than 40 veteran and healthcare professional organizations, including the Vietnam Veterans of America, the Military Officers Association of America, the Veterans of Foreign Wars, and the Iraq and Afghanistan Veterans of America.

Additional cosponsors include Sens. Jeanne Shaheen (D-NH), Thom Tillis (R-NC), Mark Warner (D-VA) and Ron Wyden (D-OR).

About the American Association of Nurse Anesthetists

Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 49,000 nurse anesthetists across the United States.

As anesthesia specialists, Certified Registered Nurse Anesthetists (CRNAs) safely provide approximately 40 million anesthetics to patients each year for surgical, obstetrical, pain management, and trauma stabilization services.

CRNAs deliver essential healthcare in thousands of communities and are able to prevent gaps in access to anesthesia services, especially in rural, inner-city, and other medically underserved areas of the country.

They are highly valued in today’s healthcare environment because they deliver the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control rising healthcare costs. Additional information about the AANA and CRNAs is available at www.aana.com and www.aana.com/future-today.