Illiana system developing own version of program that places veterans in private residences
It has been only a year since Gloria and Jesse Carr invited a Vietnam veteran in need of long-term care to live with them in their home. Six months since they welcomed two more veterans.
But today, the Portage, Mich., couple can't imagine their lives without them.
"They're family," Gloria Carr said of the three men, whom she not only houses but cares for.
"We sit and talk and crack jokes, just as I did with my kids," said Carr, who enjoys listening to the men talk about their lives. "We have meals together. They come with us to family get-togethers. When one of them goes and spends the night with his family and his chair is empty, you miss him. You look forward to when he comes back home."
The men — who include another Vietnam vet and a World War II vet — came to live with the Carrs through the Battle Creek Veterans Affairs Medical Center's medical foster home program, a model for addressing male and female veterans' long-term care needs while respecting their wishes to remain in a home setting in or near their community.
Now, the Veterans Affairs Illiana Health Care System is developing a similar program for its service area.
"Many veterans can live independently for years with the support of home care services and assistive devices," Illiana program coordinator Kelly Belinger-Sahr said, "but there may come a time when they can no longer care for themselves or it's not safe for them to remain in their home alone. Not all veterans who are at that point want to go to a nursing home or would be a good fit for that setting. Medical foster homes give them another option to remain in their communities and receive 24/7 care and the support they need to be safe."
"This is such a great service for our veterans," added Kirsten Dzialo, the Battle Creek program coordinator. "They really bond with their caregivers. They feel part of their family. They know that someone's there for them and cares about what happens to them."
The program, whose motto is "Connecting Angels with Heroes," was created by two social workers at the VA in Little Rock, Ark., and piloted there in 2002. A decade later, the program operates at 73 sites throughout the United States and in Puerto Rico, and is expanding to 29 more sites this year.
Illiana's program, which can accommodate up to 30 veterans at a time, was approved for the current fiscal year. Now Belinger-Sahr, who works at the Peoria community-based outpatient clinic, is getting the word out about the program and the need for caregivers in the Danville, Peoria, Springfield, Decatur and Mattoon areas.
"It's a new concept, so it's a lot of educating even among VA staff," said Belinger-Sahr, a licensed clinical social worker.
The program is a partnership between the VA's social work service and home-based primary care programs. Veterans must qualify for the home-based primary care program to be accepted into the new one.
Under the home-based program, an interdisciplinary treatment team provides primary care to veterans who have multiple medical conditions and/or have mobility issues, making it difficult for them to receive care at a clinic, coordinator Sandra Beaulier said.
"We go in and support the patient in their home setting," Beaulier said, adding the team includes a medical provider, nurse, social worker, physical therapist or kinesiotherapist, dietitian, pharmacist and now a psychologist. "By monitoring them and reinforcing preventative education, we hope to reduce the frequency of hospitalizations and keep them in a home-setting for as long as possible.
"It's a wonderful program, and the veterans love it," she continued, adding the program currently has 238 patients. Beaulier said some of them may benefit from the new program one day.
"It's disheartening when they have to go to that next level of care, which typically is a nursing home," she said. "So I see the medical foster care program as really making a difference in their world. It may be another person's home, but it's still giving them that freedom of having control of their day, eating home-cooked meals, just the whole gamut of being in a home instead of an institutional setting. If we can delay that as long as possible, it improves their quality of life."
The medical foster care program finds caregivers in the community who are willing to take a veteran into their home and provide 24-hour supervision in a safe, friendly environment. The national model allows a caregiver to house up to three vets in his or her home; however, in Illinois, caregivers are limited to two.
In addition to room and board, caregivers also provide veterans with personal care — bathing, dressing and grooming, if they need it — laundry and cleaning, help with medication, help communicating with health care providers, rides to appointments, church and community functions and other support.
Carr likes to take her veterans on outings to Wal-Mart, the library or the park. Sometimes they go for ice cream.
Ideally, caregivers will have some type of health care or caregiving experience, but it's not necessary. Carr is a registered nurse who liked the idea of caring for elderly patients in her home.
But "the majority of our caregivers don't have any formal training. They're just people who want to care for others, and they do a wonderful job," said Dzialo, who has placed eight vets in four medical foster homes since July 2011.
Belinger-Sahr said she visited the Tampa, Fla., VA's program, established since 2004, and met caregivers who were singles, empty-nesters, even couples with children still at home.
She added each caregiver has an alternate, who is identified during the application process. That person can step in if the main caregiver has to be away or needs respite.
In addition to the visits by the home-based primary care interdisciplinary team, Belinger-Sahr will make monthly unannounced visits to the homes to ensure everything is in order. She also will assist with any problems the veterans or caregivers may have.
In addition, the entire team performs an annual inspection.
Veterans pay for the care. The cost typically runs between $1,400 and $2,500 a month, depending on the services that are provided.
"I'll work with them to make sure they're maxing out their VA benefits and any other community financial resources that are available to them so they can afford the care they need and have money for the little extra things they like to do or have in their environment," said Belinger-Sahr, who also helps draw up the contract between caregivers and vets.
She said caregivers aren't going to make a lot of money, so they need to make sure they're doing it for the right reasons.
It's a long-term commitment, Belinger-Sahr said.
"The expectation is a veteran could live there for an extended period of time, including the end of their life," she said. "We would help support both the veteran and caregiver through that."
"Caregiving is a lot of work, and it can be difficult work sometimes," she continued. "But it can be very rewarding."
Carr, who is a Christian, said becoming a nurse and opening her home to the men is one of the ways she serves God. She also sees it as a way to give back to the vets.
"When they were in the prime of their lives, they put themselves in harm's way," Carr said. "They did that for me and all of us. I want to let them know, 'I appreciate you and what you did. You are my family, and you are loved.' You don't have to be blood-related to feel that."
If you'd like to join the program
The Veterans Affairs Illiana Health Care System is looking for caregivers for its new medical foster care program.
- Live within 30 miles of the main medical center in Danville or the community-based outpatient clinics in Peoria, Springfield, Decatur or Mattoon.
- Be over 21.
- Own or rent their home.
- Speak, read and write English.
- Complete a criminal background check and provide three references.
- Be certified in first aid and CPR.
- Allow an interdisciplinary treatment team into their home for monthly visits.
- Willingly accept, participate in and follow the veteran's treatment plan.
- Provide three healthy meals and snacks each day.
- Ensure 24-hour supervision for their veteran.
- Meet all federal, state and local licensure requirements and regulations.
Caregivers will be screened and matched to veterans who are enrolled in or qualify for the VA's Home-Based Primary Care Program. Caregivers can have up to two veterans in their home.
If you are interested in becoming a caregiver or would like more information, call program coordinator Kelly Belinger-Sahr at (309)589-6800 Ext. 47375 or email her at firstname.lastname@example.org .
Source: Veterans Affairs Illiana Health Care System