Department of Veterans Affairs Caregiver Support Program Update

Michael Kilmer, LCSWChief Consultant , Care Management and Social Work ServicesPatient Care ServicesDepartment of Veterans Affairs

June 24, 2014

VETERANS HEALTH ADMINISTRATION

Caregiver Support Program

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Mission Statement: To promote the health and well-being of family Caregivers who care for our nation’s Veterans, through education, resources, support, and services.

– Allow Veterans to remain at home in the community– Address specific needs of Family Caregivers with a menu of programs and

services– Promote Veteran & Caregiver health and well-being– Provide one location to obtain needed information – Provide training & information on common conditions– Reduce isolation with professional & peer support– Provide options to give Caregivers respite– Sensitize health care providers to the Caregivers’ role

VETERANS HEALTH ADMINISTRATION

Menu of VA Services to Support Family Caregivers

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In-Home CareSkilled NursingHome Health AideHome Based Primary CareVeteran Directed Home & Community Based Care

Services to Address Mobility IssuesEquipmentHome ModificationAutomobile Modification

Education and TrainingCore CurriculumSelf-Care Courses

Financial SupportAid and AttendanceCaregiver Stipend (Post 9-11)

Information and ReferralCaregiver Web site: www.caregiver.va.govCaregiver Support Line: 1-855-260-3274

Caregiver SupportSupport GroupsCaregiver Support CoordinatorsPeer Support Mentoring ProgramBuilding Better CaregiversTM

Respite Care

VETERANS HEALTH ADMINISTRATION

Caregiver Support Coordinators

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• At all VA Medical Centers• Clinical experts on Caregiver issues • Knowledgeable about VA and non-VA resources • Assist with application for new benefits• Organize Caregiver focused activities and services• Ensure Caregiver sensitivity is integrated into all programs• Provide National Caregiver Support Line follow-up• Establish programming for National Family Caregiver Month in

November

VETERANS HEALTH ADMINISTRATION

Caregiver Education, Training, and Support Expanding Evidence-Based Interventions & Best Practices

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Resources to Enhance All Caregivers Health VA (REACH VA)– Designed to provide education support, and teach problem-solving for

Caregivers of Veterans with Alzheimer’s Disease/dementia – Currently being expanded to Spinal Cord Injury /Disease, Multiple Sclerosis,

and Mental Health Spouse /Caregiver Telephone Support

– Groups of Post 9/11 spouses meet with a VA clinician to learn problem solving skills, resiliency training, and to receive support

– Currently being expanding to broader audienceBuilding Better CaregiversTM

– An interactive, web based workshop developed by Stanford University and provided in partnership with the National Council on Aging (NCoA)

Peer Support Mentoring Program– New Caregivers are matched to more experienced Caregivers

VETERANS HEALTH ADMINISTRATION

Caregiver Outreach

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Caregiver Support Line• More than 130,000 calls received • Averaging ~ 200 calls per day

Caregiver Website • List serve members = 38,000+• Average visits per day = 830• Pages viewed per visits = 3

www.caregiver.va.gov

VETERANS HEALTH ADMINISTRATION

Program of Comprehensive Assistance for Family Caregivers - Eligibility Criteria Overview

Veteran or Servicemember undergoing medical discharge incurred or aggravated a serious injury in the line of duty on or after September 11, 2001 (includesTraumatic Brain Injury, psychological trauma or other mental disorders).

and

Veteran or Servicemember requires on-going assistance from a Caregiver fora minimum of 6 months to:

1. Assist with the management of personal care functions required in everyday living; 2. Significantly enhance the Veteran’s or Servicemember’s ability to live at home

safely; and3. Support the Veteran or Servicemember’s potential progress in rehab.

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VETERANS HEALTH ADMINISTRATION

Program of Comprehensive Assistance for Family Caregivers - Eligibility Criteria Overview (contd.)

and

The serious injury requires another person (a Caregiver) to assist the Veteran with the management of personal care functions required in everyday living because of one or both of the following:

– An inability to perform one or more Activities of Daily Living including dressing and undressing, personal hygiene, grooming, toileting, feeding oneself, mobility, or a frequent need of adjustment of a prosthetic or orthopedic appliance

– A need for supervision, protection, or assistance based on symptoms or other impairments or injury including seizures, difficulty with planning and organizing, safety risks, difficulty with sleep regulation, delusions or hallucinations, difficulty with recent memory, or difficulty with self-regulation

**Note: there are additional criteria beyond what is listed here. 8

VETERANS HEALTH ADMINISTRATION

Primary Family Caregiver Supports and Services

• Stipend –Direct payment to primary Family Caregiver–Centrally funded and managed–Based on wages of a home health aide in the geographic area where

the Veteran resides –Tiered based on amount and degree of personal care services

provided• Health Insurance

– Civilian Health and Medical Program VA (CHAMPVA)• Travel and Lodging

– Integrate into existing programs • Mental Health Services

– Individual/Group psychotherapy and counseling– VA or by contract

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VETERANS HEALTH ADMINISTRATION

Program of Comprehensive Assistance for Family Caregivers Update*

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• Applications filed: 31,130

• Approved Applications: 15,900– Tier 3 – 6,121 (national average $2,320 per month)– Tier 2 – 6,078 (national average $1,470 per month)– Tier 1 – 3,701 (national average $610 per month)

• New Healthcare Coverage enrollees: 4,115

• Veteran Demographics:– 26% are Service Connected for TBI– 70% are Service Connected for PTSD

*Data from May 9, 2011 to June 9, 2014

VETERANS HEALTH ADMINISTRATION

Program of Comprehensive Assistance for Family Caregivers Caregiver Education and Training

Standardized Core Curriculum • Developed in collaboration with Easter Seals • In-person, workbook/DVD, or web-based• Includes modules on:

Caregiver Self-CareHome SafetyBasic Caregiver Skills (vital signs, etc)Providing Personal CareManaging Challenging BehaviorsResources (legal, financial, VA, community, advocacy)

Training Data Update:• More than 20,000 Family Caregivers have completed training to date

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