Feb 7, 2023 | Veterans

By Morgan Fezza, Care Manager

Veterans are a special and honored population of men and women who have bravely and proudly served this country.

Many of us do not realize what our veterans bring home with them when they return. This is mostly due to stigma, privacy, and pride, amongst other things, and it isn’t until we reach a crisis point or vulnerable state of being that we recognize the impact that military service has taken on them.

This stands true for many veterans, and it is why finding a qualified and compassionate care team is of the highest importance at the end of a veteran’s life. How do we help prepare the veteran and care provider for an end-of-life situation?

The Importance of a Level Five “We Honor Veterans” Service

Perhaps you know a veteran who is currently displaying some warning signs of needing end-of-life care measures, where do you start? First and foremost, find a Level Five “We Honor Veterans” hospice or palliative care team.

All military veterans under the care of this program are assessed for trauma. Those who are already receiving or could benefit from counseling, but who are too frail and medically vulnerable to travel to the VA, are referred to Post-Traumatic Stress Disorder (PTSD) specialist counselors who can support their needs at home. A Level Five provider within the hospice system will typically have a designated Veterans Liaison. This professional will have the skills and knowledge to help navigate such a vulnerable and emotionally charged journey. 

Education is a HUGE part of the puzzle. Many people don’t know that different veteran end-of-life experiences coincide/differ with the type of war and branch of service.  For example, Vietnam veterans often face specific psychological impacts due to the circumstances surrounding their service. With over 6,258,000 Vietnam veterans making up a large proportion of living veterans, it is critical to find a Level Five provider. 

For many veterans’ the end of life can be scary. Most military veterans, especially those who served in a forward or combat area, may experience PTSD. Some have also been exposed to chemical warfare, suffered a traumatic brain injury, or are more susceptible to substance abuse which creates challenges with alcohol or drug dependency, flashbacks, and sensitivity to sound. 

The Difference Between “Moral Injury” and PTSD

Some veterans suffer from something called “Moral Injury”. This is a specific type of mental injury and requires specialized attention. Another misconception is that “Moral Injury” and PTSD are essentially the same. This is clearly not the case; each requires different expertise and treatment/therapy approaches, resulting in accurate and conducive support. 

  • Moral Injury is the distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to such events. A moral injury can occur in response to acting or witnessing behaviors that go against an individual’s values and moral beliefs.
  • PTSD is fear-based. Moral injury is based on moral judgment, and having it requires a working conscience.

Educating oneself on these topics is helpful.  Knowing how real they are and how they most likely will present themselves during end-of-life will prepare all, lessening the emotional turmoil and chaos. Veterans who suffer from these topics could be “sparked” to have suicidal ideations as a result of poor diagnosis of health or simply because they have carried the internal scars of battle for so long that the feelings of grief, control, or guilt overwhelm them. Then the question becomes, “How do you help or deter thoughts or attempts of suicide within someone who is nearing end-of-life due to disease or illness?” That is what a veteran-centric Level Five provider is there for. Together with the care team that has been created, the veteran has a healthy and active support system to give an environment with a focus on not just end-of-life care, but also the quality of their life. 

Level Five Service Support and Additional Resources

A Level Five care team in end-of-life will support you in many ways: 

  • Accessing resources based on available veteran benefits
  • Adjusting medication management to ensure those with a history of drug dependency don’t relapse or live in pain
  • Incorporating non-pharmacologic and alternative therapies, such as music and art therapy
  • Fostering reconciliations and feelings of control
  • Veteran-to-veteran volunteer visits
  • Assistance with military burials
  • Emotional and spiritual support services for families, including younger children who may still be in the home

A company with a Level Five program will have trained clinical staff to handle obstacles, such as not asking about combat. This can be a major trigger for violent outbursts/episodes or bring on bouts of depression or strong emotions. Staff will be experienced in how to handle avoiding sudden movements, avoiding loud noises, and not using physical restraints, but applying alternative therapies. The staff’s experience and training are also key in working with challenges to authority, perceived disrespect, or even knowledge of certain medications. It’s important to avoid triggering nightmares, emotional wounds, acute anxiety or panic, destructive behaviors – even physical pain. Diagnosis of a terminal illness can also cause family trauma. 

The end-of-life situation is such a difficult time for all. We hope that by learning more and finding the right care team, the veteran and their family can experience quality health care and time together. 

Additional resources are available. The Suicide – Crisis hotline is available 24/7.  Dial 988, Press 1, chat live, or text 838255. A caring, qualified responder will then listen and help.  And the U.S. Department of Veterans Affairs offers a VA Caregiver Support Program. Visit the site at https://www.caregiver.va.gov/EVENTS.asp.  

If you or someone you care about needs additional support to help cope, The Option Group is here to help. Please contact our professional care management team for assistance.

About The Option Group: Founded in 2010, The Option Group’s compassionate team of experienced Certified Life Care Managers serves families, their loved ones, medical professionals, and professional family advisors in Maryland, Pennsylvania, and Delaware. The firm understands the challenges of caring for an individual who needs assistance due to aging, dementia, disability, or serious illness. Their skilled providers possess over 100 years of combined experience navigating the healthcare maze and accessing hundreds of quality resources. The Option Group helps families spend quality time with their loved ones, providing clear choices that lead to better care. For more information, visit www.theoptiongroup.net or call 410-667-0266 (MD) or 717-287-9900 / 610-885-8899/ 215-896-6756 (PA) / or 302-858-6449 (DE).