Adapting care so aging veterans remain independent

Jonathan Kaupanger
September 18, 2018 - 2:48 pm
The MISSION Act launches June 6: Here’s how to make an appointment with a private doctor.

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The fastest growing age group that Veterans Affairs serves is veterans 65 years old and older.  VA’s response is customized care for older veterans or GeriPACTs.

“We do offer a lot more than the primary care can,” says Monica Rich, an RN Geriatric Clinic Case Manager at the Iowa City VA Health Care System.  “In fact when we schedule patients we take much longer than the usual primary care does.”  Currently, there are 74 VA medical centers with Geriatric Patient Aligned Care Teams (GeriPACTs).  These consist of a group of health providers who specialize in older and chronically ill veterans.

The teams are comprised of a geriatrician - which is a doctor that specializes in preventing and treating diseases and disabilities in older adults - a nurse practitioner, social worker and pharmacist.  During a typical intake, each person spends about 45 minutes with the senior veteran.  This lets VA dig deeper into the veteran’s life, assessing the vet's memory, medications and mobility.

“One of our goals is to try and keep them in their home for as long as they can function,” says Rich.  This is possible because the team is familiar with in-home services VA offers such as physical therapy, home health aides, nursing and even homemaker services.  “If we see in our assessment that a patient needs that extra service, that’s when we have the occupational therapist come out and help with basic equipment for the home.  Like in the bathroom, they often need special equipment in their bathrooms.”

Rich says it is a tough job; they are often dealing with the final stages in a person’s life.  “There are those that, because of their cognitive issues, they may not recall why they are coming to see us,” she says.  “Sometimes it is difficult.  So we talk to them about why they may have been referred to us.  Usually they are good at accepting it for the most part, but it does take sometimes a family member to help with that.” 

VA is in the middle of a study of its GeriPACTs.  Initial data shows that older patient care through GeriPACTs is lower when compared to the traditional model of care at VA.  VA is looking at how each medical center has their GeriPACT setup and also for variations in the programs that influence how veterans receive care.  After the study is complete the GeriPACT model will be opened to all VAMCs.

Even if the medical center near you doesn’t have a GeriPACT, it will have an evaluation clinic.  You or a loved one can be evaluated and then VA will figure out how to get the needed care or services to you.  Just ask your primary care provider for a referral to a GeriPACT.   Click here to find other VA related geriatrics and extended care services

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