Title

Support for Hospice Enrolled Veterans

Meta
Meta description
Hospice Support
Content
Page introduction
What is Hospice Care?
Hospice Care is comfort care provided to Veterans and their families if the Veteran has a terminal condition, with less than 6 months to live, and is no longer seeking treatment other than palliative care. Hospice care can be provided at home or in an institutional setting.
Generate a table of contents from major headings
No table contents
Main content

Veterans Receiving Hospice Care at Home

VA works closely with community hospice agencies to provide care in the home. Care provided by hospice agencies can be covered by Medicare or VA (if Veteran is enrolled in VA healthcare and deemed eligible for hospice by a VA provider). In addition to care provided by hospice agencies, VA can offer other in-home services to support Veterans and their loved ones in the Veteran’s final phase of life.

VA in-home services include:

  • Virtual mental health treatment (telemental health)
  • Personal care from a homemaker/home health aide
  • Respite and caregiver support for family caregivers

Veterans must be enrolled in VA healthcare to access the services above.

  • Veterans and their survivors may also be eligible for burial and survivor benefits provided by the Veterans Benefits Administration and the VA National Cemetery.

Resources and Training for Health Care Professionals

Information is also available below for providers who want to learn more about these VA services to better support Veterans enrolled in home hospice.

Available locations

Robley Rex Department of Veterans Affairs Medical Center

Find other VA Locations

Learn more about these VA services and benefits in the menu options below

Learn more about hospice care

 

 

 

 

 

Telemental Health

About

Post-traumatic stress disorder (PTSD), moral injury and suicide ideation were identified areas of concern by hospice agencies nationally. This indicates a need for mental health treatment and providers with expertise to address these distressing symptoms in a Veteran’s final weeks of life. Connecting front line staff and Veterans to their VA mental health provider, through telehealth connection, can help bridge this potential gap in care.

Telemental health services enable Veterans to connect with their established VA mental health provider through a computer or mobile device in their home or their nearest VA health facility. The VA is dedicated to providing Veterans the best healthcare anywhere and VA’s telehealth services are key in supporting this mission.  

Telehealth bridges healthcare access and expertise across distances that otherwise separates some Veterans. Especially those living in rural areas or who have become homebound due to illness or injury. 

Through real time interactive video visits, VA telehealth services is bringing care to the Veteran. 

Eligibility

If a Veteran is already using VA medical services – We encourage them or their support person to ask their primary VA provider for assistance linking them to a VA mental health provider. 

If a Veteran is NOT already using VA medical servicesApply for VA Healthcare 

All Veterans who quality for VA healthcare are eligible to connect with their providers through telehealth. 

Telemental Health FAQs  

What if the established Veteran does not have their own device or internet service? 

If an enrolled Veteran does not have internet access or a video capable device, the VA’s Digital Divide Consult can help (consults can be expedited for Veterans enrolled in hospice). Through the Digital Divide Consult, their VA provider can refer them to a VA social worker, who will help determine their eligibility for programs to help them get the internet service or technology needed for VA telehealth. 

  • Need a Device?: VA can lend the Veteran an internet-connected device at no cost. VA devices may be configured in three different ways to best meet identified needs.  
  • No Cost Data: AT&T, SafeLink by TracFone, T-Mobile, and Verizon help Veteran subscribers avoid data charges when using VA Video Connect on their networks to connect to their VA providers. 
  • Subsidized Broadband: The Federal Communications Commission’s Lifeline program subsidizes the cost of home broadband and phone service. Many Veterans are eligible for Lifeline benefits, including Veterans with lower incomes and Veterans who participate in federal assistance programs. 
  • No Copays: Currently (as of October 7, 2022) there are no copays for telehealth services. This helps reduce another barrier to care for Veterans. 

 

Do I need to know how to help set up the device? 

No. The Connected Device Support Team (White Glove) conducts Veteran Orientation of the VA-loaned devices. A member from the team will contact the Veteran/supports to review the device's setup and conduct a VA Video Connect test call.  

Technical Support of the devices and getting connected using VA Video Connect is provided by the Office of Connected Care or by the local VA telehealth team. 

Additional Resources

There are additional VA mental health resources available online:

  • Smartphone apps for Veterans: The VA has partnered with the Department of Defense (DoD) to create free smartphone applications they can use to help manage their physical and mental health. These include apps to help them deal with stress, quit smoking, and more. 
    Learn more about apps for Veterans (PDF) 
  • The Veteran Training online self-help portal for overcoming everyday challenges: The tools are based on proven mental health practices that have successfully helped other Veterans and their families. The portal is free, and does not require sign in or the need to provide any personal information to use the tools. Visit the Veteran Training portal 
  • Mental Health Crisis Support: Confidential 24/7 Veterans Crisis Line at 9-8-8 (press 1 for Veterans) connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders. Help is also available by online chat, or send a text message to 838255Support for deaf and hard of hearing individuals is also available.
Caregiver Support Program

About

The VA Caregiver Support Program (CSP) mission is to promote the health and well-being of family caregivers who care for our Nation’s Veterans, through education, resources, support, and services. If you are a caregiver of a Veteran and interested in connecting with other caregivers, receiving additional support from a professional care team, or looking to enhance your skills as a caregiver the CSP may be right for you.

Services:

  • Peer support mentoring
  • Skills training
  • Coaching
  • Telephone support
  • Online programs
  • Referrals to available resources to caregivers of Veterans
  • Respite Care
  • Possible CHAMPVA health insurance (additional criteria applies)
  • Possible Monthly Financial Stipend (additional criteria applies, see eligibility below)

 

Eligibility for Caregiver Support Program

  1. The individual needing personal care is either:
  • A Veteran; or
  • A member of the Armed Forces undergoing a medical discharge from the Armed Forces
  1. Enrolled in VA healthcare (VHA); and
  2. Must be receiving personal care assistance (activities of daily living) from a caregiver for the caregiver to participate (Veteran agrees to caregiver participating in the care plan)

Note: To be eligible for a monthly stipend, Veterans must have a 70% service-connected rating or greater; require assistance with activities of daily living (ADL) for a minimum of six (6) continuous months; and be unable to self-sustain in the community (see program definitions below).

 

How to Apply for Caregiver Support Program 

Activity of Daily Living (ADL)

For purposes of PCAFC, the “inability to perform an ADL” means the Veteran or Service Member requires personal care services each time they completes one or more of the seven ADLs listed below:

  1. Dressing or undressing oneself
  2. Bathing
  3. Grooming oneself to keep clean and presentable
  4. Adjusting any special prosthetic or orthopedic appliance, that by reason of the particular disability cannot be done without assistance (this does not include the adjustment of appliances that nondisabled persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.)
  5. Toileting or attending to toileting
  6. Feeding oneself due to loss of coordination of upper extremities, extreme weakness, inability to swallow, or the need for a non-oral means of nutrition
  7. Mobility (walking, going up stairs, transferring from bed to chair, etc.)

Requiring assistance with an ADL only some of the time does not meet the definition of an “inability to perform an ADL.

 

Unable to Self-Sustain in the Community

For purposes of PCAFC, “unable to self-sustain in the community” means that an eligible Veteran either:

  • Requires personal care services each time they complete three or more of the seven activities of daily living (ADL) listed above, and is fully dependent on a caregiver to complete such ADLs; or
  • Has a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury on a continuous basis; or
  • Has a need for regular or extensive instruction or supervision without which the ability of the Veteran to function in daily life would be seriously impaired on a continuous basis.

 

Additional Resources

Homemaker Home Health Aide

About

Homemaker Home Health Aides provide personal care in the home and their services may be used as a part of an alternative to nursing home care. Services are provided by local home health agencies who contract with VA. The number of hours for which a Veteran qualifies for weekly care is based on a standardized assessment tool.

Eligibility 

The Veteran must:

  1. Be enrolled in VA healthcare;
  2. Be seen by a VA primary care provider within the last year;
  3. Require assistance with:
    1. Activities of daily living (ADLs) –  bathing, toileting, dressing, grooming, feeding, transferring, repositioning, ambulation.
    2. Instrumental activities of daily living (IADLs) – shopping, medication management, meal preparation, using a telephone, light housekeeping, transportation, money management

Note: This program emphasizes a need for ADL care. Assistance with IADLs is incidental to personal care (for example, light housekeeping might mean cleaning the bathroom after assisting with bathing).

 

How to Apply 

If a Veteran is already using VA medical services – We encourage them or their support person to ask their primary VA provider for assistance linking them to a VA mental health provider. 

If a Veteran is NOT already using VA medical servicesApply for VA Healthcare

 

Additional Resources

 

In-Home Respite

About

Self-care is important for caregivers. Respite care can be a resource to give informal caregivers time to take care of their own needs with the comfort of knowing their Veteran is safe at home with a caring aide. Services are provided by local home health agencies who contract with VA. The number of hours for which a Veteran qualifies is based on a standardized assessment tool.

Eligibility

The Veteran must:

  1. Be enrolled in VA healthcare;
  2. Be seen by a VA primary care provider within the last year;
  3. Qualify for Homemaker Home Health Aides program (see above);
  4. Be unsafe to be left alone for extended periods of time; and
  5. Have a full-time nonpaid caregiver.

How to Apply 

Most burial benefits can be applied for online, by mail or by fax. The following resources are available for additional assistance and information:

  • Funeral home directors may be able to help with applications and can be a great resource to Veterans and their families
  • Call the Veterans Benefits Administration (VBA) at 1-800-827-1000 (TTY number is 711) or visit the VBA website
  • Call the VA Memorial benefits hotline at 1-800-697-6947 (available: Mon - Fri, 8am -5pm EST)
  • Call the VA National Cemetery Administration (NCA) Scheduling office at 1-800-535-1117
  • Find a local accredited representative (also known as a Veterans Service Officer) for assistance completing and filing VA benefits claims
  • Visit the nearest VA regional office to file a claim in person
  • Contact the State Department of Veterans Affairs  for more information on local Veterans benefits (e.g., state Veteran cemeteries and benefits representatives)
  • Find a VA Benefits Application Form online using keywords, form name, or form number

Additional Resources

VA Survivor Benefits

About

There are two monthly tax-free benefits for eligible survivors:

  1. Dependency and Indemnity Compensation (DIC) For a survivor (spouse, dependent child or parent) of a service member who died in the line of duty, or the survivor of a Veteran who died from a service-related injury or illness.
  2. Survivors Pension For a surviving spouse and unmarried dependent children of wartime Veterans who meet certain income and net worth limits set by Congress.

Note: Eligible survivors may only receive DIC or Survivors Pension (cannot receive both). If eligible for both, survivors will be awarded the benefit that pays more.

Survivors who are eligible for DIC or the Survivors Pension may also be entitled to receive one of the following special monthly compensation benefits:

  1. Aid and Attendance (A&A) – For survivors who meet one of the following criteria:
    • Needs another person to help them with personal care (bathing, dressing, etc.); or 
    • Must spend a large portion of the day in bed due to illness; or 
    • Lives in a nursing home due to loss of mental or physical abilities; or 
    • Very limited eyesight (5/200 or less in both eyes; or concentric contraction of the visual field to 5 degrees or less)
  2. Housebound Benefit (HB) – For survivors who must spend most of their time in their home because of a permanent disability that does not go away.

Note: Eligible survivors may only receive A&A or HB (cannot receive both). If eligible for both, survivors will be awarded the benefit that pays more.

Note: A&A and HB compensations are not stand alone benefits. Survivors may only be eligible for A&A or HB if they are also receiving or applying for DIC or Survivors Pension.

Eligibility 

Eligibility is based on criteria both the Veteran and the survivor must meet, such as the Veterans military discharge status, period of service and the survivor’s relationship to the Veteran. To determine if a survivor is eligible for survivor benefits, visit the VA Benefits For Spouses, Dependents, Survivors, And Family Caregivers website.

How to Apply

Most survivor benefits can be applied for online, by mail or in-person.

  • Call the Veterans Benefits Administration (VBA) at 1-800-827-1000 (TTY number is 711) or visit the VBA website
  • Find a local accredited representative (also known as a Veterans Service Officer) for assistance completing and filing VA benefits claims
  • Visit the nearest VA regional office to file a claim in person
  • Find a VA Benefits Application Form online using keywords, form name, or form number
  • Call the VA National Cemetery Administration (NCA) Scheduling office at 1-800-535-1117, if seeking burial with an eligible Veteran

Additional Resources

Applying for VA Healthcare

About

The Veterans Health Administration (VHA) is the largest integrated health care system in the U.S., providing care to millions of Veterans each year.

VHA provides comprehensive care, including medical care, mental health care, caregiver support,  medication, substance use treatment and purchases some community care – such as home hospice.

Cost and copayments for certain types of care, tests or medication depend on which enrollment priority group a Veteran is assigned. There are 8 priority groups. This is determined by income, VA disability rating or other special eligibility factors (e.g., former prisoner of war, purple heart recipient). More information on Understanding VA healthcare costs.

Eligibility 

The Veteran must meet the following three criteria:

  1. Served the minimum active-duty military service requirements:
  • If entered before September 7, 1980 - served at least one day of active military service
  • If entered after September 7, 1980 (October 16, 1981 if an officer) - served at least 24 continuous months

Exception: The Veteran separated early due to hardship or disability 

  1. Discharge status is other than dishonorable

Note: If a dishonorable discharge status is thought to be incorrect, Veterans may request a review to have their discharge status upgraded.

  1. Household income is within these Threshold Limits 

Exception: Threshold limits do not apply if the Veteran meets certain factors related to military service, or has been deemed Catastrophically disabled (more on Catastrophic disability below)

How to Apply 

Veterans can apply for VA Healthcare online, by telephone, by mail, or in-person.

Note: Telephone may be the fastest method to apply.

Catastrophic Disability 

Veterans determined by VHA to be Catastrophically Disabled (CD) are automatically placed into enrollment Priority Group 4 (unless eligible for a higher Priority Group), VA income threshold limits do not apply, and they are exempt from certain copays.

Veterans may be eligible if they are quadriplegic or paraplegic, legally blind, in a persistent vegetative state, or require help with three or more Activities of Daily Living (i.e., bathing, dressing, toileting, feeding, repositioning, transferring, ambulation).

Veterans or their representative may request a CD Evaluation by calling 1-877-222-VETS (8387) or the Enrollment Coordinator at their local VA medical facility. Supporting medical documentation may be needed from the Veteran's VA or non-VA provider. Additional information can be found here.

Additional Ways to Connect With VA

There are several ways to connect and access VA Healthcare Information:

  • VA Health Benefits Hotline: 877-222-8387 (VETS) - (Mon - Fri, 8:00 a.m. to 8:00 p.m. ET)
  • MyVA411 main information line: 800-698-2411 - This serves as a single access point to all VA contact centers. It is intended for all members of the Veteran community who are seeking information or help. Callers have the option of pressing “0” to be immediately connected with a customer service agent to answer questions or provide a warm handoff to the appropriate VA expert
  • Locate your nearest VA - Search for a local VA facility
  • VA Online Search Tool - Search for VA related resources and support with this online search tool using keywords, phrases or questions
  • VA Contact Us - This link lists other important numbers and ways to access to VA information
  • Ask VA - This is an online service that all Veterans and members of the Veteran community can use to submit questions, concerns, and recommendations to VA

How to Obtain Military Discharge Papers (DD for 214)

Overview:

  • Discharge papers indicate the Veteran’s dates of military service, type of discharge, where they were stationed, service medals, etc.
  • Necessary to obtain most Veteran's benefits
  • Most common discharge paper is the DD-214 (issued since January 1, 1950)

Military Records Request 

Veterans or their survivors may request a copy of their discharge papers any one of these ways:

Additional Information

Resources and Training for Healthcare Professionals

VA Benefits and Services for Veterans Enrolled in Community Hospice

 

PTSD Consultation Service

The PTSD Consultation Program offers consultation, continuing education, and other resources to healthcare providers (including non-VA providers) who treat Veterans with PTSD in the community. 

Consultation is free and is consistent with evidence-based practices for PTSD and consensus statements such as the VA/DoD Clinical Practice Guideline for PTSD. Expert clinicians from the National Center for PTSD are available to consult about: 

  • Evidence-based treatment 
  • Medications 
  • Clinical management 
  • Informational resources about PTSD 
  • Assessment 
  • Education & training opportunities 
  • Collaborating with VA on Veterans' care 
  • Developing a PTSD treatment program 

 

We Honor Veterans Program (WHV):

This is a program of the National Hospice and Palliative Care Organization (NHPCO) in collaboration with the Department of Veterans Affairs. It provides educational tools at no cost to hospice organizations ELNEC – For Veterans Updated Curriculum - We Honor Veterans