SYNERGY The National VA Social Work Newsletter - STATES

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SYNERGY The National VA Social Work Newsletter - STATES Powered By Docstoc
The National VA Social Work Newsletter

                                                                                                                                           FALL 2011

                             Caregiver Support Program By Deborah Amdur, LCSW

Social Work & Care             Chief Consultant, Care Management and Social Work Service

Giver Leadership
                                                           One defining factor of VA         One of the challenging aspects of Public Law 111.163 –
From the Director,
and Deputy Director                                        Social Work is its role as a      the Caregivers and Veterans Omnibus Health Services
                                                           focal point for program devel-    Act of 2010, is the limitation of the key new benefits to
Education, Training                                        opment in VA.       The list of   family caregivers of seriously injured post 9-11 Veter-
National Conference
                                                           innovative new programs that      ans. As Social Workers we know this only scratches
Caregiver Support Line                                     Social Work has taken the         the surface when it comes to individuals who have made
                                                           lead in is truly amazing: pro-    major sacrifices to keep ill and injured Veterans at home
Caregiver Website
Peer Support
                                                           grams to end Veteran home-        and out of institutional settings. Recognizing this, Sec-
                                                           lessness, medical foster          retary Shinseki has ensured that we have adequate
Noteworthy                                                 home, adult day healthcare,       funds not only to implement the new stipend program,
                                                            residential care, justice out-   but also to enhance services and programs that support
Fisher House Program           Deborah Amdur, LCSW
Hero Miles Program             Chief Consultant             reach, the Fisher House          caregivers of Veterans from all eras.
                                                            program, are just a few. It
Caring for Our Veteran       should come as no surprise that when groundbreaking             We have been able to place caregiver support coordina-
Students                     legislation for new benefits and services for family caregiv-   tors at all VA medical centers; develop a Caregiver Sup-
                             ers was signed into law in May of 2010, VA leadership           port Line that has responded to over 20,000 calls for
Portland’s Cancer Survivor
Day                          looked to Care Management and Social Work to head up            assistance since opening on February 1, 2011; create a
                             the development of the plan for implementation and the roll     caregiver website that is full of helpful information on a
                             out of the new program.                                         wide range of topics relevant to family caregivers, and
From The Field                                                                               serves as a forum for sharing stories and experiences
Hospice/Palliative Care      The trust and faith in Social Work to take the lead is a true   among caregivers. We are expanding REACH VA, de-
Support Group for            reflection of the extraordinary work that VA Social Workers     signed to educate and support caregivers of Veterans
Caregivers                   do each and every day. It has been a whirlwind of activity      with Alzheimer’s disease, for use with other conditions,
Peace at Home
                             for over a year now. It gives me great pride to say that        such as spinal cord injury. We are looking at other evi-
                             together we have put into place new programs and ser-           dence based practices to include in our menu of ser-
Evidence-Based Classes       vices that are having a significant impact in the lives of      vices and benefits that support Family Caregivers.
to Support Caregivers        family caregivers and the Veterans they care for. Without       This edition of Synergy highlights national, VISN and
Two Amazing Caregivers       these unsung heroes, countless Veterans would not have          local program initiatives that support Caregivers.
                             the option of remaining at home in their community, sur-
“Steppin’ Out of the Box"    rounded by family and friends. Our Family Caregivers            Thank you for what you do each and every day in sup-
to Meet Caregiver Needs
                             make significant contributions to our health care system by     port of Family Caregivers – what better way to support
Paul’s Story                 improving the health and well-being of Veterans and by          and enhance the lives of the Veterans we care for. Let
                             reducing health care costs. It is our challenge and duty to     us all join in celebration of National Family Caregivers
Lessons Learned              find ways to ease their burden and develop programs that        Month this November.
Supporting an Uphill         meet the needs of our Veterans, and their family
Battle                       caregivers.

Special Thanks
Editor Extraordinaire
                                                                         Thank you for what you do each and every day in support
                                                                         of Family Caregivers – what better way to support and
Congratulations to
Lorn Gingrich                                                            enhance the lives of the Veterans we care for. Let us all
Laura Taylor
Kathleen Dinegar
                                                                         join in celebration of National Family Caregivers Month
                                                                         this November.
Monthly SW Calls                                                                                       Deborah Amdur
From the National Caregiver Support Program Leadership
                    Keith A. Welsh, LCSW                                                       Meg Kabat, LCSW-C, CCM
                    National Director Caregiver Support Program                                Deputy Director
                                                                                               Caregiver Support Program

                                                                                               The VA’s Caregiver Support Program has
                      Family Caregivers provide crucial support in                             multiple components designed to assist and
                      caring for our Nation’s Veterans by allowing                             support Family Caregivers of Veterans of all
                      them to stay in the homes and communities                                eras. Caregiver Support Coordinators (CSCs)
                      they defended, surrounded by the loved ones                              are located at each VA medical center and
                      they fought for. With the expanded services      serve as the champions of the Caregiver Support Program, bringing
for eligible post 9/11 Veterans provided under Public Law (PL)         all of the components together. Caregiver Support Coordinators are
111-163, VA added several new services to a continuum of care          clinical experts on caregiving and support Family Caregivers, but also
that already provides more than two dozen services to Caregivers       help to integrate Caregiver sensitivity into every aspect of the medical
of Veterans of all eras. The media coverage of our expanded post       center. They participate in team meetings, provide outreach both
9/11 Caregiver services has called attention to our existing VA        within the VA and at community venues, and serve as the voice of the
Caregiver services. It is truly outstanding to hear about Caregivers   Caregiver throughout the medical center. They will be establishing
of Veterans from all eras who are now participating in VA services     local Caregiver Support Program Councils made up of Veterans,
they were not previously aware of. Our National Caregiver Sup-         Caregivers, medical center staff, and community partners, to discuss
port Line receives more than 150 calls per day and more than half      all aspects of supporting Family Caregivers at the medical center and
of these calls are from Caregivers to Veterans of all eras.            in the community.
Early in 2011 we were directed to develop an application process,
a system to track each stage of it, and procedures for paying sti-
                                                                       We know from a study pub-      “...being the Caregiver
                                                                       lished in November 2010 by
pends to Family Caregivers along with CHAMPVA health insur-
ance benefits. There were additional procedures such as core
                                                                       the National Alliance for
                                                                       Caregiving (Caregivers of
                                                                                                      of a Veteran is like
Family Caregiver training and a home visit to assess that training     Veterans – Serving on the
and the safety and care environment in the home. This required         Homefront) that Caregivers     running a marathon.”
formalization of additional logistical steps and procedures.           of Veterans face unique
Our program has received incredible support and it has been very       challenges from those who
rewarding to collaborate with other teams of professionals from        are caring for non-Veterans. Caregivers of Veterans report higher
Chief Business Office, Geriatrics and Extended Care, Mental            levels of both emotional and physical stress. Caregivers of Veterans
Health, 10N Operations and others as we successfully designed          are also more likely to be in the caregiving role for more than 10 years
the systems, established supporting documentation or software          and are more likely to live with the Veteran they are caring for, which,
systems, designed and facilitated training, and managed the final      in many cases, means that caregiving has become a full time job.
implementation. As we enter Fiscal Year 2012, we are quickly           Caregiver Support Coordinators must work closely with our Family
approaching our anticipated target of over 3,000 post 9/11 Family      Caregivers, ensuring that they have access to all of the services and
Caregivers eligible for the expanded services offered under the        benefits that they and the Veteran they are caring for are entitled to.
Program of Comprehensive Assistance.                                   Caregiver Support Coordinators are able to view situations through
I believe what we’ve accomplished as a VA team has been truly          the Caregiver’s eyes allowing them to partner with Caregivers and
groundbreaking and I do believe we are part of a pioneering effort     ensure the best care for the Veteran. They link the family to re-
that is changing modern healthcare. I would like to thank all the      sources and community agencies, brainstorm about ways to utilize
individuals at VA Central Office, the other national program offices   neighbors and friends to assist, and perhaps most importantly, ensure
and all those in the field at VA Medical Centers including leaders,    Caregivers are taking care of themselves, in whatever way they need
medical professionals, Caregiver Support Coordinators, and eve-        to, in order to be there for the long haul. The phrase may be over-
ryone who has assisted in creating this dynamic new program for        used, but being the Caregiver of a Veteran is like running a marathon
our Veterans and their Caregivers.                                     and Caregivers need to pace themselves in order to keep meeting the
                                                                       needs of the Veteran. They must plan and utilize their resources, and
                                                                       our Caregiver Support Coordinators are there to assist in any way
                                                                       they can.
       “I do believe we are part of a                                  If you haven’t met the Caregiver Support Coordinator at your medical
       pioneering effort that is                                       center yet, please make a point to get to know them. Plan an event or
                                                                       educational class together. Discuss the Caregivers in the population
       changing modern healthcare.”                                    that you work with and brainstorm new and creative ways to support
                                                                       those Caregivers. Together, we can make the most of this important
  From the National Caregiver Support Program Leadership

                              Meg Campbell-Kotler, MPH, RN                                           The National Caregiver Support
                              Caregiver Education and                                                Conference: ―Caring For Those
                              Training Program Manager                                               Who Care For Our Veterans”
                              Caregiver Training is a required and                                   Alice M. Boone
                              essential component of the Program of                                  Program Specialist
                              Comprehensive Assistance for Family
                              Caregivers. P.L. 111-163 mandates                                     This training conference was held August
                              that primary and secondary Family                                     2-4, 2011, in Washington, DC, and high-
                              Caregivers be offered instruction,                                    lighted VA’s support to Caregivers. Staff
                              preparation, and training appropriate                                 from VA Medical Centers’ across the
                              for the Family Caregiver to provide                                   country were in attendance and offered
personal care services to the eligible Veteran. To meet this man-          best practices and gained new understanding of the unique chal-
date, VA contracted with Easter Seals to develop a Core Curricu-           lenges faced by family Caregivers of Veterans from all eras.
lum for Family Caregivers. It is available in three formats: self-         The National Caregiver Support Conference offered additional train-
instruction with a print Workbook and CD/DVD, on-line, or face-to-         ing and dispensed information to VA staff about services and bene-
face in a classroom. Caregivers are able to select the format best         fits for all our Caregivers. The Information Booth welcomed atten-
suited to their learning style and personal situation. In August, the      dees, participants, and visitors to programs such as VA Liaisons,
self-instruction workbook and classroom training were launched in          OEF/OIF/OND, Fisher House, and Social Work and Caregiver Sup-
Spanish.                                                                   port Program Support Line. Veteran Service Organizations and
The Core Curriculum is offered in six modules. Module 1 covers             community partners including non- VA resources were also in atten-
Caregiver Self-Care and includes the basics of adequate rest, nutri-       dance with information in support of Caregivers.
tion, body mechanics. An enhanced stress management portion                The centrally located Information Booth functioned flawlessly at the
provides techniques for meditation, mindfulness and journaling.            hotel and served as an informal “meet and greet” venue for all. The
This module also addresses the family’s response to the Veteran’s          Caregiver Support Program team did a remarkable job staging the
injury; especially its impact on children and adolescents. Module 2        lobby of the hotel with directional signs, pull-up banners, and break
addresses Home Safety and Emergency Preparedness. Module 3,                room tripods ensuring smooth navigation in and around the Confer-
Caregiver Skills, covers the taking of vital signs, skin care, infection   ence events.
control and universal precautions, and medication management.
Module 4 covers Veteran Personal Care and activities of daily liv-         In essence, the Information booth provided a free, informational pub-
ing, instrumental activities of daily living and assistive devices.        lic service. After spending four days away from their respective VA’s,
Module 5 addresses Managing Challenging Behaviors and provides             all concurred that the Conference was a raving success. The materi-
general guidance with regard to anger, depression and communica-
tions; suicide prevention is presented in greater depth. Module 6,         als promoted at the Information Booth provided the attendees with
Resources, includes topics such as the Caregiver as an advocate,           win-win solutions in caring for our Nation’s Veterans!
HIPAA, advance directives, legal and financial terms important for
Caregivers , and VA Caregiver Resources. After completing the
training, Caregivers complete and submit a Final Self-Assessment
Tool to Easter Seals. The Caregiver receives a certificate of com-
pletion and a copy of the certificate is mailed to the Caregiver Sup-
port Coordinator.
To date, 2,080 Family Caregivers have completed the Core Cur-
riculum training. The majority of Caregivers have selected the
Workbook and CD/DVD for their training. Those who participated
in the classroom have found the experience invaluable to share
with other Caregivers, discuss challenges and to receive support. If
a Caregiver has completed the core curriculum using the Workbook
or on-line, they are also encouraged to participate in a classroom
training. Easter Seals has developed a schedule of sites offering
classroom training Sept-Nov 2011. If your site has 5 or more eligi-
ble Family Caregivers interested in classroom training, contact
Easter Seals at 202-403-8321 to arrange for training in your com-
munity. For questions or comments I can be reached at 202-461-
6085 or
From the National Caregiver Support Program Leadership
National VA Caregiver Support Line
                          Pamela Wright, LCSW-R                         The social worker evaluates the urgency of the Caregiver’s
                                                                        needs and determines what VA supportive services and commu-
                          National Program Manager,                     nity resources would best meet the specific needs, tailoring
                          VA Caregiver Support Line                     interventions and education to the individual caller.
                          On February 1, 2011 VA launched the           A discussion then takes place to include evaluating support from
                          new toll free National VA Caregiver Sup-      family and friends, local resources, and VA services currently
                          port Line (1-855-260-3274) at the Canan-      utilized. Education about VA supportive services, local commu-
                          daigua VA Medical Center campus in            nity agencies and brainstorming options help to problem solve
                          upstate New York. The Support Line is         the caller's immediate concerns and issues.
                          available to respond to inquiries about the
                          new Caregiver benefits associated with        A referral is offered to the local VA medical center CSC for all
                          Public Law 111-163, Caregivers and                             callers. If a referral is accepted an assessment
Veterans Omnibus Health Services Act of 2010, as                                         will be completed by the Support Line social
well as serve as a resource/referral center for all Vet-                                 worker and sent to the Caregiver Application
eran caregivers, Veterans and others seeking care-                                       Tracker (CAT) computerized program which
giver information; provide referrals to local VA Medical  “Caregivers are                tracks all Veteran caregivers. The CSC will
Center Caregiver Support Coordinators (CSC) and
VA/community resources; and provide emotional sup-        the critical link to           receive a computer alert that a Support Line
                                                                                         assessment has been entered. The CSC then
port to callers.                                          ensuring Veterans              has two business days to respond to the caller
                                                                                         and report back interventions and outcomes to
VA values the sacrifices Caregivers make to help Vet-     have the highest               the Support Line. The CSC assists callers in
erans remain at home. Caregivers are the critical link
to ensuring Veterans have the highest quality care and    quality care and               connecting to the many VA services available to
                                                                                         Veterans that assist caregivers, to treatment
optimal wellness. The Support Line hours of operation     optimal wellness.”             teams, specialty teams, processes caregiver
are Monday through Friday 8am-11pm and Saturday                                          stipend applications as well as link them to vital
10:30am-6pm Eastern Standard time. The Veterans                                          community resources. The CSC and Support
Crisis Line serves as a back up to the Support Line                                      Line staff members work as a team to meet the
and takes calls when all lines are in operation and                                      needs of Veteran caregivers.
during non-operational hours, taking messages and reporting im-
mediately back to the Support Line with caller contact information.     Cari Malcolm, LCSW, is the local Support Line Program Coordi-
Callers receive call backs within one hour from a Support Line so-
                                                                        nator and manages the daily staffing and operations of the line.
cial worker who is specially trained in caregiver issues, Public Law
111-163, VA supportive services, community resources and sup-
portive counseling.                                                     Pamela Wright, LCSW-R, is the National Program Manager over-
                                                                        seeing the program from a Central Office prospective.

                                                                        If you have questions about the National VA Caregiver Support
                                                                        Line please call 1-585-393-8154.

The Support Line is staffed with fourteen licensed independent
social workers as call responders and four health technicians who
gather call outcome data from CSCs and provide follow up call
backs to callers. Support Line social workers are experts on Care-
giver issues and are knowledgeable of both VA and non-VA support
services and benefits available for Veterans and their Family Care-
givers. The Support Line calls are answered by a social worker
who quickly establishes rapport with the caller and then asks
specific questions to better understand the caller's needs.
From the National Caregiver Support Program Leadership

                      Jennifer Henius                                                           Michelle.Stefanelli
                      Health Systems Specialist                                                 National.Program.Manager
                                                                                                Caregiver Peer Support Mentoring Program

                      The Caregiver Support Program launched
                      its new VA Caregiver Support website                                      The vision of the Peer Support Mentoring
             May 31st, 2011. This                                 Program is to provide personal support to
                      exciting new web site serves as one of the                                Caregivers and to establish peer relation-
                      primary outreach tools for Caregivers and                                 ships in a non-clinical environment by
                      Veterans of all eras to help them under-                                  matching Caregiver peers.
stand the benefits and services available to them. The website is
one tool among many in the Caregiver Outreach Campaign Tool                                    Peer Mentoring is defined as a helpful rela-
Box aimed to reach all generations of family Caregivers to demon-      tionship between two individuals who have shared a similar experi-
strate that a caring and responsive community exists for family        ence. The Peer Support Mentoring Program provides personal sup-
                                                                       port and establishes peer relationships by matching Caregivers to
Caregivers through VA and its partners.
                                                                       each other. Peer Mentors can also be bridge builders for Caregivers
In many instances, Social Workers are the first point of contact for   by empowering them to form new supportive relationships and link-
Veterans and their Caregivers to the VA health care system and it      ing them to resources available within VA and in the community.
is important that we demonstrate that “VA is here to help.” Refer-
ring them to the Caregiver web site for information and resources      The Caregiver Peer Support Mentoring Program met in September
is a great place to start.                                             to begin the establishment of the program by hosting a national
                                                                       Caregiver Peer Support Mentoring Focus Group. Six Caregivers
The web site serves as a “virtual community” that provides infor-      from all Veteran eras representing a cross section of geographical
mation and resources that address challenges and questions from        regions participated in the Focus Group and serve as members of an
the Family Caregiver’s perspective, and offers an online space to      ongoing planning workgroup.
connect with other Family Caregivers of Veterans. The website
currently averages more than 1,481 hits per day, 4.5 pages             The Caregiver Peer Support Mentoring Focus Group will focus ini-
                                                                       tially on ways to strengthen interpersonal relationships between a
viewed per visit, for a total of at least 6,649 pages viewed daily.
                                                                       peer Caregiver, provide a support mechanism for social networking,
The website includes a zip code search feature to locate the near-     and empower Caregivers to help one another.
est VAMC Caregiver Support Coordinator, links to existing VA
social media, and information on future Caregiver-specific social      The Focus Group members not only serve as mentors, but also pro-
media features.                                                        vide essential input into the development of the program and contrib-
                                                                       ute to the overall vision of the Peer Support Mentoring Program: to
                                                                       provide an opportunity for peer mentors to receive guidance and to
                                                                       share experiences, wisdom, skills, and passion with other Caregiver

                 Click to visit CareGiver Webpage

Please take time to become familiar with our new site, its available
resources, and the touching stories shared by our courageous
Caregivers. The website is in its first phase of development. We
look forward to expanding our outreach capabilities to include a
mobile app, social media, and messaging. We are certainly open
to your creative ideas to enhance our efforts.
For more information please contact Jennifer Henius, LCSW
Sr. Health Systems Specialist Caregiver Support Program 202-461-6073
From the National Fisher House and Family Hospitality
Program Leadership

DC VA Medical Center Fisher House Dedication                                Fisher House Foundation Hero Miles Program
                           In 1994, The Fisher House Foundation con-        In 2004, several senior military spouses recognized a growing
                           structed and donated the first VA Fisher         concern about the cost of travel for Servicemembers receiving medi-
                           House on the grounds of the Samuel S. Strat-     cal care away from home. As a result, The Fisher House Foundation
                           ton VA Medical Center in Albany, New York.       created the Hero Miles Program. The Foundation administers the
                           Fisher Houses enable family members to be        "Hero Miles" program for the Department of Defense in accordance
                           close to a loved one at the most stressful       with Public Law 108-375, Section 58, of the 2005 Defense Authoriza-
                           times- during hospitalization for an unex-       tion Act.
                           pected illness, disease, or recovery from
                           injury. Veterans, Active Duty Service mem-       The Hero Miles Program provides free airline tickets to Veterans,
                           bers, their families and caregivers receive      Active Duty Servicemembers, their family members and caregivers
                             accommodations in a Fisher House at no         who are undergoing treatment at a military or VA Medical Center
   Jennifer Wengryn,                                                        related to Post 9-11 military service. The program is comprised of
                             cost, allowing them to focus on wellness in
   National Fisher House                                                    individual airlines whose passengers donate frequent flyer miles to
   and Family Hospitality a supportive environment. In 2010, The VA         assist Veterans, Servicemembers and their families. Airline partners
   Program Manager           Fisher House Program provided lodging to
                             9,075 families and caregivers, including 606   include: Air Tran Airways, American Airlines, Alaska Airlines, Conti-
families of Post 9-11 Active Duty Service members. Currently, there are     nental Airlines, Delta Airlines, Frontier Airlines, Midwest Airlines,
56 Fisher Houses internationally within DoD and VA, 20 of which are         United Airlines and US Airways. Since inception, The Hero Miles
located at VA Medical Centers.                                              program issued over 23,000 Hero Miles tickets, (over $38M in airline
                                                                            travel cost savings for Veterans, Servicemembers and families).
The Washington DC VA Medical Center Fisher House was dedicated
on September 8th, 2011. This Fisher House is the 19th operational VA         Eligibility for Hero Miles includes but is not limited to the following:
Fisher House and can accommodate up to 20 families and caregivers.          Veterans and Servicemembers may be given free round trip airline
Each suite consists of a bedroom and private bath. The house also           tickets to enable family or close friends to visit them while they are
has common areas such as the kitchen, family and living room, special       being treated at a medical center. Veterans must be 100 percent
community dining room, family style laundry facilities, in-room tele-       Service Connected, or receiving treatment for an illness or injury
phone and TV/DVD player and computer access.                                suffered during active duty post 9-11. Servicemembers with ap-
                                                                            proved leave of five or more days may be given a free round trip
Located within sight of the Nation’s Capital, the Washington DC VA          airline ticket for a trip from the medical center to their home and re-
Medical Center (DCVAMC) is known as the “Flagship of VA Health              turn if they are not eligible for government funded airfare.
Care”. DCVAMC is a tertiary care, Complexity Level 1a facility. It pro-
vides comprehensive primary and specialty care in medicine, surgery,        In order to apply, Veterans, Servicemembers or their family members
neurology and psychiatry. The Medical Center has 174 acute care             should contact the Social Work staff at the medical center. The re-
beds, 30 Psychosocial Residential Rehabilitation Treatment (PRRTP)          ferring Social Worker is responsible for verifying eligibility criteria and
beds, and an adjacent 120-bed Community Living Center (CLC), pro-           submits the Hero Miles application to the Fisher House Foundation
viding a full-spectrum of extended care services including geriatric and    Hero Miles Program Director, Tish Stropes, and the airline ticket will
Poly-trauma rehabilitation, long-term care, hospice and palliative care.    be issued.
DCVAMC is a clinical study site for functional-MRI supporting Veterans
with TBI and PTSD. The hospital serves over 84,000 enrolled Veter-
ans residing in the Washington, DC metropolitan area, which includes
suburban Maryland, southern Maryland, and Northern Virginia. In
addition, Robert A. Petzel, M.D., Under Secretary for Health, Depart-
ment of Veterans Affairs delivered a keynote address. This Fisher
House will ensure that many families who must travel long distances to      For More information about the Fisher House Program or the Hero
receive specialized treatment at the Washington DC VA Medical Center        Miles Program, please contact Jennifer Wengryn, National Fisher
are provided with care and comfort in a supportive environment.             House and Family Hospitality program Manager at 202-461-6074 or
                                                                            For more information about the wonderful work
                                                                            of the Fisher House Foundation please visit
                                                                            Click the magazine to see the Fisher House
                                                                            Publication with stories of Fisher House
                                                                            guests and updated Fisher House Founda-
                                                                            tion and DOD/VA information.
 From the Field...                                             Field Notes

Hospice/Palliative Care Support Group for
By Sue Pataky LCSW, MPH
Pittsburgh Healthcare System

Death can be an everyday occurrence in medical care, but it is
unforgettable for the person’s caretaker. When a patient dies and
the caretaker must move on, it can be overwhelming for the care-
giver. Providing a safe, intimate, confidential group to share sup-
port can have a lasting positive effect on the caretaker.
The loss of a partner, financial advisor, traveling companion, date,    When their loved one dies, the focus shifts from patient to caretaker.
and lover are just a few of the possible adjustments a caretaker        They may be a widow, a child, a sibling, significant other, relative or
endures as a person becomes permanently ill. Not being able "to         friend, but they share one important thing: they loved the patient who
reach the can of peaches on the top shelf" can bring a caretaker to     is no longer present in this world. One caretaker informed me, "A priest
tears due to the loss of the partner's ability to help, but the care-   declared us as one, 60 years ago, for better or worse. How do I go on
taker's feelings are always trumped by the needs of the patient.        without half of me?" The loss and bereavement of a caretaker is a two
"How can I be upset about my feelings when he is dealing with           edged sword. They not only lost a person they loved but they also lost
cancer?" An additional loss for a caretaker occurs when the pa-         the role of caretaker which had become more and more time consum-
tient is placed outside their home. In addition to caring for their     ing as the patient deteriorated. This can result in new empty spaces of
home alone, they have to arrange visits to their loved one around       time in the caretakers life, in addition to their ongoing grief. They must
the schedule where the patient now resides. These challenges can        adjust from having complete responsibility for all their loved one’s
be dwarfed by the guilt of not being able to care for their loved one   needs to the whirlwind of funeral arrangements, and emptiness.
at home.                                                                The unique aspect of the hospice/palliative care support group is that
As the patient's condition continues to deteriorate, hope declines.     any caretaker can attend when they choose, at any time of the illness
Defense mechanism may occur in the patient in unexpected ways           or death. The group is offered upon recognition of caretaker need, even
but this is also true of the caretaker. Support is offered to the pa-   if the patient is still at home. Flyers are distributed widely, caregivers
tient and caretaker but the caretaker is still putting the patient's    on the palliative care unit are consistently encouraged to attend, and no
needs first. Some caretakers have the privilege of being present at     one is turned away. Members continue to come after the death of their
the last breath of their loved one. Those who do not may experi-        loved one as long as they choose, some because they have been there
ence this as yet another loss. Some have sat vigil for weeks, only      and want to help the new members through this difficult time. One
to have their loved one pass when they left to use the bathroom.        widow informed me, "You can be honest here. If you tell your kids you
Through no fault of their own, they are denied the opportunity for      aren't fine, they will bug you until you tell them you are! You know they
this unique opportunity for closure.                                    love you but they can't handle your pain." Loss is always painful, no
                                                                        matter how you experience it. Having support when you want it in this
                                                                        difficult journey of loss, is a gift that special support groups can offer.

                                                                                                        (Left and above) Two of the sitting
                                                                                                        rooms in the hospice

                                                                                                        Thanks to Sue Pataky for sending
                                                                                                        this from Pittsburg VA!
From the Field...                                              Field Notes

Peace At Home                                                              Supporting the Family Caregivers with
                                                                           Evidence-Based Psycho-educational Classes
Marsha Blevins, LCSW
James H. Quillen VA Medical Center, Mt. Home, TN                           Viara Stoilova, MSW, LCSW and Dana Melching, MSW, LCSW
                                                                           VA Greater Los Angeles HCS/Sepulveda Ambulatory Care Center
Johann Wolfgang von Goethe once said, “He is the happiest, be he
king or peasant, who finds peace in his home.” This quote exempli-         Powerful Tools for Caregivers (PTC) is a psycho-educational work-
fies the benefits of the VA Caregiver Support Program. As Caregiver        shop geared toward improving the caregiver’s ability to engage in
Support Coordinator at Mountain Home VAMC, I received a call from          self-care by better managing the challenges of care-giving. The
the Wounded Warriors Program in July, referring Mrs. Cynthia               workshop is an evidence-based education program; delivered as a
Fletcher to the Caregiver Support Program. Cynthia had been caring         6-week series in weekly 90 minute sessions. Caregivers face many
for her husband Larry, Vietnam, Desert Storm, and OEF/OIF Veteran          challenges such as financial hardship, difficult feelings and emo-
since he returned from deployment. They had been struggling to find        tions, making placement decisions, driving issues, legal issues,
different living arrangements. She named several different triggers        their own health, inadequate support, etc. In the PTC class, care-
for PTSD in their neighborhood and mentioned several times, “I think       givers develop tools to reduce stress and to maintain well-being as
he would do better If I could find a place to live in the country; I’ve    they provide care for their loved one. Topics discussed in the six
got to get him out of the city.”                                           weekly classes include: Self-care; Identifying and Reducing Per-
                                                                           sonal Stress; Communicating Feelings, Needs and Concerns; Com-
I completed the initial
                                                                           municating in Challenging Situations; Learning from Our Emotions;
home visit with the
                                                                           and Mastering Caregiving Decisions.
Fletchers and found
them to be struggling                                                      One spouse of a Post-Korean Era Veteran with Parkinson's disease
emotionally in their                                                       said the workshop helped her realize that caregivers do not have to
current environment.                                                       "totally lose their identity". She said that she learned, "I am a per-
Cynthia reported that                                                      son, with my own needs and frustrations. It is not all about him, (the
Larry kept post on the                                                     husband who needs care), it is also about me". She noted that
front porch most days,                                                     caregivers take care of themselves so that they can continue to
coming in only for food                                                    care for their loved one. She learned to “find something to do for
and coffee. She indi-                                                      yourself, every day." In her feedback for the class she expressed
cated that he often saw                                                    how helpful it was to talk with others who were also “striving to keep
activities    in     the                                                   going and do what is best for their husband, and not get absorbed
neighborhood that trig-                                                    and become a non-person." She mentioned that some of the tools
gered his PTSD. I                                                          she learned from the PTC class were the guided imagery and
found them to be dis-                                                      breathing exercises, taking time for herself, and ways to deal with
couraged over the lack                                                     feelings like anger and guilt. She said that it was important “to
of attention from their                                                    understand that there are times when caregivers will lose their
landlord,    lack     of                                                   tempers, and then feel guilty. We are not robots, it is normal, we
                                               Photo Courtesy of Ed Hurd
finances, and feelings                                                     shouldn’t dwell on the guilt.” Practicing positive self-talk allows one
of powerless to make a change.                                             to be assertive, not aggressive, and to balance a loved one's needs
                                                                           as well as one’s own.
Shortly after admitting the Fletchers to the program, I received a call
from Cynthia stating that she and Larry had moved to “the country.”        The Powerful Tools for Caregivers workshop is also offered at the
After she learned they would be receiving the stipend she immedi-          other VA Medical Centers and Community Based Outpatient Clinics
ately found a house to move into now that she had the financial            part of the GLA HCS, and across other VA facilities, by Certified
means to help her husband.                                                 Class Leaders. PTC was developed and implemented in the com-
                                                                           munity by Legacy Caregiver Services, a non-profit healthcare
I completed a home visit to see their new surroundings and found a
                                                                           organization, and introduced to the VA in 2008 as a result of the
much brighter, happier, and more relaxed couple. I stood inside the
                                                                           VISN 22 Caregiver Support Program's efforts to offer caregiver
Fletcher’s home and watched Larry through the window as I visited
                                                                           support services and their collaboration with Legacy Health.
and talked with Cynthia. Larry had again made post on his front
porch, but this time he was not watching for possible problems, but        Dana Melching, MSW, LCSW or Viara Stoilova, MSW, LCSW, can be
enjoying his surroundings. When I sat down to talk with Larry about        reached at (818) 891-7711 ext. 9214 or ext.4203.
their new home, he told me about all of the wildlife that he had spot-
ted from the porch and directed my attention to two hummingbirds on
his bird feeder. Larry was also quick to invite my family and me back
to their home for meatloaf and mashed potatoes. Cynthia said it
best, “He will never be at peace in his mind but he is at peace in this
From the Field...                                            Field Notes

Two Amazing Caregivers                                                    "Steppin’ Out of the Box" to Meet Caregiver Needs
By Nicholle Bair, MSW, LISW-S                                             By Debra A. Volkmer, LCSW
Caregiver Support Coordinator, Dayton Ohio                                Caregiver Support Coordinator and VISN 6 CSC Lead
                                                                          Salisbury, North Carolina
                    I have worked with many family caregivers, as
                    Caregiver Support Coordinator at the Dayton
                                                                          The Caregiver Support Program guided by PL 111-163 was imple-
                    VAMC since I started in this position in April.
                                                                          mented in February 2011. We quickly recognized that meeting the
                    Here are two of my most rewarding encounters
                                                                          challenges and keeping up with the growing demand of both family
                    with caregivers:
                                                                          and general caregivers would require stepping “way outside of the
                     I received a call from a general caregiver, caring   box.”
                     for both her mother and father at home, and she                                                  “There are only four
                     was at wit's end. Her father has Parkinson's         Several innovative programs have kinds of people
   Nicholle Bair
                    disease and her mother has dementia. She              been implemented at Salisbury, North in the world:
stated that she was the only member in her family that was willing to     Carolina, and within VISN 6 to meet those who have been
care for her parents. She shared her struggles, and asked for advice      the demand. A Caregiver support caregivers,
and assistance. I provided her with many resources, including refer-      group has been implemented for care- those who currently are
rals for home health aide and home maker services, skilled nursing        givers of all era veterans and includes caregivers,
home health care, respite, nursing home care, Medicaid Passport           the ability to dial in via VANTS those who will be
services, aid and attendance, general Veteran benefits, and support       line. Caregivers have hailed the group caregivers,
groups here at the Dayton VAMC and in the community.                      with comments such as “I have been and those who need
                                                                          attempting to find the support of like caregivers.”
I spoke with this caregiver for over an hour on the telephone. She        caregivers for the past 5 years and                    Rosalynn Carter,
needed someone to talk with most of all. Not only was she caring for      now it has happened”. The group                        Former First Lady
her parents, she was running a household and working as well. She         meets monthly and over 50 partici-
is a shining example of the amazing caregivers in our communities         pants have been invited. At first, it was difficult to determine
caring for our Veterans.                                                  program eligibility so a multidisciplinary clinical team was assembled
                                                                          to evaluate the more challenging applicants on a weekly basis. The
A day or two after the program of Comprehensive Assistance for            team consists of a Post Deployment Physician, Mental Health provid-
Family Caregivers was available for eligible Veterans, one of the         ers, Health Administrative Services, Social Work and Nursing staff.
OEF/OIF case managers suggested that I contact the family of a
young Veteran with severe pain and mobility issues from a service         For the November 2011 Caregiver Support Month we are stepping
connected back injury. When I met with this Veteran's spouse, she         out of the box by hosting an educational seminar at each of three
informed me that she has always been the "bread winner", but she          CBOC's, culminating in a one-day training at the parent station for
had to quit her job to care for her husband. The Veteran and care-
                                                                          Veterans of all eras, their families, and caregivers. Activities will
giver easily qualified for the Family Caregivers Program. After the in-   include chair yoga, resiliency training, entertainment, refreshments,
home assessment was completed by our Home Based Primary Care              and guest speakers from the community as well as from the VAMC.
team, I informed the
Veteran's caregiver of                                                    Finally, we are looking at innovative changes to the respite program
the monthly stipend                                                       to better assist caregivers. One caregivers suggested taking her
that she would re-                                                        husband on vacation with her because “he deserves a vacation
ceive. After I told her                                                   too”. We are looking at the possibility of agencies going into the
the amount, she                                                           hotel to provide assistance for the caregiver/Veteran. Another care-
asked "Are you kid-
                                                                          giver indicated a desire to be out of the home for ten to fourteen
ding?" I replied that                                                     hours, “I would like to go to Caro Winds and then come home.” We
she will receive that                                                     are arranging this to allow the caregiver respite according to her
amount as long as                                                         needs.
her husband needs the care and as long as she is providing the
care. She began to cry and shared that they have been struggling          Implementation of a new program is always a challenge, but if there
for months, since she quit her job. She stated that they were behind      is a willingness to work with the clients and remain open to change,
in their mortgage and that their car was up for repossession. She         programs such as the new caregiver support can provide a much
thought that she would only receive about $500 a month. She               needed service to caregivers of all ages. Former First Lady Rosalynn
thanked me profusely for the good news and stated that I "made her        Carter sums it up best: “There are only four kinds of people in the
life". The family has been able to remain in their home and catch up      world: those who have been caregivers, those who currently are
on their car loan payments since receiving the stipend. I am so           caregivers, those who will be caregivers and those who need care-
thankful that I can be a part of such an amazing and needed
                                                                          givers. Care-giving is universal.”
From the Field...                                            Field Notes

Paul’s Story                                                              Following his father's discharge from the hospital, health care provid-
                                                                          ers came into his home on scheduled shifts to assist with daily care
Sandra Jorgenson, Milwaukee VA Medical Center                             needs. Paul had to be there 24 hours a day to provide support and
Each and every veteran has a story to tell and if we are lucky            to help move his father to and from his bed. Paul acknowledged
enough, the veteran will grace us with a glimpse of his/her life. Many    how difficult it was to watch his father's health decline.
of those stories involve enormous challenges that they face and,          After reciting his story, Paul said “We’re tough guys,” again with pride
perhaps those of their loved ones. Mr. Paul Scardino, a veteran,          in his eyes. This statement could not be more true. Through his
willingly and eagerly shared his story of being a care provider for his   words and reflections, he made no secret of the love and respect
aging father who has been battling bone cancer for the last 15 years.     that he has for his father. No obstacle would be too large or too
Four years ago, Paul found it necessary to quit his job and move in       much to overcome for him.
with his father to assist with doctor’s appointments, house cleaning,
grocery shopping and medication management despite his own                On September 8th, 2011, Paul's father lost his battle with cancer,
disability.                                                               and Paul was with him when he passed. His father was laid to rest
                                                                          on September 12th, 2011. Paul provided this picture that was used
Paul described his father as “loving, forgiving, supportive and strict    in his obituary and requested that it be submitted with his story. This
when he needed to be”. Paul spoke of his father with fondness and         was the way he wanted his father to be remembered.
                                            was quick to add that his
                                            father raised him and his
                                            brothers, having obtained
                                                                          Lessons Learned
                                            custody of them in 1963,
                                            which was very unusual        Zsa Zsa Sanders, LCSW                                                  ,
                                            for the times.
                                                                          VA Long Beach Healthcare System offers caregiver support groups
                                             Paul’s father, Joe Scar-
                                                                          and evidenced based patient/family centered care, including: Pow-
                                             dino, served in the Army
                                                                          erful Tools for Caregivers, a 6-week psycho-educational work-
                                             from 1955-1959 in the
                                                                          shop providing coping strategies to reduce stress; Support & Fam-
                                             field of communications.
                                                                          ily Education For Family Members, a weekly group for families
                                             Paul followed in his fa-
                                                                          coping with loved ones who have mental health difficulties; Be-
ther’s footsteps and enlisted in the Marine Corp at the age of 17.
                                                                          reavement group, for individuals experiencing loss and/or grief;
Following his discharge from the military, Paul held several jobs that
                                                                          Reach VA Dementia, in home intervention, telephone support for
allowed him an opportunity to use his skills in mechanics and
                                                                          caregivers; and Peer Mentoring/Support for spouses of
home/business repair. On November 3, 1988, Paul was working as
                                                                          OEF/OIF/OND, telephone support for coping skills, improving com-
a painter on a roof of a factory in Waukesha when his ladder came
                                                                          munication and increasing resilience
into contact with a live power line. Approximately 26,400 volts of
electricity entered his body through his right arm and exited through     Caregivers contact me through the Caregiver Support Line, call me
his left leg. He sustained severe damage to his arm, and his leg was      directly, or walk in to learn about VA services. As a Caregiver
so badly damaged that it would require amputation from the knee           Coordinator, I have an open door policy and give caregivers my full
down. Paul was not expected to survive. He spent 363 days in the          attention. Caregiver stress is something often overlooked by indi-
hospital, had a total of 17 operations and was given last rites on        viduals themselves, as they juggle all of their responsibilities.
three different occasions. His road to recovery required him to learn     Through continued education and teamwork with VA staff , we em-
how to live his life again.                                               power the veterans and their caregivers to advocate and obtain
                                                                          needed care.
After the accident, Paul
found himself learning
how to walk with a pros-                                                                                The Lessons:
theses, how to tie his
                                                                            Acknowledge that the caregiver’s needs are important.
shoes and eat with his
left hand and how to live                                                   Involve the Veteran and Caregiver for good patient / provider
without the physical                                                        relationships.
ease that he had before
                                                                            Remember to encourage and remember not to judge.
the accident. Paul’s
father was a source of                                                      Listen for questions they might not ask.
support throughout this
time. Paul also sought solace in alcohol and with it, came more             Ask how the Caregiver is doing; ask again if everything is okay.
problems and complications from drinking. Paul eventually entered           Respect the right of Caregivers and Veterans to think things
treatment and is now two years into his recovery. He faced the battle       through before making important decisions when urgent medical
of addiction with the same courage that he used to meet all of his          care is not needed.
other challenges.                                                   >
From the Field...                                               Field Notes

Supporting an Uphill Battle                                                   The youngest of six children Henry, like his older siblings, desper-
                                                                              ately sought work at first opportunity to help support the family.
Nancy S. Kovell
Pittsburg VAMC GEM Clinic and Spinal Cord Injury Coordinator                  Henry’s family persevered through the long days of the depression
                                                                              only to be caught up in World War II. The beginning of the war saw
The hill was steep and the motor scooter went fast!! In his younger           Henry and three of his brothers enter the military. Before young
days, Henry was famous for taking the neighborhood children on                Henry got swept up in WWII war he met the love of his life, Sarah.
scooter rides. He rode his motor scooter each day to his job at the
steel mill where he worked as a clerk for over 30 years. After work, it       She lived in the same neighborhood less than a mile from him.
was back to the neighborhood where excited children awaited his               Sarah was eighteen and Henry was twenty four when they were
arrival. His scooter became an amusement park ride for daughters              introduced to each other by Henry’s niece. They attended the same
Marie and Lisa as well as their neighborhood friends. Every child that        Catholic Church where Henry and his friends sang in the choir.
waited got their much anticipated ride                                                                     Sarah shares that Henry’s departure
up and down the hill before Henry en-                                                                      on that first deployment during World
tered his front door.                                                                                      War II “was rough”. They consistently
The well-kept home that Henry, an Army                                                                     wrote letters. Henry was stationed in
Veteran of two wars, and wife Sarah                                                                        the European Theatre serving in the
share, sits at the bottom of a steep hill in                                                               Army 5th Medical Battalion. Sarah
a quiet rural community. They’ve been                                                                      worked in a local steel mill.
there together with family and neighbors                                                                   When Henry’s battalion landed on a
for 59 years. Across the street live their                                                                 beach in France, he unexpectedly
daughter Marie and her family. Located                                                                     encountered one of his brothers where
a few miles away is the fire station                                                                       he learned the devastating news that
where, for 50 years, Henry was a volun-                                                                    their father had died. Henry was
teer fireman. Around the bend from the                                                                     forced to deal with the grief of his fa-
fire station is the small Catholic Church                                                                  ther’s death while facing daily combat.
where Henry and Sarah’s families at-                                                                       When the War ended, Henry returned
tended and Henry once sang in the                                                                          home to his widowed mother and
choir. Faith has been essential in their                                                                   Sarah.
lives from family funerals, to weddings,
to senior fellowship activities.                                                                           As Henry and Sarah’s romance flour-
                                                                                                           ished, war separated them a second
Lifetimes of cherished family and com-                                                                     time. Henry returned to the Army Medi-
munity experiences are affixed to this                                                                     cal Corps at the beginning of the Ko-
home and neighborhood, but for Henry                                                                       rean War in 1950. At the time, Henry
the memories are rapidly disappearing.                                                                     held a private deep conviction which
At age 86, the combat veteran, commu-                                                                      prevented him from asking Sarah to be
nity servant, and family man has                                                                           his wife. Later he shared openly that “it
Alzheimer disease. Children still play in                                                                  was no life for a lady” to be married to
the streets and the neighborhood is vibrant but inside the walls of           a soldier while the country was at war.
Henry’s house, wife Sarah and daughter Marie wage a daily battle
against his progressing disease.                                              During his Korean War deployment Henry remained in the states
Lately they’re getting some support with their battle from an                 but across the country in the state of Washington. After two wars
unexpected source. After a comprehensive assessment by the                    and much waiting Sarah and Henry happily married in 1952 and
Geriatric and Evaluation Management (GEM) team at the Pittsburgh              Sarah moved into Henry’s family household. She smiled warmly
VA, Henry was referred to the GEM team by his primary care physi-             when noting they are still living in this same house at the bottom of
cian who recognized the family’s high stress level as they disclosed          a large hill in a busy neighborhood. Directly across the street is the
problem behaviors Henry was exhibiting at home. The family’s                  home of one of the couple’s two daughters.
objective is to keep Henry safe, comfortable and in the home and
neighborhood he loves.                                                        Daughter Marie is married with three grown children. She shares
Henry’s sense of family commitment first developed during days of             stories of her father and states emphatically “he was kind, very
childhood hardship growing up during the great depression.                    good to his children, you wouldn’t want a better father.” Henry liked
His family struggled financially. Blindness limited his father’s ability to   building things out of wood. Once he and a neighbor built Adiron-
support them. The children wore only hand me downs. Pieces of                 dack chairs in Henry’s basement but after the chairs were con-
cardboard replaced worn out soles in Henry’s shoes. At times his              structed they realized they couldn’t get them out of the basement
family meal was one slice of bread.                                           without taking them apart. The Adirondack chairs remain on her
                                                                              porch to this day. (Cont’d)
From the Field...                                                     Noteworthy
                                                               Field Notes

Supporting an Uphill Battle (cont’d)                                        Caring for Our Veteran Students
Marie describes a recent Valentine’s Day that her mother encoun-            Lawanda Vanhorn, LGSW
tered a difficult night with Henry’s out-of-control behavior. She locked    Tuscaloosa VA Medical Center
herself in her bedroom as he pounded on the door. It was a turning          Throughout the country, numerous Veterans are facing challenges
point for the family who didn’t know where to seek help.                    returning to school after their separation from the military. Tusca-
Marie called the Alzheimer’s Association who suggested the geriatric        loosa VA Medical Center (TVAMC) was selected as one of five sites
services of the Pittsburgh VA. There, Henry’s primary care doctor           in the country to develop an initiative to help to make these Veteran-
guided them to the GEM clinic. The primary care social worker de-           Student’s academic journeys a success.
tailed VA services and began an application for Aid and Attendance.         The Veteran-Student Academic Wellness Program (VSAWP) serves
The GEM team conducted a comprehensive multidisciplinary as-                as a safe-haven for Veterans who have decided to pursue higher
sessment followed by a conference to educate Henry and family on            education and who need the support of their fellow peers to deal with
the results. A prime recommendation from the GEM team was a                 the transition back to civilian life.
referral to the Dementia Caregiver Support Program. Initially reluc-
tant to accept help, Sarah now describes this program as her “ life-        A unique aspect of the VSAWP is the Peer Support Volunteers who
line”. It encompasses a team approach between the caregiving                offer their personal time to contact our Veteran-Students and offer
family, the social worker, and the nurse in a long term partnership.        reassurance and the encouragement that they can succeed. As a
Initial home visits are made to explain the program. Then a care-           social worker, it is a privilege to care for those who have fought the
giver monitor machine is connected via the home telephone service           battle.
to VA’s receiving monitor.
                                                                            Encounters with these students is extremely rewarding. Through
Sarah answers daily questions on the caregiver monitor about her            programs such as the VSAWP, the Tuscaloosa VAMC consistently
stress level. Her answers are reviewed by the Dementia Caregiver            honors its commitment to serve America's heroes by improving their
Program center staff. Sarah speaks to her assigned nurse on a               health and well-being through Veteran and Family Centered Care.
weekly basis and whenever her stress levels are high. Sarah and
her nurse discuss problem behaviors exhibited by her husband and
sort out new solutions. The nurse offers practical suggestions, empa-
thy, and encouragement.

Today Sarah and her daughter Marie, along with Marie’s husband
and children put enormous effort into caring for Henry. The family
has bonded even more deeply as caregivers against Henry’s devas-
tating disease. Occasionally, Sarah and Henry head to the local
mall to sit and watch the shoppers. Marie adds that her father just
“light ups” when his 16 month old grandson visits. Although Henry’s
memory has faded, the baby is a source of delight. Marie elaborates
that these visits with his grandson are “like medicine,” quickly erasing
his sullen mood to a more joyful expression.
Sarah describes bedtime as the greatest hurdle of the day. Henry is
frightened to go to sleep at night. The wonderful father, veteran of
two wars, and courageous fire fighter is very distressed and agitated
at bedtime. Sarah’s strategy is to sit patiently at his bedside each
night until sleep takes over. She is a committed and caring wife.
Through it all, Sarah, at age 80, still smiles often and radiates health.
She speaks tenderly of her their relationship past and present.
Sarah is anchored to daughter Marie for support. They are clearly           For additional Information about the Tuscaloosa VA Medical
committed to caring and keeping Henry at home as long as possible.          Center's Veteran-Student Academic Wellness Program,
The Pittsburgh VA has become strategic in this family’s daily battle.       please contact:
Armed with vital information and caring VA staff, Marie summarizes,         Ms. Lawanda Vanhorn at (205) 554-2000 ext. 3791
“I don’t feel like we are on our own any more, we can reach out and
they (VA staff) are there to help us. “
Special Thanks...
Synergy Editor Extraordinaire –
Profile on Erica Taylor
                                By Erin Butler, LCSW                     Hurricane Katrina
                                San Francisco, CA                        Special Edition,
                                                                         January 2006:
                              Erica Taylor's position is Hospice
                              and Palliative Care Social Worker          (click the newsletters to
                              at the Seattle, WA VAMC. How-              read them online).
                              ever, you may have known her
                              work without even realizing it, as
                              the Synergy Editor, 2007-2009 with
                              Susan Reusser (Fort Wayne, IN)
                              and the Synergy Assistant Editor,
                              2005-2007 with Jennifer Summers
        Erica Taylor          (Northampton, MA). She returned
                              as Synergy Editor again for the
past year with Jermaine Butler (VACO). She passes the torch on
to Laurel Holland, Synergy Editor (Bedford, MA) and Lesley
Reece, Synergy Assistant Editor (Salisbury, NC) with this edition.       Jan/Feb 2007 Special Edition
                                                                         on Leadership, with an article
Erica came to Synergy with some graphic design classes "a long           about Debbie Amdur –
time ago," and applied because she was interested to know more
about the VA and how it worked. In her roles as Editor and Assis-        (talk about foreshadowing!):
tant Editor, she collected stories and articles, compiled and edited
the articles, and formatted the newsletters – devoting much of her
time and energy to this intensive job. She feels Synergy helps
connect social                                      workers in differ-
ent areas with a                                    common goal
                    “Synergy helps connect
and      mission,                                   reminds us of
                    social workers in different
what we can areas with a common goal do, and encour-
ages us to try and mission, reminds us              new ideas. She
says the most of what we can do, and                challenging part
                                                                            March 2006
of her positions encourages us to try new           as       Synergy
Editor(s) was ideas."                               that her email          VA Social Worker
couldn't      hold Erica Taylor, past Editor        everything eve-         Success Story Project
ryone sent, so                                      she was con-
stantly deleting                                    her messages.
Erica recalls two projects that stand out for her in recognizing
social work as a significant contributor to the VA. The Special
Edition on Hurricane Katrina as a forum for personal experiences
from social workers helping with the efforts, was a valuable way
to highlight what social workers can do in time of crisis. The Spe-
cial Edition on Successful Social Workers, and preceding col-
                                                                            October 2006
umns, with profiles of social workers in leadership positions, was
interesting to see how social workers achieve higher level posi-            A Case Study of a
tions and how Social Work can be used and valued. All the lead-             Reconstructed Social
ers were gracious and eager to share their experiences.                     Work Service
Erica states she is grateful for the opportunity to serve on Synergy.
We are grateful to have had the benefits of her hard work and
                          Lorn Gingrich Accepts                                                 2011 Under Secretary for Health
                          National Social Work                                                  Award Excellence in Social Work
                          Manager Position                                                      Leadership - Laura Taylor
                          Care Management and Social Work
                          Service is very pleased that Lorn Gin-                                Arranged By: Lesley Reece
                          grich, LCSW-R, has accepted the Na-
                          tional Social Work Program Manager                                   “If Social Workers don’t step up to the plate
                          position in Central Office. Lorn brings                              other professions will,” shared Laura Taylor,
                          to this position a unique combination of                             SW Executive and Director of Extended Care
                          experience and leadership. He served                                 at Robert J. Dole VA Medical Center, recent
   Lorn Gingrich          eight years as the Social Work Execu-         Laura Taylor          recipient of the Excellence in Social Work
                          tive at the Stratton VAMC in Albany, NY                             Leadership award. She goes on to share that
and twelve years of clinical practice prior to that in areas ranging     she feels honored and humbled by the announcement. In reflection,
from geriatrics to medicine to behavioral health, both hospital and      she acknowledges the wonderful staff that she has the honor of
community based. He has had many experiences at the national             leading and how hard each of them work every day to take care of
level serving on National Social Work Committees, working on             Veterans, families and caregivers. According to Robert Emmart,
national projects and serving in VACO Social Work on details             Supervisory Social Worker in Extended Care line, “In her 5 year
throughout the past few years.                                           tenure in her current position, she developed and expanded the
                                                                         service line of approximately 8 staff members, to a wide variety of
With his wealth of experience we are delighted that Lorn has             programs and disciplines with over 100 staff members to meet in-
joined our national social work team in Care Management and              creasing Veterans’ needs.”
Social Work Service.
                                                                         In the nomination it states, “Due to her encouragement and support,
                Congratulations Lorn!                                    her staff are well represented in the local Leadership Effectiveness
                                                                         Accountability Development (LEAD) program every year as well as
                                                                         in the VISN LEAD program." Taylor supports staff and facilitates
                                                                         their education to move to coordinator, supervisor, and director posi-
2011 Under Secretary for Health Award Excellence                         tions.
in Social Work Practice— Kathleen Dinegar                                “Social workers have a unique skill set and perspective that is invalu-
The recipient of the Excellence in Social Work Practice Award was        able in a system such as the VA. Plus, the opportunities for career
Kathleen Dinegar, LICSW, VA Liaison for Healthcare at Walter             growth and expansion are endless within the VA system,” says Tay-
Reed Army Medical Center, Washington DC. Kathy was recog-                lor. When asked what feedback she would offer to a Social Worker
nized for her outstanding clinical practice and expertise in ensur-      new to the system, she recalls advice she received early in her VA
ing smooth transitions for the most severely injured and ill Service-    career, “a mentor once told me, if you are going to advocate for any-
members to VA facilities nationwide. She has quietly and unpre-          thing in VHA, make sure it is Veteran-focused. The rest is neces-
tentiously changed the face of VA-DOD interaction and has effec-         sary, but doesn’t matter so much. So far, this has not failed me.”
tively laid the foundation for genuine seamless transition of care        Taylor enjoys her role as a mentor, instructor and clinical supervi-
across multiple domains.                                                 sor. “The stronger the clinical skills of our workforce, the better care
                                                                         they can provide our nation’s heroes,” she states. Emmart adds that
               Congratulations Kathleen!                                 “for social workers to have the opportunity to be promoted from staff
                                                                         to coordinator or supervisor positions, advance practice social work
                                                                         licensure is required. In Kansas, part of the requirement for this
                                                                         licensure is 150 hours of clinical supervision with a practitioner at the
                                                                         advance practice level. Taylor is generous sharing her expertise by
                                                                         providing clinical supervision to social work staff members. Cur-
                                                                         rently she is providing group supervision to four social workers, the
                                                                         maximum number allowed by state regulations. “She wants to help
                                                                         the most social workers possible so they can benefit from clinical
                                                                         growth, as well as be prepared for leadership opportunities.”
                                                                         “Laura has an amazing ability to envision services and programs
                                                                         needed to meet Veteran needs, and to lead staff toward accomplish-
                                                                         ing goals”, say her coworkers. Let us congratulate Laura Taylor on
                                         Kathleen Dinegar                her well deserved award.         Congratulations Laura!
Cancer Survivor’s Day Unites Chiefs of Social Work                      Michael D. Moody, who works in Medical Media Service, was our
Services at the Portland VAMC.                                          media wizard. Everyone appreciated his caring approach and the
                                                                        moving pictures he used for a rolling slide show.
In 1997, Jean Herrera, Chief of Social Work Service (SWS), began
Cancer Survivor’s Day (CSD) observance at Portland VAMC. CSD is         This year our participation increased by 40% with up to 350 Survivor’s
a national celebration held throughout the country to celebrate can-    and family members attending. Vendors included public transporta-
cer survivorship. I have been the Chair of the Planning Committee       tion, Aging Services, VBA, the Leukemia and Lymphoma Society, and
for 11 years. Social Work Service (SWS) has been in charge of this      the American Cancer Society, who provided fun giveaways and infor-
annual celebration since inception. However, SWS could not make         mation. We even had a massage college provide free massages.
this event a success without a team of dedicated, talented, and com-    Our biggest problem? We need more space! We have a project in
                                                                        progress to use our technology to provide live feeds throughout the
passionate staff donating their time and energy.
                                                                        medical center to the Chemo unit, inpatient services, and smaller
I have the pleasure of working with and witnessing this team work       rooms and outdoor locations for those who would like a quiet space.
miracles each year!                                                     Social Work Service has been closely involved each year with CSD,
                                                                        but diversity throughout the medical center makes it a celebration!

                                                                                                                          Don Callender,
                                                                                                                          Retired Social Work
                                                                                                                          Chief PVAMC (left)
                                                                                                                          was the emcee in
                                                                                                                          2010. As you can see,
                                                                                                                          he had a wonderful
                                                                                                                          time! This was a few
                                                                                                                          months before his
                                                                                                                          retirement and he was
                                                                                                                          even more fun than

  (l-r) Hazel Hagen, Joyce Willison, Jennifer Wesner,
  Carol McCuan, Victoria Neindow. Planning Committee
Our team consisted of Carol McCuan, Computer Specialist with Fa-
cilities Management Service, who was an absolute wonder to watch
                                                                                                                Matthew Schobert (right)
organize. Jennifer Wesner, Hazel Hagen, and Eric Dubois from the
                                                                                                                began at PVAMC in May of this
Cancer Data Center have worked with us for many years. Jennifer                                                 year. Just weeks later, he and
came up with an idea to involve employees in a competition to do-                                               our Medical Center Director
nate what we loosely call “baskets,” which are judged in eight cate-                                            John Patrick (left) kicked off the
gories for door prizes. These baskets range from barbeque sets,                                                 14th Annual Cancer Survivor’s
which include chairs and any item you could want or need for a bar-                                             Day.
beque, wheelbarrows full of gardening items, and any other donated
                                                                                                                Welcome Matthew!
theme basket you can imagine. Hazel quietly organized all the
“behind the scenes” needs and Eric, who retired this year, volun-
teered again! Larry Seaver, a former PVAMC employee, helped
anywhere he was needed. Tom Green joined the Data Center and
CSD this year and we loved his energy and positive attitude. Victoria
Neindow, Program Support Assistant in Suicide Prevention, made
the complicated registration process fun for all, and welcomed the
Veterans and participants to the celebration. This team even re-
cruited and organized volunteers for their particular area, such as
parking or registration.                                                 Submitted by Joyce Willison, LCSW
                                                                         Portland VA Medical Center
Chris Theonnes, a Primary Care LPN, was a natural Emcee; he was          Cancer Care Social Work Coordinator
spontaneous, entertaining, and hilarious for the full four hours!        503-721-1031 or 800-949-1004, ext 51031
National Social Work Monthly Calls
Sponsored by the National Social Work Program in Care Management and
Social Work Service and the Social Work Leadership Council

November 2011                                        December 2011                                          January 2012
Sun    Mon     Tue    Wed   Thu     Fri    Sat       Sun      Mon    Tue     Wed     Thu    Fri     Sat     Sun       Mon    Tue     Wed     Thu     Fri    Sat

               1      2     3       4      5                                         1      2       3       1         2      3       4       5       6      7

6      7       8      9     10      H      12        4        5      6       7       8      9       10      8         9      10      11      12      13     14

13     14      15     16    17      18     19        11       12     13      14      15     16      17      15        16     17      18      19      20     21

20     21      22     23    24      25     26        18       19     20      21      22     23      24      22        23     24      25      26      27     28

27     28      29     30                             25       H      27      28      29     30      31      29        30     31

                   Data Bytes                             New SW Leaders Coaching Call                                SW Career Development Cal
    Nov 16, Dec 21, Jan 18, 1:00pm ET                     Nov 18, Dec 16, Jan 20, 1:00pm ET                       Nov 22, Dec 27, Jan 24, 2:30pm ET
      1-800-767-1750, code 17386                            1-800-767-1750, code 11573                                1-800-767-1750, code 30485
The Social Work Data Management Committee                This call is designed for new Social Work                Brought to you by the Social Work Career
hosts a monthly question & answer (Q&A) session                                                                   Development Task Force. These calls are
                                                         Chiefs and Executives.
for the field featuring guest speakers who discuss                                                                designed to provide career development to
data management topics of concern to VA Social           The call is held the third Friday of each month.         social workers interested in leadership and
Work managers. If you have specific questions
                                                                                                                  expanded roles within VA.
that you would like addressed please send them                        Moderator: Bruce Tucker,
to the Social Work Data Management Committee                          Social Work Executive,
prior to the call so that we can be as helpful as                                                                      Moderator: Taylene Watson,
                                                                      Bath VAMC, NY                                    Director of Social Work
                                                                                                                       VA Puget Sound Healthcare System.
The call is held the third Wednesday of the month.
             Moderator: Melissa Harding,                      Social Work Managers Call                                      The call is held the fourth Tuesday
             Assistant Chief of Social Work,                       Dec 9 1:00pm ET                                           Tuesday each month
             VA Eastern Colorado HCS                          1-800-767-1750, code 16389
                                                           This conference call is designed for                   .
                                                           Social Work Chiefs and Executives.
         SW System Redesign                                         The call is held the second Friday                    SW Quarterly Training Call
           Round Table Call                                          of each month.
                                                                                                                            January 13, 1:00pm ET
      Nov 28, Jan 30, 1:00pm ET                                                                                           1-800-767-1750, code 16389
      1-800-767-1750, code 35678
                                                                  VA/DoD SW Education                                 This call focuses on Social Work
These Round Table presentations and discus-                        Training Consortium                                Practice services and programs.
sions are designed for dialogue among Social                           Nov 9, Dec 14,
Work staff and are open to all social workers to                     Jan 11, 1:00pm ET
share information and discuss experiences
with System Redesign and to learn from one                    1-800-767-1750, code 49114                              The call is held the second Friday of
another.                                                                                                                         each quarter for
                                                         Monthly calls held on the 2nd Wednesday                                 1.5 CEU credits.
            The call is held the fourth                  of the month. Social Workers can earn 1.5
            Monday of each month.                        CEU’s per session.

                                                         Moderator: Carol Sheets, National Director
                                                                  Social Work, Care Management
                                                                  and Social Work Service, Office           To download this page to your desktop, click
                                                                  of Patient Care Services, VACO            here, then save.
Editorial Staff

            Laurel Holland, LICSW, ACSW, C-ASWCM, BCD, DCSW
            Grant & Per Diem Liaison, Edith Nourse Rogers VAMC, Bedford MA

 Assistant Editor:
            Lesley S. Reece, MSW, LCSW
            Clinical Social Worker, W.G. (Bill) Hefner VAMC, Salisbury, NC

               Jermaine T. Butler, MS
               Program Specialist, Care Management and Social Work Service,
               Office of Patient Care Services, VACO

 Editorial Board:

               Carol Sheets, LICSW, ACSW
               National Director of Social Work, Care Management
               and Social Work Service, Office of Patient Care Services, VACO

               Joanna Kadis, MSW, LCSW
               Chair, Social Work Leadership Council, Chief Social Work Service,
               VA Eastern Colorado Healthcare System

               Kimberly Scheer, MSW, LCSW
               Chair, Public Relations Committee,
               Program Coordinator/Case Manager HUD/VASH, Edward Hines Jr. VAMC

               Lorn Gingrich, LCSW-R, BCD
               Social Work Program Manager, Care Management and Social Work Service
               Office of Patient Care Services, VACO

               Jana O’Leary, LCSW
               Women Veteran Program Manager,
               Central Texas VA Healthcare System

   SYNERGY provides an excellent opportunity to share information with thousands of Social Work peers and VA stakeholders.
   SYNERGY welcomes articles on leadership and innovation in practice relating to Social Work within the Department of Veterans Affairs.

   The next edition of Synergy will focus on Patient Centered Care!
   Patient Aligned Care Teams (PACT) provide accessible, coordinated, comprehensive, patient-centered care and allow Veterans
   to have a more active role in their health care. What’s working at your facility? What ―best practices‖ can you share?
   We invite submissions from chiefs, executives, and front line staff for consideration for this coming issue.

   Submissions should be sent to and by December 9, 2011.
   Also, talented social work photographers are encouraged to submit digital photography that can be used in Synergy.
   Although there is no compensation, photo credits will be listed, and you will be contributing to the quality of our National Newsletter.

   All articles and photographs that reference Veteran information must be accompanied by a signed Release of Information form.

   Contact editors and for more information. Questions and feedback are always welcome!

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